OBJECTIVE: To evaluate the effect of aerobic exercise training on the cardiovascular system in the early stroke patients by bicycle ergometer exercise test. METHOD: 16 stroke patients without cardiac disease were randomly assigned to exercise training group (8 patients) and control group (8 patients). The time interval between the onset of stroke and exercise training was within 90 days. Exercise tests by bicycle ergometer using Astrand-Ryhming protocol were performed twice before and after training. Exercise training was consisted with the intensity of 60~70% of maximal heart rate, 30 minutes per day, 3 times per week for 6 weeks using bicycle ergometer. Modified Barthel Index (MBI) score and blood lipid profile were recorded before and during training. Blood pressure and heart rate were checked before and during exercise test. RESULTS: In a training group, maximal systolic blood pressure and rate pressure product were decreased immediately after exercise test after 6-weeks exercise training (p<0.05). The MBI score and lipid profile were not changed after training. CONCLUSION: Early exercise training in the stroke patients for 6 weeks have beneficial effects on the cardiovascular system.
Blood Pressure ; Cardiovascular System* ; Exercise Test ; Exercise* ; Heart Diseases ; Heart Rate ; Humans ; Stroke

Internal jugular vein (IJV) thrombosis is a form of deep vein thrombosis that has a potentially fatal outcome associated with its intracranial propagation. Computed tomography and ultrasonography are useful diagnostic tools. We report a case of IJV thrombosis associated with lymphoma that was detected by carotid ultrasonography and had disappeared in follow up ultrasonography.
Fatal Outcome ; Follow-Up Studies* ; Jugular Veins* ; Lymphoma* ; Thrombosis* ; Ultrasonography* ; Venous Thrombosis

To assess the early results, risk factors and optimal timing for coronary artery bypass graft surgery(CABG) after an acute myocardial infarction(AMI), we reviewed our 19 patients who underwent CABG within 30 days after AMI, between June 1994 and October 1996. This study excluded 1 patient whose diagnosis was AMI with ventricular septal rupture. 14 of the patients were male and 5 were female. Their ages ranged from 41 to 77 years(mean age, 60.6+/-10.4 years), and the amount of time between AMI and CABG ranged from 8 hours to 24 days(mean time, 10.6+/-6.4 days). There were 11 anteroseptal infarctions and 8 inferior wall infarctions. 11 patients had transmural infarctions and 8 had subendocardial infarctions. Indications of operations were primary revascularization and postinfarction angina. Three patients required preoperative intra-aortic balloon pump(IABP) support, and 4 additional patients required IABP to be separated from cardiopulmonary bypass. An average of 3.6+/-0.6 vessels per patient were bypassed. The early mortality rate for these 19 patients was 5.3% and late mortality rate was 5.5%, 1-year and 2-year actuarial survival rates were 89.5%. Univariate analysis of mortality showed that an ejection fraction less than 30% and intraopretative IABP supports were associated with risk factors(p value=0.018 and 0.015 respectively). Age, sex, time to CABG, emergency operations, types and locations of infarctions were not significant. Although our studies have weak points in that there was only a small number of patients and the lack of long-term results, we could conclude that early myocardial revascularization is relatively safe after AMI for those individuals with an ejection fraction greater than 30%.
Cardiopulmonary Bypass ; Coronary Artery Bypass ; Diagnosis ; Emergencies ; Female ; Humans ; Infarction ; Male ; Mortality ; Myocardial Infarction* ; Myocardial Revascularization ; Risk Factors ; Survival Rate ; Transplants ; Ventricular Septal Rupture

PURPOSE: Administration of antiretroviral drugs to mothers and infants significantly decreases mother-to-child human immunodeficiency virus (HIV) transmission; cesarean sections and discouraging breastfeeding further decreases this risk. The present study confirmed the HIV status of babies born to mothers infected with HIV and describes the characteristics of babies and mothers who received preventive treatment. METHODS: This study retrospectively analyzed medical records of nine infants and their mothers positive for HIV who gave birth at Korea University Ansan Hospital, between June 1, 2003, and May 31, 2013. Maternal parameters, including HIV diagnosis date, CD4+ count, and HIV ribonucleic acid (RNA) copy number, were analyzed. Infant growth and development, HIV RNA copy number, and HIV antigen/antibody test results were analyzed. RESULTS: Eight HIV-positive mothers delivered nine babies; all the infants received antiretroviral therapy. Three (37.5%) and five mothers (62.5%) were administered single- and multidrug therapy, respectively. Intravenous zidovudine was administered to four infants (50%) at birth. Breastfeeding was discouraged for all the infants. All the infants were negative for HIV, although two were lost to follow-up. Third trimester maternal viral copy numbers were less than 1,000 copies/mL with a median CD4+ count of 325/microL (92-729/microL). Among the nine infants, two were preterm (22.2%) and three had low birth weights (33.3%). CONCLUSION: This study concludes that prophylactic antiretroviral therapy, scheduled cesarean section, and prohibition of breastfeeding considerably decrease mother-to-child HIV transmission. Because the number of infants infected via mother-to-child transmission may be increasing, studies in additional regions using more variables are necessary.
Breast Feeding ; CD4 Lymphocyte Count ; Cesarean Section ; Diagnosis ; Female ; Growth and Development ; Gyeonggi-do ; HIV Infections ; HIV* ; Hospitals, Teaching* ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; Korea ; Lost to Follow-Up ; Medical Records ; Mothers ; Parturition ; Postnatal Care ; Pregnancy ; Pregnancy Trimester, Third ; Retrospective Studies ; RNA ; Zidovudine

BACKGROUND AND OBJECTIVES: Angiotensin -converting enzyme (ACE) inactivates bradykinin, substance P, and neurokinin A, which are thought to play important roles in the pathogenesis of inflammatory diseases. An insertion/deletion (I/D) poly - morphism in the ACE gene was reported to be associated with atopy in a Czech population. MATERIALS AND METHODS: Using the polymerase chain reaction, we investigated the frequencies of the genotypes and alleles of the ACE gene in 137 patients with allergic rhinitis and 498 healthy control subjects. RESULTS: There was no difference in the frequencies of the genotypes in the controls and patients with allergic rhinitis (p>0.05). The D allele was more frequent in patients with allergic rhinitis, but the difference was not statistically significant (p>0.05). CONCLUSION: Our results indicate that I/D polymorphism in the ACE gene is not related to susceptibility to allergic rhinitis in the Korean population.
Alleles ; Angiotensins ; Bradykinin ; Genotype ; Humans ; Neurokinin A ; Polymerase Chain Reaction ; Rhinitis* ; Substance P

BACKGROUND AND OBJECTIVES: There are relatively few studies that have evaluated the optimal timing, risk of mortality, and outcome for patients with coronary artery bypass graft surgery (CABG) performed in the setting of acute myocardial infarction (AMI). MATERIALS AND METHODS: We reviewed our 18 patients who underwent CABG within 14 days after AMI, between June 1994 and June 1997. Thirteen of the patients were male and 5 were female. Their ages ranged from 41 to 77 years (mean age, 60.6+/-10.4 years), and the amount of time betweenAMIandCABGrangedfrom4hoursto14days (meantime,7.0+/-4.7days).Therewere11 anteroseptal infarctions and 7 inferior wall infarctions. Eleven patients had transmural infarctions and 7 had subendocardial infarctions. Indications of operations were postinfarction angina, cardiogenic shock and intractable ventricular arrhythmia. Six patients required preoperative intra-aortic balloon pump (IABP) support, and 3 additional patients required IABP to be separated from cardiopulmonary bypass. An average of 3.4+/-0.5 vessels per patient were bypassed. RESULTS: The early mortality rate for these 18 patients was 5.6% and late mortality rate was 5.9%, and 2-year actuarial survival rates were 89.5%. Univariate analysis of mortality showed that an ejection fraction less than 30% was associated with risk factor (p value=0.016 ). Age, sex, time to CABG, emergency operations, locations of infarctions were not significant. CONCLUSION: Although our studies have weak points in that there was only a small number of patients and the lack of long-term results, we could conclude that early myocardial revascularization is relatively safe after AMI for those individuals with an ejection fraction greater than 30%.
Arrhythmias, Cardiac ; Cardiopulmonary Bypass ; Coronary Artery Bypass ; Emergencies ; Female ; Humans ; Infarction ; Male ; Mortality ; Myocardial Infarction* ; Myocardial Revascularization ; Risk Factors ; Shock, Cardiogenic ; Survival Rate ; Transplants

From July 1994 to August 1995, 32 patients underwent coronary artery bypass surgery. There were 14 men and 18 women. The mean age was 59 years(range from 37 to 81 years). Preoperatively 26 patients had unstable angina pectoris and 6 patients had stable angina pectoris. Nine patients had previous myocardial infarction history. Five patients had preoperative left ventricular ejection fraction of 40% or less. The involved risk factors were as follows ; smoking 19 cases, hypertension 16 cases, hypercholesterolemia 14 cases, diabetes mellitus 6 cases, and obesity 3 cases. 21 patients had three-vessel disease, 7 patients had two-vessel disease, 2 patients had one-vessel disease and 2 patients had left main coronary artery disease. We performed 103 distal bypasses out of 32 cases, and the mean number of grafts per patients is 3.22. We used arterial grafts (left internal mammary artery ; 31, radial artery ; 2) in 32% of total grafts. Postoperative complications were low cardiac output, perioperative myocardial infarction, respiratory failure and atrial fibrillation, etc. Early mortality was 6.25% (2/32). The causes of deaths were low cardiac output (1), and perioperative myocardial infarction(1).
Angina, Stable ; Angina, Unstable ; Atrial Fibrillation ; Cardiac Output, Low ; Cause of Death ; Coronary Artery Bypass* ; Coronary Artery Disease ; Coronary Vessels* ; Diabetes Mellitus ; Female ; Humans ; Hypercholesterolemia ; Hypertension ; Male ; Mammary Arteries ; Mortality ; Myocardial Infarction ; Obesity ; Postoperative Complications ; Radial Artery ; Respiratory Insufficiency ; Risk Factors ; Smoke ; Smoking ; Stroke Volume ; Transplants

From July 1994 to August 1995, 32 patients underwent coronary artery bypass surgery. There were 14 men and 18 women. The mean age was 59 years(range from 37 to 81 years). Preoperatively 26 patients had unstable angina pectoris and 6 patients had stable angina pectoris. Nine patients had previous myocardial infarction history. Five patients had preoperative left ventricular ejection fraction of 40% or less. The involved risk factors were as follows ; smoking 19 cases, hypertension 16 cases, hypercholesterolemia 14 cases, diabetes mellitus 6 cases, and obesity 3 cases. 21 patients had three-vessel disease, 7 patients had two-vessel disease, 2 patients had one-vessel disease and 2 patients had left main coronary artery disease. We performed 103 distal bypasses out of 32 cases, and the mean number of grafts per patients is 3.22. We used arterial grafts (left internal mammary artery ; 31, radial artery ; 2) in 32% of total grafts. Postoperative complications were low cardiac output, perioperative myocardial infarction, respiratory failure and atrial fibrillation, etc. Early mortality was 6.25% (2/32). The causes of deaths were low cardiac output (1), and perioperative myocardial infarction(1).
Angina, Stable ; Angina, Unstable ; Atrial Fibrillation ; Cardiac Output, Low ; Cause of Death ; Coronary Artery Bypass* ; Coronary Artery Disease ; Coronary Vessels* ; Diabetes Mellitus ; Female ; Humans ; Hypercholesterolemia ; Hypertension ; Male ; Mammary Arteries ; Mortality ; Myocardial Infarction ; Obesity ; Postoperative Complications ; Radial Artery ; Respiratory Insufficiency ; Risk Factors ; Smoke ; Smoking ; Stroke Volume ; Transplants

BACKGROUND: Research of clinical contents and proper development of education program is essential in family medicine. Therefore, this study is carried out to obtain data for residency training, and to provide references to family physicians who give primary health care in rural community by analyzing prospectively the clinical contents of new patients in a local family practice clinic. METHODS: The authors visited family practice clinic in a rural area practiced by a family physician board certified in family medicine. There were 3,126 new patients from Jan. 1996 to Dec. 1996 evenly distributed by month and area, 1,000 patients were sampled randomly and the collected data were classified according to the ICPC(International Classification of Primary Care) coding system. RESULTS: Among the selected 1,000 patients, males were 432(43.2%) and females were 568(56.8%). Age distribution was highest In the fifties(50-59 years old) (20.7%). The total number of Reason For Encounter(RFE) was 1,417, the average RFE was 1.41 per patient and the kind of RFEs was 93, among which cough was the most frequent RFE by 233 cases(16.4% ). The 87 kinds of diagnoses were used and URl(Upper Respiratory Infection) accounted for the major portion by 287 cases(21.9%). The diagnostic examination per patient was 0.42. The most frequently used test was x-ray of an extremity by 68 cases(16.1% ). Referrals to other departments were made in 3.3% of visitors of which Internal Medicine was highest(39.4%). CONCLUSIONS: The clinical contents were classified more comprehensively by using ICPC with given code RFE, care process, and diagnosis. More study on ICPC is necessary for classification to help analyze clinical contents in primary care.
Age Distribution ; Classification ; Clinical Coding ; Cough ; Diagnosis ; Education ; Extremities ; Family Practice* ; Female ; Humans ; Internal Medicine ; Internship and Residency ; Male ; Physicians, Family ; Primary Health Care ; Prospective Studies ; Referral and Consultation ; Rural Population

PURPOSE: Myelodysplastic syndrome (MDS) in children needs to be elucidated in terms of clinical characteristics, natural history, the most effective treatment and prognostic factors, as the disease is very rare and its definition and classification has not reached a consensus by many physician. This study was aimed to describe the characteristics and the disease courses of Korean children with MDS, and to analyze the usefulness of prognostic scoring systems in the prediction of transformation to acute myelogenous leukemia (AML) and overall survival among subgroups. MATERIALS AND METHODS: Fourteen children with MDS seen at Chonnam University Hospital and additional 59 patients identified by the review of Korean literature were evaluated to define clinical characteristics and disease courses. Kaplan-Meier (K-M) probability of leukemic transformation and overall survival were plotted. FAB subtypes, subgroups by Boumemouth Scoring System (BSS), and International Prognostic Scoring System (IPSS) risk groups were compared to predict transformation to AML and overall survival. RESULTS: The median age of 14 patients was 36.5 months. The sex ratio was 3.7:1 (M: F). The frequency of FAB subtypes in Korea was similar to that of other countries except for higher proportion of RA (37%). K-M 3-yr probability of AML transformation and survival for Korean patients were 54.7%, and 49.8%, respectively. Although FAB system, BMS and IPSS were all capable of discriminating subgroups in the prediction of AML transformation and survival, they did not reach the significant level possibly due to small number of patients assigned to each subgroup. CONCLUSION: The clinical characteristics of Korean children with MDS were not different from those of other countries. This study showed the high rate of AML transformation and poor survival in children with MDS.
Child ; Classification ; Consensus ; Humans ; Jeollanam-do ; Korea ; Leukemia, Myeloid, Acute ; Myelodysplastic Syndromes* ; Natural History ; Prognosis ; Sex Ratio