BACKGROUND: Left ventricular function and left ventricular hypertrophy often show weak correlation with the degree of blood pressure in hypertensive patients. So we assessed correlation of hemodynamic load to left ventricular hypertrophy and left ventricular performance, and whether left ventricular wall stress is the major factor on the regulation of left ventricular function. METHODS: Relationships between echocardiographic hemodynamic parameters and indices of left ventricular hypertrophy and left ventricular function were evaluated in 40 patients with essential hypertension who have not been previously treated. RESULTS: Left ventricular mass index correlated weakly with blood pressure, cardiac index, and stroke volume. End-diastolic left ventricular relative wall thickness, as an index that assess the severity of concentric hypertrophy showed significantly negative correlation with cardiac index (r=-0.49, p<0.001),stroke index(r=-0.46, p<0.001) and a positive correlation with total peripheral resistance (r=0.55, p<0.001). Furthermore, patient with cardiac indices tend to have higher end-diastolic wall thickness at any given level of blood pressure. Fractional shortening suggesting left ventricular systolic function was not related with blood pressure. stroke volume, cardiac index, left ventricular mass index, and peak systolic wall stress. In contrast there were significant negative correlations between fractional shortening with mean wall stress index (r=-0.42, p<0.005) and with end-systolic wall stress (r=-0.72, p<0.001). CONCLUSIONS: These results suggest that anatomic and hemodynamic changes may be pathophysiologically interdependent and left ventricular function was regulated by the level of left ventricular wall stresses reflecting afterload (blood pressure).
Blood Pressure ; Echocardiography ; Hemodynamics* ; Humans ; Hypertension* ; Hypertrophy ; Hypertrophy, Left Ventricular* ; Stroke Volume ; Vascular Resistance ; Ventricular Function, Left

Canal paresis in patients with benign paroxysmal positional vertigo (BPPV) has been variously reported from 26 to 50%. In such cases, BPPVs are developed secondary to accompanying vestibulopathy or other underlying inner ear diseases. Also the side of canal paresis is regarded as involved ear in the lateralization of horizontal canal BPPV (HC-BPPV), in which lateralization is sometimes ambiguous just by Eward's second law. In this case, authors report a woman who had HC-BPPV and pathologic canal paresis which resolved after canalith repositioning. This case may imply that dislodged particles block the endolymphatic flow resulting canal paresis.
Caloric Tests ; Ear ; Female ; Humans ; Jurisprudence ; Labyrinth Diseases ; Paresis* ; Vertigo*

BACKGROUND AND OBJECTIVES: We aimed to evaluate the clinical manifestation and treatment outcome of the nasal cavity squamous cell carcinoma (SCC) and compared its survival rate with that of the maxillary sinus (MS) SCC. SUBJECTS AND METHOD: Thirty two patients who were diagnosed as nasal cavity SCC or ethmoid sinus SCC between 1984 and 2005 were selected. These patients were referred to as the intranasal (IN) SCC group. Ten prognostic factors were evaluated in terms of survival rate and recurrence. The survival rate of 61 patients who were diagnosed as MS SCC was compared with that of the IN SCC. RESULTS: Chief complaints of the patients with IN SCC were nasal obstruction (40.4%), epistaxis (25.0%), and rhinorrhea (13.5%). The 5 year survival rate of IN SCC was 44.6% and the 5 year disease free survival rate was 27.7%. The most important prognostic factor was T stage (p<.001). The 5 year survival rate of MS SCC was 55.4%, and it was statistically not different from that of the IN SCC (p=.472). In the T1, T2, T3 stages, the 5-year-survival rate of the IN SCC was similar to that of MS SCC (p=.637). But in the T4 stage, IN SCC tended to have a worse prognosis (p=.074). CONCLUSION: The prognosis of IN SCC was similar to that of the MS SCC. However, MS SCCs were detected in a more advanced stage and T4 stage of the IN SCC had a worse prognosis compared to the same stage of MS SCC.
Carcinoma, Squamous Cell* ; Disease-Free Survival ; Epistaxis ; Ethmoid Sinus* ; Humans ; Maxillary Sinus ; Nasal Cavity* ; Nasal Obstruction ; Paranasal Sinuses ; Prognosis ; Recurrence ; Survival Rate ; Treatment Outcome

No abstract available.

Lung fibrosis is a life-threatening disease caused by overt or insidious inflammatory responses. However, the mechanism of tissue injury-induced inflammation and subsequent fibrogenesis remains unclear. Recently, we and other groups reported that Th17 responses play a role in amplification of the inflammatory phase in a murine model induced by bleomycin (BLM). Osteopontin (OPN) is a cytokine and extracellular-matrix-associated signaling molecule. However, whether tissue injury causes inflammation and consequent fibrosis through OPN should be determined. In this study, we observed that BLM-induced lung inflammation and subsequent fibrosis was ameliorated in OPN-deficient mice. OPN was expressed ubiquitously in the lung parenchymal and bone-marrow-derived components and OPN from both components contributed to pathogenesis following BLM intratracheal instillation. Th17 differentiation of CD4+ alphabeta T cells and IL-17-producing gammadelta T cells was significantly reduced in OPN-deficient mice compared to WT mice. In addition, Th1 differentiation of CD4+ alphabeta T cells and the percentage of IFN-gamma-producing gammadelta T cells increased. T helper cell differentiation in vitro revealed that OPN was preferentially upregulated in CD4+ T cells under Th17 differentiation conditions. OPN expressed in both parenchymal and bone marrow cell components and contributed to BLM-induced lung inflammation and fibrosis by affecting the ratio of pathogenic IL-17/protective IFN-gamma T cells.
Animals ; Bleomycin ; Bone Marrow Cells ; Fibrosis* ; Inflammation ; Interleukin-17 ; Lung ; Mice* ; Osteopontin* ; Pneumonia* ; Pulmonary Fibrosis ; T-Lymphocytes* ; T-Lymphocytes, Helper-Inducer

OBJECTIVE: This study was conducted to investigate the different cause of pelvicectasia and its clinical outcome. The most important management of pelvicectasia consist of the early diagnosis and evaluation of the pathologic abnormalities of congenital pelvicectasia. This will help to offer the guideline on management of neonatal pelvicectasia. METHODS: We examined one hundred and seventy-one live neonates who were hospitalized and diagnosed with pelvicectasia at Soonchunhyang University Cheonan Hospital from January 2008 to December 2008. A retrospective study was carried out in these patients for last three years. Renal ultrasonography was repeated at 1 month after birth and then 3 months interval. Diuretic renal scan with (99m)Tc-labeled diethylenetriamine pentaacetic acid augmented with furosemide and voiding cystourethrogram was done after 4 to 6 weeks of first renal ultrasonography. Patients were followed-up for 1 to 30 months (average, 7.2 months). RESULTS: Pelvicectasia was postnatally detected in 171 cases (33.7%) among 507 neonates. Males were twice than females. Additional imaging studies revealed that normal kidney structure was the most common postnatal diagnosis (97.1%), followed by ureteropelvic obstruction, vesicoureteral reflux, multicystic kidney, ureteric duplication. Spontaneous regression of pelvicectasia was revealed in 165 renal units (67.6%). CONCLUSION: There are many cause of spontaneous regression in mild to moderate pelvicectasia. Urinary tract infection occurs in many neonates with pelvicectasia. Mild to moderate neonatal pelvicectasia without vesicoureteral reflux is clinically much less significant. Accordingly, close observation with serial renal ultrasonography may be sufficient.
Early Diagnosis ; Female ; Furosemide ; Humans ; Infant, Newborn ; Kidney ; Male ; Multicystic Dysplastic Kidney ; Parturition ; Pentetic Acid ; Polyamines ; Retrospective Studies ; Ureter ; Urinary Tract Infections ; Vesico-Ureteral Reflux

Staphylococcus aureus and Staphylococcus epidermidis strains isolated at eight large medical centers in Korea were examined for methicillin resistance and resistance to eight other antibiotics; cefazolin, cefamandole, cefuroxime, cefoxitin, cefotaxime, moxalactam, penicillin G and vancomycin. Methicillin resistance was found in 296 of 1225 strains (24.2%) of S. aureus and 126 of 348 strains (36.2%) of S. epidermidis. Methicillinresistant strains were isolated from all sources with the frequency of isolation ranging from 11% to 60%. From pleural effusion, throat swab and blood, methicillin-resistant strains of S. aureus were more frequently isolated with statistical significance (Chi-squared test, 95% confidence). Almost all of Methicillin-resistant S. aureus (MRSA) and S. epidermidis (MRSE) strains were multiply resistant to one or more tested eight antibiotics. However only 7(2.4%) of 296 MRSA strains and 2(1.6%) of 126 MRSE strains were resistant to vancomycin. Vancomycin was the most effective antibiotic against staphylococcal isolates as well as MRSA and MRSE.
Anti-Bacterial Agents/*pharmacology ; Cross Infection/microbiology ; Drug Resistance, Microbial ; Humans ; Korea ; Staphylococcal Infections/microbiology ; Staphylococcus aureus/*drug effects/isolation & purification ; Staphylococcus epidermidis/*drug effects/isolation & purification

OBJECTIVES: Tympanic membrane perforations are common, but there have been few studies of the factors determining the extent of the resulting conductive hearing loss. The aims of this study were to determine whether the size of tympanic membrane perforation, pneumatization of middle ear & mastoid cavity, and location of perforation were correlated with air-bone gap (ABG) of patients. METHODS: Forty-two patients who underwent tympanoplasty type I or myringoplasty were included and preoperative audiometry were analyzed. Digital image processing was applied in computed tomography for the estimation of middle ear & mastoid pneumatization volume and tympanic membrane photograph for the evaluation of perforation size and location. RESULTS: Preoperative mean ABG increased with perforation size (P=0.018), and correlated inversely with the middle ear & mastoid volume (P=0.005). However, perforations in anterior versus posterior locations showed no significant differences in mean ABG (P=0.924). CONCLUSION: The degree of conductive hearing loss resulting from a tympanic membrane perforation would be expected with the size of perforation and pneumatization of middle ear and mastoid.
Audiometry ; Ear, Middle ; Hearing Loss, Conductive* ; Humans ; Mastoid ; Myringoplasty ; Tympanic Membrane ; Tympanic Membrane Perforation* ; Tympanoplasty

BACKGROUND AND OBJECTIVES: This study aims to evaluate audiologic results and subjective satisfaction of bone anchored hearing aids (BAHA) patients. SUBJECTS AND METHOD: Preoperative air-conduction and bone-conduction thresholds, postoperative aided thresholds were measured for 14 patients. To evaluate patient satisfaction, two questionnaires derived from single sided deafness (SSD) questionnaire and Bern Benefit in SSD questionnaire were used. RESULTS: The mean age of patients, consisting of 8 males and 6 females, was 40.0+/-5.9 year. Ten patients (71%) received implantations for conductive or mixed hearing loss and 4 (29%) for SSD. The mean follow-up period was 27.8+/-5.6 months. The mean preoperative bone-conduction threshold of conductive or mixed hearing loss group was 21.4 dB and the mean air-conduction threshold was 65.4 dB. The mean bone-conduction threshold of SSD group was 60.0 dB and the mean air-conduction threshold was 105.9 dB. The postoperative aided threshold was significantly improved in conductive or mixed hearing loss group (p=0.005). The patients in the conductive or mixed hearing loss group showed more satisfaction with BAHA than those in the SSD group did, but the degree of satisfaction was not statistically significant (p=0.08 for questionnaire 1, p=0.12 for questionnaire 2). Patients with better preoperative bone-conduction threshold and patients with better preoperative speech discrimination score showed more satisfaction with BAHA in the questionnaire 1 (p=0.045, p=0.036). CONCLUSION: BAHA can be considered effective and beneficial for patients with conductive or mixed hearing loss and SSD. Further studies will be needed to choose the appropriate indications for BAHA, especially in SSD group in Korea.
Bone Conduction ; Deafness ; Female ; Follow-Up Studies ; Hearing ; Hearing Aids ; Hearing Loss, Conductive ; Hearing Loss, Mixed Conductive-Sensorineural ; Humans ; Korea ; Male ; Patient Satisfaction ; Surveys and Questionnaires ; Silver Sulfadiazine ; Speech Perception ; Suture Anchors

Sudden sensorineural hearing loss is an emergent disease in otologic field. Because the etiology and pathological mechanism were not proven yet, treatment protocol was not established. Therefore, medications, duration, and dosage were different from each institute. In this review, authors collected and analyzed articles on sudden sensorineural hearing loss published during recent 11 years. From those, we described the recommendations on the criteria and method of diagnosis, tools for treatment and their results, and guideline for reporting results and follow up.
Audiometry ; Clinical Protocols ; Hearing Loss, Sensorineural ; Prognosis