No abstract available.
Asthma* ; Humans ; Physicians, Primary Care* ; Primary Health Care*

No abstract available.
Antioxidants* ; Oxidative Stress*

No abstract available.
Biopsy, Fine-Needle* ; Paraganglioma*

No abstract available.
Biopsy, Fine-Needle*

BACKGROUND: There are many suggested methods for the indirect determination of anaerobic threshold(AT) using the changes of ventilatory parameters in respones to ventilatory load accompanying the increase of blood lactic acid level during exercise and the threshold derived from them is called ventilatory threshold( VT). They include ventilatory equivalent method(VEM), End-tidal PO2 method(PETO2), V-slope method(VSM), and respiratory quotient method(RQ). But in the patients with chronic airway ohstruction(CAO), the AT determined by ventilatory methods may not reflect true AT because the patients with GAO show inadequate ventilatory response to the increase of blood lactic acid level during excercise. METHODS: For the investigation of detection rate and reliability of above four VT determination methods in the patients with GAO, we performed the symptom-limited and maximal incremental exercise test in 17 patients with GAO and 12 normal controls. The incremental workload was 10 W/min in GAO group and 25 W/min in control group. The reliability of VT in each group was investigated by the calculation of Spearman correlation coefficient. RESULTS: The detection rates of VT were 100% by RQ, 91.7% by both VEM and POETO2, and 83.3% by VSM in normal control group, while 94.1% by RQ, 64.7% by VEM and PETO2, and 83.3% by VSM in GAO group. Good correlations were noted among VEM, PETO2, and VSM except RQ in normal control group. But there was no significant correlation except between VEM and PETO2 in GAO group. CONCLUSIONS: RQ is very sensitive but crude and VEM is near similar to PETO2. The clinical usefulness of VT determined by ventilatory method might be limited in patients with severe GAO.
Airway Obstruction* ; Exercise Test ; Humans ; Lactic Acid

BACKGROUND: Normal humans meet the increased ventilatory need during exercise initially by the increase of tidal volume (TV) and later by the increase of respiratory frequency (Rf). And the inspiratory duty cycle (Ti/Ttot) is also increased more than 50% for the compensation of the decrease of respiratory cycle provoked by the increase of respiratory frequency. The patients with chronic airflow obstruction show rapid and shallow breathing pattern during exorcise because of the degreased ventilatory capacity and the increased dead space ventilation. However, the studies about the change of inspiratory duty cycle are only a few and there is no literature about the relationship between the change of inspiratory duty cycle and the degree of airflow obstruction. METHODS: The subjects were the twelve patients with chronic airflow obstruction (CAO) and ten normal people. The incremental exercise test was done. The increase of work load was 10 Win CAO group and 25 Win normal control group. The analysis of the results was done by the comparison of the parameters such as minute ventilation (VE), TV, Rf, physiologic dead space (Vd/vt), and inspiratory duty cycle between the two groups. Each parameters were compared after transformation into % control duration base that means dividing the total exercise time into five fractons and % control duration data were obtained at rest, 20%, 40%, 60%, 80%, and max. Statistical analysis was done by repeated measure ANOVA using SAS program. RESULTS: The changes of VE and TV were significantly different between two groups while the change of Rf was not significant. The decrease of Vd/vt was significantly low in CAO group. Ti/Ttot was markedly increased from 38.4+3.0% at rest to 48.6+4.5% at max in normal control group while Ti/Ttot showed little change from 40.5+2.2% at rest to 42.6+3.5% at max. And the change of inspiratory duty cycle showed highly good correlation with the degree of airflow obstruction (FEVl%). (r=0.8151, p<0.05) CONCLUSIONS: The increase of Ti/Ttot during exercise observed in normal humans is absent in the patients with CAO and the change of Ti/TtDt is well correlated with the degree of airflow obstruction.
Compensation and Redress ; Exercise Test* ; Humans ; Pulmonary Disease, Chronic Obstructive* ; Respiration* ; Tidal Volume ; Ventilation

We herein report a case of transient acrodermatitis enteropathica in a 3-month-old, breast-fed, full-term infant. The patient was presented with a 2-month history of diarrhea and crusted erythema- tous patches on the periorificial area. Similar lesions were seen in his siblings. His serum zinc level and the zinc level in his mother's breast milk were markedly reduced. Diarrhea and skin lesions disappeared promptly with oral zinc supplementation and did not recur when zinc was discontinued after three weeks. Our case indicates that even full-term infants, who feed excl-usively on mothers milk, run a risk of developing zinc deficiency, if the concentration of zinc in the breast milk is very low.
Acrodermatitis* ; Diarrhea ; Humans ; Infant* ; Milk ; Milk, Human ; Mothers ; Siblings ; Skin ; Zinc

Intracranial vasculitis is a rare and disastrous complication of tuberculous meningitis if not treated properly. Focal neurologic deficits according to the vessels involved are common manifestation. Here, we report a 29-year-old man who suffered abrupt, bizarre behavioral changes caused by vasculitis complicating tuberculous meningoencephalitis. The diagnosis of tuberculous meningitis is based upon both the CSF findings and a chest X-ray. His systemic symptoms disappeared by after being administered antituberculous medication but various psychotic features such as hypersomnia, hyperphagia and aggressivebehavior continued. A brain MRI showed multiple small parenchymal tuberculous nodules, and the brain MR angiography revealed a narrowing of the proimal middle cerebral arteries and a reduced visualization of the cerebral vessels, suggesting widespread vasculitis. Intravenous dexamethasone successfully ameliorated his behavioral changes. In addition both the follow up brain MRI and angiography showed a normalization of the previous findings.
Adult ; Angiography ; Brain ; Dexamethasone ; Diagnosis ; Disorders of Excessive Somnolence ; Follow-Up Studies ; Humans ; Hyperphagia ; Magnetic Resonance Imaging ; Meningoencephalitis* ; Middle Cerebral Artery ; Neurologic Manifestations ; Thorax ; Tuberculosis ; Tuberculosis, Meningeal ; Vasculitis

PURPOSE: There is increasing awareness of the clinical importance of early detection and treatment of posterior cruciate ligament(PCL) injury. We evaluate the usefulness of Magnetic resonance(MR) imaging in the diagnosis of PCL injury. MATERIALS AND METHODS: We retrospectively analysed the MR images of 140 cases with clinically suspected knee injury. Arthroscopic or surgical correlation was available in 63 cases. We observed the finding and extent of PCL injury and other associated abnormalities. The frequency of anterior and posterior meniscofemoral ligament was evaluated. RESULTS: Eleven PCL injuries were observed, six midsubstance tears, two tibial attachment tears, two fernoral attachment tear, one laxity. The sensitivity, specificity and accuracy of MR imaging diagnosis are 100%, 98.1%, 98.4%. MR findings of PCL injury are discontinuity and focal mass formation, irregular increased signal intensity, detachment or redundancy of the ligament with avulsed bony fragment. In all cases of injured PCL, other associated abnormalities of adjacent structures were observed. Accessory anterior and posterior meniscofemoral ligaments were observed in 67.4%(87/129). CONCLUSION: MR imaging is useful in evaluation of presence or absence of PCL injury, accurate extent of PCL injury and other important associated abnormalities of adjacent structures.
Diagnosis ; Knee Injuries ; Ligaments ; Magnetic Resonance Imaging* ; Posterior Cruciate Ligament* ; Retrospective Studies ; Sensitivity and Specificity

A primary skin adenoid cystic carcinoma first described by Boggio in 1975, is one of the rarest type of eccrine sweat gland carcinoma. Histologically, a tumor with typical morphologic features closely resembles adenoid cystic carcinoma was found in other tissues but in the skin must be distinguished from aggressive basal cell carcinoma. The natural history of this tumor is not yet fully determined but suggests a long indolent and progressive course. We report a case of a 77-year-old male with a small skin nodule in the abdomen.
Male ; Humans