BACKGROUND: The purpose of this study was to investigate the correlation between yoga and autonomic nervous system in women with metabolic syndrome. METHODS: A randomized controlled study was performed in participants recruited from a public center for managing chronic diseases located in Gyeong-gi Province. The 39 women participants diagnosed with metabolic syndrome were randomly assigned to the 12-week yoga exercise group (n=22) or the wait-listed control group (n=17). Biochemical laboratory tests and heart rate variability were measured before and after the 12-week program. RESULTS: In post-menopausal women, the low frequency power of frequency domain significantly decreased in the yoga exercise group compared to the control group (P=0.07). On the time domain of heart rate variability and metabolic syndrome components, there were no significant differences between the groups. CONCLUSIONS: Sympathetic activity was decreased in post-menopausal women with metabolic syndrome who practiced yoga. Our results suggest that yoga might be beneficial in improving the autonomic nervous system in post-menopausal women with metabolic syndrome.
Autonomic Nervous System ; Chronic Disease ; Female ; Heart Rate* ; Humans ; Yoga*

Many investigators are trying to elucidate the pathogenesis of psychiatric disorders on the basis of neuroendocrine responses to stimulation or perturbation. Dexamethasone(DEX) suppression has been the most widely utilized as the prototypical challenge test. Dexamethasone suppression test(DST) has proven to be valuable in diagnosing the depressive spectrum disorder. Reported specificity of diagnosis of depression is relatively high, but sensitivity is limited. Some researchers used the combination of dexamethasone and corticotropin releasing hormone(CRH) in order to improve the sensitivity. They reported that combined DEX/CRH test, i.e., we administered the insulin instead of CRH. Total subjects were 28(7 normal controls, 10 manic patients, 11 schizophrenic, patients). Subject were token DEX(1.5mg p.o.) at 11 p.m., insulin 16 hours later(0.1 unit/kg i.v.). Five blood samples for the determination of cortisol and ACTH were serially drawn at 15 minute interval. The results are as following : 1) The cortisol an ACTH levels of manic subjects increased following insulin administration. Manic subjects showed higher levels of cortisol and ACTH than schizophrenic and normal control subjects. The cortisol and ACTH levels of schizophrenic and normal control subjects did not show gross changes. 2) The sensitivity of the test was lower than that of reported DEX/CRH test.
Adrenocorticotropic Hormone ; Depression ; Dexamethasone ; Diagnosis ; Humans ; Hydrocortisone ; Insulin ; Research Personnel ; Sensitivity and Specificity

A case of calcifying synovial sarcoma, occuring in the deep muscle fascia of the left thigh is reported. The presence of extensive calcification in synovial sarcoma is a favorable sign for prognosis. The patient was a 31-year-old female. The tumor mass had been present for 3 years, accompanying local tenderness. X-ray revealed a soft tissue tumor with central calcification, which was located between the adductor magnus and brevis of the left thigh. The tumor size was 7 x 5.5 cm. There was no connection with the knee joint or the femur. Grossly, the tumor was a relatively well circumscribed hard tumor with massive calcification. Microscopically, the tumor was composed of predominantly spindle cells with accompanying hyalinization, numerous spherical concretions and ossification. The epithelial component was not clearly noted. Mitotic figures were rarely noted in the densely cellular area. Immunohistochemical staining for EMA, S-100, vimentin, and carcinoembryonic antigen was negative while vimentin and cytokeratin were weakly and focally positive. EM study revealed multiple desmosome-like calcification intercellular junctions with a slit-like lumen and an incomplete basal lamina, which suggest that tumor show these cells were undergoing epithelia] differentiation. Above evidence suggest that this tumor is a synovial sarcoma associated with a large area of calcification, a so called calcifying synovial sarcoma. No recurrence was noted in one and half years of follow up.
Female ; Humans

OBJECTIVES: Nonspecific esophageal motility disorder(NEMD) is a vague category used to group poorly defined contraction abnormalities. We evaluated the clinical characteristics and esophageal transit time (ETT) in patients with NEMD. METHODS: Total 205 patients with NEMD were compared with 20healthy controls and 99patients with other motility disorders of the esophagus. Esophageal manometry was performed with a lowcompliance pneumohydraulic capillary infusion system and esophageal scintigraphy was performed for the liquid and solid swallow after manometric study. RESULTS: 1) Among the total 258abnormal contractions in 205patients with NEMD, non-transmitted contractions were 125(45.5%), low amplitude 110(42.6%), triple peaked 3(1.2%), prolonged duration contractions 12(4.7%) and isolated incomplete LES relaxation 8(3.1%). 2) NEMD patients have significantly delayed ETT similar to that seen in patients with diffuse esophageal spasm, nutcracker esophagus, hypertensive lower esophageal sphincter for liquid, and diffuse esophageal spasm, hypertensive lower esophageal sphincter for solid. 3) ETT for liquid and solid according to abnormal contractions were 39.0 and 55.6seconds in non-transmitted, 38.3, 68.4 seconds in low amplitude, 17.0, 30.0 seconds in triple peaked, 29.4, 25.8 seconds in prolonged-duration contractions and 13.7, 15.5 seconds in isolated incomplete LES relaxation, respectively. CONCLUSION: Patients with NEMD have significantly delayed ETT for liquid and solid compare to normal control. The main abnormal contractions of NEMD were non-transmitted and low amplitude contractions. And low amplitude contractions were the main cause of delayed solid transit in patients with NEMD(p<0.01).
Capillaries ; Esophageal Motility Disorders* ; Esophageal Spasm, Diffuse ; Esophageal Sphincter, Lower ; Esophagus ; Humans ; Manometry ; Radionuclide Imaging ; Relaxation

BACKGROUND: The aim of this study is to evaluate the therapeutic effect of splenectomy in children with chronic idiopathic thrombocytopenic purpura(ITP) who do not respond to corticosteroids and intravenous immunoglobulin(IVIG). METHODS: Fifteen patients(7 boys and 8 girls) who were admitted to St. Mary's Hospital under the diagnosis of ITP from December 1990 to February 1997 were enrolled In this study. All had chronic forms(more than 6 months after diagnosis) and were refractory to corticosteroids(prednisolone 1~2mg/kg) and IVIG(400mg/kg for 5 days or 1 g/kg for 2 days). We you-finely employ pneumococcal vaccine in 13 patients before splenectomy slnce 1992. Antiplatelet antibody was examed in 10 patients. We measured platelet count at preoperative time, postoperative 1 day, 1 month, and 3 months or more. Hematologic results were analyzed according to Berchtold and McMillan's criteria (1) complete response(CR) >120 x 10(9)/l; (2) partial response(PR) >50 x 10(9)/l (3) no response(NR) < 50 x 10(9)/l. RESULTS: The median age at operation was 10 yr(6~16). The median time interval between diagnosis and splenectomy was 2 yr 2 mo(6 mo~5 yr 5 mo). Antiplatelet antibody was positive in 2 cases of 10 cases(20%). Of 15 cases, 12 cases were corticosteroid resistant and 3 cases were corticosteroid dependent. The postsplenectomy platelet count(median 407 x 10(9)/l of 1 day; 254 x 10(9)/l of 1 month; 227 x 10(9)/l of 3 months or more) was significantly higher than presplenectomy platelet count(median 9 x 10(9)/l)(P<0.05). All patients showed complete or parial response throughout the follow up period. Accessory spleen was found in 1 case and removed during operation. There were no serious complications following splenectomy except mild fever in 2 cases(14%). CONCLUSION: Splenectomy appears to be an effective and relatively safe treatment for patients with chronic ITP who have had inadequate response to conventional therapies.
Adrenal Cortex Hormones ; Blood Platelets ; Child ; Diagnosis ; Fever ; Follow-Up Studies ; Humans ; Platelet Count ; Purpura, Thrombocytopenic* ; Spleen ; Splenectomy*

No abstract available.
Acidosis* ; Diagnosis*

Turner's syndrome results from complete or partial monosomy of the X chromosome and is characterized by hypogonadism or related other congenital anomalies in phenotypic females. In these patients, there are failure to develop normal secondary sex characteristics, amenorrhea, or short stature at puberty and the ovaries are reduced to atrophic fibrous strands devoid of ova and follicles(streak gonads). Individuals with this condition are particularly prone to the development of gonadoblastoma. For this reason, the gonads should be early removed and supplemental estrogen therapy given. We experienced a case of Turner's syndrome, 45, XO/46, XY karyotype in a 20-year-old phenotypic female complained an amenorrhea. On the exploratory laparotomy, the right gonadal mass is sevearly adhered to the adjacent organs and measures 8 x 5 x 5 cm in dimension and 75gm in weight and shows multiple foci of hemorrhage with necrosis. The left streak gonad measures 3.5 x 2 x 1.5 cm in dimension and shows multiple foci of calcification. Microscopically, the right gonadal mass reveals malignant mixed germ cell tumor, composed of endodermal sinus tumor, composed of endodermal sinus tumor with dysgerminoma and gonadoblastoma. The left streak gonad consists of mainly dense fibrous connective tissue and shows some foci of calcification associated with gonadoblastoma. On immunohistochemical and special stainings, the cytoplasm and hyalin droplets of the endodermal sinus tumor component reveal strong positivity to the a-fetoprotein and PAS. After removal of both gonads, the serum level of the a-fetoprotein is markedly down from 1742ng/ml to 2.6 ng/ml.
Female ; Humans

Adrenal cortical carcinoma is a rare disease both in adults and in children. Most of these tumors are functional, especially in children, producing endocrine syndromes such as virilization, Cushing syndrome, hyperaldosteronism or feminization. We experienced a case of adrenal cortical carcinoma in a 7yr old boy who showed features of virilization such as rapid growth rate, penile enlargement, and pubic hair. This case was diagnosed with typical hormonal findings and abdominal MRI and confirmed by pathologic findings. He was successfully treated by total left adrenalectomy and has been followed up without problem over eight months.
Adrenalectomy ; Adrenocortical Carcinoma* ; Adult ; Child ; Cushing Syndrome ; Feminization ; Hair ; Humans ; Hyperaldosteronism ; Magnetic Resonance Imaging ; Male ; Rare Diseases ; Virilism

No abstract available.
Family Practice* ; Fatigue* ; Humans ; Pilot Projects* ; Prospective Studies*

Purpose: To evaluate the efficacy and safety of preservative-free latanoprost in patients with normal-tension glaucoma who had mild to moderate dry eye after switching from preserved latanoprost. Methods: This retrospective study was conducted in patients with normal-tension glaucoma who had mild to moderate dry eye. All enrolled patients had used preserved latanoprost and switched to preservative-free Latanoprost. The study consisted of a baseline visit (treatment with preserved latanoprost) and four follow-up visits conducted after 1, 3, 6, and 12 months of treatment with preservative-free latanoprost. Intraocular pressure (IOP), mean deviation (MD), ocular surface disease index (OSDI), Shirmer’s test score, tear break-up time (TBUT), corneo-conjunctival fluorescein staining, and adverse drug reactions were evaluated. Results: The mean IOP and MD values during treatment with preserved latanoprost were 14.1 ± 2.6 mmHg and -2.68 ± 0.11 dB, respectively. The mean IOP and MD values at 12 months after switching to preservative-free latanoprost were 13.9 ± 1.9 mmHg and -2.66 ± 0.12 dB, respectively. The OSDI, Shirmer’s test score, BUT, and corneo-conjunctival fluorescein staining during treatment with preserved latanoprost were 53.15 ± 8.86, 4.97 ± 1.71 mm, 4.92 ± 1.72 seconds, and 2.92 ± 1.05, respectively. The OSDI, Shirmer’s test score, TBUT, and corneo-conjunctival fluorescein staining at 12 months after switching to preservative-free latanoprost were 49.07 ± 6.97, 5.51 ± 1.48 mm, 5.49 ± 1.46 seconds, and 2.47 ± 1.09, respectively. There were no serious adverse drug reactions causing ocular damage. Conclusions Preservative-free latanoprost was effective for improving objective and subjective symptoms compared to preserved latanoprost; it maintained a stable IOP and visual field value in patients with normal-tension glaucoma who had mild to moderate dry eye.