Eight cases of Myositis Ossificans observed in paralytic patients were studied. The original lesions leading to the paralysis were Cord Injury(4), C.V. A.(2), and Coma of various causes(2). The results were as follows; 1) In half of all, the occurrence of the ossification ranged between 3 and 4 weeks after the initiation of passive exercise. 2) The most frequent site of the lesion was the paraarticular area. 3) To cessation of passive exercise the lesion responded with prompt decrease in size. 4) It seems that as in normal ossification the repair process of aseptic inflammation derived from the bleeding or the hematoma formation may be the main etiological factor of this lesion in paralytic patients whom the passive exercise were forced.
Coma ; Hematoma ; Hemorrhage ; Humans ; Inflammation ; Myositis Ossificans ; Myositis ; Paralysis

No abstract available.
Thyroid Diseases* ; Thyroid Gland*

CT has becom increasingly important diagnostic method as the inital examination in the diagnosis of subarachnoid hemorrhage with direct detection of extravasated blood inbasal cistern and cortical sulci. Furthermore, CT provides better and exact visualization of the presence, localization, extent and degree of intracerebral, intraventricular and subdural hemorrhage, infarction, hydrocephalus and rebleeding which may be associated wtih subarachnoid hemorrhage, and also could detect the causative lesions with contrast enhancement inmany cases. The purpose of the paper is to describe the CT findings of subarachonid hemorrhage due to various causes and to evalute the diagnostic accuracy of CT in subarachonoid hemorrhage. Authors analysed a total of 153 cases with subarachnoid hemorrhage confirmed by lumbar puncture at Seoul National University Hospital from March 1979 to April 1981, with special emphasis on CT findings.All of the cases took CT scan and 125 cases of the mangiography. The results are as follows; 1. Most prevalent age group was 4th to 6th decades (78%). The ratio ofmale to female was 1.1:1. 2. Of all 125 with angiography, aneurysm was a major cause (68%). Others were arterio-venous malformation (9.6%), Moya-moya disease(4%) and unknown (18.4%). 3. Of all 153 cases with CT scan,hemorrhage was demonstrated in 98 cases (64.1%); SAH in 72 cases (47.1%), ICH in 65 cases (42.5%), IVH in 34 cases(22.2%) and SDH in 1 case(0.7%). SAH combined with ICH was a major group (34.7%) in SAH. Detecton rate of SAH was68.3% within the first 7 days and 5.8% after 7 days. 4. In aneurysms, SAH was detected in 60 of 85 cases (70.6%);88.1% within the first 7 days and 5.6% after 7 days. Anterior communicating artery was the most common site of theaneurysms(40%), in which detection rate of SAH was 100% within the first 7 days. SAH was combined with ICH in38.3%. 5. On CT, SAH of unilateral Sylvian fissure was pathognomonic for ruptured MCA aneurysm and ICH of corpuscallosum for ACA aneurysm. 6. The detection rate of aneurysm itself on CT was 20%(17/85) and its size was variablefrom 5 to 25mm. 7. Infarction was demonstrated in 9 cases (6%) and there was no significant correlation between infarction and angiospasm, 8. Hydrocephalus was detected in 65% cases(42.5%), and 21 cases (32.3%) were demonstrated within the first 3 days.
Aneurysm ; Angiography ; Arteries ; Diagnosis ; Female ; Hematoma, Subdural ; Hemorrhage ; Humans ; Hydrocephalus ; Infarction ; Methods ; Seoul ; Spinal Puncture ; Subarachnoid Hemorrhage ; Tomography, X-Ray Computed

BACKGROUND: The several forms of treatment of Graves disease-thyroidectomy, antithyroid drugs and radioiodide therapy-are in wide use now. But which therapy is best is a matter of debate. Some authors reported that in patients who underwent thyroidectomy, higher titers of serum antimicrosomal antibody were associated with 1) higher formation rates of germinal centers, 2) more lymphocyte infiltration in the thyroid tissue, 3) higher incidence of hypothyroidism, and 4) lower incidence of recurrence. We were interested in the relationship of thyroid autoantibody titers, ADCC(antibody-dependent cell-mediated cytotoxicity) activity and the clinical response to antithyroid medication. METHODS: We measured ADCC activities from patients in Graves disease(n-48), Hashimoto thyroiditis(n=17) and normal control(n=9). The patients of Graves disease were followed up for more than 1 year, and they were grouped into A(n=17, well responsed group to antithyroid medication) and B(n=31, poorly responsed group). We examined ADCC activities of patients' sera by chromium release assay. RESULTS: 1) Mean age of patients with Graves disease was 34.4210.4 years and 15 patients were male(31%). 2) Results of thyroid function tests of the Graves' patients were T 585.9 +/- 255.3 ng/dL, T4 21.3 +/- 12.2 mg/dL, TSH 0.11 +/- 0.06mIU/mL. Concentrations of antimicrosomal antibody, antithyroglobulin antibody and thyrotropin binding inhibitory immunoglobulin were 1279.1 +/- 1486.7 IU/mL, 488.1 +/- 751.1 IU/mL, and 38.5 +/- 33.4U/L respectively. 3) There was no significant difference between levels of thyroid hormones or concentrations of thyroid autoantibodies and ADCC activities in graves patients. 4) The ADCC activity of the Graves patient group(24.49%) was significantly higher than that of the normal control group(3.76%), and significantly lower than that of the Hashimotos thyroiditis group(36.34%). 5) There was no significant difference in ADCC activity between group A(18.24 +/- 13.44%) and B(27.91 +20.02%). CONCLUSION: From this results, we suggested that ADCC activity seems to be no value as a prognostic factor in predicting the response to antithyroid drugs in Graves disease patients. But, further studies, larger number of patients and long-term follow up, are needed.
Antibody-Dependent Cell Cytotoxicity ; Antithyroid Agents ; Autoantibodies ; Chromium ; Follow-Up Studies ; Germinal Center ; Graves Disease* ; Humans ; Hypothyroidism ; Immunoglobulins ; Incidence ; Lymphocytes ; Recurrence ; Thyroid Function Tests ; Thyroid Gland ; Thyroid Hormones ; Thyroidectomy ; Thyroiditis ; Thyrotropin

BACKGROUND: QT dispersion, reflecting inhomogenous ventricular repolarization, increases in myocardial ischemia. In addition, Many studies reported that prolonged QT dispersion reduced to normal after reperfusion treatment. We have carried out this study to evaluate the QT and JT dispersion before and after the angioplasty in patients with coronary artery diseases. METHOD AND MATERIALS: Seventy-two patients (55 men and 17 women:18 acute myocardial infarction, 9 unstable angina and 45 stable angina) who underwent percutaneous transluminal coronary angioplasty were evaluated. Standard 12-lead electrocardiograms were recorded 24 hours before and 24 hours after angioplasty at a paper speed of 25 mm/sec. RESULTS: There was no significant change in heart rate or the maximum or minimum QT interval after angioplasty. QT dispersion significantly decreased after angioplasty (p<0.05). And QTc dispersion (QTcd) also similary reduced (p<0.01). JT dispersion (JTc) and JTc dispersion (JTcd) were not changed significantly. There were significant reduction in QTd and QTcd in the group of patients without acute myocardial infarction (p=0.005, 0.004, respectively) but not in JTd and JTcd. However, in patients with acute myocardial infarction, all four dispersion were not reduced significantly. And in patients with multivessel angioplasty, there were significant reduction of QTd, QTcd, JTd and JTcd (p=0.016, 0.014, 0.036, 0.030, respectively). CONCLUSIONS: As changes in QT and JT dispersion reflect successful reperfusion by angioplasty, they can be accepted as promising test for assessing the effectiveness of angioplasty clinically. However the methodology still has several unresolved issues and larger, prospective clinical studies are needed.
Angina, Unstable ; Angioplasty* ; Angioplasty, Balloon, Coronary ; Coronary Artery Disease ; Electrocardiography ; Heart Rate ; Humans ; Male ; Myocardial Infarction ; Myocardial Ischemia ; Reperfusion

BACKGROUND AND OBJECTIVES: Iron is a key component in the production of oxidized low density lipoprotein (LDL), which increases cardiovascular disease through inflammation. However, there is little data to suggest that oxidative stress is positively correlated with C-reactive protein (CRP). The purpose of this study was to examine the influence of the serum ferritin level and cardiovascular risk factors on CRP in a Korean population. SUBJECTS AND METHODS: A total of 808 subjects (465 men, 343 women), who had undergone a medical check-up at the health promotion center at Kangbuk Samsung Hospital, between September 2002 and November 2002, were included in this study. Logistic regression models were computed using elevated or nonelevated hsCRP, as dependent variable, with cardiovascular risk factors, such as, serum ferritin, total, LDL and HDL cholesterols, controlling for potential confounders, including age, gender, body mass index (BMI), hypertension, diabetes and smoking. RESULTS: Significant positive correlations were found between hsCRP and age, BMI, triglyceride and the level of serum ferritin, with a negative correlation found between hsCRP and HDL cholesterol. In age, gender, BMI, hypertension, diabetes, a smoking-adjusted model, an elevated ferritin level were not significantly associated with elevated hsCRP in low LDL subjects (OR=1.68, 95% CI=0.81-3.48), but significant associations were observed in high LDL subjects (OR=11.21, 95% CI=1.14-110.27). And we observed the significant effect modification of the association of hsCRP with serum ferritin level by LDL-cholesterol (p=0.002). CONCLUSION: Our results suggest that increased LDL cholesterol and ferritin have an effect on the increment of hsCRP. Thus, iron-catalyzed oxidation of LDL cholesterol may be an important step of the development of the inflammatory process. Further prospective studies will need to be performed to establish the relationship between the decreasing of the serum ferritin level and CRP for the prevention of cardiovascular disease.
Body Mass Index ; C-Reactive Protein* ; Cardiovascular Diseases ; Cholesterol, HDL ; Cholesterol, LDL ; Ferritins* ; Health Promotion ; Humans ; Hypertension ; Inflammation ; Iron ; Lipoproteins ; Logistic Models ; Male ; Oxidative Stress ; Risk Factors* ; Smoke ; Smoking ; Triglycerides

BACKGROUND: Increased C-reactive protein (CRP), very sensitive acute phase reactant, is an independent risk factor for coronary artery disease. However, the relationship between insulin resistance and CRP has not been thoroughly studied. We intended to observe the association between metabolic syndrome, insulin resistance and CRP, thus identify the role of CRP in the atherosclerosis and insulin resistance. METHODS: Total 767 subjects (436 men, 331 women) who underwent medical check-up at health promotion center in Kangbuk Samsung Hospital during March 2002, aged 20-84 years (mean+/-SD: 47.3+/-11.2), were included in this study. Age, sex, height, body weight, waist circumference, blood pressure, blood cholesterol, triglyceride, HDL cholesterol, and fasting glucose levels were measured. HOMA (Homeostasis model assessment index) and QUICKI (quantitative insulin sensitivity check index) were calculated and the correlations between indices of insulin resistance and CRP were evaluated. RESULTS: The mean concentrations of CRP in subjects according to the presence of 0, 1, 2, 3, 4, 5 features of metabolic syndrome defined by NCEP-ATP III were 0.64, 0.95, 1.14, 1.19, 2.40, 2.53 mg/L, respectively. The mean concentrations of CRP were significantly higher in subjects with higher insulin resistance (high HOMA index and lower QUICKI) compared to those with lower insulin resistance (p<0.01). In the group with the highest quartile of CRP (CRP>or=1.1 mg/L), the waist circumference, triglyceride, blood pressure and glucose levels were significantly higher and the HDL cholesterol level was significantly lower than the group with the lowest quartile of CRP (CRP<0.2 mg/L, p<0.01). There was a statistically significant positive correlation between CRP and BMI, waist circumference, triglyceride, blood pressure, glucose and HOMA index. A significant negative correlation was found between CRP and HDL cholesterol and QUICKI (above all p<0.001). CONCLUSION: These data suggest that metabolic syndrome and insulin resistance are associated with systemic inflammatory response, which plays an important pathogenetic role in atherosclerosis. Therefore, early diagnosis and tight control of metabolic syndrome should be administered for the prevention of cardiovascular events.
Adult* ; Atherosclerosis ; Blood Pressure ; Body Height ; C-Reactive Protein* ; Cholesterol ; Cholesterol, HDL ; Coronary Artery Disease ; Early Diagnosis ; Fasting ; Glucose ; Health Promotion ; Humans ; Insulin Resistance* ; Insulin* ; Male ; Risk Factors ; Triglycerides ; Waist Circumference

BACKGROUND AND OBJECTIVES: Atrial fibrillation (AF) has long been recognized as a random phenomenon. Recent studies, however, suggest that activation sequence during atrial fibrillation is not entirely disorganized and organized activations as the transitional rhythm exists in the process of conversion from atrial fibrillation to atrial flutter. The purpose of this study is to characterize the process and significance of transitional rhythm during conversion of atrial fibrillation to atrial flutter. MATERIALS AND METHODS: In 9 patients with paroxysmal atrial fibrillation, 13 episodes that atrial fibrillation spontaneously converted to atrial flutter during electrophysiological study were analyzed. To map the right atrium (RA), 10 bipolar Halo catheter was positioned in the lateral free wall of the RA and multielectrode catheters were positioned in the coronary sinus, high RA, and His bundle area, respectively. Calculation of cycle length (CL) was performed with digital caliper during atrial fibrillation and atrial flutter. Direction of activation sequences was compared between transitional rhythm and following atrial flutter. RESULTS: During conversion of atrial fibrillation to atrial flutter, characteristic findings were observed as follows. 1) There was a gradual increase in atrial fibrillation cycle length before transitional rhythm. 2) A pause appeared in atrial fibrillation immediately prior to transitional rhythm, and between transitional rhythm and following atrial flutter. 3) Direction of activation sequences of the transitional rhythm to atrial flutter was concordant in 9 episodes and discordant in 4 episodes. 4) Spontaneous termination of atrial flutter (n=3) was also preceded by organized rhythm showing different sequence of activations from those of atrial flutter. CONCLUSION: A stereotypical pattern of activation sequence exists in the process of conversion of atrial fibrillation to atrial flutter. The occurrence of transitional rhythm influences the activation sequence of atrial flutter. Spontaneous termination of atrial flutter also preceded by transiently changing pattern of activation.
Atrial Fibrillation* ; Atrial Flutter* ; Bundle of His ; Catheters ; Coronary Sinus ; Heart Atria ; Humans

BACKGROUND AND OBJECTIVES: The correlation between brain natruretic peptide (BNP) level and cardiac autonomic function has been studied in type 2 diabetic patients. However, there is limited data from patients with normal systolic function. We evaluated the association between heart rate recovery (HRR) representing autonomic dysfunction and three plasma BNP levels: pre-exercise, post-exercise, and change during exercise in patients with normal systolic function. SUBJECTS AND METHODS: Subjects included 105 patients with chest pain and normal systolic function. HRR was defined as the difference between the peak heart rate and the rate measured two minutes after completion of a treadmill exercise test. We measured plasma BNP levels before exercise, 5 minutes after completion of exercise, and during exercise (absolute value of difference between pre- and post-exercise BNP levels). RESULTS: Patients with abnormal HRR values (< or =24 beats for the first 2 minutes of HRR) had lower high-density lipoprotein, lower peak heart rates, and higher pre- and post-exercise BNP levels than patients with normal HRR values. The patients with coronary artery disease (CAD) had abnormal HRR. However, no significant differences were found between the two groups in terms of history of hypertension (HTN), diabetes, and peak systolic blood pressure (SBP) and diastolic blood pressure (DBP). HRR was significantly associated with pre-exercise BNP (r=-0.36, p=0.004) and post-exercise BNP (r=-0.27, p=0.006), but not BNP changes. Further, pre-exercise BNP levels showed a greater association with HRR than post-exercise BNP levels. CONCLUSION: HRR is independently associated with pre-exercise and post-exercise BNP levels, even in patients with normal systolic function.
Blood Pressure ; Brain ; Chest Pain ; Coronary Artery Disease ; Exercise Test ; Heart ; Heart Rate ; Humans ; Hypertension ; Lipoproteins ; Plasma ; Stroke Volume ; Thorax

Appendiceal intussusception is a rare disease with variable clinical findings, ranging from acute appendicitis to chronic recurrent abdominal pain or rectal bleeding. Occasionally, it is incidentally discovered with no symptoms. Because a preoperative diagnosis is difficult, it can be diagnosed either after surgery, in the case of acute appendicitis, or after a polypectomy, based on being mistaken for a polyp. During a colonoscopy, an appendiceal intussusception should be suspected if the appendiceal orifice is not observed at the cecum and there is a polypoid lesion at the location where the appendiceal orifice is expected. Treatments are usually determined according to preceding diseases. It is important that the colonoscopist avoid careless endoscopic removal by mistaking the intussusception for a polyp.
Abdominal Pain ; Appendicitis ; Cecum ; Colonoscopy ; Hemorrhage ; Intussusception ; Polyps ; Rare Diseases