No abstract available.
Delusions* ; Schizophrenia*

Multiple factors including gastroesophageal reflux disease (GERD) were evaluated for a case-control study in Chonnam area to investigate the causative entity of COPD. Data on the multiple causative factors from hospital records and interview survey were analyzed in three groups of COPD(64 cases as case group), normal lung (83 cases as control group 1) and non-COPD lung disease (45 cases as control group 2). Smoking status, history of adulthood pulmonary infection and frequent history of URI, socioeconomic status, and GERD were significantly different between COPD group and control group 1. Drinking status, physical height of the subjects and GERD were significantly different between COPD group and control group 2. If control group 1 was used, odds ratio of GERD and COPD was 5.68(95%confidence interval, 95% CI:2.59-12.45) and 4.81 (95% CI:1.89-10.53) when adjusted by age and smoking status. If control group 2 was used. Odds ratio of GERD and COPD was 4.22 (95% CI:1.69-10.56) and 4.59 (95% CI:1.64-12.86) when adjusted by alcohol and adulthood respiratory infection status. In summary, there results suggested that GERD might play a causative role in the development of COPD.
Case-Control Studies ; Drinking ; Gastroesophageal Reflux* ; Hospital Records ; Jeollanam-do ; Lung ; Lung Diseases ; Odds Ratio ; Pulmonary Disease, Chronic Obstructive* ; Smoke ; Smoking ; Social Class

To investigate frequency of painful and/or silent myocardial ischemia(SMI) determined by ECG ST-segment depression(more than 1.0mm depression for 0.08 second after J point over 60 seconds) during unrestricted daily activities, 24-hour dynamic ECG was performed in 19 patients(11 males, 8 females) with chronic stable angina pectoris, aged 57.4 years(44 to 73 years). During 456 hours of recording, there were 154 episodes of SMI. Of these, 139 episodes(90.3%) were silent and 15 episodes(9.7%) accompaned chest pain. The higher incidence of SMI than previously published data is probably influenced by 1 patient who disclosed 56 episodes (excluding this, SMI 84.7%). Sixty one percent of episodes of SMI occurred during light activities such as slow walk, hand labor, eating or at rest(sitting at ease), smoking and sleep, and 39% during more strenuous activites such as walk, climbing stairs and physical exercise. In contrast, most of the painful myocardial ischemia(PMI) developed during climbing stairs, walk and physical exercise. Heart rate during episodes of SMI varied ranging from 85.2+/-13.7/min at rest to 115.5+/-19.2/ min druing climbing stairs. Mean ST-segment depressions during episodes of SMI and PMI were 2.0(1.0-4.0)mm and 2.6(1.2-7.0)mm, respectively, in 6 patients who disclosed both SMI and PMI on 24-hour ECG recordings. However, frequency of ischemic episodes was higher(9.0 vs 2.5/day) and duration was longer(13.8min vs 3.0min) in SMI. These findings indicate that transient SMI in patients with chronic stable angina pectoris occurs more frequently than painful myocardial ischemia. In addition, SMI develops during activities that increase heart rate(increased O2 demand) as well as during activites that do not increase heart rate(decreased O2 supply). Therefore, both O2 demand and supply mechanisms may be involved in the pathogenesis of transient SMI in Patients with chronic stable angina pectoris.
Angina, Stable* ; Chest Pain ; Depression ; Eating ; Electrocardiography ; Exercise ; Hand ; Heart ; Heart Rate ; Humans ; Incidence ; Male ; Myocardial Ischemia* ; Smoke ; Smoking

BACKGROUND: The two most commonly used drugs as a stressor during wtress echocardiography are dipyridamole and dobutamine. The purpose of this study was to compare diagnostic accuracies of dipyridamole and dobutamine stress echocardiography for fixed coronary artery disease and evaluate complications related to the two agents in the same patients. METHODS: 30(M : 5=19 : 11, age=56+/-8.8yr) consecutive patients without history of previous myocardial infarction underwent coronary angiography, dipyridamole and dobutamine stress echocardiography in random order. Dipyridamole was infused up to 0.84mg/Kg for 10 minutes during clinical, ECG and echocardiographic montioring. Dobutamine was infused in dose increments from 5 to 40microg/Kg/min under the same condition. Positive criteria for myocardial ischemia by echocardiography was now regional wall mation abnormatity or worsening of regional wall motion after stress. Significant coronary disease was defined as more than 70% stenosis by coronary angiography. RESULTS: The sensitivity and specificity of both stress echocardiography were same, 82% and 92% respectively. In a single vessel disease the sensitivity of dipyridamole echocardiography was 75% and dobutamine echocardiography was 83% without statistical difference. The correlation of ischemic free time during both stress test was 0.375. During dipyridamole infusion no test was prematurely terminated because of side effects, but 3 patients(10%) developed severe hypertension and ventricular arrytricular arrythmia during dobutamine infusion and test was terminated. CONCLUSION: Thus, by this prospective direct comparison of both stress test, dipyridamole and dobutamine stress echocardiography have similar diagnostic accuracies for the detection of coronary artery disease. But during dobutamine infusion, careful monitoring for hemodynamic changes arrythmia is required for possible serious complications.
Arrhythmias, Cardiac ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Disease ; Dipyridamole* ; Dobutamine* ; Echocardiography ; Echocardiography, Stress* ; Electrocardiography ; Exercise Test ; Hemodynamics ; Humans ; Hypertension ; Myocardial Infarction ; Myocardial Ischemia ; Prospective Studies ; Sensitivity and Specificity

To assess the efficacy of amiodarone on chronic atral fibrillation(AF) and to evaluate the relation between the ability to convert AF to sinus rhythm (SR) with amiodarone therapy and left atrial(LA) size and atrial fibrillatory wave forms, 22 patients with AF, aged 40 to 60 years(mean 47.5 years), were studied. Nine patients(40.9%) had mitral valvaular heart disease, 6(27.3%) hypertension, 5(18.2%) lone AF and 2 (9.1%) cadiomyopathy. Amiodarone therapy with either 600mg for 1 week, 200mg for 4 weeks in 5 consecutive patients, or 800mg for 1 week, 400mg for 4 weeks and 200mg for 6 weeks in 17 patients, converted AF to SR in 9(40.9%) patients 3 to 6 weeks after amiodarone was started on. In either group, patients who achieved conversion had smaller LA size(mean 43.7mm) than those who failed conversion(mean50.2mm)(P<0.05). Those who had LA size less than 45mm achieved conversion of AF to SR in 70%, comparing to 16.7% in patients with LA size more than 46mm(P<0.05). Among patients who achieved conversion, LA size was less than 46mm in 77.8% comparing to 23.1% in patients who failed conversion on Amiodarone. Those with coarse AF(46.2mm), althogh the difference was not significant statistically. There was no converstion in patients with LA size greater then 58mm and in patients with coarse AF who concomittantly had MVD. These findings suggest that the efficacy of amiodarone was related to LA size, and to the atrial fibrillation wave form in patients with mitral valvular heart disease.
Amiodarone* ; Atrial Fibrillation* ; Heart Diseases ; Heart Valve Diseases ; Humans ; Hypertension

When bronchogenic carcinoma is coexisting with pulmonary tuberculosis, it is difficult to differentiate bronchogenic carcinoma from pulmonary tuberculosis radiologically. Thus, the object of this study is to define differential diagnosis of bronchogenic carcinoma by computed tomography. We analized CT scans of 27 patients with radiologic findings of pulmonary tuberculosis and mass of which twelve cases were pulmonary tuberculosis and fifteen cases were primary lung cancer. The location of parenchymal infiltration and the mass was the same in 60%(9/15) of the primary lung cancer in cases and 83%(10/12) of the pulmonary tuberculosis cases. The common location of the mass was the both upper lobes in 92%(11/12) of the pulmonary tuberculosis cases and 53%(8/15) of the primary lung cancer cases. The common locations of the mediastinal lymphadenopathy were 4R, 2R of the pulmonary tuberculosis cases and 4R, 10R of the primary lung cancer cases. In the feature of post enhanced lymph nodes, homogenous increased density was more frequent in primary lung cancer. Measurements of the maximum thickness part of the cavity wall was not a reliable indication of malignancy.
Carcinoma, Bronchogenic ; Diagnosis* ; Diagnosis, Differential ; Humans ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Lymphatic Diseases ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary*

PURPOSE: To report a case of epidemic keratoconjunctivitis complicated by Alcaligenes xylosoxidans. METHODS: A 37-year-old man suffered epidemic keratoconjunctivitis in both eyes. Eleven days later, he developed a corneal ulcer in his left eye. Bacterial staining, culture, and antibiotics sensitivity test were performed from a corneal scrape. RESULTS: The cultures revealed a growth of Alcaligenes xylosoxidans, and the patient was treated with ceftazidime and levofloxacin, based on the sensitivity test results. After 21 days of treatment, the infection was resolved with mild scaring and final vision in the left eye of 20/20. CONCLUSIONS: Alcaligenes xylosoxidans should be considered a rare but potential pathogen able to produce corneal ulcer complication in epidemic keratoconjunctivitis.
Male ; Keratoconjunctivitis/*complications/pathology ; Humans ; Gram-Negative Bacterial Infections/*complications/pathology ; Corneal Ulcer/*microbiology/pathology ; Adult ; *Achromobacter denitrificans

Leiomyoma is rare. Most of patients present with urinary tract infection, hematuria, dyspareunia, or complaint of mass. A case of leiomyoma on urethrovaginal septum in a 36 years old female was presented. The presenting symptom was a protruding mass at the anterior vaginal wall The mass was removed surgically and confirmed as a leiomyoma pathologically.
Adult ; Dyspareunia ; Female ; Hematuria ; Humans ; Leiomyoma* ; Urinary Tract Infections

A new technical method using bone plugs with oblique posterior interbody fusion(OPIF) was designed to increase the fusion rate. One hundred-seventy-five patients were operated for lumbar instability between November 1990 and December 2000. The L5/S1 segment was affected in 129 cases(74%) of the patients. Oblique posteior interbody fusion with bone plugs by unilateral approach was performed in all patients. Eight-nine percent of these patients showed good surgical results. This stable transplant interbody fusion has the several advantages. Foreign substance is not used and this method increases fusion rate and cost-effective. OPIF using bone plugs along with Oh's screw could provide sufficient stability for segmental instability of the lumbar spine including spondylolisthesis of the lumbar spine, with or without concurrent herniated intervertebral disc or spondylotic narrowing.
Humans ; Intervertebral Disc ; Spine ; Spondylolisthesis

We studied two intraabdominal desmoplastic small cell tumors. The patients were two men, 37 and 23 years old, with jaundice and palpable abdominal masses. On exploratory laparotomy, each patient revealed a huge mass in the greater omentum with disseminated peritoneal seeding, measuring 32 cm and 11 cm in its greatest dimension, respectively. The tumor involved the diaphragm, rectal shelf, and cul de sac in case 1, and it involved the porta hepatis, retroperitoneum, and serosal surface of the ascending and transverse colon in case 2. Omentectomy of the huge mass and satellite masses was performed in each patient. Both tumors showed nearly the same histopathologic features. The histologic pattern was suggestive of a metastatic small cell carcinoma, but there was no specific, single primary site. The tumors consisted of variably sized, discrete islands of epithelial-like small cells in dense desmoplastic stroma. The tumor cells revealed divergent epithelial, mesenchymal, and neural differentiation by histologic, immunohistochemical, and electron microscopic observations. Only one cycle of chemotherapy including cisplatin and VP-16 was given in case 1 because of a subsequent hepatic problem, who, thereafter, showed massive intraabdominal recurrent tumors 6 months after diagnosis. In case 2, the poor condition of the patient had made chemotherapy and radiotherapy impossible. Case 2 died of disseminated intravascular coagulation following progressive cachexia 7 months after diagnosis.
Neoplasm Metastasis