No abstract available.
Muscle, Smooth*

No abstract available.

No abstract available.

We report a case of a 51-year-old woman with Evans syndrome (autoimmune hemolytic anemia and primary immune thrombocytopenia) and hypothyroidism. She was previously diagnosed with Hashimoto's thyroiditis in 1994 (age, 35) and autoimmune hemolytic anemia (AIHA) 3 years ago. She was treated with oral prednisolone. After a period, in which the anemia waxed and waned, there was an abrupt development of thrombocytopenia (nadir 15x10(9)/L) that coincided with the tapering off of prednisolone after 3 years of administration. Because her thrombocytopenia was refractory to prednisolone, we administered rituximab (375 mg/m2 weekly) for 4 weeks. Two weeks after the completion of the rituximab treatment, her platelet count was up to 92x10(9)/L. No intermittent peaking of thyroid stimulating hormone occurred after rituximab treatment was initiated. Evans syndrome and autoimmune thyroiditis might share common pathophysiological mechanisms. This notion supports the use of rituximab in a patient suffering from these disorders.
Anemia ; Anemia, Hemolytic ; Anemia, Hemolytic, Autoimmune ; Antibodies, Monoclonal, Murine-Derived ; Female ; Humans ; Hypothyroidism ; Middle Aged ; Platelet Count ; Prednisolone ; Stress, Psychological ; Thrombocytopenia ; Thyroid Gland ; Thyroiditis ; Thyroiditis, Autoimmune ; Thyrotropin ; Rituximab

Our objective was to assess the clinical factors that would reliably distinguish methicillin-resistant S. aureus (MRSA) from methicillin-susceptible S. aureus (MSSA) endocarditis. A retrospective cohort study of clinical features and mortality in patients with MRSA and MSSA endocarditis between March 1986 and March 2004 was performed in a 750-bed, tertiary care teaching hospital. A total of 32 patients (10 MRSA [31.3%] vs 22 MSSA [68.7%]) were evaluated. Their mean age and sex ratio (male/female) were as follows: 30.8 +/- 16.0 vs 24.4 +/- 19.6 years old and 6/4 vs 13/9, for MRSA and MSSA infective endocarditis (IE), respectively. Univariate and multivariate analyses revealed that persistent bacteremia was significantly more prevalent in MRSA IE (OR, 10.0 [1.480- 67.552]; p, 0.018). There was a higher mortality trend for MRSA IE (50.0%) than for MSSA IE (9.1%) (p=0.019). However, persistent bacteremia was not associated with higher mortality (p > 0.05). These results indicate that if persistent bacteremia is documented, the likelihood of MRSA endocarditis should be viewed as high, and the patient's anti- staphylococcal therapy should be prolonged and/or changed to a more "potent" regimen.
Adult ; Bacteremia/drug therapy/microbiology ; Cohort Studies ; Comparative Study ; Endocarditis, Bacterial/drug therapy/*microbiology ; Female ; Humans ; Male ; *Methicillin Resistance ; Middle Aged ; Retrospective Studies ; Staphylococcal Infections/drug therapy/*microbiology ; Staphylococcus aureus/*drug effects

PURPOSE: With the aim of objectively assessing the symptoms' severity and treatment outcomes of urinary incontinence in the Korean population, the King's Health Questionnaire (KHQ) instrument was translated into Korean, with subsequent linguistic validation. MATERIALS AND METHODS: Between May 2002 and December 2002, two bilinguists independently translated the original English version of the KHQ into written Korean. A panel consisting of the aforementioned translators and three authors (SJO, HGP and SHP) reviewed the translations to form a single reconciled forward translation of the Korean version. Another bilingual translator, who had never seen the original KHQ, translated the draft Korean version of the KHQ back into English and subsequently assessed for equivalence to the original. Discrepancies between the original English form and the first draft Korean translation were reviewed by the panel. Cognitive debriefing interviews with five incontinent patients were performed to test the interpretation of the translation. A summary of the changes from the patient interviews were then reflected in the final Korean version. The document was finally proofread to check the spelling, grammar, layout and formatting. RESULTS: The multi-step process of forward translation, reconciliation, back-translation, cognitive debriefing and proofreading of the Korean version of the KHQ was completed. Conclusions: Translation and linguistic validation of the Korean version of the KHQ instrument were completed. Further tests for its psychometric performance will be required.
Humans ; Linguistics* ; Psychometrics ; Surveys and Questionnaires* ; Translations ; Urinary Incontinence ; Urination

PURPOSE: Congenital factor VII(FVII) deficiency is a rare bleeding disorder and surgery can cause excessive bleeding due to an extrinsic pathway problem. It can be diagnosed by increased PT and decreased FVII level in coagulation test. Symptom varies according to the level of FVII, but it is essential to prevent intraoperative excessive bleeding. METHODS: In this report, we described the orthognatic surgery experience in a mandibular prognathism patient with congenital F'VII deficiency, in which recombinant activated factor VII(rFVIIa) was used to manage the bleeding. Rsults: We could get a successful result without any complication and there was minimal intraoperative bleeding. CONCLUSION: The orthognathic surgery could therefore be safely performed in patients with congenital factor VII deficiency using rFVIIa.
Factor VII ; Factor VII Deficiency ; Factor VIIa ; Hemorrhage ; Humans ; Orthognathic Surgery ; Prognathism ; Recombinant Proteins

PURPOSE: This study aimed to characterize the autonomic and chaotic control of heart rate and circadian rhythm in asymptomatic patients with postoperative tetralogy of Fallot (pTOF). METHODS: Twenty-four-hour electrocardiogram recordings were obtained in 30 asymptomatic pTOF patients and in 30 age-and sex-matched controls, aged between 6 and 11 years. The data was digitized and partitioned into sections of 30- minute'durations. For each section, time-domain and frequency-domain measures (low- and high- frequency component) of heart rate variability and three measures based on chaotic dynamics- approximate entropy, correlation dimension and Lyapunov exponent-were calculated. RESULTS: In pTOF patients, 24-hour mean values of the time domain measures, high-frequency component, and all chaotic measures were significantly lower, while 24-hour mean value and all 6-hour mean values of the low-frequency component were significantly higher; all 6- hour mean values of high-frequency component, except from 6am to midday, were significantly lower. In pTOF patients, all 6-hour mean values of all three chaotic measures were significantly lower. In pTOF patients, the day- night circadian variation seen in controls was diminished (time- domain measures) or absent (low- and high- frequency component). CONCLUSION: Even in asymptomatic patients with pTOF, who are thought to be at minimal risk of fatal arrhythmia, a sustained increase in sympathetic activity and decrease in vagal activity, abnormal circadian rhythm of the autonomic activity, and decreased cardiac chaos were found. When other arrhythminogenic risk factors are superimposed, these abnormalities may contribute to the development of fatal arrhythmia and sudden death.
Arrhythmias, Cardiac ; Child* ; Circadian Rhythm* ; Death, Sudden ; Electrocardiography ; Entropy ; Heart Rate ; Humans ; Risk Factors ; Tetralogy of Fallot*

Left ventricular(LV) diastolic filling is abnormal at rest in many patients with coronary arery disease, even in the presence of normal resting LV systolic function. To determine the effects of improved myocardial perfusion on impaired LV diastolic filling and to detect the most sensitive parameter to assess LV diastolic function, gated radionuclide ventriculography were performed in 14 patients with coronary artery disease before and after successful percutaneous transluminal coronary angioplasty(PTCA). All patients had no previous myocardial infarction and no abnormal wall motion in gated radionuclide and contrast ventriculography. The following results were obtained; 1) There were no significant differences in the parameters of LV systolic function, such as peak ejection rate(PER, time to peak ejection rate(TPER), ejection fraction(EF) after successful PTCA. 2) Peak filling rate(PFR) and time to peak filling rate(TPFR), indexes of LV diastolic function, had no significant changes after successful PTCA. 3) The percent contribution of late diastolic filling to stroke volume(%LDF/SV) decreased from 26.5+/-6.8% to 19.1+/-6.6%(p<0.005 by paired t-test). These data suggest that in many patients with angina and normal LV systolic function, impaired global diastolic filling is a reversible manifestation of impaired coronary flow, and percent contribution of late diastolic filling to stroke volume(%LDF/SV) can be a sensitive parameter to evaluate impaired LV diastolic filling in coronary artery disease.
Angina Pectoris* ; Angioplasty, Balloon, Coronary* ; Coronary Artery Disease ; Gated Blood-Pool Imaging ; Humans ; Myocardial Infarction ; Perfusion ; Radionuclide Ventriculography ; Stroke

PURPOSE: With the aim of utilization in objectively assessing the symptom's severity and the treatment outcomes of urinary incontinence in Korean population, we translated the Bristol Female Lower Urinary Tract Symptom (BFLUTS) instrument into Korean which subsequently was linguistically validated. MATERIALS, METHODS AND RESULTS: Between May 2002 and December 2002, two bilinguists independently translated the original English version of BFLUTS into written Korean. A panel consisting of aforementioned translators and three authors reviewed the translations to form a single reconciled forward translation of the Korean version. Another bilingual translator who had never seen the original BFLUTS back-translated the first Korean version into English. The back-translation was subsequently assessed for equivalence to the original. Discrepancies between the original English form and the first draft Korean translation were reviewed by the panel. Cognitive debriefing interviews with five incontinent patients to test the interpretation of the translation were made. Summary of the changes from patient interviews were then reflected in the final Korean version. Finally, it was proofread to check spelling, grammar, layout and formatting. CONCLUSION: Translation and linguistic validation of Korean version of BFLUT instrument were completed. Further tests for psychometric performance are needed.
Female* ; Humans ; Linguistics* ; Psychometrics ; Surveys and Questionnaires ; Translations ; Urinary Incontinence ; Urinary Tract* ; Urination