BACKGROUND: Blunted perception of dyspnea, which may be related to the increased mortality, has been demonstrated in patients with a history of near-fatal asthma and in the elderly. OBJECTIVE: The purpose of this study was to evaluate the relationship between the perception of dyspnea and the severity of asthma. METHOD: Baseline spirometry and Borg score change(A Borg score) during breathing through an inspiratory muscle trainer were measured in 27 consecutive asthma patients and 11 normal subjects. RESULTS: The baseline Borg score was negatively related to FEV1 A Borg score was significantly lower in asthmatics than in controls at high level of loads. A Borg score was lower in severe asthma than in mild asthma. A Borg score was positively related to the baseline FEV1. Seventy-five percent of severe asthma, 62.5% of moderate one, and 9.1% of mild one showed impaired dyspnea perception. Dyspnea perception was related to age(r, = -0.49, p<0.001). CONCLUSION: Three quarters of patients with severe asthma showed impaired dyspnea perception to inspiratory resistive load. Dyspnea perception was related to asthma severity and age.
Aged ; Asthma ; Dyspnea* ; Humans ; Mortality ; Respiration ; Spirometry

BACKGROUND: Dopamine is an inotropic agent that is often selected for continuous infusion. For hemodynamic stability, the rate of infusion is controlled in the range of 5-15 µg/kg/min. This study aimed to compare the time intervals from the administration of dopamine to the onset of its hemodynamic effects when dopamine was administered through three different peripheral veins (the cephalic vein [CV], the great saphenous vein [GSV], and the external jugular vein [EJV]). METHODS: Patients in group 1, group 2, and group 3 received dopamine infusions in the CV, GSV, and EJV, respectively. A noninvasive continuous cardiac output monitor (NICCOMO™, Medis, Ilmenau, Germany) was used to assess cardiac output (CO) and systemic vascular resistance (SVR). Six minutes after intubation, baseline heart rate (HR), systolic blood pressure (BP), diastolic BP, mean arterial pressure (MAP), CO, and SVR values were recorded and dopamine infusion was initiated at a dose of 10 µg/kg/min. Hemodynamic changes at 0, 4, 8, 12, and 15 minutes postinfusion were recorded. RESULTS: No statistically significant differences were observed among the three groups with respect to the rate of hemodynamic change. In all groups, systolic BP, diastolic BP, MAP, and SVR tended to increase after decreasing for the first 4 minutes; in contrast, HR and CO decreased until 8 minutes, after which they tended to reach a plateau. CONCLUSIONS: For patients under general anesthesia receiving dopamine at 10 µg/kg/min, there were no clinical differences in the effect of dopamine administered through three different peripheral veins.
Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Cardiac Output ; Dopamine* ; Heart Rate ; Hemodynamics* ; Humans ; Intubation ; Jugular Veins ; Saphenous Vein ; Vascular Resistance ; Veins*

No abstract available.
Causality* ; Humans ; Infant, Newborn* ; Pneumothorax*

PURPOSE: We reported the CT and MR findings of 2 cases with Sturge-Weber syndrome which were not accompanied by facial nevi. MATERIALS AND METHODS: They were examined with both CT and MR in one case and with MR only in the other case. RESULTS: CT was better than MR in the demonstration of the characteristic cortical calcification. MR was superior to CT in the depiction of the abnormalities of the surrounding parenchyma and the intense enhancement of pial angiomatosis with Gd-DTPA enhancement. CONCLUSION: Gd-DTPA enhanced MR imaging could be useful in the demonstration of the presence and extent of pial angiomatosis in patients with suspected Sturge-Weber syndrome.
Angiomatosis ; Gadolinium DTPA ; Humans ; Magnetic Resonance Imaging ; Nevus* ; Sturge-Weber Syndrome*

BACKGROUND: It is well known that ischemic preconditioning protects the heart against infarction or arrhythmias from a subsequent ischemic injury. Recent laboratory data indicate that the adenosine during the ischemic period may trigger protection via A1 or A3 adenosine receptor and also protein kinase C(PKC) plays a central role. This study was designed to determine the role of adenosine receptor subtypes and PKC in the preconditioning protection. METHODS: All cat heart groups were subjected to 40min ischemia and 30min reperfusion. The preconditioning protocol consists of 4min ischemia and then 10min of reperfusion 4 times. The effects of ischemic preconditioning, nonselective adenosine receptor blocker(SPT), an A1 specific antagonist(DPCPX) and protein kinase C inhibitor(Polymyxin B), on ischemic preconditioning were determined by infarction size. There were 5 groups : (1) control group (Group 1, n=10)(2) Ischemic preconditioned group(Group 2, n=9)(3) DPCPX pretreatment group(Group 3, n=6)(4) SPT preteatment group(Group 3, n=6)(5) Polymyxin B pretreatment group(Group 5, n=6). SPT and DPCPX were given intravenously 5 min before ischemic preconditioning. Polymyxin B was administered to cats for 30min during ischemic preconditioning period. RESULTS: Ischemic preconditioning only or pretreatment with DPCPX prior to preconditioning demonstrated a significant reduction in infarct size(22.6+/-1.5, 25.4+/-0.9% infarction of the risk zone, respectively, p<0.05) with respect to control, SPT-pretreatment, and polymyxin B-pretreatment groups(44.0+/-1.7, 43.0+/-2.0 and 40.3+/-0.4% infarction of the risk zone, respectively). CONCLUSIONS: Ischemic preconditioning protects heart from subsequent ischemia. Protection was blocked by SPT and protein kinase C inhibitor(polymyxin B), but not by A1 antagonist DPCPX. The cardioprotective effects by ischemic preconditioning in the in vivo cat heart appear to be dependent on A3 adenosine receptors and activation of protein kinase C.
Adenosine* ; Animals ; Arrhythmias, Cardiac ; Cats* ; Heart* ; Infarction ; Ischemia ; Ischemic Preconditioning* ; Polymyxin B ; Polymyxins ; Protein Kinase C* ; Protein Kinases* ; Receptors, Purinergic P1* ; Reperfusion

We decribe the CT findings in a case of mediastinal hemangioma. Precontrast enhanced CT demonstrated a homogeneous soft tissue mass with weveral nodular calcifications indicating phleboliths. Contrast enhanced CT revealed some areas of enhancement similar to that of adjacent vascular structures. Hemangiomas of the mediastinum, although rare, should be included in the differential diagnosis of enhancing mediastinal masses.
Diagnosis, Differential ; Hemangioma* ; Mediastinum

The uterine cervical cancer is the rnost common tumor of malignant gynecologic tumors and complete remission of the cancer has been possible through early diagnosis and treatment. To evaluate the efficacy of tumor markers SCCA and CEA in patients with uterine cervical cancer as markers for monitoring, we analyzed serum SCCA and CEA crncentrations of 43 patients wit.h uterine cervical caner as a study group and 73 patients with benign pelvic disease as a contrnl group, were admitted to depar tment of Obstetncs & Gynecology, College of Medicine, Kyung Hee University from May 1991 to January 1993. The results were as follows ; 1. The distrihution of the clinical stages of 43 cervical cancers were : CIS 9, stage I 11, stage II 12, stageg III 5, stage lV 6. 2. The positive rate of SCCA of control group was 17%, and that of CEA nf control group was 12%. And the positive rate of SCCA of study group was 46.5% and that of CEA of study was 27.9%. 3. The average concentration of SCCA of control group was 0.71ng/ml and that of SCCA of study group was 8.25ng/ml(p<0.05). 4. The average concentration of CEA of control group was 1.95ng/ml and that of CEA of study group was 8.33ng/ml(p<.0.05). 5. The average concentration of SCCA by stage were 1.15ng/rnl for C1S, 1.14ng/ml for stage I, 9.72ng/rnl for stage III, 16.75ng/rnl for stage III, 21.95ng/ml for stage IV. Here, the mean value of SCCA was increased stepwise through cliinical stage, there was a correlation between the clinical stage and the concen tration of serum SCCA (p>0.05). 6.The average concentration of CEA by stage were 3.11ng/ml for CIS, 1.96ng/ml for stage I, 8.11ng/rnl for stage II, 18.92ng/ml for stage III, 19.44ng/ml for stage IV. There was not a correlation between the clinical stage and the concentration of serm CEA. 7. When the cervical cancer was divided by histologic subtypes, the average concentration of SCCA in squamous cell carcinoma of uterine cervix was 11.86ng/ml and the positive rate of SCCA in squamous cell carcinoma was 53.6%(9.46ng/ml & 58.8% in large keratinizing cell type, 15.56ng/ml & 45.5% in large nonkeratinizing cell type). And the average concentration of SCCA in adenocarcinoma was 1.32ng/ml positive rate was 40.0%. The tumor marker SCCA was more sensitive to squamous cell carcinoma rather than adenocarcinoma. 8. The sensitivities of SCCA in preinvasive cancer and invasive cancer were 22.2% and 52.9%, respectively. The average concentration of SCCA in invasive cancer was 10.04ng/ml and was more significantly elevated than of SCCA in preinvasive cancer. 9. Using SCCA & CEA together as markers for monitoring, the positive rate significantly incresaed to 70.6%(p<0.05). But measuring the two tumor marker alone, that not significantly increased. 10) . The diagnostic efficacy of SCCA in cervical cancer was 59.0%, that was higher as compaired with that of CEA. These results suggest that the serum concentration of SCCA is significantly increased stepwise by clinical stage and concomitant measurements of serum SCCA & CEA are more useful in diagnosis of cervical cancer. However measurements of SCCA and/or CEA have little efficacy in the detection of early cervical cancer considering it's low rate of positivity in early cervical cancer. We will evaluate the efficacy of two tumor markers in determining prognosis, therapeutic response and early detection of recurrence for the posttreatment patients in the future.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cervix Uteri ; Diagnosis ; Early Diagnosis ; Female ; Gynecology ; Humans ; Prognosis ; Recurrence ; Selective Estrogen Receptor Modulators ; Biomarkers, Tumor* ; Uterine Cervical Neoplasms*

We examined 984 objects for exercise stress test, using CASE I(computer assisted system for exercise). They exercised according to Bruce's protocol, Among them, the mal were 613 and the female were 371. (Male:Female;17:1) The 5th and 6th decades occupied 61% of total objects. The purpose of test was evaluation of chest pain in 84% of total cases. The most frequent end point of test was dyspnea(42%) and chest pain was observed in 13% of total cases. Most of all objects above 8-9 METS. Positive results of exercise stress tert were obtained in 23%. As complications, ventricular tachycardia occurred in 7 cases, supraventricular tachycardia; 8, high degree VPB's; 6, sudden cardiovascular collapse;15, The complication rate was 0.36% but morbidity and mortality were 0. All complicated cases recoved spontaneously only by rest.
Chest Pain ; Electrocardiography* ; Exercise Test ; Female ; Humans ; Mortality ; Tachycardia, Supraventricular ; Tachycardia, Ventricular

No abstract available.
Angiofibroma* ; Estrogens* ; Progesterone* ; Receptors, Progesterone*

Isolated angiitis of the central nervous system is a rare clinicopathologic entity characterized by vasculitis restricted to the vessels of central nervous system without other apparent systemic vasculitis. It manifests headache, higher cortical dysfunction. focal neurologic dysfunction and cranial nerve palsies. We experienced a case of isolated angiitis of the central nervous system in 6 year-old girl who was admitted to out unit because of headache, hemiparesis and altered consciousness. The laboratory test for blood, urine, and cerebrospinal fluid are all within normal ranges. There was no evidence of systemic vasculitis. The contrast enhanced brain CT scan showed low densities along the left cerebellar hemisphere and posterior aspect of temporal lobe without enhancement, and left lateral internal carotid angiogram showed poorly contrast filling along the territory of left posterior cerebral artery due to narrowing or ischemic changes of the vessels. Axial T2WI (TR/TE, 2190/80) of magnetic resonance imaging showed multiple scattered high signal intensities at left pons with cerebellar hemisphere and diffuse high signal intensity along the left occipital lobe with enlarged surrounding gyral patterns, and axial T1WI(TR/TE, 665/25) showed intense gyral pattern contrast enhancement along the left occipital lobe. Steroid was tried with apparent benefit. We report a case of isolated angiitis of central nervous system with review of literature.
Brain ; Central Nervous System ; Cerebrospinal Fluid ; Child ; Consciousness ; Cranial Nerve Diseases ; Female ; Headache ; Humans ; Magnetic Resonance Imaging ; Nervous System* ; Neurologic Manifestations ; Occipital Lobe ; Paresis ; Pons ; Posterior Cerebral Artery ; Reference Values ; Systemic Vasculitis ; Temporal Lobe ; Tomography, X-Ray Computed ; Vasculitis*