Brucellosis is a zoonosis caused by several species of Brucella. Brucellosis is usually an acute or sub-acute febrile illness that histologically develops granulomatous inflammation. Brucella prostatitis is a very rare complication and is usually accompanied by epididymo-orchitis. We now report a case of histologically proven granulomatous prostatitis due to Brucella without clinical evidence of epididymo-orchitis. A 61-year-old farmer presented with myalgia, low back pain, and fever. A needle biopsy of the prostate was performed due to symptoms of urinary frequency and high prostate specific antigen levels (17.3 ng/mL). Histologically, the prostate showed granulomatous inflammation without caseous necrosis. Polymerase chain reaction (PCR) studies of blood and prostatic tissue for Brucella were positive, while a PCR study for Mycobacterium tuberculosis was negative. The patient was treated with doxycycline and rifampin. A possibility of Brucella prostatitis should be considered in the differential diagnosis of granulomatous prostatitis or prostatitis of unknown origin associated with or without epididymo-orchitis.
Biopsy, Needle ; Brucella ; Brucellosis ; Diagnosis, Differential ; Doxycycline ; Fever ; Granuloma ; Humans ; Inflammation ; Korea ; Low Back Pain ; Middle Aged ; Mycobacterium tuberculosis ; Necrosis ; Polymerase Chain Reaction ; Prostate ; Prostate-Specific Antigen ; Prostatitis ; Rifampin

Measurements of mitral flow velocity by pulsed Doppler echocardiography are very useful in evaluating left ventricular diastolic filling properties. In hypertensive patients, abnormalities of diastolic function may precede systolic abnormalities and may serve as a more sensitive marker of end organ damage. We estimated left ventricular nass by 2-D echo short axis area-length method and compared with peak mitral flow velocity in early diastole(PFVE)and during atrial systolic(PFVA). There was a significant increase of LV mass and LV mass indices in the hypertensive patients and PFVE/PFVA ratio was decreased in them. Aithough there was no relationship between blood pressure and PFVE/PFVA ratio, a significant relationship was demonstrated between LV mass index and PFVE/PFVA ratio in the hypertensive patients.
Axis, Cervical Vertebra ; Blood Pressure ; Echocardiography, Doppler, Pulsed ; Humans

Early and longterm prognosis depended on the extents of acute myocardial infarction and residual myocardial function. Many clinical methods have been evaluated to determine their ability to estimate the size of myocardial infarcts. But because of many disadvantages simplified QRS scoring system, used with standard 12-lead EKG, was developed, which is noninvasive, inexpensive and easily releatible. Therefore, the correlation between QRS and peak CK,killip classification were evaluated in 55 patients with initial acute myocardial infarction at the Chung-Ang University, Yong-San and Pil-Dong Hospital during the period from January 1983 to December, 1986. The results were as follows : 1) The average QRS score of the anterior wall infarction is 7.1 and that of the inferior wall infarction is 4.5 and there is a statistical significance(p<0.01). 2) In the acute myocardial infarction, the correlation coefficeient between the QRS score and the killip classification is 0.66(p<0.05). 3) In the acute myocardial infarction, the average QRS score is 6.3 and the correlation coefficient between the leak CK and the QRS score is 0.52(p<0.05). 4) In the anterior wall infarction, the average QRS score is 7.1 and the correlation coefficient between the peak Ck and QRS score is 0.48(p<0.05). 5) In the inferior wall infarction, the average QRS score is a 4.5 and the correlation coefficient between the leak CK and QRS score is 0.79(p<0.05).
Classification ; Electrocardiography ; Humans ; Infarction ; Myocardial Infarction* ; Prognosis

The fundamental alterations in the cardiovascular system that occur consequent to aging are of great pratical importnace to clinicians. Senescent cardic muscle has many features of prolonged tension development, impaired relaxation and diminished response to receptor-mediated inotropic interactions. We estimated left ventricular mass by 2-D echo area-length method using a high quality planimeter. Age-related increments in left ventricular mass demostrated, but left ventricular enddiastolic cavity volumes were unaffected by age. The increase in left ventricular mass observed with aging is typical of pressuer-overload hypertrophy and its stimulus may be increased afterload from senescent changes.
Aging* ; Cardiovascular System ; Hypertrophy ; Relaxation

BACKGROUND: In Korea, cerebrovascular accident (CVA) is the most significant cause of death among older people, and the incidence of cerebral hemorrhage is much higher than that of developed countries. There have been many investigations about the risk factors for CVA in both Korea as well as developed countries. A few papers reported various risk factors for cerebral hemorrhage in developed countries:however, well-designed studies of risk factors for the various causes of CVA were rare in Korea. Therefore, the purpose of this study was to compare the risk factors for the various causes of CVA and to evaluate the risk factors compared with age- and sex-matched control groups. In addition, duplex sonographic findings of the carotid artery were evaluated in patients with cerebral infarction. METHODS: One hundred and sixty-four patients admitted to the hospital in 1996 were enrolled. The four groups were divided based on the following states: cerebral infarction (n-63), cerebral hemorrhage (n-64), cerebral infarction with atrial fibrillation (n-19), and lacunar infarction (n-18). Major risk factors were compared with age- and sex-matched control groups and among CVA groups. Duplex sonography of the carotid artery was done in 14 patients with cerebral infarction. RESULTS: In multiple logistic regression analysis, patients with cerebral infarction had higher prevalence of diabetes mellitus and lower high density lipoprotein-cholesterol level than the control group, and hypertension showed borderline significance. Patients with cerebral hemorrhage had higher prevalence of hypertension, higher high density lipoprotein-cholesterol level, and more frequent prevalence of smoking compared with the control group. Patients with cerebral infarction showed lower high density lipoprotein-cholesterol, higher low density lipoprotein-cholesterol levels, more frequent diabetes mellitus, lower prevalence of hypertension and older age than patients with cerebral hemorrhage. Patients with cerebral infarction and atrial fibrillation showed only older age than patients with cerebral infarction only. There were no differences in risk factors between patients with cerebral infarction and lacuna infarction. Atheromatous plaque was found in 71% of patients with cerebral infarction. CONCLUSION: Metabolic abnormalities played more important role in the development of cerebral infarction and hemodynamic abnormalities in cerebral infarction. Sonographic examination of the carotid artery may be useful for predicting the occurrence of cerebrovascular accident in high risk patients.
Atrial Fibrillation ; Carotid Arteries* ; Cause of Death ; Cerebral Hemorrhage ; Cerebral Infarction* ; Developed Countries ; Diabetes Mellitus ; Hemodynamics ; Humans ; Hypertension ; Incidence ; Infarction ; Korea ; Logistic Models ; Prevalence ; Risk Factors* ; Smoke ; Smoking ; Stroke ; Stroke, Lacunar ; Ultrasonography*

This study was performed to evaluate the effect of bone graft materials including demineralized freeze-dried bone, freeze-dried bone, deproteinized bovine bone on space-making capacity and bone formation in guided bone regeneration with titanium reinforced ePTFE membrane(TR-ePTFE). Adult male rabbits(mean BW 2kg) were used in this study. Intramarrow penetration defects were surgically created with round bur on calvaria of rabbits. TR-ePTFE membrane was adapted to calvarial defect and bone graft materials were placed. Animals were sacrificed at 2, 8, 12 weeks after surgery. Non-decalcified specimens were processed for histologic analysis and prepared with Villaneuva bone stain. The results of this study were as follows: 1. TR-ePTFE membrane was biocompatible and capable of maintaining the space-making. 2. Tissue integration was not good at TR-ePTFE membrane. Fixation was not enough. so, wound stabilization was not good. 3. In animals using deproteinized bovine bone, demineralized freeze-dried bone, bone formation was little. 4. In animals using freeze-dried bone, bone formation was better. Within the above results, bone formation may be inhibited when wound stabilizafion was not good.
Adult ; Male ; Female ; Humans ; Rabbits ; Animals

BACKGROUND: Midazolam is often used as an anxiolytic premedication before surgery, but it is difficult and complex to assess its effect. This study evaluated the bispectral index as an objective indicator of midazolam premedication and the relation of cardiovascular response to anesthetic induction. METHODS: Forty patients (aged 20 to 60 and in ASA class I or II) to undergo simple elective surgery under general anesthesia entered the study. The patients were divided into the midazolam group (n = 20) that received midazolam (0.08 mg/kg IM) and glycopyrrolate (0.2 mg IM) premedication, and the control group (n = 20) that received glycopyrrolate (0.2 mg IM) only. Then, anesthetic induction (fentanyl 1 microgram/kg, propofol 2 mg/kg, succinylcholine 1 mg/kg) was done. The bispectral index of the electroencephalogram, blood pressure, and heart rate were measured under unanesthetized conditions, after fentanyl, propofol injection, and intubation. RESULTS: The bispectral index was significantly lower in the midazolam group as compared with the control group before anesthetic induction, after fentanyl injection, and intubation. Blood pressure was not significantly different in the two groups. Heart rate was significantly lower in the midazolam group compared with the control group before anesthetic induction and after fentanyl injection. CONCLUSIONS: Midazolam-premedicated patients appear to maintain stable hemodynamics during anesthetic induction and intubation. The bispectral index can be objectively used in midazolam-premedicated patients when evaluating the degree of sedation. (Korean J Anesthesiol 2000; 38: 947~953)
Anesthesia, General ; Blood Pressure ; Electroencephalography ; Fentanyl ; Glycopyrrolate ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Midazolam* ; Premedication* ; Propofol ; Succinylcholine

Endoscopic endoprosthesis is well established as a cheap, fast and durable procedure for palliation of malignant dysphagia. But the placement of conventional endoprosthesis is difficult and is associated with significant complications such as hemorrhage, perforation and dysfunction of the prosthesis. Recently, self -expand- able metal prosthesis have also been utilized for malignant esophageal stenosis, and palliation of this modality seems to be more effective than other modalities. However the main problems with these metal stents are tumor ingrowth leading to reobstruction, migration, and eophageal trauma by the distal, hard skirt of the stent. EsophaCoil stent is a simple coil with close loops made from a single flat wire of nickel titanium alloy. The radial force of this material is much stronger than stainless steel, expansion time is faster and the stent is able to dilate even extremely resistant strictures. This new metalic stent seems to have several advantages over the current commnerically available ones. We report our experiences with this EsophaCoil stent and review of literature.
Alloys ; Constriction, Pathologic ; Deglutition Disorders ; Esophageal Stenosis* ; Hemorrhage ; Nickel ; Prostheses and Implants* ; Stainless Steel ; Stents ; Titanium

We report our experience in five patients with malignant obstructive jaundice with a new self expandable metallic stent, a coil spring made from nickel-titanium alloy. Endoscopic biliary drainage(EBD) is a safe and effective noninvasive biliary drainage method and is indicated with malignant obstructive jaundice. In order to avoid being limited by the size of the instrumentation channel of the endoscope, expandable stents have been developed. The main problems with these expandable metal stents are tumor ingrowth leading to reobstruction, migration of the stent from its original position, and epithelial trauma by the distal hard edges of the stent. The new super-elastic metallic coil stent which has a very strong radial force (EndoCoil'" stent, Instent Co.) was developed to solve the above mentioned problems. The stent which is constricted over an introducing catheter is inserted by transduodenal approach. It expands spontaneously after release to its original 8 mm diameter. During the last 6.5 rnonths, 5 stents were inserted in patients with cholangiocarcinoma, pancreatic carcinoma and cancer of the ampulla of Vater to releave jaundice. Clinical improvement was achieved in all the patients except in one who died from multiple organ metastasis. After a mean follow-up of 6 month., patients had no evidence of biliary reobstruction. Although follow-up is short, these results are encouraging, and this new metallic stent seems to have several advantages over the current commercially available ones.
Alloys ; Ampulla of Vater ; Catheters ; Cholangiocarcinoma ; Drainage ; Endoscopes ; Follow-Up Studies ; Humans ; Jaundice ; Jaundice, Obstructive* ; Neoplasm Metastasis ; Stents*

Trichuriasis is an intestinal infection of human beings caused by Trichuris trichiura, more commonly known as whipworm because of its whip-like appearance. It is characterized by the invasion of the colonic mucosa by the adult trichuris. It is prevalent throughout the world, especially in tropical areas. Diagnosis is made typically by the identification of characteristic barrel-shaped eggs in the feces, although adult worms may be seen rarely at sigmoidoscopy or colonoscopy. We report five cases of whipworm infection that was diagnosed on colonoscopic examination.
Adult ; Colon ; Colonoscopy ; Diagnosis* ; Eggs ; Feces ; Humans ; Mucous Membrane ; Ovum ; Sigmoidoscopy ; Trichuriasis ; Trichuris