PURPOSE: Heart rate variability (HRV) is a tool used to measure autonomic nervous function; however, there is no evidence that it can be used to define sympathetic hyperactivity in men with lower urinary tract symptoms (LUTS). We suspected that LUTS would differ between sympathetic hyperactive and hypoactive patients. Therefore, we measured HRV and divided the LUTS patients into two groups, a sympathetic hyperactive group and a sympathetic hypoactive group according to the low frequency/high frequency (LF/HF) ratio and made clinical comparisons between the groups. METHODS: A total of 43 patients with symptomatic LUTS (International Prostate Symptom Score [IPSS] over 8) and 49 healthy volunteers were enrolled. No subjects had diseases that could affect the autonomic nervous system, such as diabetes or hypertension. Electrocardiographic signals were obtained from subjects in the resting state and HRV indexes were calculated with spectral analyses. We divided the LUTS patients into two groups by an LF/HF ratio of 1.9, which was the median value in the healthy volunteers, and compared the differences in clinical characteristics, IPSS, prostate-specific antigen (PSA), and transrectal ultrasound (TRUS) results. The parameters were compared by independent sample t-test by use of SPSS ver. 19. RESULTS: There were no significant differences in age, serum PSA, or volume of the prostate between the 2 LUTS groups. However, analyzing IPSS questionnaires between two groups showed that there were significant differences in mean of Q2 score (frequency) and storage symptom score ([Q2+Q4+Q7]/3) (P<0.05). CONCLUSIONS: We suggest that an imbalance of autonomic nervous system activity may be a factor that evokes varieties of symptoms in men with LUTS. LUTS patients with hypoactive sympathetic tone may suffer from frequency and storage symptoms.
Autonomic Nervous System ; Electrocardiography ; Heart Rate ; Humans ; Hypertension ; Lower Urinary Tract Symptoms ; Male ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia

We report the case of a 16-year-old male patient who was involved in a traffic accident and transferred to the emergency department with mild chest pain. We initially did not find evidence of tracheal injury on computed tomography (CT). Within an hour after presentation, the patient developed severe dyspnea and newly developed subcutaneous emphysema and pneumoperitoneum were discovered. Abdominal CT showed no intra-abdominal injury. However, destruction of the right main bronchus was identified on coronal images of the initially performed CT scan. Emergency exploratory surgery was performed. The amputated right main bronchus was identified. End-to-end tracheobronchial anastomosis was performed, and the patient recovered without any complications.
Accidents, Traffic ; Adolescent ; Bronchi* ; Bronchial Diseases ; Chest Pain ; Dyspnea ; Emergencies ; Emergency Service, Hospital ; Humans ; Male ; Pneumoperitoneum* ; Rupture* ; Subcutaneous Emphysema ; Tomography, X-Ray Computed

BACKGROUND: Adenoviruses (Ads) are a worldwide cause of endemic and epidemic respiratory infections, particularly in children, young adults and immunocompromised patients. They are responsible for 5% of the acute respiratory infections in children under the age of 4 years and account for about 10% of all cases of childhood requiring hospitalization in this age group. In this study, we report the characteristics of adenoviruses isolated from children with respiratory illness in Busan, 1999~2000. METHODS: A total of 765 children with acute respiratory illness from ten local clinics were studied. Isolation of Ads was performed by inoculating throat swab from patients into Hep-2 cells. The virus propagation was confirmed by the presence of cytopathic effect and adenoviruis specific PCR. Typing of isolated viruses was determined by sequencing analysis of hexon gene. RESULTS: Ads were isolated from throat swab of 17 (2.2%) out of 765 children. The epidemic of Ads infection was concentrated on winter months (December, January, and February). Seventeen Ad isolates showed four serotypes, with Ad3 being the most frequent strain. The distribution of Ads serotypes were eleven (64.7%) Ad3 strains, three (17.6%) Ad5 strains, two (11.8%) Ad2 srtains, and one (5.9%) Ad1 strain. CONCLUSION: Acute respiratory infections by adenoviruses in children were occurred particularly in winter season in Busan. More extended and systematic surveillance of adenovirus infection among populations is required to elucidate the extent of epidemic and disease burden of adenovirus infection.
Adenoviridae Infections ; Adenoviridae* ; Busan* ; Child* ; Hospitalization ; Humans ; Immunocompromised Host ; Pharynx ; Polymerase Chain Reaction ; Respiratory Tract Infections ; Seasons ; Young Adult

Fowl typhoid (FT) reported since 1992 in Korea is a septicemic disease of domestic birds caused by Salmonella gallinarum (S. gallinarum). The purpose of this study was to investigate the biochemical characteristics and antimicrobials susceptibility of field isolates of S. gallinarum isolated by year in Korea. A total of 258 isolates of S. gallinarum from 1995 to 2001 showed the same pattern in the majority of biochemical test such as IMViC (indole, methyl red, Voges-Proskauer and citrate utilization), carbohydrate fermentation and amino acid decarboxylation, and these results were almost in accordance with the traditional biochemical characteristics of S. gallinarum strain. When the antimicrobial susceptibility test against 258 isolates of S. gallinarum was performed by the disk diffusion method using 12 antimicrobial agents, all isolates from 1995 appeared to be susceptible to all of the antimicrobial agents tested except for tetracycline and oxytetracycline, whereas the vast majority of isolates from 2001 showed the reduced susceptibility to ampicillin (13.0%), gentamicin (43.4%), kanamycin (69.6%), enrofloxacin (6.5%), ciprofloxacin (10.9%), norfloxacin (52.5%) and ofloxacin (82. 6%). The prevalence of the prevalence of completely resisyany isolates resistant isolates to one or more drugs rapidly increased from 0% in 1995 to 93.5% in 2001. The minimal concentrations range of the majority of antimicrobial agents to inhibit 50% (MIC50s) against S. gallinarum isolates increased from 0.06 -- 8 microgram/ml in 1997 to 2 -- 256 microgram/ml in 2001. Especially, MIC50s for gentamicin and fluoroquinolones of isolates from 2001 increased over 10-fold than those of isolates from 1997. Therefore, our results indicate that sorbitol fermentation and arginine decarboxylation showed the diversity by isolates and the vast majority of isolates from 2001 showed the reduced susceptibility to antimicrobials tested.
Animals ; Anti-Bacterial Agents/*pharmacology ; Chickens ; Korea ; *Microbial Sensitivity Tests ; Poultry Diseases/microbiology ; Salmonella/*drug effects/isolation & purification ; Salmonella Infections, Animal/microbiology

Fabry's disease, angiokeratoma corporis diffusum, is a rare X-linked inborn error of glycosphingolipid metabolism due to the lack of the lysosomal enzyme, alpha-galactosidase A, resulting in a progressive intracellular deposition of neutral glycosphingolipids in various tissues, including the dorsal root ganglia, autonomic nervous system, vascular endothelial, and smooth muscle cells. Clinical manifestations of Fabry's disease result predominantly from the progressive deposition of globotriaocylceramide in the nervous system or vascular endothelium, and are characterized by acro-paresthesia, angiokeratoma, corneal opacity, TIA or stroke, ischemic heart disease, and renal failure. We report a case of a 19-year-old man presenting with a 12-year history of severe distal pain, acroparesthesia, short stature, and delayed puberty. An enzymatic assay disclosed substantially diminished alpha-galactosidase A activity and an electron microscopy of the peripheral nerve showed lipid inclusions which were composed of concentrically laminated, ovoid osmiophilic bodies in the perineural fibroblast and endothelial cells. These findings are typical of Fabry's disease and additional genetic study revealed deletion mutation(TTAG) at the 6th exon of the alpha-galactosidase A gene, which is a novel mutation that had never been reported in literatures. Symptomatic treatment with carbamazepine and clonazepam was tried with a good response.
alpha-Galactosidase ; Angiokeratoma ; Autonomic Nervous System ; Carbamazepine ; Clonazepam ; Corneal Opacity ; Endothelial Cells ; Endothelium, Vascular ; Enzyme Assays ; Exons* ; Fabry Disease* ; Fibroblasts ; Ganglia, Spinal ; Humans ; Metabolism ; Microscopy, Electron ; Myocardial Ischemia ; Myocytes, Smooth Muscle ; Nervous System ; Neutral Glycosphingolipids ; Peripheral Nerves ; Puberty, Delayed ; Renal Insufficiency ; Stroke ; Young Adult

PURPOSE: This study investigated the relationship between empathy and medical education system, grades, and personality in medical college (MC) students and medical school (MS) students. METHODS: One hundred fifty-five MC students and 137 MS students participated in this study, completing questionnaires on sociodemographic data, Jefferson Scale of Empathy, S-version, Korean edition (JSE-S-K), and Temperament and Character Inventory (TCI). RESULTS: Reward Dependence (RD), Cooperativeness (C), and Self-directedness+ Cooperativeness (SC), which are subscales of the TCI, correlated significantly with JSE-S-K score. Third-year students had significantly higher scores on the JSE-S-K than first-year students. MS students had significantly higher scores on the JSE-S-K and the SC subscale of the TCI than MC students. However, there were no significant differences in empathy with regard to age, sex, motivation toward medical science, club activity, and applied specialty. CONCLUSION: These results suggest that empathy is associated with personality traits, such as RD, C, and SC, and medical education curriculum contributes incrementally to empathy for students. The difference in test scores for empathy between MC students and MS students might be due to differences in personality traits, such as SC.
Curriculum ; Education, Medical ; Empathy ; Human Characteristics ; Humans ; Motivation ; Reward ; Schools, Medical ; Temperament ; Surveys and Questionnaires

No abstract available.
Evoked Potentials ; Humans ; Neural Conduction ; Poisoning*

PURPOSE: Tibial internal torsion is prevalent in East Asian countries such as Korea and Japan, where sitting on the floor is common behavior. Tibial internal torsion or excessive lateral tibial torsion may cause esthetical, functional, or psychological problems and also may induce degenerative arthritis in older age. The aim of this study is to evaluate the therapeutic effect of Tibial Counter Rotator (TCR) in patients with tibial internal torsion. Method:One hundred forty nine children (274 limbs) with tibial internal torsion participated in this study. Transmalleolar angle were measured with gravity goniometer. When tibial internal torsion was detected, TCR was applied at least for 3 hours a day during sleep. The patient's progress was followed monthly and transmalleolar angle was reevaluated by the same examiner. RESULTS: Transmalleolar angle was significantly increased in patients with tibial internal torsion during TCR application (P<0.001). CONCLUSION: TCR can be one of the effective methods for correcting tibial internal torsion in children under 12 years old of age.
Asian Continental Ancestry Group ; Child* ; Gravitation ; Humans ; Japan ; Korea ; Osteoarthritis ; Tibia*

Glycogen storage disease type Ia (GSD-Ia) is an autosomal recessive disorder that has defects in glucose-6-phosphatase (G6Pase) in liver, kidney and intestinal mucosa. The defect leads to inadequate conversion of glucose-6-phospate to glucose in the liver and thus makes affected individuals susceptible to fasting hypoglycemia, hyperuricemia, lactic acidemia and hyperlipidemia. Hyperuricemia has been observed in a considerable number of patients and in some of those, clinical gout has occurred. Inhibited tubular secretion of uric acid due to hyperlacticacidemia and ketonemia, and overproduction of uric acid have been postulated as a mechanism for hyperuricemia in patients with GSD-Ia. A 30-year-old male was admitted with fatigue, foot pain and multiple gouty tophi on knee, ankle, and elbow. GSD-Ia and gout were confirmed by analysis of the G6Pase gene and tophi aspiration respectively. He was treated with allopurinol and uncooked cornstarch. After treatment, foot pain improved and the number and size of tophi were decreased.
Adult ; Allopurinol ; Ankle ; Elbow ; Fatigue ; Foot ; Glucose ; Glucose-6-Phosphatase ; Glycogen Storage Disease* ; Glycogen* ; Gout* ; Humans ; Hyperlipidemias ; Hyperuricemia ; Hypoglycemia ; Intestinal Mucosa ; Ketosis ; Kidney ; Knee ; Liver ; Male ; Starch ; Uric Acid

BACKGROUND AND OBJECTIVES: Clinical differentiation of peritonsillar abscess from peritonsillar cellulitis can be difficult and often relies on diagnostic needle aspiration that is invasive. The differential diagnosis of the two conditions is very important for the planning of treatment. This study is to evaluate the usefulness of gray scale image (GSI) and color doppler image (CDI) using intraoral ultrasonography in differential diagnosis of the peritonsillar abscess from peritonsillar cellulitis. MATERIALS AND METHODS: Twenty patients with suspected peritonsillar abscess were included in this study. GSI and CDI of the intraoral ultrasonography with 7-MHz curved linear array transducer were used. RESULTS: The peritonsillar abscess showed inhomogeneously hypoechoic or cystic space on GSI and rim-shaped color flow signal on CDI. The peritonsillar cellulitis showed homogeneously hypoechoic or striated textual appearance on GSI and diffusely increased color signal on CDI. The sensitivity of GSI for diagnosis of peritonsillar abscess and peritonsillar cellulitis was 91.7% and 77.8%, respectively, whereas the specificiy of CDI proved to be 100% for the diagnosis of both conditions. CONCLUSION: This study demonstrates that intraoral ultrasonography is a useful and noninvasive technique for diagnosis of peritonsillar abscess.
Cellulitis ; Diagnosis* ; Diagnosis, Differential ; Humans ; Needles ; Peritonsillar Abscess* ; Transducers ; Ultrasonography*