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*

Paralytic shellfish poisoning results from consumption of mollusks that have fed on dinoflagellates capable of producing neurotoxins such as saxitoxin. The saxitoxin is concentrated in the shellfish and acts by decreasing sodium-channel permeability, thereby blocking neuronal transmission in skeletal muscles. Symptoms including paresthesia, perioral numbness, perioral tingling, nausea, vomiting, extremity numbness, extremity tingling, dizziness, ataxia, dysphagia, and weakness have been reported. In serious cases, respiratory hold may occur up to 6~24 hours after ingestion. Generally, the treatment for paralytic shellfish poisoning is supportive care, but mechanical ventilation is needed in serious cases acompanied by respiratory hold. We experienced two cases of paralytic shellfish poisoning. Respiratory hold was presented in one case and only mild paresthesia in the other case. After supportive management, including mechanical ventilation in former case, both patients were discharged without sequalae.
Ataxia ; Deglutition Disorders ; Dinoflagellida ; Dizziness ; Eating ; Extremities ; Humans ; Hypesthesia ; Mollusca ; Muscle, Skeletal ; Nausea ; Neurons ; Neurotoxins ; Paresthesia ; Permeability ; Respiration, Artificial ; Saxitoxin* ; Shellfish ; Shellfish Poisoning* ; Vomiting

Recent molecular studies indicate two different genetic pathways leading to the development of glioblastoma; final progression of astrocytoma and de novo formation. To define the mutual relationships of cytogenetic changes in the pathogenesis of glioblastoma, molecular histopathologic alterations of p53 and epidermal growth factor receptor (EGFR) were evaluated by single stranded conformational polymorphion, reverse transcriptase-polymerase chain reaction and immunohistochemical stains in 15 primary and 21 secondary glioblastomas. Mutations in p53 gene and positive immunoreactivity to p53 protein (DO1) were more prevalent in secondary glioblastomas than in primary glioblastomas. A correlation between p53 mutations and p53 immunopositivities in glioblastomas was observed in 83.3% of the cases. All cases with positive p53 immunoreactivities showed p53 mutations; however, 13.9% of glioblastomas with p53 immuno-positivities lacked the relevant mutations. EGFR amplifications were detected in 73.3% of primary glioblastomas and 9.5% of secondary glioblastomas (p<0.001). The concurrence of p53 mutation and EGFR amplification was revealed in only 2 out of 15 primary glioblastomas and none among the secondary glioblastomas. Immunoreactivities for EGFR were noted in 66.7% of primary glioblastomas and in 9.5% of secondary glioblastomas (p<0.001). A correlation between EGFR amplification and EGFR immunopositivity in glioblastomas was observed in 91.7% of the cases. These data indicate that EGFR amplification and p53 mutations are two independent genetic events in the development of glioblastomas.
Adolescence ; Adult ; Brain Neoplasms/*genetics/metabolism ; Female ; *Genes, p53 ; Glioblastoma/*genetics/metabolism ; Human ; Immunohistochemistry ; Loss of Heterozygosity ; Male ; Middle Age ; *Mutation ; Protein p53/analysis ; Receptor, Epidermal Growth Factor/analysis/*genetics ; Reverse Transcriptase Polymerase Chain Reaction

PURPOSE: To evaluate the age-related risk factors, clinical manifestations, and prognosis in infectious keratitis. METHODS: Records of patients with infectious keratitis who visited one of the two tertiary medical centers at Jeolla-do from January 2000 to December 2007 were reviewed. Risk factors depending on patient age distribution standardized over and under the age of 60 were reviewed retrospectively by analyzing sex, age, previous history of trauma, systemic disease, previous ocular disease, causative organism and treatment. RESULTS: A total of 757 patients (757 eyes) visited either one of the two tertiary medical centers. The mean age was 58.2+/-18.0 (4 to 93) years, and patients included 437 males (57.7%), and 320 females (42.3%). The most common risk factor among all age groups was trauma, especially due to vegetable matter. The second most frequent risk factor among the younger patients was contact lens use (19.2%), and common risk factors among the elderly were previous ocular disease (20.0%), systemic disease (15.5%), and ocular surgery (9.7%). The most prevalent causative organisms among all age groups were Gram-positive bacteria, in particular Staphylococcus epidermidis. Elderly patients had a higher frequency of corneal perforation than did younger patients. In addition, elderly patients had a worse prognosis and more often required surgical treatment. CONCLUSIONS: Infectious keratitis has more severe clinical manifestations and complications and a worse prognosis in elderly than in younger patients. Elderly patients have more diverse risk factors. Prevention should aim at avoiding ocular trauma, especially by vegetable matter, and at controlling ocular surface diseases, such as exposure keratitis and bullous keratopathy.
Age Distribution ; Aged ; Corneal Perforation ; Female ; Gram-Positive Bacteria ; Humans ; Keratitis ; Male ; Prognosis ; Retrospective Studies ; Risk Factors ; Staphylococcus epidermidis ; Vegetables

PURPOSE: Successful treatment of bladder cancer greatly depend upon the regular surveillance for early detection of persistent or recurrent cancer. We assessed the efficacy of urinary NMP22 test in screening and post-trearment follow-up for bladder cancer. MATERIALS AND METHODS: Urinary NMP22 test kit, which is based on an enzyme-linked immunosorbent assays, were used to measure the values of urinary NMP22 in 30 patients of transitional cell carcinoma of the bladder, 32 healthy volunteers, 12 patients of urinary tract infection and 13 patients of other urinary malignancy. RESULTS: Median values of urinary NMP22 in patients with bladder cancer were significantly greater than in healthy volunteers(p<0.05). With a cutoff value of 15units/ml, urinary NMP22 test had a 90.0% of sensitivity and a 90.6% of specificity in predicting bladder cancer. There was significant postoperative decrease of urinary NMP22 values in all patients with bladder cancer(p<0.05). CONCLUSIONS: These results suggest that urinary NMP22 test is useful for screening and postoperative surveillance of patients with transitional cell carcinoma of urinary bladder. Further comparative studies of urinary NMP22 test with the results of postoperative cystoscopy or cold cup biopsies are requested to enhance the practical utility of urinary NMP22 test.
Biopsy ; Carcinoma, Transitional Cell ; Cystoscopy ; Enzyme-Linked Immunosorbent Assay ; Follow-Up Studies* ; Healthy Volunteers ; Humans ; Mass Screening* ; Sensitivity and Specificity ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urinary Tract Infections

BACKGROUND AND SIGNIFICANCE: Neck manipulation or trauma uncommonly be associated with serious and even fatal vascular complications. We presented the clinical and radiologic findings in 3 patients of brainstem and/or cerebellar infarct with basilar artery occlusion and extracranial vertebral artery stenosis or occlusion,. Cases : In the patient 1, the infarction of pons and lsft cerebellar hemisphere outbroke just after being seized by the collar. The angiographic findings were complete occlusion of basilar artery and left vertebral artery on C1 level and vertebrobasilar junctional occlusion of right vertebral artery. In the patient 2, extensive infarction of pons and left cerebellar hemisphere developed just after chiropractic manipulation of the neck. The angiographic findings were occlusions of left vertebral artery and distal portion of the basilar artery. In the patient 3, right cerebellar and medullary infarction of posteroinferior cerebellar artery territory occurred just after autobicycle accident. The angiographic finding was complete occlusion of left vertebral artery on C1 lever. They had not another risk factor of the stroke. CONCLUSIONS: We experienced and presented 3 cases of posterior circulation infarctio with vertebrobasilar stenoocclusion just following cervical manipulation or neck trauma.
Arteries ; Basilar Artery ; Brain Stem ; Humans ; Infarction* ; Manipulation, Chiropractic ; Manipulation, Spinal* ; Neck ; Pons ; Risk Factors ; Stroke ; Vertebral Artery ; Vertebrobasilar Insufficiency

Adenomatoid tumor is the common neoplasm of the paratesticular tissue that generally is considered to be of mesothelial derivation. But, there are only few reports on adenomatoid tumor of the epididymis associated with cryptorchid testis in the world. We report an unusual tumor that occurred in epididymis associated with intraperitoneal cryptorchid testis of a 32-year-old man andwas confirmed as an adenomatoid tumor by light microscopy.
Adenomatoid Tumor* ; Adult ; Epididymis* ; Humans ; Male ; Microscopy ; Testis*

Tumors of the epididymis are rare. The most common one is adenomatoid tumor. At least more than two hundred cases have been reported in the literature but only one was reported by us last year in this country. We add another one which is involving bilateral epididymis simultaneously and review literature briefly.
Adenomatoid Tumor* ; Epididymis* ; Male

We report a case in which traumatic epistaxis with a carotid cavernous fistula was successfully treated by using radiologic intervention. Since the inner facial bone is an anatomically weak structure and has numerous bleeding sites, traumatic epistaxis is profuse and can not be controlled well by using traditional treatments such as gauze, merocel(R), and foley balloon packing. Uncontrolled epistaxis may cause unstable vital signs and threaten the patient. In the case of failure through traditional treatments, angiographic embolization can be used as a treatment of choice because angiographic embolization can be done at a high success rate with few complications. Stroke, facial palsy, visual loss, and facial pain are the most common complications. In our case, we had tried traditional treatments first, but there was no marked improvement. After the angiographic embolization had been conducted, epistaxis was successfully controlled. The patient 's vital signs were stabilized, and he was admitted to the ICU.
Epistaxis* ; Facial Bones ; Facial Pain ; Facial Paralysis ; Fistula ; Hemorrhage ; Humans ; Stroke ; Vital Signs

Giant hydronephrosis is a clinical entity in which errors of diagnosis are frequent due to the silent development of this pathologic state. We present a case which has been considered worthy of detailed report for various reasons. First, it was a 22 liter hydronephrosis which is, so far as can be discovered from available Korean literature, the largest that has been removed surgically. Secondly, despite of huge hydronephrosis, the patient experienced delivery.
Diagnosis ; Humans ; Hydronephrosis*