In recent study, exercise hypertension is associated with a lower adjusted mortality rate and is likely to a good prognostic sign, although its clinical significance is uncertain. The purpose of this investigation was to study exercise hypertensive reaction and to search its related factors. From June. 1st to Aug. 31st 1996, 108 males, mean age 41.5years(range, 20~70) attended the exercise stress test as volunteers during checking-up of health & disease at Health Service Center of Kwang-ju Christian hospital. The exercise stress test using stationary leg bicycle was done until the examiner were exhausted, at which we measured peak exercise systolic blood pressure & Pulse rate. The results are shown as follows. Exercise hypertension was present in 22 subjects(20.0% ). Including age, body mass index, RPE scales at 70% maximal heart rate, rate of level of elevation of heart rate during exercise, no significant related factors associated with exercise hypertension was present by the discriminant analysis. Multivariate regression analysis demonstrated that exercise-induced increase in systolic blood pressure was positively correlated with only resting systolic pressure(r=0.101, p less than 0.01). RPE(Rating of Perceived Exertion) scales was 18.05+/-1.31 when pulse rate of the examiner was reached to 70% of rnaximal heart rate(220-age (years) ). In conclusion, no significant related factor associated with exercise hypertension was presents, but exercise-induced increase of systolic blood pressure was positively correlated with only resting systolic pressure.
Blood Pressure ; Body Mass Index ; Exercise Test ; Gwangju ; Health Services ; Heart ; Heart Rate ; Humans ; Hypertension* ; Leg ; Male ; Mortality ; Volunteers ; Weights and Measures

Clinical study was carried out on the 64 hemodialysis patients(HD) with chronic renal failure who had been treated from December 1992 to July 1993 in Yeungnam University Hospital. The following results were obitained. In hematologic parameters, MCH was 28.8±2.0pg, and MCV was 92.4±4.7fl. Result revealed normochromic and normocytic anemia. Mean values of serum ferritin were 657.4±292.0ng/ml in men and 511.5±370g in women. Mean values of serum iron were 145.5±63.7µg/dl. Mean values of transferrin saturation was 61.6±28.4%. Serum frerritin, serum iron and transferrin saturation were higher in HD group than normal reference. In erythropoeitin treatment group, Hb and Hct were significantly higher than non-erythropoietin treatment group. Amount of transfusion was significantly higher in non-erythropoietin treatment group than erythropoeitin treatment group(p<0.05). Values of iron, transferrin saturation were significantly higher in abnormal liver function test(LFT0 hemodialysis group than normal LFT group(p<0.05). Transfusion amounts revealed positive correlation with ferritin(r=0.4675), transferrin satruation (r=0.3823) and iron(r=0.3386) (p<0.05).
Anemia* ; Clinical Study ; Erythropoietin* ; Female ; Ferritins ; Humans ; Iron ; Kidney Failure, Chronic ; Liver ; Male ; Renal Dialysis ; Transferrin

PURPOSE: Febrile seizure, the most common seizure disorder in children between 6 months and 5 years of age, is mostly caused by viral infections, except severe CNS infection. It can also be caused by disorders in organic acid metabolism, especially accompanied by fever. Therefore we decided to investigate the relationship between children with febrile seizures and disorders in organic acid metabolism. METHODS: We examined 54 children with febrile seizure who visited Chunchon Sacred Heart Hospital Emergency Department from February 2002 to January 2004. We conducted urine organic acid analysis, CBC, urine analysis, serum ammonia and gas analysis. RESULTS: Thirteen(24.1%) patients showed ketonuria, eight(14.8%) patients showed lactic aciduria and ketonuria, two(3.7%) patients showed pyruvic aciduria, and one(1.8%) showed mandelic aciduria. CONCLUSION: Twenty four of 54(44.4%) showed abnormal findings in urine organic acid analysis. Most results are ketonuria or lactic aciduria with ketonuria. They may show in fasting, severe infection or ketolytic defect(ex, 3-ketothiolase deficiency). Patients with 3-ketothiolase deficiency, can develop seizures during fever, and fasting state. Therefore further evaluation is necessary.
Acetyl-CoA C-Acyltransferase ; Ammonia ; Child ; Emergency Service, Hospital ; Epilepsy ; Fasting ; Fever ; Gangwon-do ; Heart ; Humans ; Ketosis ; Lactic Acid ; Metabolism ; Seizures ; Seizures, Febrile*

OBJECTIVE: Vasospasm of cerebral vessels remains a major source of morbidity and mortality after an aneurysmal subarachnoid hemorrhage (SAH). The purpose of this study was to evaluate the safety and efficacy of transluminal balloon angioplasty (TBA) for SAH-induced vasospasm. METHODS: Eleven patients with an angiographically confirmed significant vasospasm (>50% vessel narrowing and clinical deterioration) were studied. A total of 54 vessel segments with significant vasospasm were treated by TBA. Digital subtraction angiography was used to confirm the presence of vasospasm, and TBA was performed to dilate vasospastic arteries. Medical and angiographic reports were reviewed to determine technical efficacy and for procedural complications. RESULTS: TBA using Hyper-Glide or Hyper-Form balloons (MicroTherapeutics, Irvine, CA) was successfully accomplished in 88.9% vasospastic segments (48 of 54), namely, in the distal internal carotid artery (100%, n=7), the middle cerebral artery (100%), including the M1 (n=10), M2 (n=10), and M3 segments (n=4), in the vertebral artery (100%, n=2), basilar artery (100%, n=1), and in the anterior cerebral artery (ACA), including the A1 (66%), A2 (66%), and A3 segments (100%). Vessel diameters significantly increased after TBA. There were no cases of vessel rupture or thromboembolic complications. GCS at one day after TBA showed an improvement in all patients except one. CONCLUSION: This study suggests that TBA using Hyper-Glide or Hyper-Form balloons is a safe and effective treatment for subarachnoid hemorrhage-induced cerebral vasospasm.
Aneurysm ; Angiography, Digital Subtraction ; Angioplasty, Balloon ; Anterior Cerebral Artery ; Arteries ; Basilar Artery ; Carotid Artery, Internal ; Endovascular Procedures ; Glycosaminoglycans ; Humans ; Middle Cerebral Artery ; Rupture ; Subarachnoid Hemorrhage ; Vasospasm, Intracranial ; Vertebral Artery

Cyclosporine A is the most frequently used immunosuppressive agent for prevention of graft versus host disease (GVHD) and treatment of frequently relapsing nephrotic syndrome in childhood. Some adverse effects such as hepatic and renal toxicity, have been frequently encountered. But central nervous system toxicity caused by cyclosporine A is rare, and the incidence of encephalopathy among patients recieving cyclosporine A is unknown. Brain magnetic resonance imaging is an essential tool for diagnosis of cyclosporine A neurotoxicity. It typically demonstrates nonenhancing symmetric subcortical, and sometimes deep white matter changes resembling edema with posterior hemisphere predominance. We report a child with nephrotic syndrome who developed encephalopathy during cyclosporine A therapy. Based on this study, we emphasize that careful follow up of patient's neurological finding is very important to prevent serious life-threatening complications.
Brain ; Central Nervous System ; Child* ; Cyclosporine* ; Diagnosis ; Edema ; Follow-Up Studies ; Graft vs Host Disease ; Humans ; Incidence ; Magnetic Resonance Imaging ; Nephrotic Syndrome*

BACKGROUND: We sought to examine the use and outcomes with early intraaortic balloon couterpulsation(IABP) combined early reperfusion therapy in patients presenting with cardiogenic shock complicating acute myocardial infarction. The use of IABP in patients with cardiogenic shock is widely accepted. however, there is a paucity of information on the use of this technique in patients with cardiogenic shock who are treated with reperfusion therapy in Korea. MATERIALS AND METHODS: Twenty-eight Patients presented with cardiogenic shock were classified into two groups: the early IABP group (insertion within 12 hours after AMI onset time) and late IABP group (insertion after 12 hours). We compared In-hospital mortality in two group (early IABP group vs late IABP group). RESULTS: Two groups show no significant difference at clinical feature and coronary angiographic results. Among total 28 patients, 7 patients were treated with thrombolytic therapy and 21 patients with PTCA. Insertion site bleeding, fever, thrombocytopenia were reported as some of the complications of IABP insertion. In-hospital mortality of early IABP group and late IABP group were 4 patients(25%) and 8 patients(66%), respectively(p<0.05). Early IABP insertion and early PTCA showed lower hospital mortality rates. There was significant difference in the time to PTCA after AMI onset between the to groups(p<0.05). CONCLUSION: IABP appears to be useful in patients presenting with cardiogenic shock unresponsive medical therapy. Early IABP insertion and early Reperfusion therapy may reduce In-hospital mortality rates in PostMI Cardiogenic shock patients.
Fever ; Hemorrhage ; Hospital Mortality ; Humans ; Korea ; Myocardial Infarction ; Reperfusion* ; Shock, Cardiogenic* ; Thrombocytopenia ; Thrombolytic Therapy

Scrub typhus, which is caused by Orientia tsutsugamushi, is systemic illness that causes generalized vasculitis. The central nervous system (CNS) is the most crucial target in scrub typhus as in other rickettsial disease. A 54-year-old woman, who was receiving doxycycline under the diagnosis of scrub typhus, developed rapidly progressive neurologic symptoms. During the treatment, abnormal mental function, abnormal lateral gaze, paralysis in upper extremities and dysphasia occurred in the patient. To investigate CNS involvement in the patients, CSF profile (cell count and levels of protein and glucose) and brain radiologic image (brain CT, brain MRI) were concurrently examined. And ampicillin and high-dose steroid were empirically added to her treatment with doxycycline. With use of high-dose steroid, the initial neurologic symptoms such as restlessness and irritability and other disorders like abnormal lateral gaze and paralysis in upper extremities were recovered. And also any other neurologic sequelae did not appear. We could observe the clinical improvements of abnormal neurologic symptoms and signs after use of high-dose steroid in the Orientia tsutsugamushi infected patients. A further intensive study about the steroid therapy in Orientia tsutusgamushi infected patients with focal neurologic symptoms is required.
Ampicillin ; Aphasia ; Brain ; Central Nervous System ; Diagnosis ; Doxycycline ; Female ; Humans ; Middle Aged ; Neurologic Manifestations* ; Orientia tsutsugamushi ; Paralysis ; Psychomotor Agitation ; Scrub Typhus* ; Upper Extremity ; Vasculitis

Uterine artery ligation or embolization is a minimally invasive alternative for treatment of symptomatic leiomyoma. However, the experience with pregnancy management and outcome after ablating uterine blood flow is still unknown. We have recently experienced a case of a woman who had two successful spontaneous intrauterine pregnancies after laparoscopic uterine artery ligation to treat uterine myoma for dysmenorrhea and menometrorrhagia.
Dysmenorrhea ; Female ; Humans ; Leiomyoma* ; Ligation* ; Myoma ; Pregnancy* ; Uterine Artery*

PURPOSE: This paper compares a RSS (Rapid Streptococcal Screening) detection test with a throat culture. The RSS detection kit is an easier and faster way to identify the infection of Group A beta-hemolytic streptococcus (GABHS), the most common causal agent of acute bacterial pharyngitis. We also examine the clinical symptoms that are associated with bacterial pharyngitis. METHODS: A throat culture and a RSS detection test were performed simultaneously to all 239 patients who were suspected of having acute pharyngitis, and visited the emergency department between September 1st, 2002, and June 30th, 2003. Then the values of the RSS detection test were analyzed comparatively on a chi square test. The correlation between Centor criteria clinical features and bacterial pharyngitis was examined through a logic regression test. RESULTS: Comparative analysis of the results of a throat culture and RSS detection test showed a test sensitivity of 83.6%, specificity was 97.2%, and the kappa coefficient was 0.83 (95% C.I: 0.75~0.91). This suggests that the RSS detection test is valuable statistically. CONCLUSION: The RSS detection test is more accurate than the diagnosis of bacterial pharyngitis based on clinical features. Assuming that all patients with acute pharyngitis take antibiotics, an RSS detection test reduce of unnecessary antibiotics use.
Anti-Bacterial Agents ; Emergencies ; Humans ; Logic ; Pharyngitis ; Pharynx ; Sensitivity and Specificity ; Streptococcal Infections ; Streptococcus

Nontuberculous mycobacterial infections are a rare, but clinically important cause of infections in continuous ambulatory peritoneal dialysis (CAPD) patients. This is typically suspected when a patient does not respond to treatment with the usual antibiotics. We describe here a case of Mycobacterium abscessus exit site infection with abdominal wall abscess formation that was associated with CAPD, which required peritoneal catheter removal, surgical debridement of the abscess and long term antibiotic therapy.
Abdominal Wall ; Abscess ; Anti-Bacterial Agents ; Catheters ; Debridement ; Humans ; Mycobacterium ; Nontuberculous Mycobacteria ; Peritoneal Dialysis, Continuous Ambulatory