BACKGROUND: Recently, cardiopulmonary exercise testing (CPX) has become a popular diagnostic method for differentiating the main cause of exertional dyspnea or exercise limitation. We evaluated the difference in the CPX results according to interpretative algorithms and the methods of exercise in Korea. METHOD: Sixty-six patients with chronic lung disease and 48 adults with dyspneic symptoms, but with no abnormalities in a spirometry performed symptom limited CPX, were included in this study. The results were interpreted using both Wasserman's(WA) and Eschenbacher's algorithm (EA), and a comparison between both algorithms was made. Thirty-three healthy medical students performed the CPX with a cycle ergometer and treadmill. The results were interpreted with EA and the concurrenec in interpretations was evaluated according to the methods of exercise. RESULTS: 1. In patients with chronic lung disease, the overall concordance rate between the two algorithms was 63.6%. The concordance rates were 69.8% in patients with obstructive, 25.0% in those with restrictive, and 66.7% in those with mixed pulmonary insufficiency. In patients with dyspneic symptoms but normal findings in resting spirometry, the concordance rate was 60.4%. 2. In healthy medical students, in results interpreted with EA, the concordance rate between the cycle ergometer and treadmill exercise was 25.0%. CONCLUSION: Both interpretative algorithms and methods of exercise may affect the CPX results. In using CPX as a diagnostic test for the causes of dyspnea in the Korean population, the interpretative algorithms and method of exercise need to be standardized, and a predictive VO2max equation needs to be established.
Adult ; Diagnostic Tests, Routine ; Dyspnea ; Exercise Test* ; Humans ; Korea ; Lung Diseases ; Methods* ; Spirometry ; Students, Medical

No abstract available.
Animals ; Epididymis* ; Male ; Mice* ; Muscle Cells*

PURPOSE: To evaluate the effect of common three photon energies (6-MV, 10-MV, and 15-MV) on intensity-modulated radiation therapy (IMRT) plans to treat prostate cancer patients. MATERIALS AND METHODS: Twenty patients with prostate cancer treated locally to 81.0 Gy were retrospectively studied. 6-MV, 10-MV, and 15-MV IMRT plans for each patient were generated using suitable planning objectives, dose constraints, and 8-field setting. The plans were analyzed in terms of dose-volume histogram for the target coverage, dose conformity, organs at risk (OAR) sparing, and normal tissue integral dose. RESULTS: Regardless of the energies chosen at the plans, the target coverage, conformity, and homogeneity of the plans were similar. However, there was a significant dose increase in rectal wall and femoral heads for 6-MV compared to those for 10-MV and 15-MV. The V20 Gy of rectal wall with 6-MV, 10-MV, and 15-MV were 95.6%, 88.4%, and 89.4% while the mean dose to femoral heads were 31.7, 25.9, and 26.3 Gy, respectively. Integral doses to the normal tissues in higher energy (10-MV and 15-MV) plans were reduced by about 7%. Overall, integral doses in mid and low dose regions in 6-MV plans were increased by up to 13%. CONCLUSION: In this study, 10-MV prostate IMRT plans showed better OAR sparing and less integral doses than the 6-MV. The biological and clinical significance of this finding remains to be determined afterward, considering neutron dose contribution.
Head ; Humans ; Neutrons ; Organs at Risk ; Prostate ; Prostatic Neoplasms ; Retrospective Studies

The funding acknowledgment in this article was omitted as published.

OBJECTIVE: This study is proposed to examine the relationship between bone loss after hormone replacement therapy for one year and initial bone markers. METHODS: One hundred postmenopausal women were studied for one year. At first visit, measurements were made of bone mineral density(BMD) at the lumbar spine and femoral neck, and of serum osteocalcin and urine deoxypyridinoline. After hormone replacement therapy was done for one year, BMD was rechecked. RESULTS: Serum osteocalcin was correlated with the rate of bone change(r=0.150, 0.262) and urine deoxypyridinoline was weakly correlated(r=-0.003, 0.038). The changes of femoral BMD in women with higher concentration of osteocalcin and deoxypyridinoline were significant different from those in women with normal concentration. At the lumbar spine, no significant differences were showed. In women with higher concentration of osteocalcin, the incidence of subjects with increased spine BMD was increased up to around 71.1%, which showed not significant increase compared with normal concentration of osteocalcin. And the incidence of increased spine BMD in women with higher concentration of osteocalcin was marked increased compared with the incidence of normal concentration. The level of the osteocalcin with increased spine BMD was 11.5+/-6.6 ng/ml, and the level with decreased spine BMD was 9.2+/-4.7 ng/ml, respectively. And the level of the deoxypyridinoline was 7.2+/-4.2 pmol/ mol cr in women with increased spine BMD and 7.2+/-2.7 pmol/ mol cr in women with decreased spine BMD, which was not statistically different. The concentration of deoxypyridinoline with increased and decreased in BMD in spine and femur was not statistically different. but the concentration of osteocalcin was 12.2 +/-5.5 ng/ml in significantly increased in BMD and 8.5 +/-4.5ng/ml in significantly decreased in BMD, which was showed significant different. CONCLUSION: Present study indicates that the serum osteocalcin more reflcets bone turnover changes at the menopause than deoxypyridinoline, however, the clinical utility of measurements of osteocalcin only to response to therapy is uncertain.
Bone Density* ; Female ; Femur ; Femur Neck ; Hormone Replacement Therapy* ; Humans ; Incidence ; Menopause ; Osteocalcin ; Spine

BACKGROUND: To evaluate the influence of changes in mitral valve area (MVA) and left atrial pressure on pulmonary vein flow (PVF) we analyzed PVF with transesophageal echocardiography (TEE) before, after and one-year after percutaneous mitral valvuloplasty (PMV) in patients with mitral stenosis (MS) in sinus rhythm. METHODS: PMV was guided with TEE. Follow-up TEE was done about one year after PMV. MVA and transmitral mean gradient (TMG) were measured. Systolic velocity (S), diastolic velocity (D), atrial reversal velocity (AR), their time-velocity integral (S-TVI, D-TVI, AR-TVI) and their ratio (S/D ratio, S-TVI/D-TVI ratio were evaluated. RESULTS: The number of patients was twenty-two (F:20). The age was 39+/-9 years (range:26-64). Follow-up duration was 16+/-6 months (range:7-28). MVA increased from 0.9+/-0.2 cm2 to 1.9+/-0.3 cm2 after PMV and decreased to 1.7+/-0.3 cm2 on follow-up TEE significantly. TMG decreased from 15.4+/-4.3 mmHg to 5.5+/-1.9 mmHg after PMV and was 6.2+/-2.4 mmHg on follow-up. S increased significantly on follow-up at both pulmonary vein (PV). D increased on follow-up at left PV. S/D ratio increased on follow-up at both PV. AR increased on follow-up at both PV. S-TVI increased after PMV at left PV and increased on follow-up at both PV. D-TVI had no change. S-TVI/D-TVI ratio increased on follow-up at left PV. AR-TVI increased on follow-up at right PV. CONCLUSIONS: The main changes after PMV in patients with MS in sinus rhythm were increasing tendency in S, S-TVI, S/D ratio, S-TVI/D-TVI ratio and AR. And these changes were statistically significant on follow-up TEE rather than immediately after PMV.
Atrial Pressure ; Echocardiography* ; Echocardiography, Transesophageal ; Follow-Up Studies ; Humans ; Mitral Valve ; Mitral Valve Stenosis* ; Pulmonary Veins

Cranocsynostosis is the term that designates premature fusion of one or more sutures in either the cranial vault or cranial base. Especially scaphocephaly, brachycephaly and trigonocephaly are included in simple symmetric craniosynostosis. In simple symmetric craniosynostosis, the functional deformity is rare, but deformity in external appearance is always a serious problem. The purpose of forehead reshaping in simple symmetric craniosynostosis is recovery of normal cerebral growth and improvement of cranial cosmetic problem by restoration of normal calvarial anatomic structure. Various surgical methods have Bbeen developed in an effort to correct craniosynostosis. Cranial vault remodeling with or without supraorbital band advancement is a widely accpeted method of correcting simple symmetric craniosynostosis. However, the standardized surgical method has not yet been estabilished in reshaping the forehead during cranial vault remodeling of simple symmetric craniosynostosis. The authors developed a new osteotomy method, the bull's osteotomy, which is a limited osteotomy for cranial vault remodeling. It produces posterior tilting of a prominant forehead as well as increased biparietotemporal distance for effective forehead reshaping. We applied this techriaue in 8 scaphocephaly and 2 brachycephaly patients under 5 years of age who have not yet reached bony consolidation. All patinets obtained satisfactory results with properly corrected deformity and no relapse was observed during the follow-up period. This new osteotomy method is simple and effective and a consistant surgical outcome is expected. particularly the contour of the forehead on the frontotemporal area is corrected to have a smooth and natural curvature. Based on our experience using bull's osteotomy, we offer this new surgical technique for managing simple symmetric cranoisynostosis patients.
Congenital Abnormalities ; Craniosynostoses* ; Follow-Up Studies ; Forehead* ; Humans ; Osteotomy* ; Recurrence ; Skull Base ; Sutures

No abstract available.
Adenocarcinoma*

No abstract available.
Factor VIII* ; Hemophilia A* ; Humans

No abstract available.
Defense Mechanisms*