Dermatomyositis (DM) is an autoimmune disorder with idiopathic myopathy and characteristic skin manifestations that one often accompanied by an internal malignancy. The association between dermatomyositis and malignancy has been reported several times, although tonsillar carcinoma is extremely rare not only in far eastern populations but also in caucasian populations. We report two cases of Korean patients with dermatomyositis associated with tonsillar carcinoma.

BACKGROUND: Although there have been many studies on the risk factors for coronary artery disease, the etiology and risk factor of coronary artery spasm has not yet been determined. The objective of this study was to examine the risk factors for coronary vasospasm through a comparison of patients with angiographically determined vasospastic angina and patients without vasospasm and normal coronary artery. METHODS: Intracoronary injection of acetylcholine in order (20microg, 50microg, 100microg) were administered to all patients (Total 81:34 males, 47 females : mean age 50 years) who had a history of chest pain with normal or near normal coronary arteriographic fingings. After documentation of vasospasm in major epicardial coronary arteries by acetylcholine (Ach)-provocated dcoronary angiography, various risk factors (smoking, hypertension, diabetes, drinking and hyperlipidemia) were compared between patients with vasospasm and patients without vaspasm. RESULTS: 24 patients showed significant luminal narrowing (> or =75%)(Vasospasm group) and 57 patients showed no significant change (Control). Vasospasm group were suffered from typical chest pain in 92% of patients but control complained typical chest pain in 51% of subjects. The sites of vasoconstriction induced by Ach were LAD (11 cases), LCX (4 cases), RCA (11 cases) and vasoconstriction occurred 2 vessels (LAD and LCx) at the same time in two cases. The amount of Ach to provocate vasoconstriction was 20~50microg (90%) and there were no difference between left and right coronary arteries. The ratio of smoker was more frequent in the vasospasm group than control (58.3% vs 30.4%, p=0.046). But total cholesterol, low density lipoprotein, high density lipoprotein, triglycerides, apolipoprotein A, apolipoprotein B, lipoprotein (a), diabetes and body mass index, drinking were not statistically significant between two groups. CONCLUSION: Smoking appears to be a major risk factor for vasospastic angina by endotheilal dysfunction without significant coronary artery narrowing. But other fisk for coronary artery disease may not contribute to coronary vasospasm.
Acetylcholine* ; Angiography ; Apolipoproteins ; Body Mass Index ; Chest Pain ; Cholesterol ; Coronary Artery Disease ; Coronary Vasospasm ; Coronary Vessels* ; Drinking ; Female ; Humans ; Hypertension ; Lipoprotein(a) ; Lipoproteins ; Male ; Phenobarbital ; Risk Factors* ; Smoke ; Smoking ; Spasm* ; Triglycerides ; Vasoconstriction

BACKGROUND AND OBJECTIVES: There is little data to indicate that hypertrophy of adenoid and tonsil may cause short stature. However, there is no data relating short stature to allergic rhinitis in the Korean population. The aim of this study was to investigate the effect of hypertrophy of adenoid and tonsil and allergic rhinitis on children with short stature. SUBJECTS AND METHOD: One hundred and ninety-one children were included in the disease group, which consisted of three groups, allergic rhinitis only (n=83), hypertrophy of adenoid and tonsil only (n=67), and combintorial of allergic rhinitis and hypertrophy of adenoid and tonsil (n=41). There were 174 pediatric patients in the control group. Growth hormone levels, thyroid function and both wrist X-rays were checked on the children with short stature in order to exclude other chief medical problems causing short stature. For the purpose of evaluating the relationship between short stature and clinical factors, allergy parameters, eosinophil partition rate and total IgE levels were checked in the allergic rhinitis group, and the size of the adenoid and tonsil were checked in the adenoid and tonsil hypertrophy group. The relationship between the incidence of short stature and above clinical factors was evaluated. RESULTS: The incidence of short stature was significantly higher in each disease group than in the control. However, there was no statistically significant differences between each disease group. The above clinical factors were not associated with short stature. CONCLUSION: Hypertrophy in adenoid and tonsil and allergic rhinitis might be an independent cause of short stature.
Adenoids* ; Body Height ; Child* ; Eosinophils ; Growth Hormone ; Humans ; Hypersensitivity ; Hypertrophy* ; Immunoglobulin E ; Incidence ; Palatine Tonsil* ; Rhinitis* ; Thyroid Gland ; Wrist

Soft tissue sarcoma of the head and neck is a rare and heterogenous group of malignant tumors. Especially, adult soft tissue sarcomas occur rarely in nasal cavity and paranasal sinus. They are, when poorly differentiated, termed as pleomorphic sarcoma, spindle cell sarcoma, or malignant fibrous histiocytoma (MFH) like tumor. The main stay of the treatment of adult soft tissue sarcomas is surgical resection with negative margin. Tumor grade, tumor size and extension of local infiltration are recognized prognostic factors, but classification of histologic type appears to have less prognostic significance. In case of uncontrolled locoregional disease, it often results in death due to intracranial extension. We report a case of a 68-year-old female with locoregional high grade pleomorphic sarcoma in the nasal cavity. This tumor was managed by wide local excision of tumor with negative margin.
Adult ; Aged ; Classification ; Female ; Head ; Histiocytoma, Malignant Fibrous* ; Humans ; Nasal Cavity ; Neck ; Sarcoma

BACKGROUND: Although recent studies have demonstrated that infusion of L-arginine reduces myocardial necrotic area during prolonged ischemia, its effects on transient postischemic myocardial dysfunction(myocardial stunning) and microvascular dyfunction(vascular stunning) are not well known. To investigate whether intravenous administration of L-arginine, physiological nitric oxide(NO) precursor, during reperfusion would attenuate postischemic myocardial dysfunction and microvascular dysfunction, 15 open-chest dogs were studied. METHODS: In 15 pentobarbital anesthesized open-chest dogs, left circumflex coronary artery was occluded for 20 minutes and was followed by a reperfusion for 60 minutes. L-Arginine(30mg/kg)(L-arginine group, n=8) or saline(control group, n=7) was given intravenously by a bolus 1 minute before reperfusion and was followed by a continuous infusion(10mg/kg/min) for 30 minutes during reperfusion. Before coronary occlusion and 60 minutes after reperfusion, coronary blood flow(CBF) and coronary vascular resistance(CVR) wre measured after intracoronary injection of each of acetylcholine(0.01/kg) and adenosine(1.5/kg), and reactive hyperemia with coronary occlusion(RH20) for 20 seconds was measured. Myocardial segment thickening in the area of ischemia-reperfusion was measured using 2D-echocardiography. The echocardiographic images were digitized and analyzed by cardiac image analyzer. RESULTS: The results obtained 60 minutes after reperfusion were as follows. 1) CBF was decreased by 41% in L-arginine group vs 30.1% in control group(p < 0.05) and CVR was increased by 83.9% in L-arginine group vs 19.3% in control group after 60 minutes of reperfusion, compared with pre-occlusion baseline values. 2) Percent change of CBF was decreased in control group(acetylcholine by 25.8%, adenosine by 29.2%, RH20 by 39.8%), while it was increased in L-arginine group(acetylcholine by 60%, adenosine by 22%, RH20 by 26.7%). Percent change of CVR was increased in control group(acetylcholine by 10.5%, adenosine by 6.9%, RH20 by 21%), but it was decreased in L-arginine group(acetylcholine by 10%, adenosine by 6.6%, RH20 by 1.6%). Increase of CBF and decrease of CVR were significant on acetylcholine and RH20 between control group and L-arginine group. 3) Fraction of myocardial segment thickening was significantly decreased in L-arginine group(by 80%) compared with control group(by 61.7%, p < 0.05). CONCLUSIONS: The finding that L-arginine depressed post-ischemic myocardial contractil function suggests that systemic infusion of L-arginine has unfavorable effect on myocardial stunning. In contrast, the finding that L-arginine improved CBF and CVR with acetylcholine and adenosine and reactive hyperemia indicates that L-arginine may exert a beneficial effect on vascular stunning. These results suggest that L-arginine may have independent effects on myocardial stunning and vascular stunning.
Acetylcholine ; Adenosine ; Administration, Intravenous ; Animals ; Arginine* ; Coronary Occlusion ; Coronary Vessels ; Dogs* ; Echocardiography ; Hyperemia ; Ischemia ; Myocardial Reperfusion ; Myocardial Stunning ; Nitric Oxide ; Pentobarbital ; Reperfusion

Percutaneous transluminal coronary angioplasty of chronic total coronary artery occlusions are at a high risk of failure and complication. We report a case of arteriovenous fistula with drainage into the coronary sinus during the percutaneous transluminal coronary angioplasty of the chronic total occlusion of circumflex coronary artery. We think that the arteriovenous fistula of this case was occurred by the guide wire- induced trauma. But after 20-30 minutes later, the injection of contrast no longer detectd arteriovenous fistula. Later we recommended coronary artery bypass graft surgery to the patient, but he refused. Thereafter he received conservative treatment and dyspnea, chest pain were improved.
Angioplasty* ; Angioplasty, Balloon, Coronary ; Arteriovenous Fistula* ; Chest Pain ; Coronary Artery Bypass ; Coronary Sinus* ; Coronary Vessels* ; Drainage* ; Dyspnea ; Humans ; Transplants

BACKGROUND: It is well known that collateral circulation has important roles in ischemic heart diseases. The method most commonly used at present to evaluate collateral flow is coronary angiography. However, there are debates about the functional significance of angiographically visible collaterals because angiography visualizes only vessels that are larger than 100um in diameter. Recent studies suggest that myocardial contrast echocardiography (MCE) is a useful method in assessing collateral flow because it uses small microvascular tracers (4-12um) as a contrast agent. By using MCE, this study evaluates the role of angiographically visible collaterals in patients with acute myocardial infarction (AMI) and chronic ischemic heart disease. METHOD: Forty-one patients who underwent coronary angiography and MCE were included in this study (22 patients with acute myocardial infarction and 19 patients with chronic ischemic heart disease). Antegrade coronary flow was less than TIMI 3 flow in all patients. Myocardial perfusion through collaterals with MCE was evaluated by injecting sonicated Hexabrix into nonobstructing coronary arteries. Angiographically visualized collateral vessels were analysed as four grades and compared with the degree of myocardial opacification by MCE through collateral vessels. RESULT: Angiographic collaterals were frequently observed in patients with AMI and chronic ischemic heart disease with< or = TIMI 2 flow . There was poor correlation between TIMI grade and the grade of collaterals by angiography in AMI (r--0.29, p-0.20) and chronic ischemic heart disease (r--0.31, p-0.19). There was no correlation between collateral grades and myocardial opacification by MCE through collateral vessels in AMI (r-0.07, p-NS) and chronic ischemic heart disease (r-0.10, p-NS). In patients with relatively well developed collaterals (Grade II or III), the ischemic zone was perfused better through collateral flow in the chronic ischemic heart disease group than in the AMI group (Mean Retrograde Opacification Index 0.84+/-0.23 vs 0.32+/-0.22, p<0A65A>0.05). CONCLUSION: The study suggests that the role of angiographically visible collaterals is different in chronic ischemic heart disease and acute myocardial infarction. The grade of angiographically visible collaterals does not imply the extent of perfusion to myocardum at risk through collateral vessels.
Angiography ; Collateral Circulation ; Coronary Angiography ; Coronary Vessels ; Echocardiography ; Heart ; Humans ; Ioxaglic Acid ; Myocardial Infarction ; Myocardial Ischemia* ; Perfusion*

Wild yeasts on the surface of various fruits including grapes were surveyed to obtain yeast strains suitable for fermenting a novel wine with higher alcohol content and supplemented with rice starch. We considered selected characteristics, such as tolerance to alcohol and osmotic pressure, capability of utilizing maltose, and starch hydrolysis. Among 637 putative yeast isolates, 115 strains exhibiting better growth in yeast-peptone-dextrose broth containing 30% dextrose, 7% alcohol, or 2% maltose were selected, as well as five alpha-amylase producers. Nucleotide sequence analysis of the 26S rDNA gene classified the strains into 13 species belonging to five genera; Pichia anomala was the most prevalent (41.7%), followed by Wickerhamomyces anomalus (19.2%), P. guilliermondii (15%), Candida spp. (5.8%), Kodamaea ohmeri (2.5%), and Metschnikowia spp. (2.5%). All of the alpha-amylase producers were Aureobasidium pullulans. Only one isolate (NK28) was identified as Saccharomyces cerevisiae. NK28 had all of the desired properties for the purpose of this study, except alpha-amylase production, and fermented alcohol better than commercial wine yeasts.
alpha-Amylases ; Base Sequence ; Candida ; DNA, Ribosomal ; Fermentation ; Fruit ; Glucose ; Hydrolysis ; Maltose ; Mass Screening ; Metschnikowia ; Osmotic Pressure ; Pichia ; Saccharomyces cerevisiae ; Starch ; Vitis ; Wine ; Yeasts

BACKGROUND: The aim of our study was to evaluate the "diagnosis changed" rate in patients notified as tuberculosis (TB) on the Korean TB surveillance system (KTBS). METHODS: A total of 1,273 patients notified as TB cases on the KTBS in one private tertiary hospital in 2011 were enrolled in the present study. Patients were classified into three groups: "diagnosis maintained", "diagnosis changed" (initially notified as TB, but ultimately diagnosed as non-TB), and "administrative error" (notified as TB due to administrative errors). RESULTS: Excluding 17 patients in the "administrative error" group, the "diagnosis maintained" and "diagnosis changed" groups included 1,097 (87.3%) and 159 patients (12.7%), respectively. Common causes of "diagnosis changed" were nontuberculous mycobacterial (NTM) disease (51.7%, 61/118), and pneumonia (17.8%) in cases notified as pulmonary TB, and meningitis (19.5%, 8/41) and Crohn's disease (12.2%) in cases notified as extrapulmonary TB. Being older than 35 years of age (odds ratio [OR], 2.18) and a positive acid-fast bacilli stain (OR, 1.58) were positive predictors and a TB-related radiological finding (OR, 0.42) was a negative predictor for a "diagnosis changed" result via multivariate logistic regression analysis in pulmonary TB cases. CONCLUSION: Because of a high "diagnosis changed" rate in TB notifications to the KTBS, the TB incidence rate measured by the KTBS may be overestimated. Considering the worldwide trend toward increased NTM disease, the "diagnosis changed" rate may increase over time. Thus, when reporting the annual TB notification rate in Korea, the exclusion of "diagnosis changed" cases is desirable.
Crohn Disease ; Diagnostic Errors ; Humans ; Incidence ; Korea ; Logistic Models ; Meningitis ; Nontuberculous Mycobacteria ; Pneumonia ; Tertiary Care Centers* ; Tuberculosis*

The drug resistance of microorganisms isolated from laboratory animals never treated with antibiotics is being reported consistently, while the number of laboratory animals used in medicine, pharmacy, veterinary medicine, agriculture, nutrition, and environmental and health science has increased rapidly in Korea. Therefore, this study examined the development of antimicrobial resistance in bacteria isolated from laboratory animals bred in Korea. A total of 443 isolates (7 species) containing 5 Sphingomonas paucimobilis, 206 Escherichia coli, 60 Staphylococcus aureus, 15 Staphylococcus epidermidis, 77 Enterococcus faecalis, 27 Citrobacter freundii, 35 Acinetobacter baumannii were collected from the nose, intestine, bronchus and reproductive organs of ICR mice and SD rats. Of these species, Acinetobacter baumannii and Enterococcus faecalis showed significant antimicrobial resistance according to the minimum inhibition concentration (MIC) in E-test. In case of Acinetobacter baumannii, several isolates showed MIC values 16-128 microg/mL for cefazolin and cefoxitin, and higher resistance (128-512 microg/mL) to nitrofurantoin than that of standard type. Resistance to cefazolin, cefoxitin and nitrofurantoin was detected in 17.14, 20.00, and 8.57% of the Acinetobacter baumannii isolates, respectively. In addition, 44.1% of the Enterococcus faecalis isolates collected from the laboratory animals were resistant to oxacillin concentration of 16-32 microg/mL range, while MIC value of standard type was below oxacillin concentration of 6 microg/mL. These results suggest that in rodent species of laboratory animals, Acinetobacter baumannii are resistance to cefazolin, cefoxitin and nitrofurantoin, whereas those of Enterococcus faecalis were resistance to oxacillin.
Acinetobacter baumannii ; Agriculture ; Animals ; Animals, Laboratory ; Anti-Bacterial Agents ; Bacteria ; Bronchi ; Cefazolin ; Cefoxitin ; Citrobacter freundii ; Drug Resistance ; Drug Resistance, Microbial ; Enterococcus faecalis ; Escherichia coli ; Intestines ; Korea ; Mice ; Mice, Inbred ICR ; Nitrofurantoin ; Nose ; Oxacillin ; Pharmacy ; Rats ; Rodentia ; Sphingomonas ; Staphylococcus aureus ; Staphylococcus epidermidis ; Veterinary Medicine