PURPOSE: Although it is well known that the pulsatile Doppler waveforms change in shape with disturbed flow, interpretation of the waveforms has largely been subjective. We aimed to describe the Doppler waveforms of the lower extremity objectively by parameters of Fourier transformation. METHOD: Sixty-eight Doppler arterial waves were analyzed in this study. They were classified according to the clinical findings; Group I: no ischemic symptoms with ankle pressure>100 mmHg (N=17). Group II: no ischemic symptoms with ankle pressure 80~100 mmHg (N=18). Group III:symptoms of claudication (N=19). Group IV: rest pain or tissue loss (N=14). The waveforms were Fourier transformed and their amplitudes and phases were compared up to the third harmonics. RESULT: Both the fundamental and second harmonics were predominant in group I. In contrast, fundamental harmonic was predominant with disturbed flow. The phases of the fundamental and second harmonics were delayed with disturbed flow. Relative phase (difference of phase between higher harmonics and fundamental harmonic) tended to be shortened with disturbed flow. CONCLUSION: Abnormal waveforms are characterized by predominant amplitude of the first harmonic, phase delay, and shortening of the relative phase. These parameters may be useful for differentiation of Doppler waveforms.
Ankle ; Fourier Analysis* ; Lower Extremity*

BACKGROUND: There are two methods to understand a periodic signal. One is describing it in the time domain, and the other is in the frequency domain. Various methods have been described for analysis of Doppler signals in terms of velocities and they need to be further characterized. Frequency domain analysis involves conventional Fourier transformation and analysis by modeling. In 1980's, Skidmore et al. applied Laplace transformation analysis to the femoral and ankle Doppler waveforms and described the waveforms in terms of damping, stiffness and distal impedance. However, few subsequent studies have been reported by other authors. Further, an appealing feature of frequency function analysis is that it can be used for modeling of the resistive and/or storage property of the circuit. PURPOSE: The purpose of study is to analyze the Doppler waveforms of lower extremity in frequency domain and compare the results with the currently known parameters of pusatility in the time domain. METHODS: This study includes 119 Doppler waveforms from 7 non-symptomatic limbs and from 18 limbs with symptoms of chronic low extremity ischemia. Each five representative beats of Doppler waveforms were curve-fitted by third-order AR (auto-regressive) model and z-transformed resulting in three representative roots in the z-plane. Maximum velocity (Max), minimum velocity (Min), maximum excursion of the waveform (Max-Min; MaxE), mean velocity (Avg), pulsatility index (PI) and resistive index (RI) were calculated and compared with the values of the roots. RESULTS: Mostly, the poles of the transfer function were two imaginary and one real poles. Severely diseased waveforms had all three poles in real axis or the imaginary poles approached toward the real axis. The average value of the three poles (Rmean) was 0.5096 ( 0.0967 S.D.) (range: 0.2193~0.7197). The real value of the first pole (R1real) was 0.8957 ( 0.067 S.D.) (range: 0.5964~0.97). The absolute value of imaginary value of the first pole (R1imag) was 0.0998 ( 0.0713 S.D.) (range: 0~0.2336). Significant correlation was observed between 1) Rmean and MaxE (r=0.769), Max (r=0.7498), Avg (r=0.3106), RI (r=0.4378), 2) R1real and MaxE (r=0.5382), Max (r=0.4732), RI (r=0.3629), and 3) R1imag and MaxE (r=0.4785), Max (r=0.3333), Min (r= 0.3703), RI (r=0.5611). CONCLUSIONS: The position of roots of third-order transfer function of Doppler waveforms seems to correlate with the known parameters of velocity. In addition to these parameters of velocity, transfer function analysis appears to be a useful tool to evaluate the Doppler waveforms. Further studies are needed in relation to clinical manifestation.
Ankle ; Axis, Cervical Vertebra ; Electric Impedance ; Extremities ; Fourier Analysis ; Ischemia ; Lower Extremity*

No abstract available.
Intracranial Arteriovenous Malformations* ; Microsurgery*

BACKGROUND: Propafenone is a new class Ic antiarrhythmic compound.This study was performed to evaluate the clinical efficacy and safety of propafenone by double-blind, placebo-controlled, randomized cross-over comparison of propafenone and disopyramide in patients with stable ventricular ectopy. METHODS: All patients were included in the study if they had an average of at least 30 PVC/hr on a 24-hour Holter recordings. During the 1st 7 days, two placebo tablets(identical in apperance to the propafenone and the disopyramide tablets) were administrated in a double-blind manner(run-in period). Then 1st treatment period lasting 1 week with one verum and the other placebo, wish-out period of 3 day,2nd treatment period lasting 1 week with cross-over drugs were followed. RESULTS: Twenty patients were enrolled. During the run-in period, VPCs were reduced to 18%, compared to the baseline data before the administration of placebo.During the treatment period,propafenone 600mg/day reduced VPCs by 43% and disopyramide 400mg/day reduced VPCs by -10% Propafenone was effective(80% or greater reduction of VPCs) in 7 of 20 patients. Disopyramide was not effective in all patients. Propafenone and disopyramide produced no significant change of paired VPCs and VT events. Propafenone had no effect on heart rate. It increased the PR interval(7.9%;p<0.01) and QRS interval(5.2%;p<0.01). The drug did not change QTc interval(-1.1%) significantly. There were no cardiovascular side effects. Propafenone produced nausea in one patient. Disopyramide produced dysuria in 2 patients. CONCLUSIONS: Propafenone was more effective in controlling VPC than disopyramide, and there was no major limiting side effects.
Cross-Over Studies* ; Disopyramide* ; Dysuria ; Heart Rate ; Humans ; Nausea ; Propafenone* ; Ventricular Premature Complexes*

No abstract available.
Agaricales ; Dermatitis

There have been many studies between serum uric acid (UA) and chronic kidney disease (CKD). However, as far as we know, little research has been done to examine the prospective association between serum UA and development of CKD in Korean men. This prospective cohort study was performed using 18,778 men who participated in a health checkup program both on January, 2005 and on December, 2009. CKD was defined as an estimated glomerular filtration rate < 60 mL/min per 1.73 m2. The odds ratio (OR) from binary logistic regressions for the development of CKD was determined with respect to the quintiles grouping based on serum UA. During 74,821.4 person-years of follow-up, 110 men were found to develop CKD. The OR for the development of CKD increased as the quintiles for baseline serum UA levels increased from the first to fifth quintiles (1.00 vs 1.22, 1.19, 2.59, and 3.03, respectively, p for linear trend < 0.001) after adjusting for covariates. The adjusted OR comparing those participants with hyperuricemia ( > or = 7.0 mg/dL) to those with normouricemia ( < 7.0 mg/dL) was 1.96 (1.28-2.99). Elevated serum UA levels were independently associated with increased likelihood for the development of CKD in Korean men (IRB number: KBC10034).
Adult ; Age Factors ; Alcohol Drinking ; Asian Continental Ancestry Group ; Blood Pressure ; Body Mass Index ; Cohort Studies ; Follow-Up Studies ; Glomerular Filtration Rate ; Humans ; Hyperuricemia/etiology ; Insulin Resistance ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Prospective Studies ; Renal Insufficiency, Chronic/*blood/complications/diagnosis ; Republic of Korea ; Smoking ; Triglycerides/blood ; Uric Acid/*blood

BACKGROUND: The average duration of diabetes and predictive factors of macrovascular complications in Korean diabetic patients remain to be elucidated. This study examines the average duration of diabetes up to the onset of macrovascular complications and clinically important factors of early development of these complications in Korean type 2 diabetic patients. METHODS: Clinical characteristics in type 2 diabetics with (n = 121) and without macrovascular complications (n = 115) were analyzed. In addition, early onset (< or = 5 years, n = 54) and late onset groups (> 5 years, n = 67) were compared, as were the clinical characteristics between male and female patients in the macrovascular complications group. RESULTS: The average duration of diabetes was 8.7 +/- 7.8 years in the macrovascular complications group. Average age, systolic and diastolic blood pressures and smoking history were all higher in the macrovascular complications group than the control group. However, HbA1c levels and prevalence of microvascular complications were higher in the controls. Average age was lower in the early onset group and many more patients of that group had a smoking history. In the analysis based on sex, marcrovascular complications developed earlier in male patients. In addition, the prevalence of family history of diabetes was higher in males and 77.8% of male patients had a smoking history (female: 3.4%). CONCLUSION: Our study confirms that older age, high blood pressure and smoking history are major risk factors for the development of macrovascular complications. Moreover, a smoking history in males can be both risk and predictive factors for earlier development of macrovascular complications in Korean type 2 diabetic patients. We also found that several clinical characteristics including age, family history of diabetes, hypertension and smoking history, vary between the sexes, and these findings can provide useful indices for the prevention of macrovascular complications.
Diabetes Complications ; Diabetes Mellitus, Type 2 ; Female ; Humans ; Hypertension ; Male ; Prevalence ; Risk Factors ; Smoke ; Smoking

PURPOSE: Nocodazole, a microtubule disrupting reagent, is known to arrest cells in the M phase, To gain insight on the regulatory mechanism of H2B histone gene expression by nocodazole in HL-60 cell, the binding pattern of nuclear proteins to cis element in the human H2B histone gene promoter has been investigated with DNase I footprinting and DNA mobility shift assay. MATERIALS AND METHODS: Northern blot hybridization was performed by the method of Virca et al. A Hinc II-Sac I fragment of pSPH28 was used as probe for Northern blot analysis of H2B histone mRNA. DNase I footprinting and DNA mobility shift assay were performed by the method of Lim et al. End labeled DNA oligomer (upper strand, 5'-CTTCACCTTATTTGCATAA GCGATTC-3') for octamer binding activity was mixed with nuclear extracts in a 20 ul reaction volume containing 60 mM KC1, 12 mM HEPES, pH 7.9, 5 mM MgCl2, 0.2 mM EDTA, 0.2 mM DTT, 12% glycerol, and 2 ug of poly [dI-dC]. RESULTS: The level of H2B histone mRNA rapidly was reduced at 24 hours in nocodazole-treated HL-60 cells and the mRNA was repressed in proportion to the concentration of nocodazole. Nocodazole-dependent repression of H2B histone gene was restored by replacement with nocodazole-free media. In DNase I footprinting analysis, one nuclear factor bound at 42 bp site (octamer motif) in the absence of nocodazole. In the presence of nocodazole, the binding of nuclear factor on octamer motif partially vanished. In DNA mobility shift assay, one DNA-protein complex (Octl) was formed when octamer motif was incubated with nuclear extract of HL-60 cell. After nocodazole treatment, Octl binding activity was reduced by time dependent manner. CONCLUSION: These results suggest that nocodazole-dependent repression of H2B histone gene is correlated with reduction of Octl binding activity in HL-60 cell.
Blotting, Northern ; Cell Division ; Deoxyribonuclease I ; DNA ; Edetic Acid ; Electrophoretic Mobility Shift Assay ; Gene Expression* ; Glycerol ; HEPES ; Histones* ; HL-60 Cells* ; Humans ; Hydrogen-Ion Concentration ; Magnesium Chloride ; Microtubules ; Nocodazole* ; Nuclear Proteins ; Repression, Psychology ; RNA, Messenger

BACKGROUND AND OBJECTIVES: Because of the wide application of the endoscopic diagnostic system and increased amount of attention for early stage congenital cholesteatoma (CC) recently, the detection of CC in stages I and II has increased. In this study, we investigated the effectiveness of minimally invasive transcanal myringotomy (MITM), and compared its results with those of postauricular approach (PAA) in early stage CC consisting of stage I and II of Potsic's classification. SUBJECTS AND METHOD: We retrospectively studied 70 patients who were diagnosed with CC after surgery performed by an otologist from June 2006 to June 2013. Thirty-two patients were in early stage CC consisting stage I and II. Of the 32 patients, MITM was performed on 20 and PAA was performed on 12. We analyzed the characteristics of disease, operation time, hospitalization period, recurrence and complications according to the stage and each operation. RESULTS: There were no significant differences between the stages and types of the disease between the MITM and the PAA group (p>0.05). The operation time and hospitalization period for the MITM group were significantly shorter than for the PAA group (p<0.001). There was no recurrence in the two groups during the average follow-up period of 33 months follow-up. Tympanic membrane perforation occurred in one patient in the MITM group. One patient presenting an external aural epidermal cyst in the PAA group was treated with surgical removal. CONCLUSION: The MITM is an efficacious and feasible method to remove early stage CC.
Cholesteatoma* ; Classification ; Epidermal Cyst ; Follow-Up Studies ; Hospitalization ; Humans ; Recurrence ; Retrospective Studies ; Tympanic Membrane Perforation

No abstract available.
Child* ; Humans ; Hypertrophy* ; Snoring*