No abstract available.
Hemolytic-Uremic Syndrome*

BACKGROUND: The measurement of carbon monoxide concentration in expired air is used as an objective method to analyze the smoking status. This method has been proven to be reliable and is used throughout the world but it has been only recently accepted in Korea. Therefore the purpose of this study was to examine if measuring the concentration in expired air accurately reflects the Korean's smoking status. METHODS: The subjects were from ages of 19 through 75 healthy people including smokers and nonsmokers. The smokers had their carbon monoxide measured after answering a questionnaire. This questionnaire was formed to obtain information concerning smoking status, smoking habit and factors that influence carbon monoxide measurement. Micro II smokerlyzer (Bedfont Instruments Ltd., England) was used to analyze CO concentration in expired air. The method used for measuring CO concentration was to deeply inhale and hold one's breath for 15 seconds and measure CO concentration while exhaling. RESULTS: The total number of subjects was 148(143 males, 5 females) consisting of 114 smokers, 34 non smokers(never smokers 23, ex smokers 11). The average CO concentration in exhaled air in smokers was 17.247.30 ppm, in nonsmokers 6.031.06 ppm(in ex smokers 6.361.29 ppm, in never smokers 5.870.92 ppm). A significant difference was evident between smokers and non smokers(P<0.0001). The CO concentration values compared among the groups divided in terms of daily smoking rate were as the following 11.885.57 ppm in subjects smoking less than 10 cigarettes/day, 17.356.48 ppm in those smoking 11 20 cigarettes/day, 20.006.35 ppm in the 21 30 cigarettes/day group, and 24.889.70 ppm in the 31 cigarettes/day group (p<0.0001). In addition, the CO concentration was influenced by the change of the degree of inhalation and the elapsed time since last smoking. CONCLUSION: The measurement of CO concentration in exhaled air among the Koreans proved to be an accurate and reliable method reflecting the present smoking status.
Carbon Monoxide* ; Carbon* ; Exhalation ; Humans ; Inhalation ; Korea ; Male ; Smoke* ; Smoking* ; Surveys and Questionnaires

Marchiafava-Bignami disease (MBD) is characterized by cerebral white matter lesions associated with chronic alcoholism. Premortem diagnosis of MBD is usually based on history and clinical manifestations. We report a case of acute MBD in which diffusion-weighted MRI (DWI) showed high signal intensities along the white matter including the corpus callosum. DWI may be useful in premortem diagnosis of acute MBD.
Alcoholism ; Corpus Callosum ; Diffusion ; Diffusion Magnetic Resonance Imaging ; Humans ; Leukoencephalopathies ; Marchiafava-Bignami Disease

BACKGROUND: Conventional visual assessment of coronary arteriogram is fraught with large interobserver variance and disagreement with pathologic findings. Thus quantitative coronary angiography had been recently developed to meet the requirement of more reproducible measurement of severity of coronary artery disease. This study was designed to evaluate the interobserver variability of quantitative coronary angiography and its usefulness in clinical application. METHODS: Three independent observers analysed coronary angiogram of 31 consecutive patients by visual assessment and quantitative measurement using computer based algorithm. RESULTS: 1) There was considerable disagreement between 3 observers in the identification of significant coronary stenosis. Complete agreement was achieved in only 29/61 (47%) coronary lesion and agreement of more than 2 observers in 41/61(67%) lesion. 2) In visual assessment, the largest interobserver variance was found in acute marginal artery and distal circumflex artery, whereas the least variance was observed in proximal right coronary artery. 3) The average interobserver variance was 13.1% in visual assessment, 14.9% in geometric analysis, and 10.5% in video densitometric analysis. There was no significant difference between these values. 4) Visual assessment was noted to overestimate the severity of stenotic lesion, by 5.6% compared to geometric analysis and by 11.8% compared to video-densitometric analysis. CONCLUSION: These findings suggest that identifying significant lesion is major source of interobserve variability in both visual and quantitative analysis of coronary arteriogram. In addition, suboptimal image quality was responsible for the inability of quantitative analysis to reduce the variance. These factors seem to be major limitation of quantitative coronary arterirogam.
Arteries ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels ; Humans ; Observer Variation*

Acromegaly and hyperprolactinemia have been described in association with polyostotic fibrous dysplasia. The pathogenic mechanisms of this endocrinopathy are not clear. We experienced a 19-year-old male with hypersecretion of GH, hyperprolactinemia and fibrous dysplasia. He was referred for evaluation of suspected acromegaly. He had no skin pigmentation. Plasma GH, PRL, somatomedin-C, LH, FSH, testosterone, estradiol, progesterone, T3, T4, TSH and cortisol were measured. Among those, the levels of plasma GH, PRL and somatomedin-C were high. Serum alkaline phosphatase was increased. OGTT did not suppress plasma OH concentration and GH showed paradoxical response to TRH and LHRH. GH was suppressed after a test-dose of somatastatin and bromocriptine. Brain MRI demonstrated a mass lesion in sella turcica and another mass lesions in nasal cavity and posterior occipital bone. Whole body bone scan revealed increased uptake in skull, nasal bone, both 9th posterior rib, both femurs, both tibias, left scapular and pelvic bone. These fmdings were consistent with bone tumor such as fibrous dysplasia. We report a case with incomplete MeCune-Albright syndrome including acromegaly, hyperprolactinemia and polyostotic fibrous dysplasia.
Acromegaly ; Alkaline Phosphatase ; Brain ; Bromocriptine ; Estradiol ; Femur ; Fibrous Dysplasia, Polyostotic ; Glucose Tolerance Test ; Gonadotropin-Releasing Hormone ; Humans ; Hydrocortisone ; Hyperprolactinemia ; Magnetic Resonance Imaging ; Male ; Nasal Bone ; Nasal Cavity ; Occipital Bone ; Pelvic Bones ; Plasma ; Progesterone ; Ribs ; Sella Turcica ; Skin Pigmentation ; Skull ; Testosterone ; Tibia ; Young Adult

PURPOSE: Currently, there are many developmental tests of scale and screening for infants and children. However, it has been questioned about the discriminating power and the correlation among developmental tests of scale and screening. So we comprared the Bayley Scales of Infant Development-II(BSID-II) and Korean Infant and Child Developmental Test(KICDT) in terms of correlations and agreement. METHODS: Seventy two infants were studied, who visited the pediatric outpatient clinic at Cheonan Soonchunhyang University Hospital between December 2002 and September 2003. They were classified into three groups, group A of 24 full term infants, group B of 24 preterm infants, and group C of 24 disabled full term infants. We performed both tests to the all infants. RESULTS: The mean scores of mental and psychomotor developmental indices of BSID-II of group A were higher than those of group B and group C, which was statistically significant. Also, the mean scores of personal-social, language and cognitive- adaptive fields of KICDT of group A were much higher than those of group B and group C. The correlation coefficients between BSID-II and KICDT were high in many indices. The kappa coefficient by Cohen between BSID-II and KICDT is 0.45(0.24-0.66). CONCLUSION: There was a reasonable corrrelation between BSID-II and Korean infant and child developmental test in infants younger than 12 months. The kappa coefficient by Cohen between BSID-II and KICDT is not so good in this study. Further study is needed to standardize the items of KICDT.
Ambulatory Care Facilities ; Child ; Child Development* ; Child* ; Chungcheongnam-do ; Humans ; Infant* ; Infant, Newborn ; Infant, Premature ; Mass Screening ; Weights and Measures*

BACKGROUND AND OBJECTIVES: This study was undertaken to evaluate the effect of superior cervical ganglionectomy (SCG) on anosmia, which is peripherally induced in the mice. MATERIALS AND METHOD: Three groups of mice (BCF1) were studied: normal control (nasal instillation of saline, n=6); zinc sulfate group (nasal instillation of 64 mM zinc sulfate, n=25); SCG group (superior cervical ganglionectomy after nasal instillation of 64 mM zinc sulfate, n=25). Tissues of olfactory mucosa were obtained at 1, 2, 3, 4 and 7 weeks after instillation of zinc sulfate, and processed for immunohistochemistry using antisera to olfactory marker protein (OMP) to evaluate the olfactory regeneration. RESULTS: No OMP-positive cells were observed in the first two weeks after the instillation of zinc sulfate in both zinc sulfate group and the SCG group. However, the OMP-positive cells appeared first at 3 weeks after the instillation in both groups, and gradually increased in number at 4 and 7 weeks. In the SCG group, the increase of OMP-positive cells was significantly greater than those of the zinc sulfate group. The number of OMP-positive cells in the SCG group at 7 weeks was almost similar to that of the normal control group. CONCLUSION: SCG enhances regeneration of olfactory receptor cells at 3 weeks after injury. It was inferred from the above results that SCG has a significant effect on the regeneration of olfactory receptor cells and we suggest that SCG could be an effective treatment modality for olfactory dysfunction.
Animals ; Autonomic Nerve Block ; Ganglionectomy* ; Immune Sera ; Immunohistochemistry ; Mice* ; Olfaction Disorders ; Olfactory Marker Protein ; Olfactory Mucosa ; Olfactory Receptor Neurons ; Regeneration ; Smell* ; Zinc Sulfate

PURPOSE: The purpose of this study is to evaluate the usefulness of computed tomography (CT) for spiral tibia shaft fracture by analyzing associated distal tibia intra-articular fractures diagnosed by CT only which met the indication of surgical fixation and were fixed. MATERIALS AND METHODS: Ninety-five spiral tibia shaft fractures with preoperative ankle plain radiographs and CT were analyzed retrospectively. The incidence and type of associated distal tibia articular fractures were evaluated by reviewing ankle plain radiography and CT. The number of fractures diagnosed by CT that correspond with the indication of fixation and that were actually fixed were analyzed. RESULTS: Among 95 spiral tibia shaft fractures, 62 cases (65.3%) were associated with distal tibia intra-articular fracture. There were 37 cases of posterior malleolar fracture, 5 cases of avulsion fracture of the distal anterior tibiofibular ligament, 5 cases of medial malleolar fracture, and 15 cases of complex fracture. Among 52 posterior malleolar fractures including complex fracture, 20 cases were diagnosed by ankle plain radiograph. Of these 20 cases, 16 posterior malleolar fractures (80.0%) met the indication of surgical fixation, and 14 cases were actually fixed with a screw. Among 32 posterior malleolar fractures diagnosed by CT only, 26 cases (81.3%) met the indication of surgical fixation and 18 cases (56.3%) were fixed by screw. CONCLUSION: Approximately 50% of associated fractures were diagnosed by CT only and more than 80% of associated posterior malleolar fractures met the indication of surgical fixation and among these fractures, 18 cases (56.3%) were actually fixed by screw. This result suggests that CT is useful in diagnosis and treatment of distal tibia intra-articular fracture associated with spiral tibia shaft fracture.
Ankle ; Ankle Fractures ; Diagnosis ; Incidence ; Intra-Articular Fractures* ; Ligaments ; Radiography ; Retrospective Studies ; Tibia*

PURPOSE: We wanted to clinically evaluate the antibiotic therapy used from pre- to postlaparoscopic cholecystectomy along with the improved surgical techniques and instruments and the patient nutrition. METHODS: We prospective studied 105 patients who were treated with laparoscopic cholecystectomy for acute and chronic cholecystitis at Busan St. Mary Hospital from March 2007 to January 2008. The two groups were divided as follows: (A) the group was not injected with antibiotics, and the other group (B) was injected with antibiotics. We did not used antibiotics when the patient had no acute aggravating symptoms, and we exclude the patients with old age (<70 years), a past history of diabetes mellitus (DM) or hypertension (HTN), and a past operation history. RESULTS: Between the two group, there was no difference when they were compared for age, BMI (Body Mass Index), the operation time (minute) and the length of the hospital stay: (A) Group 49.3+/-13.0 years, 24.4+/-3.2 kg/m2, 37.9 +/- 10.0 minute and 4.6 +/- 1.3 days, respectively, and (B) Group 55.9+/-15.6 years, 23.5+/-3.5 kg/m2, 43.2 +/- 23.8 minute and 5.5 +/- 2.5 days, respectively. There was a significant different in the leukocyte count and the % of neutrophils: (A) Group 6396microliter(-1) and 53.4%, respectively and (B) Group 9354microliter(-1) and 66.6%, respectively. In (B) group, there were 2 cases of atrial fibrillation, 1 case of diarrhea and 1 case of wound seroma. There were no surgical related complications in group (A). CONCLUSION: For the well nourished chronic cholecystitis patients, the use of the prophylatic antibiotics may be less effective because of the many drug-induced side effects. More studies about the use of prophylactic antibiotics are needed.
Anti-Bacterial Agents ; Atrial Fibrillation ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Diabetes Mellitus ; Diarrhea ; Humans ; Hypertension ; Leukocyte Count ; Prospective Studies ; Seroma

Chronic granulomatous disease(CGD) is a rare inherited disorder of phagocytic cells which results in a susceptibility to infections by catalase-positive bacteria and fungi, as well as granuloma formation. And acute poststreptococcal glomerulonephritis(APSGN) is one of the most common glomerular lesions of gross hematuria in children. We experienced a case of APSGN accompanied with CGD presenting with a liver granuloma.
Bacteria ; Child ; Fungi ; Glomerulonephritis* ; Granuloma ; Granulomatous Disease, Chronic* ; Hematuria ; Humans ; Liver ; Phagocytes