Brain size is a useful parameter describing ontogenic character and function. Despite its potential contribution to functional study and diagnosis of disease, it has been hampered by poor assessment tools in vivo and postmortem changes. Recent development of medical imaging techniques such as MRI and CT enable us to understand brain structures in vivo. Many morphometirc studies of the brain has given us new insights in the field of functional neuroanatomy and neuropsychiatric diseases. In spite of these advances, volumetric data of normal Korean brain is not available yet. As an initial approach to Korean standard brain size, we measured the cerebellar volume between 20 and 80 years old Koreans. The MRI films free from lesions in brain was analyzed and measured by NIH image program. The Korean cerebellar volume were ranged between 86.2cm(3) and 141.3 cm(3) and average male cerebellum volume was significantly larger than that of female[male : 118.2+/-11.2cm(3)] > female : 108.0+/-9.6cm(3), P=0.1021E-07<0.05]. And we could not find volume change according to aging process. This is the first report on normal Korean cerebellar volume and the presence of gender difference in the Korean cerebellar volume. These data will be used for the standard useful in studying cerebellar function and cerebellum associated disorders in the future.
Aged, 80 and over ; Aging ; Brain ; Cerebellum ; Diagnosis ; Diagnostic Imaging ; Female ; Humans ; Magnetic Resonance Imaging* ; Male ; Neuroanatomy ; Postmortem Changes

BACKGROUND: The pathophysiology of migraine is not yet fully understood. Homocysteine acts as an excitatory amino acid in vivo and may influence the threshold of migraine. The previous studies have revealed strong association between the homozygous C677T mutation in the methylenetetrahydrofolate reductase (MTHFR) gene and hyperhomocysteinemia. In this study, we examined the association between both homocysteine and MTHFR C677T polymorphism and headache, such as migraine and tension headache. METHODS: We enrolled 148 headache patients (75 tension headache, 34 migraine with aura [MWA], and 39 migraine without aura [MOA]) and 121 normal controls; checked their fasting homocysteine levels and analyzed for the MTHFR C677T polymorphism. For the multivariate analysis, we used logistic regression to adjust for age and sex. RESULTS: Plasma homocysteine levels were significantly higher in patients with MWA than those in controls (adjusted odds ratio (AOR), 1.12; 95% confidence intervals (CI), 1.02~1.23). The AOR and 95% CI of the MTHFR 677TT genotype was significantly higher in patients with total migraine (AOR, 3.32; 95% CI, 1.30~9.55; p< 0.05) and with MWA (AOR, 4.70; 95% CI, 1.44~15.29; p<0.01) than the controls. However, the AOR was not significant in patients with tension headache (AOR, 0.93; 95% CI, 0.37~2.32) and with MOA (AOR, 2.77; 95% CI, 0.78~9.74). CONCLUSIONS: Our findings suggest that both elevated homocysteine level and the homozygous C677T mutation in the MTHFR gene are associated with migraine with aura.
Excitatory Amino Acids ; Fasting ; Genotype ; Headache ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Logistic Models ; Methylenetetrahydrofolate Reductase (NADPH2) ; Migraine Disorders* ; Migraine with Aura* ; Migraine without Aura ; Multivariate Analysis ; Odds Ratio ; Plasma ; Risk Factors ; Tension-Type Headache

The prevalence of right-sided infective endocarditis is increasing with a growing number of intravenous drug abusers. A case of right-sided endocarditis is reported in a 18-year-old female heroin addict. Tricuspid valve vegetation, septic pulmonary emboli and staphyloccus aureus in blood cultures are noted. During antimicrobial therapy, she developed remittent fever and skin rash due to vancomycin. After a change of the antibiotic to teicoplanin, she was freed from fever and discharged in an improved condition.
Adolescent ; Drug Users ; Endocarditis* ; Exanthema ; Female ; Fever ; Heroin ; Humans ; Malaria ; Prevalence ; Pulmonary Embolism* ; Teicoplanin ; Tricuspid Valve* ; Vancomycin

BACKGROUND: The autonomic nervous system plays a critical role in triggering ventricular arrhyhmia and sudden death early after acute myocardial infarction. This study was designed to determine whether or not vagal and sympathetic responses are impaired after myocardial infarction and to evaluate the utility of physiologic stress tests for assessing autonomic dysfunction after myocardial infarction. METHODS: 8 male patients with acute myocardial infarction(Group A) and old myocardial infarction(Group B) were studied with 8 control subjects of coinciding age and sex. 5 physiologic stress tests(deep breathing, sudden standing, Valsalva maneuver, ice bag application on the face, 70degrees headd-up tilt test) were performed. RESULTS: 1) Variation in heart rate during deep breathing, Standing-up, Valsalva maneuver, and ice bag application on the face was less in Group A than in Group B or Group C. 2) There was no significant difference in variation of heart rate between Group B and Group C. 3) Variation in heart rate caused by 70degrees tilt was not significantly different among the three groups. CONCLUSION: Early after myocardial infarction, parasympathetic responses were significantly impaired, whereas sympathetic responses remained intact. Heart rate variability using physiologic stress test may be provide a means of detecting autonomic dysfunction after acute myocardial infarction.
Autonomic Nervous System* ; Death, Sudden ; Exercise Test ; Heart Rate ; Humans ; Ice ; Male ; Myocardial Infarction* ; Respiration ; Valsalva Maneuver

The use and safety of the esophageal electrocardiogram for detection and diagnosis of using lead ll in major burn patient, especially burn of chest and face Compared with lead ll , 100% of cardiac rhythm was properly detected with the esopha-geal electrcardiogram. Large distinct P waves, resulting from the proximity of the esophageal lead to the left atrium, clearly established the temporal relationship between atrial and ventricular depo- larization Ne complications were encountered during the atudy. The esophageal lead is safe, simple to use, and provides valuable information fur dele- ction or diagnosis of cardiac rhythm during major burn anesthesia.
Anesthesia ; Burns* ; Diagnosis ; Electrocardiography* ; Heart Atria ; Humans ; Thorax

BACKGROUND: Internet use is taking place as a necessary part in modern life. Recently, internet use among adolescents has bocome a prominent social problem. In accordance with assessment of internet using pattern and addiction, this study analyzed addiction, this study analyzed addiction-relating factors. According to analysis of intimate relating factor, this study attempted to provide appropriate countermeasure. METHODS: The author had performed physical examination on the subjects on May, 2001. The subjects were elementary, middle, and high school students. Among them, 913 students were surveyed with questionnaires. Among the 193 students, elementary school students were 222, middle school 369, high school 291, and 31 did not complete the survey. Addiction-relating factors were sex, age, frequency, mostly connected web-site, time, and place. Young's scale was used as internet addiction assessment, 70 points, and above were used as criteria for internet addiction. RESULTS: There were 32 addicted students among the subjects. By sex, male students were 7, female students 25. By age, elementary school student was 1, middle school students 9, and high school students 22. In frequency, 424 students used the internet more than 5 times per week among all subjects. 30 students used the internet more than 5 times per week among addicted students. CONCLUSION: Internet use of chatting sire is an intimate addiction-relating factor. Therefore, substitute activity which can reduce computer using time, and frequency should be encouraged. Especially, avoiding chatting site is considered a preventive methive of addiction during the computer using time.
Adolescent* ; Factor Analysis, Statistical* ; Female ; Humans ; Internet* ; Korea* ; Male ; Physical Examination ; Social Problems ; Surveys and Questionnaires

BACKGROUND: The estimation of coronary flow velocity(CFV) is essential for assessing the impaired coronary flow reserve in patients whith angina pectoris and normal coronary arteries. But, intracoronary blood flow velocity measurement remains invasive,requiring cardiac catheterization and can not be repeated without risk during serial follow-up study. Transesophageal Doppler echocardiography(TEE) is a new noninvasive method of assessing CFV in the proximal portion of left anterior descending coronary artery. This study was performed to clarify the value of TEE in evaluating CFV, to compare the coronary flow patterns among various cardiac diseases, to estimate the coronary flow dynamics according to change of blood pressure, and to evaluate the parameters influencing CFV. METHODS: We studied 95 subjects, 51 men and 44 women, mean age 46. Normotensive subjects were 29, hypertensive patients 41, aortic stenosis 5, aortic regurgitation 4, mitral stenosis 8, and others 8. After transthoracic echocardiography(H-P Sonos 1000,2.5 MHz), transesophageal echocardiography was performed using a 5-Hz(omniplane)transesophageal probe connected to a H-P Sonos 1000 to assess CFV in the proximal portion of left anterior descending coronary artery. Doppler evaluation of left anterior descending coronary blood flow velocity was obtained in restiong conditions and after sublingual administraion of nitroglycerim(0.6mg), Blook pressure and heart rate were monitored thoughout the entire procedure. RESULTS: 1) The detection rate of CFV by TEE was 89.5%. 2) The morphology of CFV in proximal left anterior descending coronary artery was biphasic(greater diastolic and smaller systolic). 3) The baseline CFV in hypertensive patients was greater than in normotensive subjects(p<0.05) but there was no difference between two groups in diastolic/systolic CFV ratio. 4) The diastolic CFV and diastolic/systolic CFV ratio in patients with aortic stenosis were greater than in normotensive subjects(p<0.05). 5) The CFV was significantly decreased after administration of nitroglycerin(p<0.05) and the decrement of CFV correlated closely with the decrement of systolic(r=0.65, p<0.05) and diastolic blood pressure(r=0.57, p<0.05). 6) Major parameters influencing CFV were systolic blood pressure and heart rate. CONCLUSION: The CFV is influenced by various parameters and the TEE may be a useful, noninvasive tool to investigate the coronary flow dynamics.
Angina Pectoris ; Aortic Valve Insufficiency ; Aortic Valve Stenosis ; Blood Flow Velocity ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Vessels ; Echocardiography, Doppler* ; Echocardiography, Transesophageal ; Female ; Follow-Up Studies ; Heart Diseases ; Heart Rate ; Humans ; Male ; Mitral Valve Stenosis

The erectile response is peripherally mediated by cavernous nerve that contains thoracolubar sympathetic nerve and sacral parasympathetic nerve. It is known that thoracolubar sympathetic nerve involves in detumescence and sacral parasympathetic nerve in tumescence, however there are some opinions that rhoracolubar sympathetic nerve participates in psychogenic erectile mechanism. We previously reported that by the comparison with electrostimulation-induced erection, apomor- phine-induced erection was a vascular event. The aim of our study was to determine the infraspinal neural pathway of APO-induced erection. The sham operated rats remained normal in all measured respects. All rats having undergone neurotomy ot the hypogastric nerves showed APO-induced erection except one. The only 5 rats having undergone neurotomy of the pelvic nerves showed APO-induced erection. Erections could be elicited upon cavernous or pelvic nerves stimulation in all rats having undergone neurolomy of the hypogastric nerves. Among 17 rats having undergone neurotomy of the pelvic nerve erection could be elicited upon cavernous nerves slimulation in 14 rats, however. the intracavernous pressure (47.9+/-16.5 mmHg) was lower than that found in sham-operated rats. Erectile response in these 14 rats appeared to result from stimulation of penile neurons coming from the major pelvic ganglion. In contrast to no response in sham-operated rats, stimulation of the hypogastric nerves also resulted in erections in 7 out of 17 rats. In conclusion, this present study suggests that APO-induced ereclion is primarily mediated via the sacral parasympathetic nerve system and may be mediated by the thoracolumbar sympathetic pathway following injury to the parasympathetic nerve system. Furthermore we can guess the possibility that the neural pathway of psychogenic erection is same that of AP0- induced erection.
Animals ; Apomorphine ; Ganglion Cysts ; Models, Animal* ; Neural Pathways* ; Neurons ; Rats*

BACKGROUND: The interest of patients with chest pain and normal coronary arteries has been increased since 1960. From the year 1973, the syndrome representing these characteristics has been classified as syndrome X. Treadmill test and exercise TI-201 SPECT are important in the diagnosis of syndrome X. This study was designed to evaluate the clinical value of exercise TI-201 SPECT and the difference of clinical characteristics between exercise TI-201 SPECT positive(Group A) and negative (Group B) in patients with chest pain and normal coronary angiogram. METHODS: Twenty seven patients with chest pain and normal coronary angiogram underwent echocardiogram and exercise TI-201 SPECT. Patients received 2 mCi of thallium intravenously during exercise, redistribution images were performed 4 hour later and second dose of 1 mCi of thallium was injected at rest immediately thereafter. These three sets of image(stress, redistribution and reinjection) were analyzed. RESULTS: 1) 12 of 16 patients in Group A, none of 11 patients were positive on exercise treadmill test(p<0.005). 2) The incidence of systemic hypertension in Group A was significant greater than Group B(p<0.05). 3) The left ventricular end diastolic pressure was significantly higher in Group A than in Group B (p<0.05). CONCLUSION: The exercise TI-201 SPECT is a useful method to evaluate the patients with chest pain and normal coronary angiogram and the reversible perfusion defects on the exercise TI-201 SPECT might be related to systemic hypertension and elevated left ventricular end diastolic pressure.
Blood Pressure ; Chest Pain* ; Coronary Vessels ; Diagnosis ; Exercise Test ; Humans ; Hypertension ; Incidence ; Perfusion ; Thallium ; Thorax* ; Tomography, Emission-Computed, Single-Photon*

WPW syndrome is the most common variaty of preexcitaton syndrome in which whole or part of ventricular muscle is activated by the atrial impulse earlier than would be expected if the impulse reached the ventricle by way of normal conduction system alone. WPW syndrome result from existence of accessory muscle bridge(atrio ventricular connection) between atrium and ventricle. The ventricular complex observed in WPW syndrome during periods of sinus rhythm is the result of fusion, with intial phase of ventricular activation representing excitation via accessory pathway and later forces produced by excitation of residual portions of ventricle via normal His-purkinje system. The variations in QRS aberrancy in WPW syndrome depend on varying degree of preexcitation. This experimental study was undertaken to increase our knowledge on the ventricular fusion in WPW syndrome through epicardial mapping after experimental induction of ventricular preexcitaion of WPW type. In 5 normal dogs, the heart was widely exposed through transverse thoracotomy and positioned in a pericardial cradle, then electric wires were fixed on the epicardium of right atrium and ventricular bases(anterobasal and posterobasal) areas of right ventricle, anterobasal and poaterobasal areas of left ventricle for atrial and ventricular pacing. Epicardial mapping was then performed during atrial pacing alone and during atrioventricular sequential pacing at the same rate. Atrioventricular sequential pacing was done with various short AV intervals(60-110 msec) for the purpose of premature stimulation on ventricular base. In mapping we used the grid system which consisted of 29 areas to cover the right ventricle and 23 areas to cover the left ventricle. We drew 9 epicardial ishochrone maps in 5 dogs. The epicardial data during atrio-ventriclar sequential pacing were then compared with those during atrial pacing at an identical rate to study the ventricular fusion in WPW syndrome. The results were as follows; 1) The preexciting wave spread radially from the stimulated basal area to the right and left(or anterior and posterior wall) and the apex. 2) Preexciting wavefronts collided with the normal wavefronts in a wide range of ventricular activation time. 3) Preexcitation widened according to the degree of the shortening of the AV interval. 4) The duration of ventricular activation was greater in preexcited ventricles than in normally activated ventricles. The more prematurely the ventricle was stimulated, the greater the duration of ventricular activation was.
Animals ; Dogs ; Epicardial Mapping ; Heart ; Heart Atria ; Heart Ventricles ; Pericardium ; Thoracotomy ; Wolff-Parkinson-White Syndrome*