No abstract available.
Colonoscopy*

Two cases of exercise-induced atrial fibrillation were diagnosed in 68 years old female and 47 years old male. They complained palpitation during exercise, and emotional upset for the last 5 years. There was no evidence of organic heart disease except mild hypertension in female patient. The atrial fibrillation was induced repeatedly by treadmill exercise test and intravenous infusion of isoproterenol. The beta blocker(atenolol 50mg po dialy) prevented the induction of atrial fibrillation during treadmill exercise. We report two cases of exercise-induced atrial fibrillation which is very rare and might be related to catecholamine.
Aged ; Atrial Fibrillation* ; Exercise Test ; Female ; Heart Diseases ; Humans ; Hypertension ; Infusions, Intravenous ; Isoproterenol ; Male ; Middle Aged

To assess the likelihood of procedural success in patients with multivessel coronary artery disease, 46 consecutive patients (male 34, female 12, mean age 60+/-9 years) umderwent single or multiple site angioplasty. The clinical diagnosis of unstable angina was in 20(44%), stable angina in 10 and acute or old myocardial infarction in 16. Coronary angiographic findings of 2 vessel disease was in 38(83%), triple vessel disease in 8. Left ventricular function was generally well preserved (mean ejection fraction 65+/-12%, range 30-82%) and mean 2.0 stenosis per patient angic, lasty had attempted. Single vessel angioplasty (SVA) was performed in 13 and multivessel angioplasty (MVA) in 33. Procedural success was achieved in 79(86%) out of total 92 stenoses. Sixty-six(88%) out of 75 stenoses in MVA and 13(76%) out of 17 stenoses in SVA had procedural success respectively. According to angiographic morphology of lesions, procedural success of type A stenoses was 17/17(100%), type B stenoses 57/66(86%) and type C stenoses was 5/9(33%). In 13 failures included inability to pass the guide wire cross the lesion in 7, inability to guide the griding catheter in 2 and inability to dilate lesions in 4. Before and after angioplasty, treadmill test (modified Bruce protocol)could be performed in 29 patients. Total duration of exercise and maximal double product improved significantly from 8.5+/-2.3 minute 5188+/-2403 to 12.2+1.3 min., 23,062+/-4111 respectively (p<0.001). 17 out of 24 patients who had positive treadmill test before angioplasty showed negative conversion after procedure. Complications included dissection in 29, prolongd chest pain in 5, acute closure in 3, cardiac tamponade in 1 and ventricular fibrillation due to side branch oclusion in 1. Thus, coronary angioplasty in selected paients with multivessel coronary artery disease might be useful and have relatively good immediate results, but the long-term efficacies with other forms of treatment must be evaluated prospectively.
Angina, Stable ; Angina, Unstable ; Angioplasty* ; Cardiac Tamponade ; Catheters ; Chest Pain ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Diagnosis ; Exercise Test ; Female ; Humans ; Myocardial Infarction ; Ventricular Fibrillation ; Ventricular Function, Left

PURPOSE: The purpose of this study is to evaluate the characteristics of hallux valgus with severe hallux valgus angle (HVA) and moderate intermetatarsal angle (IMA) after proximal chevron osteotomy. MATERIALS AND METHODS: Between January 2008 and December 2010, 41 patients (48 feet) were treated with proximal chevron osteotomy and distal soft tissue procedure for symptomatic severe hallux valgus deformity (HVA > or =40degrees). Patients were divided into two groups, group M (IMA <18degrees) and group S (IMA > or =18degrees). Mean age of patients was 55.7 years (34~70 years) in group M and 60.0 years (44~78 years) in group S. Mean duration of follow-up was 20.4 months (12~41 months) in group M and 18.5 months (12~35 months) in group S. Radiographic parameters, including HVA, IMA, sesamoid position, metatarsus adductus angle (MAA), and distal metatarsal articular angle (DMAA), were compared between groups. Clinical results were assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue scale (VAS). Recurrence rate at the last follow-up was compared between group M and group S. RESULTS: Preoperative HVA and grade of sesamoid position did not differ between the groups. However, immediate postoperative HVA and grade of sesamoid position were significantly larger in group M. Preoperative MAA and DMAA were significantly larger in group M. No significant difference in AOFAS score and VAS was observed between the groups at the last follow-up. Ten of the 27 feet (37.0%) in group M and two of the 21 feet (9.5%) in group S showed hallux valgus recurrence at the last follow-up. Group M showed a significantly higher recurrence rate than group S. CONCLUSION: Recurrence rate for severe hallux valgus with moderate IMA is higher than that of severe hallux valgus with severe IMA.
Ankle ; Congenital Abnormalities* ; Follow-Up Studies ; Foot ; Hallux Valgus* ; Humans ; Metatarsal Bones ; Metatarsus ; Osteotomy ; Recurrence

OBJECTIVES: This study was carried out to investigate the clinical availability of topographic auditory event related potential P300 as a biological marker in children with attention deficit hyperactivity disorder(ADHD). METHODS: The subjects were composed of children with ADHD(n=22:16 boys, 6 girl s:mean age=89.8+/-17.1months) and normal controls(n=20:12 boys, 8 girls:mean age=90.6+/-16.8months). Topographic auditory event related potential was measured by "oddball paradigm", and the latencies and amplitudes of P300 of both groups were determined by Global Field Power Measurement. After 8 weeks treatment with methylphenidate, P300 of ADHD children were also measured. RESULTS: Both P300 latency and amplitude were not different between ADHD children after treatment and normal controls, but significantly different between ADHD children before treatment and normal controls, and between before and after treatment of ADHD children. CONCLUSIONS: The results implicate that the latency and amplitude of P300 may be considered as state markers of ADHD.
Attention Deficit Disorder with Hyperactivity* ; Biomarkers ; Child* ; Evoked Potentials* ; Female ; Humans ; Methylphenidate

No abstract available.
Thorax*

Castleman's disease is a rare disorder characterized by tumorous masses that may develop in the lymph node tissue throughout the body. Most common location is mediastinum, but it can also affect retroperitoneum, neck, pelvis, and/or axilla. It may exceptionally affect extranodal sites like striated muscle, thoracic wall, lungs, skull, larynx, and/or vulva. The presentation is varied and diagnosis is difficult. There are two main types of Castleman's disease: hyaline-vascular type and plasma cell type. The hyaline vascular type accounts for approximately 90% of the cases. Most individuals exhibit no symptoms of this form of the disorder or they may develop non-cancerous growths in the lymph nodes. The plasma cell type is often associated with fever, weight loss, skin rash, early destruction of red blood cells, leading to unusually low levels of circulating red blood cells (hemolytic anemia), and/ or abnormally increased amounts of certain immune factors in the blood (hypergammaglobulinemia). We here report a case of Castleman's disease of ileal mesentery in 30-years old female patient. Abdominal mass, 4.7x3.6 cm in size, was completely removed from ileal mesentery without complication, and confirmed histologically mesenteric Castleman's disease of the mixed type.
Adult ; Axilla ; Diagnosis ; Erythrocytes ; Exanthema ; Female ; Fever ; Giant Lymph Node Hyperplasia* ; Humans ; Hyalin ; Immunologic Factors ; Larynx ; Lung ; Lymph Nodes ; Mediastinum ; Mesentery ; Muscle, Striated ; Neck ; Pelvis ; Plasma Cells ; Skull ; Thoracic Wall ; Vulva ; Weight Loss

OBJECTIVE: A number of soluble factors,which play important role in the pathophysiology of rheumatoid synovitis are also known to be involved in osteoclast differentiation and activation through RANKL (Receptor activator of NF-kB ligand). To investigate the importance of RANKL in the pathogenesis of bone erosion in rheumatoid arthritis (RA) patients, we analyzed the expression of RANKL and Osteoprotegerin (OPG) and examined the formation of osteoclasts in rheumatoid synovial fibroblasts under the influence of various osteotropic factors. METHODS: Primary culture synoviocytes or fibroblast-like synoviocytes isolated from synovial tissues of 8 RA patients were cultured and treated with IL-1beta (2 ng/ml), TNF-alpha (2 ng/ml), INF-gamma(1000 micro/ml), IL-15 (10 ng/ml), IL-12 (10 ng/ml), dexamethasone (10(-9) M), PMA (10 ng/ml) or 1,25 (OH)2D3 (10(-9) M) for 18 hours. Expression RANKL or OPG mRNA was measured by semiquantitative RT-PCR within linear amplification condition. TRAP (+) MNC (tartrate resistant acid phosphatase-positive multinucleated cell) formation was induced from primary culture synoviocytes or in coculture system of synovial fibroblasts with PBMCs in the presence of M-CSF and 1,25 (OH)2D3. RESULTS: 1. The intensity of base-line expression was different from patient to patient. Primary culture synoviocytes and synovial fibroblasts express RANKL and OPG mRNA with decreasing intensity when they are passaged. 2. Expresssion of RANKL mRNA was significantly increased by 1,25 (OH)2D3 and IL-1beta (158.8+/-21% and 197.2+/-17% of controls, p<0.05 and p<0.005, respectively), while decreased significantly by dexamethasone (25.6+/-4.6% of controls, p<0.005). Expression of RANKL mRNA was significantly increased by IL-1beta and decreased by dexamethasone, in a dose- and time-dependant manner. 3. TRAP (+) MNCs are formed from primary culture synoviocytes or in coculture system of synovial fibroblasts and PBMC in the presence of M-CSF and 1,25 (OH)2D3. Dexamethasone clearly inhibited TRAP (+) MNCs formation from synovial cells. CONCLUSION: The regulatory mechanism for the expression of RANKL or OPG in rheumatoid synoviocytes might be different from that in bone marrow cells. Modulating the expression of these molecules could have potential therapeutic implication targeting bone destruction in RA.
Arthritis, Rheumatoid ; Bone Marrow Cells ; Coculture Techniques ; Dexamethasone ; Fibroblasts* ; Humans ; Interleukin-12 ; Interleukin-15 ; Macrophage Colony-Stimulating Factor ; NF-kappa B* ; Osteoclasts* ; Osteoprotegerin ; RNA, Messenger ; Synovitis ; Tumor Necrosis Factor-alpha

BACKGROUND: The kinetics of recovery oxygen consumption plays an important role in determining exercise capacity. This study was performed to evaluate the kinetics of recovery oxygen consumption and the effects of percutaneous balloon mitral valvuloplasty (PMV) and exercise training on the recovery kinetics in mitral stenosis (MS). METHOD: Thirty patients with MS (valve area 1.0 cm2) and thirty age-and size-matched healthy volunteers were included for this study. All subjects performed symptom-limited, upright, graded bicycle exercise. Patients were randomized to either the exercise training group or the non-training group after successful PMV (valve area 1.5 cm2 and mitral regurgitation grade 2). The exercise group performed daily exercise training for 3 months. RESULTS: Half-recovery time of peak oxygen consumption (T1/2VO2) was significantly delayed in MS patients than in the volunteers (12,042 sec vs 595, p<0.01). Peak oxygen consumption (pVO2, ml/min/kg) was significantly increased in both the training (16.84.9 to 25.36.9) and the non-training group (16.35.1 to 19.66.0) 3 months after PMV. T1/2VO2 was significantly shortened in the training group (12,439 to 7,613, p<0.01), but not in the non-training group (11,446 to 10,944 sec, p-0.12) at 3 months follow-up. The degrees of symptomatic improvement after PMV were more closely correlated with the changes of T1/2VO2 than those of pVO2. CONCLUSION: Kinetics of recovery oxygen consumption was markedly delayed in MS patients, but the kinetics improved after exercise training but not after PMV alone. These results suggest that adjunctive exercise training may be useful for improvement of recovery kinetics and subjective symptoms after PMV.
Follow-Up Studies ; Healthy Volunteers ; Humans ; Kinetics* ; Mitral Valve Insufficiency ; Mitral Valve Stenosis* ; Oxygen Consumption* ; Volunteers

It is well known that Rhododendron sclippenbashii contains the toxic material grayanotoxin. So, Koreans do not eat it, but they do eat azalea although it contains grayanotoxin. That is why there have been no reports about Rhododendron sclippenbashii intoxication after ingesting it intentionally, not accidentally. In this case, the patient was admitted to the emergency room with several toxic symptoms after intentionally consuming 50 blossoms of Rhododendron sclippenbashii to get rid of thirst. Treatment with saline infusion and atropine was successful and the outcome was favorable enough in this case to produce a complete cure without any sequelae at discharge. But toxic symptoms were seen for 24 hours, although the symptoms usually fade in 9 hours. Therefore, we should carefully treat and observe, for over 24 hours, the patient who intentionally ingests about 50 blossoms of Rhododendron sclippenbashii.
Adult ; Atropine ; Bradycardia ; Drug Combinations ; Emergencies ; Flowers ; Humans ; Intention ; Piperonyl Butoxide ; Pyrethrins ; Rhododendron ; Thirst