Background: Hypertension results from an impaired baroreceptor reflex and enhanced sympathetic activity. The prevalence of hypertension differs among ethnicities and is more frequent in South Asians than in Caucasians, suggesting that baseline autonomic nervous system functions and their regulation may also differ among ethnic groups. In most studies, the reference values for clinical autonomic function tests are obtained from heterogeneous ethnic populations, or ethnic factors are not considered in the study design. Obtaining reference data in a homogenous ethnic group and comparing them within various ethnic groups could be helpful to detect ethnic differences in autonomic functions. The aim of this study was to identify normative reference values for standard autonomic reflex measurements in a homogeneous Korean population. Methods: A total of 181 healthy Korean volunteers (age, 20–74 years) underwent standard autonomic function tests: heart rate difference during deep breathing, Valsalva maneuver, and the quantitative sudomotor axon-reflex test. Mean and 5th and 95th percentile values were obtained for each age group. We also analyzed factors (age, sex, and body mass index) that can influence autonomic functions. Results: The heart rate difference during deep breathing and expiratory-inspiratory ratio were higher in males than in females and were inversely related to age. The Valsalva ratio was inversely related to age. Males had higher sweat volumes at all body areas evaluated than those of females, and only forearm sweat volume was significantly different between the age groups. Conclusions: Cardiovagal function was affected by age and sex in Koreans. Sudomotor function was affected by sex, and only forearm sweat volume was affected by age and sex. These results represent preliminary normative clinical autonomic data in a Korean population comprised of a single ethnicity
Hypertension

There are numerous agents with potential toxic effects on the lung. In particular, cytotoxic drugs constitute the largest and most imprtant group of agents associated with lung toxicity. Bleomycin is commonly used, either alone or in combination with other chemotherapeutic agents, in the treatment of squamous cell carcinoma(head and neck, esophagus, and genitourinary tract), lymphoma, and germ cell tumor. One of the therapeutic advantages of bleomycin is its minimal bone marrow toxicity. However, pulmonary toxicity is one of the most serous adverse side effect. Classically, pulmonary toxicity manifests as a diffuse interstitial process or less commonly as a hypersensitivity reaction. This pulmonary toxicity is generally considered to be dose related and can progress to a fatal fibrosis. It is also possible that bronchiolitis obliterans organizing pneumonia(BOOP) is another manifestation of bleomycin induced toxicity. Bleomycin induced BOOP is less common and has a favorable response to steriod therapy. Here we present a case that demonstrates a BOOP, secondary to a relatively small cumulative dose of bleomycin(225mg/??, may be reversible.
Bleomycin* ; Bone Marrow ; Bronchiolitis Obliterans* ; Bronchiolitis* ; Cryptogenic Organizing Pneumonia ; Esophagus ; Fibrosis ; Hypersensitivity ; Lung ; Lymphoma ; Neck ; Neoplasms, Germ Cell and Embryonal ; Pneumonia*

BACKGROUND AND PURPOSE: The systemic inflammatory response syndrome(SIRS), as defied recently by critical-care specialists, may result from various etiologies including infection, bum, or trauma. The purpose of this study was to determine whether TNF- alpha is associated with the development of systemic inflammatory response syndrome caused by multiple trauma. METHODS: The study population consisted of 21 patients with multiple trauma presented emergency department within 2 hours after insult were enrolled in this study Multiple blood samples were serially drawn to measure seam TNF-alpha level on admission, 12 hours, 24 hours, and every day until 5 days after injury. Serum TNF-alpha was measured by ELISA ("Sandwich type"). Blood samples of fifteen volunteers were used as a reference value far serum TNF-alpha. RESULTS: Serum TNF-alpha. levels of SIRS group were persistency elevated above reference value until 3 days after on admission. Peak seam TNF-alpha level at 12 hours after admission was higher in SIRS group than non-SIRS group(p< 0.05). There was no significant correlation between injury severity score and TNF-alpha levels on regression analysis, all patients with ISS higher than 16 had SIRS. No one had SIRS among patients with ISS less than 16. CONCLUSION: the result of this study suggests that persistent elevation of TNF-alpha and degree of injury severity are associated with the development of systemic inflammatory response syndrome in multiple trauma.
Emergency Service, Hospital ; Enzyme-Linked Immunosorbent Assay ; Humans ; Injury Severity Score ; Multiple Trauma* ; Reference Values ; Specialization ; Systemic Inflammatory Response Syndrome* ; Tumor Necrosis Factor-alpha* ; Volunteers

Over the physiologic range of heart rate, the duration of electrical systole(QT) is shorter than that of electromechanical systole(QS2), which reflects direct physiologic link between electrical repolarization and mechanical events of the cardiac cycle. The present study designed to test usefulness of systolic time intervals and QT-QS2(QT minus QS2) value as complication predictors, which may predict prognostic status of myocardial infarction. The studied subjects were consisted of 33 healthy adults as control(22 men, 11 women) and 35 patients with myocardial infarction. And studied patients were divided into 3 groups; group I of 14 patients with or without complication in acute stage, group II of 11 uncomplicated patients under recovery of chronic status, group III of 10 complicated patients under recovery or chronic status. The observation periods were 3 to 13 days in group I, 5 to 96 weeks in group II and III after their onset. The results were follows; 1) The normal ranges were defined as mean+/-2 standard deviations of the measured values of control, that of QTc were shorter than 431ms of man and 458ms of woman, that of QS2 I were longer than 503ms of man and 514ms of woman, that of PEP/LVET ratio was less than 0.40, that of QT-QS2 value was less than 0 ms respectively. 2) QTc of all patient groups were significantly prolonged compared with that of control, and that of group III was significantly longer than that of group II(481+/-25 vs 432+/-32, p<0.005). 3) The changes of QS2 I were not significant in all patient groups compared with QS2 I of control. 4) QT-QS2 value showed QT>QS2 in group I and III. and QTQS2 had positive predictive value of 82% for predicting probability of previous complicated status. We concluded that QT-QS2 value, including PEP/LVET ratio and QTc, could be used as complication predictors. But it is necessary to examine these indicators prospectively to confirm its clinical applicability.
Adult ; Female ; Heart Rate ; Humans ; Male ; Myocardial Infarction* ; Reference Values ; Sensitivity and Specificity ; Systole*

Objectives: White matter hyperintensities are known to influence dementia in Alzheimer’s disease. Genetic components are suggested as putative risk factors for vascular pathology and cognitive decline. This study aimed to determine whether there is an association between candidate genetic polymorphisms and the severity of white matter hyperintensities in patients with Alzheimer’s disease. Methods: Seventy-five patients diagnosed with Alzheimer’s disease underwent genetic tests for specific alleles of apolipoprotein E, angiotensin-converting enzyme, and methylenetetrahydrofolate reductase. All patients underwent brain magnetic resonance imaging scans and neuropsychological tests. The severity of white matter hyperintensities was semiquantified using the CREDOS rating scale, and patients were divided into three groups according to their rating. Results:The severity of white matter hyperintensities was related to age and hypertension. However, none of the gene polymorphisms we tested was found to be associated with the severity of white matter hyperintensities. Conclusion:The genetic polymorphisms found in apolipoprotein E, angiotensin-converting enzyme and methylenetetrahydrofolate reductase did not contribute to white matter hyperintensities in Alzheimer’s disease.Only age and hypertension factors were found to be contributory to white matter hyperintensities.
Alzheimer Disease ; Dementia

No abstract available.
Cerebral Infarction* ; Heart Massage* ; Intracranial Embolism

Focal ventricular dilatation of the temporal horn caused by an occlusion of the cerebrospinal fluid pathway at the atrium of the lateral ventricle is a form of non communicating hydrocephalus, and this condition is termed as "entrapment of the temporal horn". The choroid plexus is important central nervous system(CNS) structure, but it is often neglected in pathologic and clinical studies of intracranial diseases. Even though choroid plexitis is very rare, it may be occurred as the resultant of CNS infections and primary choroid plexitis can be associated with bacterial, viral, and parasitic etiologies. Some aspects of the neuroimaging findings of this infection mimick those of a intraventricular neoplasms. The most important neoplasms which should be differentiated, are choroid plexus papilloma and carcinoma. Wherem primary neoplasms of the choroid plexus are well known, but primary infections of the choroid plexus (such as choroid plexitis) are not commonly encountered. Pseudomonas stutzeri infections are especially rare as the causative organism of the choroid plexitis and often have serious underlying disease but generally respond well to treatment with antibiotics. We report a 65-year-old female patient with primary choroid plexitis due to Pseudomonas stutzeri and the findings of her brain computerized tomography and magnetic resonance imaging. In conclusion, our case revealed that choroid plexitis may result in ventricular entrapment and mimick intraventricular tumors. Although it is very rare, when a intraventricular mass was observed in imaging studies and combined with signs and symptoms suggesting CNS infection, choroid plexitis should be considered.
Aged ; Animals ; Anti-Bacterial Agents ; Brain ; Cerebral Ventricle Neoplasms ; Cerebrospinal Fluid ; Choroid Plexus ; Choroid* ; Dilatation ; Female ; Horns* ; Humans ; Hydrocephalus ; Lateral Ventricles* ; Magnetic Resonance Imaging ; Neuroimaging ; Papilloma, Choroid Plexus ; Pseudomonas stutzeri* ; Pseudomonas*

BACKGROUND: Mirror movement is common in young children, and it could be seen in normal adults. Several mechanisms including motor pathway reorganization involved in motor recovery after stroke. Motor pathway reorganization has been reported to be a mechanism in several studies of patients with mirror movement. However, the correlation of motor recovery and mirror movement has been debated. We studied the degree of mirror movement in stroke patients compared with a controlled group to look into their relationship. METHODS: Our controls were 50 adults without neurologic symptoms and signs. The hemiparetic group was comprised 94 patients who had incurred unilateral brain lesion: 36 patients were acute stroke patients, 58 patients were chronic stroke patients. Mirror movements were assessed by three different tasks: abduction of thumb, sequential finger tapping, and grasping. We analyzed mirror movements in controls and patients, and tried to find a correlation between the degree of mirror movement and the recovery of motor power in chronic stroke patients. RESULTS: In controls, male exhibited more frequent mirror movement than female at specific tasks, and there was no difference between tasks of right or left hand. In stroke patients, there was more mirror movement in the nonparetic hand than in the paretic one during the movement of contralateral hand. In acute stroke, the frequency of mirror movement had no variability according to the degree of motor power. The recovery of motor power at a late stage was not correlated with the degree of mirror movement. Consclusions: Motor pathway reorganization seems to be insignificant for motor recovery because the degree of mirror movement was not correlated with the recovery of motor power in this study.
Adult ; Brain ; Child ; Female ; Fingers ; Hand ; Hand Strength ; Humans ; Male ; Neurologic Manifestations ; Stroke* ; Thumb

No abstract available.
Humans ; Stomach Neoplasms* ; Stomach*

BACKGROUND: To investigate the clinical significance of interictal serum prolactin level (ISPL), especially in the medical intractability, in patients with complex partial seizure involving the temporal lobe. METHODS: Forty-one male patients older than 16 years, who had motionless staring, were selected. The patients were divided into paired groups according to medical intractability, secondary generalization, duration of disease, seizure frequency, number of antiepileptic drugs, hippocampal sclerosis in MRI, and interictal epileptiform discharge. Serum was sampled in the morning before breakfast, and ISPL was measured. RESULTS: ISPL of the medically intractable patients (11.43 +/- 1.25 ng/ml, n=23) was relatively higher than the treatable patients (9.67 +/- 1.52, n=18), but it was not statistically significant (p>0.05). ISPL of the patients with secondary generalization was significantly higher (11.58 +/- 1.10, n=33) than that of the patients without secondary generalization (6.84 +/- 1.39, n=8; p=0.049). The other factors did not make significant changes in ISPL (p>0.05). CONCLUSIONS: The medical intractability of epilepsy with clinically determined complex partial seizures involving temporal lobe did not change the ISPL. Therefore, ISPL may not be useful as a biochemical marker of the medical intractability of complex partial seizures involving the temporal lobe. However, there was the evidence suggesting that the secondary generalization of complex partial seizures may be an important factor to increase ISPL, which implies that more widespread robust activation of limbic structures may be needed to elevate ISPL.
Anticonvulsants ; Biomarkers ; Breakfast ; Epilepsy ; Generalization (Psychology) ; Humans ; Magnetic Resonance Imaging ; Male* ; Prolactin* ; Sclerosis ; Seizures* ; Temporal Lobe*