BACKGROUND: Circardian variation in the onset of cardiovascular events includig sudden cardiac death, myocardial infarction and ventricular arrhythmias has been discribed. The frequency of ventricular premature complexes has also been reported to demonstrate a pattern consisting of a daytime peak and nightime nadir. We tried to see if the same circardian pattern is found in dilated cardiomyopathy patients. We have also studed how various modifying factors such as left ventricular ejection fration and ACE inhibitor use may affect the circardian pattern. METHOD: 24-hour ambulatory electrocaridiographic monitorings were performed in 50 dilated cardiomyopathy patients and 20 control subjects. Patients were prospectively divided in 2 groups based on LVEF and ACE inhibitor use. RESULTS: In dilated cardiomyopathy patients, the expected morning increase in VPC frequency is absent and show a peak in evening. This pattern is not correlated with heart rate. Evening peak is more prominent in low LVEF group and ACE inhibitor non-user group. CONCLUSION: In dilated cardiomyopathy patients, VPC frequency show a peak in the evening.
Arrhythmias, Cardiac ; Cardiomyopathy, Dilated* ; Death, Sudden, Cardiac ; Heart Rate ; Humans ; Myocardial Infarction ; Prospective Studies ; Ventricular Premature Complexes*

The brachial plexus injury causes a catastrophic loss of functions of the corresponding upper extremity. However, for a long time, it must have been treated by conservative methods. Recently, with the development of the microsurgery, the brachial plexus lesions were begun to be treated by surgical means, such as neuroiysis, interfascicuiar nerve graft, or neurotization. We experienced seven cases, managed by interfaseicular nerve graft under the operating microscope, and here we presented four cases with the over-one-year results after operations.
Brachial Plexus ; Microsurgery ; Nerve Transfer ; Transplants ; Upper Extremity

No abstract available.
Humans ; Liver Cirrhosis* ; Liver* ; Sepsis* ; Vibrio cholerae* ; Vibrio*

These experiments were performed to investigate the effect of photoperiod and melatonin on serotonergic immunoreactivity in rat brain stem. The animals were injected with melatonin (1 mg/kg, i.p.) after light and dark treatment. The results by immunohistochemical method were as follows; 1. Immunohistochemical serotonin intensity in brain stem (dorsal raphe nucleus of midbrain, nucleus tractus solitarius and dorsal raphe nucleus of vagus nerve in medulla) appeard weakly in medium in control group compared with light and dark treated group. It suggest that enhanced effect in single injection (light or dark) was canceled by complex mechanism when two factors (light and dark) bring about together. 2. Serotonin immunoreactive neurons in brain stem (dorsal raphe nucleus of midbrain, nucleus tractus solitarius and dorsal raphe nucleus of vagus nerve in medulla) were significantly increased in light and dark treated group compared with control group. These results show that serotonin pathways are more important in mediating the effects of retinally perceived light in the rat. 3. Serotonin immunoreactive neurons in brain stem (dorsal raphe nucleus of midbrain, nucleus tractus solitarius and dorsal raphe nucleus of vagus nerve in medulla) were incresesed in melatonin treated group compared with melatonin non-treated group in light and dark. These results indicated that melatonin injection during photo and dark period enhanced serotonergic neurons activity and then light control influenced the development of serotonergic systems in brain stem including dorsal raphe nucleus of midbrain, nucleus tractus solitarius and dorsal nucleus of vagus nerve in medulla.
Animals ; Brain Stem* ; Brain* ; Melatonin* ; Mesencephalon ; Negotiating ; Neurons ; Photoperiod* ; Raphe Nuclei ; Rats* ; Serotonergic Neurons ; Serotonin ; Solitary Nucleus ; Vagus Nerve

Plasma renin activity (ORA) was determined by radioimmunoassay in 55 normal controls and 121 hypertensive patients in basal state and after double stimulation with furosemide administration and upright posture of 4 hrs. The results were obtained as follows, 1) Mean value of PRA of normal control was 2.2+/-1.41ng/ml/hr in basal state and 2.9+/-1.39ng/ml/hr after double stimulation, respectively. The latter was elevated significantly as compaired to the former. 2) PRA in males was significantly higher than in females, and PRA tend to be decreased as age become old. 3) Normal value of PRA after double stimulation was ranged from 1.0 to 5.0 ng/ml/hr. Of total 121 hypertensive patients(55 males and 66 females), PRA was low in 33 cases(27.3%), normal in 77 cases (63.6%), and high in 11 cases(9.1%). 4) Of 55 male hypertensive patients, PRA was low in 13 cases(23.6%), normal in 35 cases (63.7%), and high in 7 cases(12.7%). Of 66 female hypertensive patients,, PRA was low in 20 cases (30.3%), normal in 42 cases(63.6%), and high in 4 cases(6.1%). High renin group was observed more frequently in male hypertensive patients than in female hypertensive patients, while low renin group more frequently in famale than in male patients. 5) Low renin group was observed more frequently in older age group than in younger age group, while high renin group more frequently in younger age than in older age group.
Female ; Furosemide ; Humans ; Hypertension* ; Korea* ; Male ; Plasma* ; Posture ; Radioimmunoassay ; Reference Values ; Renin*

With the improvement of the nutritive conditions and the influence of overflowing informations and various cultural aspects imported from foreign countries, children develop more rapidly in the bodily and sexual growth. This study was conducted to suggest some ideas useful in planning sexual education program in elementary schools and ultimate aim is to promote sexual health. The subject of this survey consisted of 802 fourth, fifth, sixth graders from 6 schools in Seoul, Hongchon and Chunchon. Major findings are summarized as follows. 1. The degree of sexual knowledge of children showed low averaged 26.96 and the degree of sexual attitude showed usual averaged 55.70. 2.With the respect to the demographic characteristics, there were stastically significant differences in sexual knowledge, according to children's grade(F=64.031, p=. 000), father's education(t=-2.504, p=.013), experience of menarche(t=3.470, p=.001), experience of sex-related question to their parents(t=-.6054, p=.000), experience of sex-related question to the teachers (t= -3.385, p=.001), experience of sexual education(t=8.607, p=.000) and in sexual attitude, there were stastically significant differences according to children's grade (F=6.588, p=.001), experience of sex- related question to their parents(t=-5.387, p=.000), experience of sex-related question to the teachers(t=-2.845, p=.005), experience of sexual education(t=5.070, p=.000). 3. The level of sexual knowledge and sexual attitude of childrens' was correlated at significant level(r=.354, p=.000) The findings of this study indicated that variety of the systematic sexual education program suitable for the stage of children should be developed and family, society, contry's higher concern and enlightment are required.
Child ; Education ; Gangwon-do ; Humans ; Reproductive Health ; Seoul ; Child Health

PURPOSE: Vitamin D deficiency has been suggested to play a role in the pathogenesis of atopic dermatitis. In addition, inverse correlationship between serum 25-hydroxyvitamin D concentration and severity of atopic dermatitis has been suggested. METHODS: Clinical and laboratory parameters including serum 25-hydroxyvitamin D level and serum total IgE of 251 patients with atopic dermatitis who were 13 months to 18 years were measured. Severity of atopic dermatitis was assessed with SCORing Atopic Dermatitis (SCORAD) index. Statistical analysis was performed using Pearson correlation coefficient, one-way analysis of variance test and chi-square test. RESULTS: Among 251 patients, vitamin D deficiency (25-hydroxyvitamin D<20 ng/mL, group 1) was present in 76 subjects (30.3%), vitamin D insufficiency (25-hydroxyvitamin D 20-29 ng/mL, group 2) was present in 101 (40.2%), and vitamin D sufficiency (25-hydroxyvitamin D> or =30 ng/mL, group 3) was present in 74 (29.5%). There was a statistically significant inverse correlation between serum concentration of 25-hydroxyvitamin D and values of SCORAD index (R=-0.24, P<0.000). Serum concentration of 25-hydroxyvitamin D were inversely correlated with total IgE (R=-0.29, P<0.000), and age (R=-0.49, P<0.000). CONCLUSION: The results from this study indicate that serum concentration of 25-hydroxyvitamin D is inversely correlated with clinical severity of atopic dermatitis in children.
Child* ; Dermatitis, Atopic* ; Humans ; Immunoglobulin E ; Vitamin D ; Vitamin D Deficiency

This report describes two cases of complete heart block associated with acute myocarditis. Both cases developed Adams-Stokes attack. One patients was considered to be due to viral infection as judged by clinical course and the other patient was confirmed as Korean hemorrhagic fever by indirect immunofluorescent antibody test. Both cases improved during about 4 weeks admission without sequelae with general supportive treatment only.
Heart Block* ; Heart* ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Myocarditis*

PURPOSE: In the analysis of risk factors affecting the renal graft survival and graft function, time-dependent effect of each risk factor should be differentiated from net effect of risk factor. We attempted to analyze the impact of immunologic and/or non-immunologic risk factors on the graft function and survival after renal transplantation among the recipients having same immunologic risks at the time of transplantation. METHODS: Three hundred ninety recipients who underwent haplotype matched living related donor kidney transplantation and have been regularly followed-up were retrospectively evaluated in a single center. All recipients were treated with cyclosporine-based double or triple regimens. The graft function was evaluated by serum creatinine (Scr) level and 24 hours urinary excretion of protein every year until 5 years after transplantation. The donor kidney weight/ recipient body weight ratio (KW/BW), donor age/ recipient age ratio (DA/RA), donor-recipient sex (D-R sex) relationship, and episodes of acute rejection (AR) within 1 year were regarded as the potential risk factors affecting the graft survival and function in this study. Kaplan-Meier method and Cox proportional-hazard model were used for survival analysis. ANOVA to evaluate time-point difference of graft function, and repeated measures ANOVA to evaluate the yearly difference of graft function were used. RESULTS: Only the episode of AR was a significant risk factor affecting the graft survival. However, each non-immunologic risk factors (KW/BW, DA/RA, D-R sex) and AR episode persistently showed statistically significant impact on Scr level until 5 years after transplantation. Recipients having lowest KW/BW (1st Q KW/BW) and highest DA/RA (4th Q DA/RA) had experienced accelerated increment of Scr level from 4th year after transplantation. From 3rd year after transplantation, there is a significant correlation between the numbers of non-immunologic risk factor the recipients having had and yearly increment of Scr level. However, episode of AR didn't influence the annual slope of Scr level even 4th year after transplantation. CONCLUSIONS: Non-immunologic risk factors had an detrimental effect on renal graft function, especially from 3rd year after transplantation. To have a better long-term graft function, non-immunologic risk factors should be considered from the time of live donor evaluation for transplantation. From the early period of transplantation, the recipients should be aware of the negative impact of overweight in terms of graft function and other metabolic derangement.
Body Weight ; Creatinine ; Graft Survival* ; Haplotypes* ; Humans ; Kidney ; Kidney Transplantation ; Living Donors* ; Overweight ; Retrospective Studies ; Risk Factors ; Tissue Donors ; Transplantation* ; Transplants*

Closure of interdental spaces using proximal build-ups with resin composite is considered to be practical and conservative. However, a comprehensive approach combining two or more treatment modalities may be needed to improve esthetics. This case report describes the management of a patient with multiple diastemas, a peg-shaped lateral incisor and midline deviation in the maxillary anterior area. Direct resin bonding along with orthodontic movement of teeth allows space closure and midline correction, consequently, creating a better esthetic result.
Diastema ; Esthetics ; Humans ; Incisor ; Tooth ; Tooth Movement