OBJECTIVES: Face-to-face interviews were conducted to investigate the relationship between blood pressure and the impairment of cognitive function in rural elderly (N=932) aged 60-64 in Dalsung County, April to September in 1996 METHODS: Impairment of cognitive function was defined as a score of less than 23 by the Korean version of the Mini-Mental State Examination (MMSEK). Blood pressure was measured once in each subject using a portable automatic sphygmomanometer. RESULTS: By univariate logistic regression on males, no category of systolic blood pressure bore statistical significance. Groups with diastolic blood pressures of, less than 80 mmHg, 90-94 mmHg, and more than 95mmHg had odds ratios of more than one compared with the reference group (80-89 mmHg). This was most significant in the group with blood pressures lower than 80 mmHg, which had a statistically significant odds ratio of 1.68 (95 % confidence interval Cl; 1.02-2.75). No category of blood pressure was statistically significant in females. Multivariate logistic regression for males, with adjustment for age, educational attainment, smoking, alcoholic drinking, body mass index, atherosclerotic disease, and antihypertensive medication use, did not alter the odds ratios significantly in terms of systolic blood pressure. However, the group with diastolic blood pressure of less than 80 mmHg had an increased odds ratio of 2.01 (95 % Cl; 1.15-3.52) compared with the reference group. In females, systolic blood pressure did not alter the odds ratio, but the group with a diastolic blood pressure of less than 80 mmHg had a statistically significant odds ratio of 0.57 (95% Cl; 0.37-0.89). CONCLUSIONS: These results suggest that the relationship between blood pressure and cognitive function status is stronger diastolic than systolic blood pressure and that there is a complex relationship between blood pressure and cognitive function by sex.
Aged ; Alcoholics ; Blood Pressure* ; Body Mass Index ; Drinking ; Female ; Humans ; Logistic Models ; Male ; Odds Ratio ; Smoke ; Smoking ; Sphygmomanometers

BACKGROUND: Defective adhesion and migration of melanocyte may be involved in pathogenesis of vitiligo. Tenascin, a glycoprotein of the extracellular matrix, has a role in cell adhesion and migration. It has been reported that abundant expression of tenascin in vitiligo lesion may inhibit melanocyte adhesion and migration. OBJECTIVE: To investigate the tenascin expression in vitiligo skin lesions and to compare with clinical findings. METHODS: We studied 9 patients with vitiligo. The expressions of tenascin were studied by immunahistochemieal techniques.
Cell Adhesion ; Extracellular Matrix ; Glycoproteins ; Humans ; Melanocytes ; Skin ; Tenascin* ; Vitiligo*

PURPOSE: We report a case of congenital accessory punctum and canaliculus in a patient with dry eye, which had not previously been reported in Korea. METHODS: A 56-year old woman presented with dry eye that was more pronounced in the left eye than in the right. An accessory punctum was found in the left medial canthus. Dacryocystogram showed that the accessory punctum had an independent canaliculus which was connected to a normal upper canaliculus. RESULTS: The symptoms were relieved after permanent punctal occlusion of the lower and accessory puncta. CONCLUSIONS: Severe dry eye can be induced by congenital accessory punctum and canaliculus.
Dry Eye Syndromes ; Female ; Humans ; Korea ; Middle Aged

BACKGROUND AND AIMS: A cholangiogram, immediately taken after bile duct stone removal, does not always provide adequate information about the presence of fragmented small stones in the bile duct, due to a large amount of bowel gas around the commom bile duct (CBD) or air-bubbles in the bile duct. We performed this study to evaluate the clinical usefulness of intraductal ultrasonography (IDUS) on the detection of small remnant stones after endoscopic papillary balloon dilatation (EPBD). METHODS: Among the 42 patients treated with EPBD for the removal of CBD stones, 19 patients who had undergone ESWL or mechanical lithotripsy with basket, were evaluated by IDUS for the detection of remnant bile duct stones. RESULTS: 17 out of 19 (89.5%) patients were successfully performed IDUS. Among the 17 patients, 13 showed no definite stones on cholangiogram, but CBD stones were detected using IDUS in 4 patients (30.7%). Among the 4 whose cases were difficult to differentiate air-bubbles from stones on a cholangiogram, 3 patients were diagnosed as having air-bubbles and 1 patient was diagnosed as having stones, through IDUS. During the process of conducting IDUS 19 times, one ultrasonic miniature probe was damaged. CONCLUSIONS: IDUS is very effective in detecting remnant small bile duct stones that are occasionally undetected on cholangiogram, and in differentiating stones from air-bubbles just after the removal of stones using EPBD. More efforts, however, are needed to improve the durability of the ultrasonic miniature probe.
Bile Ducts ; Dilatation* ; Humans ; Lithotripsy ; Ultrasonics ; Ultrasonography*

We performed penile biothesiometry for determining the penile sensitivity on 56 normal men and 120 patients with primary premature ejaculation (PE) to realize the organic reasons of premature ejaculation. The mean vibration perception threshold at the glans penis and penile shaft was 0.222+/-0.133, 0.124+/-0.046 Microns in normal control, 0.058+/-0.026, 0.055+/-0.023 Microns in patients with PE respectively. The mean vibration perception threshold at the glans penis and penile shaft in patients group showed significantly lower than that of normal controls (P<0.001). The mean vibration perception threshold at the glans penis was higher than that of the penile shaft in normal control, but the mean vibration threshold at the glans penis was as much low as the penile shaft in patients with PE (p<0.001). The vibration perception threshold at the glans penis and penile shaft was increasing with aging in normal men, but in patients with PE, consistently lower values were noted with no increasing tendency with age (p<0.001). The mean vibration perception threshold at the index finger and scrotum was 0.041+/-0.023, 0.334+/-0.184 Microns in normal controls, and 0.039+/-0.023, 0.294+/-0.213 Microns in patients with PE respectively. There were no significant differences between two groups (p>0.05). In conclusion, patients with primary premature ejaculation have a penile hypersensitivity regardless of aging. Penile hypersensitivity may give rise to uncontrolled ejaculation, which is thought to be an organic implication of premature ejaculation."
Aging ; Ejaculation ; Fingers ; Humans ; Hypersensitivity ; Male ; Penis ; Premature Ejaculation* ; Scrotum ; Vibration*

We present the case of a 7 year-old child who underwent angioplasty with a stent for anastomosis site stenosis between a left subclavian artery free graft and the left main coronary artery in an arterial switch operation.
Angioplasty* ; Child* ; Constriction, Pathologic ; Coronary Vessels ; Humans ; Stents* ; Subclavian Artery ; Transplants ; Transposition of Great Vessels

OBJECTIVE: To determine the clinical and radiological safety of 15 consecutive patients managed with plate and screw fixation systems applied to the cervical lateral mass. METHODS: 15 patients who underwent posterior cervical and T1 arthrodesis were reviewed from Jan 2002 to Dec 2004. Posterior cervical screw and plate fixation was applied on the lateral mass of the cervical spine. The authors have tried lateral mass screw fixation using a modified Magerl's technique (20 degrees lateral and 20~30 degrees rostral screw trajectory) under preliminary radiological study. The average patient age was 39.73 degrees+/-11.00 years, and the average follow-up period was 9.73 degrees+/-6.77 months. Computed tomography scans taken after surgery were reviewed to confirm the attempted screw trajectory correct and safety. RESULTS: Three of 93 lateral mass screws were malpositioned but clinical damage was not noted. Two of 8 pedicle screws on the T1 vertebrae were not placed on the correct pedicle area. Screw and plate loosening was observed in one case but was not subjected to an additional procedure because of maintained screw position observed during follow-up periods. CONCLUSION: The results of this study indicate that lateral mass screw fixation using the Modified Magerl's technique on the cervical lateral mass may provide safe and effective application on the patients. In addition, the chance of incorrectly placed screws was higher in T1 pedicle screw fixation than in lateral mass screw fixation of the cervical area.
Arthrodesis ; Follow-Up Studies ; Humans ; Spine

Pacemaker twiddler's syndrome is reported as a very rare complication of permanent pacemaker implantation. There was a recent report suggesting that the incidence of pacemaker twiddler's syndrome increase recently presumably as a result of the implantation of thinner and smaller pacemaker system than before. We experienced a case of pacemaker twiddler's syndrome complicated 3 times with the conventional method of implantation or replacement during 14 months after the first implantation(Optims MP 158C and Pacing lead 400, Telectronic)on June 13th 1987. This case was an 18 year-old high school girl who had suffered frequent syncope for 2 years and extertionl dyspnea for 5 years due to congenital complete heart block, of which block site was proved to be AV nodal by His bundle electrogram. Pacemaker twiddler's syndrome developed 3 times;firstly 6 weeks after the first implantation in the right subclavicular fossa, secondly 10 weeks after the replacement of the twisted pacing lead, thirdly 10 months after the change of implantation site to the left subcalvicular fossa with the replacement of the twisted and fractured lead. Finally, the pacemaker generator was anchored to the clavicular periostium and pectoralis fascia at several points by using Dacron pouch.
Adolescent ; Dyspnea ; Electrophysiologic Techniques, Cardiac ; Fascia ; Female ; Heart Block ; Humans ; Incidence ; Polyethylene Terephthalates ; Syncope

The only clinically avilable levo-isomer type of beta-recepter blocker is penbutolol sulfate, and it is already accepted as one of beta-receptor blockers for initial antihypertensive drug therapy according to the report of 1988 Joint National Committee on Detection, Evaluation, and Tratment of High Blood Pressure. To evaluate the antihypertensive efficacy, effect on the quqlity of life, and side effects of penbutolol recently introduced into Korea, penbutolol was administered to 29 essential hypertensive(mild 9, moderate10, and severe 10) patients for 12 weeks or longer. The result of the clinical analysis are as follows; 1) The mean age was 50.0+/-10.9(M+/-SD), and the sex distribution between male and female was16:13. 2) The blood pressure lowering effects of penbutolol as a monotherapy were marked in 16, moderate in 6, and insignificant in 2 cases. The systolic blood pressure was significantly decreased from 179.1+/-20.2 to 135.4+/-16.5mmHg(P<0.005), and the diastolic blood pressure from 112.6+/-13.5 to 84.0+/-11.9mmHg(P<0.005)after 12 weeks' penbutolol therapy. 3) The heart rate was significantly decreased from70.3+/-13.3 to 65.5+/-9.1 per minute(P<0.05). 4) The quality of life was improved markely in 5(17.2%) and slightly in 8 cases(29.6%). 5) There were no significant laboratory changes after 12 weeks' penbutolol therapy. 6) Two out of three cases with non-specific ST segment and T wave changes in EKG and two out of 9 cases with EKG were normalized, 2 cases of LAH with strain were improved. 7) The side effects of penbutolol were dizziness in 4, sexual dysfunction in 2, and skin rash in 1 case. 8) Final multifarious assessment of penbutolol therapy showed that it was very useful in 11(37.9%), useful in 4(13.8%) and slightly useful in 7 cases(24.1%). These reult suggest that penbutolol is a first-line antihypertensive agent with an effective antihypertensive action, improving quality of life, with no significant laboratory changes and few side effects.
Blood Pressure ; Dizziness ; Drug Therapy ; Electrocardiography ; Exanthema ; Female ; Heart Rate ; Humans ; Hypertension ; Joints ; Korea ; Male ; Penbutolol ; Pheniramine ; Quality of Life ; Sex Distribution

Hibernoma is a rare, benign soft tissue tumor that is derived from the remnants of fetal brown tissue. The term hibernoma was proposed in 1914 by Cery because of its morphologic similarity to the cel s of the so-called hibernating gland of animals. The most common site of hibernomas is the subcutaneous tissue of the back, especially the interscapular area. These tumors are considered benign and malignant transformation has not been reported. We experienced a case of hibernoma, 60-year-old woman had suffered from the palpable mass without pain or tenderness on posterolateral lower chest wall, left. The tumor was extirpated under the impression of angiolipoma, but was confirmed hibernoma. She was discharged without complication.
Adipose Tissue, Brown ; Angiolipoma ; Animals ; Female ; Humans ; Lipoma* ; Middle Aged ; Subcutaneous Tissue ; Thoracic Wall* ; Thorax*