BACKGROUND: Wheezing which is defined as a continuous sound with a musical quality is commonly auscultated in patients with chronic obstructive airway diseases. The correlation between wheezing and airway obstruction is unclear. OBJECTIVE: This study was designed to evaluate the relationships among wheezing, severity of airway obstruction, and pulmonary function tests. METHOD: Forty-one subjects were examined by the same observer. Wheezing during normal breathing and maximal forced exhalation, was auscultated respectively. Posterior lung bases were auscultated bilaterally with the seated patient taking repeated inspiratory capacity breaths through an open mouth. To quantify wheezing intensity, a regional score was assigned for each area after a minimum of 3 breaths, according to the following scale: zero, no wheezing heard: one, faint or intermittent wheezes: two, moderate wheezing during every expiration: three, loud wheezing during every expiration. The lung function tests by standard pneumotachograph were performed by skilled technicians. RESULTS: Wheezing was auscultated more in forced exhalation than in normal breathing in patients with asthma and COPD [8/9(88%) vs 1/9(11%), p<0.01 ll/15(73%) vs 1/15(6%), p<0.05)]. Forced expiratory wheezes group (n=25) compared to no wheezes group (n=16) had significantly lower FEVl (75+-5.8% vs 95.6+-6.6%, p<0.05). Compared to no wheezes group, the group with forced expiratory wheezes had lower FEV1 and FEV1/FVC (50.4+- 21.3% vs 81.15+-27.7%, 70.4+-22.4% vs 92.5+-19.3%, respectively, p<0.05). Bronchial asthma compared with COPD tended to have higher wheezing scores (Wheeze scores Bronchial asthma 3.5 vs COPD 2.4, p=0.08). Wheezing scores were correlated to FEV1 (normal breathing: r=-0.35, p<0.05: forced exhalation: r=-0.45, p<0.05), but no differences were found in wheezing incidence according to severity of airway obstruction. CONCLUSION: These findings suggest that wheezing on maximal forced exhalation may be a useful physical indicator for evaluating the severity of airway obstruction.
Airway Obstruction ; Asthma ; Exhalation ; Humans ; Incidence ; Inspiratory Capacity ; Lung ; Mouth ; Music ; Pulmonary Disease, Chronic Obstructive* ; Respiration ; Respiratory Function Tests ; Respiratory Sounds*

PURPOSE:Ghrelin is an endogenous ligand of the growth hormone secretagogue receptor, and stomach is the major site of ghrelin secretion. The purpose of this study is to compare the serum ghrelin concentrations between patients with type 2 diabetes mellitus (DM) and normal adults. We studied also whether serum ghrelin levels in the patients with type 2 DM are correlated with body mass index (BMI), serum insulin, lipid profiles, and creatinine levels. METHODS:Forty patients with type 2 DM and forty normal adults were included in this study. We measured heights and weights of the subjects and calculated their BMIs. Blood samples were obtained to measure the ghrelin concentration and their sera were stored at -20degreeC until used. In all subjects, serum ghrelin levels were measured using the commercially available Ghrelin(human) EIA kit. RESULTS:No differences of mean values were detected between the control group and the type 2 diabetic group for age, body weight, BMI, and the levels of serum total cholesterol, triglyceride, HDL cholesterol, and creatinine. But ghrelin level of the type 2 diabetic group (71.1+/-30.5 ng/L) was significantly lower than the control group (139.7+/-36.9 ng/L). In the control group, the ghrelin level showed positive correlation with HDL cholesterol (Pearson's correlation coefficient=0.37, P<0.05). In the diabetic group, the ghrelin level showed weakly positive correlation with insulin concentration. However, there was no significant relationship between serum ghrelin and various parameters in the diabetic patients group. CONCLUSION: In this study, ghrelin concentration in type 2 diabetic patients was lower than that in the control group. In the control group, serum ghrelin concentrations were positively correlated with HDL cholesterol. In the type 2 diabetic group, there was no significant correlation between insulin and ghrelin concentrations.
Adult ; Body Mass Index ; Body Weight ; Cholesterol ; Cholesterol, HDL ; Creatinine ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Ghrelin* ; Humans ; Insulin ; Receptors, Ghrelin ; Stomach ; Triglycerides ; Weights and Measures

Benign symmetric lipomat,osis is a rare disease of undetermined cause characterized by symmetric deposits of adipose tissue o:n the neck, upper trunk and abdomen. We report three cases of kienign symmetric lipomatosis, one of which is associated with alcoholic liver disease and the patient complained of a diffieulties in neck motion, All of them are about sixty year old men with history of frequent alcohol consumption. In histopathologic findings, the reticular dermis was completcly replaced by mature fat cells and there was a slight increase in vascular and fibrous elements.
Abdomen ; Adipocytes ; Adipose Tissue ; Alcohol Drinking ; Dermis ; Humans ; Lipomatosis* ; Liver Diseases, Alcoholic ; Male ; Neck ; Rare Diseases

Time to antagonism induced by pyridostigmine from different levels of neuromuscular blockade was evaluated in 45 patients anesthetized with nitrous oxide, fentanyl, and vecuronium. Neuromuscular blockade, as monitered by train-of-four count, was antagonized at varing degrees of spontaneous recovery. Train-of-four ratio was used as an index of the ability of the patients to maintain adequate spontaneous ventil'ation, and maximum inspiratory pressure as an index of the ability of the patients to protect their airways against aspiration or obstruction. We measured time from administration of pyridostigmine to train-of-four ratio of 70% indicating the recovery of the ability to maintain adquate spontaneous ventilation, and time to maximum inspiratory pressure of -45 cmH2O indicating the recovery of the ability to protect the patients airways against aspiration or obstruction. For a train-of-four count level of 0-1, reversal time to train-of-four ratio of 70% was 22.73+/-3.00 minutes and that to maximum inspiratory pressure of -45 cmH2O was 30.33+/-2.69 minutes. For a train-of-four count level of 2- 3, reversal time to train-of-four ratio of 70% was 17.33+/-3.18 minutes and that to maximum inspiratory pressure of -45cmH2O was 22.27+/-2.91 minutes. For a train-of-four count level of 4, reversal time to train-of-four ratio of 70% was 8.40+/-3.58 minutes and that to maximum inspiratory pressure of -45 cmH2O was 14.60+/-3.11 minutes. It is concluded that the more shallow is the neuromuscular blockade, the more rapid and the safer is the reversal of neuromuscular blockade, although the dose of reversal drug was determined according to the depth of neuromuscular blockade. Moreover, it should take more than 30 minutes to antagonixe profaund neuromuacular hlock- ade induced by vecuronium to such a degree that not only can the patients maintain adequate spontaneous ventilation, but they can maintain the airways and protect them against aspiration as well.
Fentanyl ; Humans ; Neuromuscular Blockade* ; Nitrous Oxide ; Pyridostigmine Bromide ; Vecuronium Bromide* ; Ventilation

BACKGROUND: It is important to know the location, number, size and shape of bullae before thoracotomy or VATS bullectomy. Chest X-ray and chest CT may be used but with some limitation. The purpose of this study was to compare the diagnostic value of thoracography with that of chest X-ray in preoperative detection of bullae. Meterial and Method: Thoracography was performed by injection of non-ionic water-soluble dye into pleural space in 22 primary spontaneous pneumothoraces, which underwent thoracotomy or VATS bullectomy. Chest X-ray and thoracography were compared through operative finding. RESULTS: Sensitivity and accuracy of thoracography (75% and 72.7%) were higher than those of chest X-ray (30% and 36.4%). However, specificity of thoracography (50%) was lower than that of chest X-ray (100%). There were no complications during or after thoracography. CONCLUSION: Thoracography is a safer and more useful method for preoperative detection of bullae when compared with chest X-ray.
Pneumothorax* ; Sensitivity and Specificity ; Thoracic Surgery, Video-Assisted ; Thoracotomy ; Thorax ; Tomography, X-Ray Computed

The authorsinvestigated the effects of UV-B and amniotic membrane graft about PRK induced inflammatory cell infiltration into corneal stroma, lipid peroxidation and keratocyte apoptosis. Total 20 white rabbits were divided into 5 groups; 1)mechanical epithelial removal, 2)epithelial removal and UV-B irradiation, 3)PRK only, 4) PRK and UV-B irradiation, 5)Amniotic membrane graft after PRK and UV-B irradiation. All corneas were harvested after 24hrs. H & E stain for PMNs infiltration, MDA immunohistochemical stain for lipid peroxidation and TUNEL stain for keratocyte apoptosis were performed. UV-B had little effect on infiltration of inflammatory cell into corneal stroma, lipid peroxidation and keratocyte apoptosis. Amniotic membrane suppressed infiltration of PMNs into corneal stroma, lipid peroxidation and keratocyte apoptosis. Environmental UV-B exposure should not be avoided after PRK. Amniotic membrane graft is beneficial to reduce keratocyte apoptosis and related corneal haze.
Amnion* ; Apoptosis* ; Cornea ; Corneal Stroma ; In Situ Nick-End Labeling ; Inflammation* ; Lipid Peroxidation* ; Membranes ; Rabbits ; Transplants

Eosinophilic colitis is a chronic inflammatory bowel condition of unknown etiology and a rare subtype of eosinophilic gastrointestinal diseases. It is characterized by gastrointestinal symptoms and increased eosinophil numbers in the intestinal mucosa and absence of other potential causes of gastrointestinal eosinophilia. The clinical presentation is varied and depends on the involved layer of the large intestine. There are no confirmatory laboratory tests, and the morphologic evaluation of biopsies or surgical specimens is required to confirm the diagnosis. A 65-year-old man presented with an 8 day duration of bloody diarrhea and lower abdominal pain. The patient was diagnosed with eosinophilic colitis by histopathological evaluation of biopsies and was further categorized as a nonatopic variant associated with non-IgE-mediated reaction. The patient was successfully treated with systemic corticosteroid for 2 weeks. On follow-up after 9 months, the patient remained well without relapse or new lesions.
Abdominal Pain ; Aged ; Biopsy ; Colitis ; Diarrhea ; Eosinophilia ; Eosinophils ; Follow-Up Studies ; Gastrointestinal Diseases ; Humans ; Intestinal Mucosa ; Intestine, Large ; Recurrence

Along with traditional goal of 'straightening teeth', today's orthodontics put more and more emphasis on facial esthetics. Naturally, the importance of soft tissue, which dictates one's facial form, is noticed. There have been many cephalometric studies on growth of hard tissue; however, only a few on that of soft tissue. In Korea, various methods of sampling, measuring and analysing were used to study soft tissue changes, and yet, soft tissue changes along with process of normal growth have not been studied. The author carried out this study as a part of semi-longitudinal study on craniofacial growth and development of Korean children from ages of six to seventeen. 409 boys and 436 girls who'd had no systemic disease for the last three years and shown normal developmental and occlusal status were chosen as subjects. Cephalometric X -rays were taken of each subject, and facial form, lip position & form, nose form, and lip thickness were measured, Mean values and standard deviations were calculated according to age and gender, and figures and tables were drawn accordingly. The following results were obtained: 1. In respect to facial form, boys showed growth for longer period compared to girls. Also, lower face showed higher growth rate than upper face. 2. There was not much change in thickness of upper and lower lips with age; however , they appeared more prominent compared to caucasian children. 3. Nose grew horizontally with age. 4. Horizontal thickness of lower face increased with age, and upper lip thickness at nose base[A-Sn(FH)] showed more growth than anywhere else.
Child* ; Esthetics ; Female ; Growth and Development* ; Humans ; Korea ; Lip ; Nose ; Orthodontics

BACKGROUND: Diabetic nephropathy is the most frequent complication in patients with diabetes mellitus (DM). In clinical practice, the glomerular filtration rate (GFR) is often estimated from serum creatinine. Recently, serum cystatin C has been suggested being a better parameter for diagnosis of impaired renal function. We evaluated serum cystatin C as a potential new marker of GFR in diabetes patients. METHODS: Serum cystatin C and serum creatinine (sCr) were measured in 73 DM patients to evaluate their usefulness in diabetic patients. DM patients were divided into three groups (whole DM patients, albuminuric patients, and DM patients with sCr<1 mg/dL). Serum cystatin C and sCr were compared with creatinine clearance (CCr). RESULTS: The overall correlation coefficient for the reciprocal of serum cystatin C was superior to that of the reciprocal of serum creatinine in all three patient groups. With CCr cut-off values of 60 mL/min and 80 mL/min, receiver operating characteristic (ROC) plotting demonstrated that serum cystatin C had a higher sensitivity and specificity for detecting decreased GFR than did serum creatinine in all three patient groups. CONCLUSIONS: These findings suggest that serum cystatin C is superior to serum creatinine as a marker of GFR measured by correction or mean ROC-plot AUC in diabetic patients; therefore, serum cystatin C could be used for the early detection of the impairment of renal function.
Area Under Curve ; Creatinine ; Cystatin C* ; Diabetes Mellitus ; Diabetic Nephropathies ; Diagnosis ; Glomerular Filtration Rate ; Humans ; ROC Curve ; Sensitivity and Specificity

PURPOSE: We evaluated the effect of tamsulosin for the short-term treatment of urinary stones. MATERIALS AND METHODS: Two hundred forty-seven patients who were diagnosed with urinary stones were enrolled in this prospective, randomized multicenter study. The treatment and extracorporeal shock wave lithotripsy (ESWL) group (Group 1, n=115) was given diclofenac sodium 100 mg plus tamsulosin 0.2 mg for 1 week. The control and SWL group (Group 2, n=92) was given diclofenac sodium for 1 week. The treatment and no SWL group (Group 3, n=19) was treated the same as Group 1. The control and no SWL group (Group 4, n=21) was given diclofenac sodium only. Patients in Groups 3 and 4 did not want to take SWL treatment. The size of the stone, expulsion rate according to stone location and ESWL machines, changes in pain score, and distance of stone migration when expulsion of the stone failed were compared among the groups. RESULTS: There were no differences in the 4 groups in sex or stone size. The stone expulsion rate of lower ureter stones in group 1 (59.6%) was significantly higher than in group 2 (30.8%) (p=0.01). The distance of stone migration in group 3 was longer than that in group 4 (5.63+/-5.48 cm compared with 0.33+/-0.68 cm; p=0.002). Although the difference was not significant in the SWL groups, the distance of stone migration in group 1 was longer than that in group 2 (7.08+/-6.9 cm compared with 5.46+/-7.4 cm; p>0.05). There were no significant differences in changes on the pain scale among the groups. CONCLUSIONS: These results suggest that adjunctive medical therapy for 1 week with tamsulosin after SWL increases the stone expulsion rate of lower ureteral stones and increases the distance of stone migration in case of failure of stone expulsion.
Diclofenac ; Humans ; Lithotripsy ; Prospective Studies ; Shock ; Sulfonamides ; Ureter ; Urinary Calculi