Brucellosis is not a rare disease, although it has not been reported recently in Korea. Spondylitis is the most prevalent and important clinical form of osteoarticular involvement in adults infected by Brucella. Concerning brucellosis, clinical diagnosis of brucellosis starts with a suspicion of the disease. Vertebral body signal changes without destructive changes, marked signal increase in the intervertebral disc on T2-weighted and contrast-enhanced sequences, soft tissue involvement without abscess formation and facet joint involvement, can be distinguishing magnetic resonance imaging(MRI) features of brucellar spondylitis. Tuberculous spondylitis, metastasis, spinal degenerative diseases, and postoperative changes Should be differentiated. We report upon the first case of brucellar spondylodiscitis in a Korean, and present review of the literature.
Abscess ; Adult ; Brucella ; Brucellosis ; Diagnosis ; Discitis* ; Humans ; Intervertebral Disc ; Korea ; Neoplasm Metastasis ; Rare Diseases ; Spondylitis ; Zygapophyseal Joint

No abstract available.
Cyclotrons*

OBJECTIVES: To confirm the HAVS in workers exposed to hand-arm vibration with using the objective diagnostic methods METHODS: Several tests were used to help substantiate a clinical diagnosis of HAVS. Some other diseases were excluded by a medical interview, hematologic assessment, urinalysis, X-rays. The hand-arm vibration acceleration level of the grinder was evaluated for considering HAVS. Peripheral vascular changes were examined by a cold provocation test. An electromyography was implemented to ascertain the peripheral neural changes. RESULTS: 8 workers with symptoms in hands & fingers, exposed to hand-arm vibration were examined. Some other diseases(primary Raynauds disease, secondary Raynauds disease in not occupational origin) were excluded by a medical interview, hematologic assessment, urinalysis, X-rays. The hand-arm vibration acceleration level of the grinder was 7. 9 m/sec2. The recovery time of a skin temperature followed finger cooling was significantly prolonged in 6 workers with HAVS. The nerve conduction velocity was reduced in 6 workers with HAVS. CONCLUSIONS: So we report 6 cases of HAVS in grinding workers exposed to hand-arm vibration diagnosed objectively by an exclusion of some other disease, handarm vibration acceleration level, cold provocation test, electromyography.
Acceleration ; Diagnosis ; Electromyography ; Fingers ; Hand* ; Hand-Arm Vibration Syndrome* ; Neural Conduction ; Raynaud Disease ; Skin Temperature ; Urinalysis ; Vibration*

No abstract available.
Brain Stem* ; Classification* ; Hemorrhage*

No abstract available.
Muscle, Smooth* ; Smooth Muscle Tumor*

No abstract available.

A new angiotensin converting enzyme inhibitor, enalapril, was administered in 20 hypertensive patients (7 mild, 6 moderate and 7 severe hypertensives) for 8 weeks or longer in order to see the blood pressure lowering effects. Additionally the left ventricular mass index was measured by 2-D guided M-mode echocardiography before and after enalapril therapy, and subjective symptoms and laboratory findings were also followed. The results were as follows: 1) After 8 weeks of enalapril treatment (the doses form 10 mg to 20mg once a day) blood pressure were lowered markedly in 10, moderately in 4, mildly in 4 cases, but the blood pressures were not lowered in 2 cases with severe hypertension. The means of the blood pressures of the group were lowered form 182.1+/-19.2 to 148.0+/-26.0mmHg in systolic and from 111.9+/-14.7 to 95.1+/-17.1mmHg in diastolic after 8 weeks of treatment (p<0.001). 2) Heart rates were not changed significantly with enalapril. 3) The symptoms of insomnia and headache were reported to be improved after enalapril in 13 cases. 4) No discernable changes in CBC and serum level of creatinine were observed. But the random urine protein was decreased in 6 cases with proteinuria in routine urinalysis. The serum lipid profile was not significantly changed, but in the 2 cases in which the ratio of total to HDL-cholesterol was above 5.0, the ratio fell to below 5.0. 5) There was no significant EKG change after enalapril. 6) In 9 cases out of 13 cases with the left ventricular mass index (LVMI) above 125g/m2 BSA, LVMI was followed by echocardiography after enalapril. LVMI was significantly decreased in 8 of 9 cases and mean values after enalapril was decreased from 183.1+/-88.0g/m2 BSA to 150.8+/-61.3g/m2 BSA (p<0.0025). 7) Side effects after enalapril administration were transient dizziness in 4 cases and ageusia in 2 cases. Above results suggest that the enalapril could be an initial choice in the treatment of essential hypertension as a single oral agent in once a day regimen resulting in good antihypertensive effects, improvement of subjective symptoms, regreassion of the left ventricular hypertrophy and few side effects.
Ageusia ; Blood Pressure ; Creatinine ; Dizziness ; Echocardiography ; Electrocardiography ; Enalapril* ; Headache ; Heart Rate ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Peptidyl-Dipeptidase A ; Proteinuria ; Sleep Initiation and Maintenance Disorders ; Urinalysis

BACKGROUND: The coronary collateral circulation has been frequently observed in significant coronary artery disease and its protective role in ischemic myocardium is still remained unclear. But the study on the anti-ischemic effect in human model of ischemic myocardium is rare. METHODS: To observe the anti-ischemic role of coronary collateral circulation in ischemic myocardium, perfusion defect areas were measured during PTCA(percutaneous transluminal coronary angioplasty) in angina patients with single vessel disease and analyzed according to the grade of collateral circulation. The 99mTc-MIBI myocardial scanning images were obtained at 24 hours before PTCA with dipyridamole stress, at ballooning during PTCA and at 24 hours after the opening of the artery and perfusion defect volume ratios(DVR) were measured in each of the images of the patient with angina and single vessel disease. RESULTS: 1) Studied subjects were 14 patients(10 male, 4 female, mean age : 56.6+/-103) and subdivided into two groups. All patients had angina with single vessel disease, 7 proximal left anterior descending artery(LAD) stenosis, 4 middle LAD stenosis, 1 middle right coronary artery(RCA) stenosis and 2 proximal left circumflex artery(LCX) stenosis. Group A was composed of 7 patients with angina and coronary collateral circulation more than grade 1. Group B was 7 patients with angina and grade 0 collateral. 2) Mean age of group A was 62.4+/-8.2 years, 5 male and 2 female patients, That of group B was 56.6+/-8.9 years and all male patients. Group A was composed of 7 patients ; 5 unstable and 2 stable angina ; 2 proximal LAD stenosis, 3 midddle LAD stenosis, 1 middle RCA stenosis and 1 proximal LCX stenosis. One patients had grade 1, two patients grade 2 and four patients grade 3 coronary collateral circulation. All of the patients were unstable angina in group B showing 5 proximal LAD stenosis, 1 middle RCA stenosis and 1 proximal LCX stenosis. No collateral circulation was demonstrated in group B. 3) In group A, DVR was 17.5+/-13.9% on stress image before PTCA and 7.1+/-1.4% on the ballooning image during PTCA. DVR was smaller in ballooning image than in stress image(p<0.01). 4) In group B, DVR was 12.4+/-16.0% on stress image before PTCA and 26.6+/-10.0% on ballooning image during PTCA. DVR was larger in ballooning image than in stress image(p<0.001). 5) DVR on stress image and open image were not different in both groups, but DVR on ballooning image were 7.1+/-4.7% in group A and 26.6+/-10.0% in group B, which was larger than in group A(p<0.01). CONCLUSION: These results suggest that myocardial perfusion defect area may be smaller in angina patients with good collateral circulation than patients with no collateral, and coronary collateral circulation have a protective role on the jeopardized myocardium during coronary artery occlusion.
Angina Pectoris* ; Angina, Stable ; Angina, Unstable ; Arteries ; Collateral Circulation* ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Vessels ; Dipyridamole ; Female ; Humans ; Male ; Myocardium ; Perfusion*

42 patients with mitral stenosis(MS), diagnosed by M-mode, 2-D sector scan and pulsed Doppler echocardiography, were evaluated. Among them 28 patients were complicated with atrial fibrillation and one foruth was normal sinus rhythm. Pulsed Doppler echocardiographic left ventricular inflow velocity patterns(PELVIVP) were compaired with the EF slop of anterior mitral valve leaflet. The results were as follows; The normal PELVIVP showed a biphasic pattern during diastole. PEVIVP in MS were classified into 5 types and measured EF slop of anterior mitral valve leaflet in each type. Type I was characterized by a biphasic flow pattern showing a relative increase in the atrial contraction wave compared with the rapid filling wave and the prolonged deceleration time. EF slop was 24.7+/-6.1mm/sec. Type II was turbulent scaphoid pattern during diastole. EF slop was 14.5+/-4.4mm/sec. Type IIIa was monophasic with gradual descending slop during diastole. EF slop was 16.9+/-4.0mm/sec. Type IIIb was also turblent monophasic with gradual ascending slop during diastole. EF slop was 8.1+/-2.3mm/sec. Type IV was diastolic turblent and was characterized by dome shaped pattern. EF slop was 7.9+/-1.9mm/sec. There was a significant correlation between the 3 groups(I, II and IIIa, IIIb and IV) of LVIVP in MS and EF slop(P<0.005). This result indicated that type I of the flow pattern was well observed in mild MS, type II and IIIa in moderate MS, and type IIIb and IV in severe MS. Pulsed Doppler flow pattern in MS was alterable in the atrial fibrillation.
Atrial Fibrillation ; Deceleration ; Diastole ; Echocardiography* ; Echocardiography, Doppler, Pulsed ; Humans ; Mitral Valve ; Mitral Valve Stenosis*

For the evaluation of the left ventricular diastolic function in mild to moderate hypertensive patients without left ventricular hypertrophy, 15 hypertensive patients (group A) and 15 normotensive subjects (group B) were examined by 2-D guided M-mode echocardiography. Various systolic and diastolic indices were derived from computer-assissted analysis of differential curves of left ventricular dimension and posterior wall thickness. The systolic and diastolic function indices of each of the two groups were compared. The results were as follows : 1) There were no significant differences in ejection fraction, left ventricular peak ejection rate and posterior wall thickening rate between two groups. 2) There were no significant differences in % ventricular A wave, left ventricular peak filling rate and posterior wall peak relaxation rate between two groups. 3) One third filling rate was 2.07+/-0.41 EDD/sec in group A and which was significantly lower than 3.29+/-0.88 EDD/sec of group B. Above result suggests that computer-assisted analysis of differential curves of left ventricular dimension and posterior wall thickness could be helpful in the early detection of diastolic dysfunction, and that left ventricular diastolic dysfunction in its early filling period may develop in the mild to moderate hypertensive patients even before left ventricular hypertrophy develops.
Echocardiography ; Humans ; Hypertrophy, Left Ventricular* ; Relaxation