No Abstract Available.
Fatigue Syndrome, Chronic* ; Fatigue* ; Prevalence*

Survival after acute myocardial infarction (AMI) is related to the number of diseased vessel, ejection fraction, extent of residual ischemic tissue, presence of ventricular arrhythmia. Because a variety of revascularization modalities are tried in recent years, the natural course after AMI seems to become difficult ot assess. From the experience of 129 cases of coronary angiography in AMI from Jan 1984 to Apr 1987, the factors related to invasive modality were analysed to evaluate the effect on the survival after AMI. The following results are obtained. 1) Single vessel disease and insignificant lesion were present in 60%, and multivessel disease comprised 40% in all group. 2) Patients were followed for a mean of 16.3 months and 2 cases(1.6%) expired suddenly and reinfarction developed in 6 cases(4.7%). 3) After exclusion of 4 cases taken CABG operation, the event free survival of all patients was 0.98, 0.90, 0.78, 0.78, 0.78 in double vessel disease, 0.94, 0.87, 0.87, 0.77, 0.51 in triple vessel disease. The survival was better in single vessel disease compared to multivessel disease (p<0.05), but no difference was present between double and triple vessel disease. 5) Event free survival in group with left ventricular end diastolic pressure(LVEDP) >16mm Hg was better than that of a group with LVEDP <16mm Hg. But no difference was present between group with ejection fraction <40% and group with ejection fraction >40%. From the above results, it can be concluded that the event free survival after mainly uncomplicated AMI in Koreans depends on the number of diseased vessel and LVEDP.
Arrhythmias, Cardiac ; Coronary Angiography ; Disease-Free Survival* ; Humans ; Myocardial Infarction*

A method for exact evaluation of ligament integrity of the knee joint would be of clinical importance from the diagnostic point of view as well as from the desire to introduce objective measurement of stability either pre-and postoperatively, or before and after conservative treatment. Assessment of the posterior cruciate injury has been considered by numerous authors over the past decades. Even stress machine, such as Gonylaxometer, knee ligament arthrometer(KT-l000) and Genucome, have many problems such as soft tissue error, expansiveness and low popularity. Generally, orthopedic surgeons use passive tests, in which the displacing force is applied externally, to evaluate the integrity of the ligaments of the knee. Posterior tibial displacement of knee was measured at quadriceps neutral angle using a specially designed frame which minimized the rotational error to negate the quadriceps pulling effect. Posterior displacement of both sides of knee was measured in 15 patients who had posterior cruciate ligament injury and 40 adults who had normal knee. The following results were obtained. l. In the normal knee, the mean score of posterior tibial displacement was 3.0875mm in left, 2.8125mm in right each other and there was a mean of 1.05mm posterior displacement of tibia compared to the contralateral knee(range: 0–2.5mm). 2. More than 6mm displacement of lateral femoral condyle compared to the uninjured knee suggested posterior cruciate ligament injury. 3. This radiological measurement seems very efficient in detecting the posterior cruciate ligament instability of knee because of its simplicity, inexpensiveness and easy reproducibility with minimal error.
Adult ; Humans ; Knee ; Knee Joint ; Ligaments ; Methods ; Orthopedics ; Posterior Cruciate Ligament ; Surgeons ; Tibia

In this study, clinical effectiveness of Pharmacia CAP system for determination of allergen specific IgE was evaluated depending on the results of Bencard skin prick tests in 100 atopic and 18 nonatopic asthmatics. The Pharmacia CAP specific IgE positive rates were higher as the SPT grades were increased : negative (n=623) (17.8%); + (n=81) (34.6%); 2+ (n=223) (56.5%); 3+ (n=106) (70.8%); and 4+/-< (n=127)3+ (92.1%), respectively. The overall concordant rate between Bencard SPT and Pharmacia CAP system was 81.7% with range of 70.7~92.1%. The Overall sensitivity of Pharmacia CAP system was 80.7%. The sensitivities for 10 allergens, which ranged from 57.5% to 100 %, were as followed; D.pteronyssinus (96.1%), D.farinae (96.7%), cat dander (61.5%), cockroach (65.2%), Aspergillus fumigatus (57.1%), ragweed (62.5%), mugwort (75.0%), Meadow fescue (100%), birch (62.4%), and oak (80.0%), respectively. Overall specificity of Pharmacia CAP system was 82.2%. The specificity of CAP system in nonatopic subjects (n=18, 160 test) was 94.4% which was quite different with the 77.6% of atopic subjects (n=100, 463 test). SPT A/H ratios were significantly correlated with Pharmacia CAP specific IgE concentration (KU/L) in D.pteronyssinus (r=0.520, p<0.001), D.farinae (r=0.490, p<0.001), A.fumigatus (r=0.315, p<0.01), mugwort (r=0.210, p<0.05), ragweed (r=0.213, p<0.05), birch (r=0.232, p<0.05), M.fescue (r=0.410, p<0.001). But, in cockroach (r=0.192, p<0.1), cat dander and oak pollen, SPT A/H ratios were not correlated with the concentration of specific IgE. These results suggest that Pharmacia CAP system is useful for etiologic evaluation of immediate hypersensitivity and quantitative evaluation of specific IgE in atopic asthma.
Allergens ; Ambrosia ; Animals ; Artemisia ; Aspergillus fumigatus ; Asthma* ; Betula ; Cats ; Cockroaches ; Dander ; Evaluation Studies as Topic ; Hypersensitivity, Immediate ; Immunoglobulin E* ; Pollen ; Sensitivity and Specificity ; Skin

BACKGROUND AND OBJECTIVE: House dust mites have been known as the most important allergens in respiratory allergic disease. Since environmental factors may have influences on the pathogenesis of allergic disease, the study using Korean house dust mites for immune and biologic reactions in house dust mite-sensitive allergic disease is considered as significant. MATERIAL AND METHOD: We made two in-house allergenic extracts of Korean house dust mites (D. farinae and D. pteronpsssinus) and performed this study for the allergen standardization by in vivo methods and for the evaluation of the reliabilities for clinical applications. RESULT: As a results of biologic standardization using skin prick test teachnique, the activity of 1: 1,500w/v of D. farinae extract was estimated 1,000 biology unit(BU), concentration that elicits a wheal of the same size as that of histamine dihydrochloride 1mg/ml. The activity of 1: 1,000w/v of D. pteronyssinus was condiered as 1,000BU. The activity of 1:100w/v of both D. farinae and D. pteronpssiuns extracts were considered as 100,000 Allergy Unit(AU), based on intradermal skin testing of 30 subjects with strong sensitive reaction. The concordant rates between results of skin prick test done with 5,000BU/ml concentration of in-house allergenic extracts and thoae with the commercially available allergen(Bencard Co., UK) were 84.6% and 81.0% for D. farinae and D. pteronpssinus, respectively. The wheal erythema size and A/H ratios induced by in-house extracts were significantly correlated with those induced by Bencard allergen. CONCLUSION: This results suggest that in-house extracts of the whole bodies of two house dust mites have good allergenic activities in vivo. It is considered to be clinically useful and reliable allergenic extracts.
Allergens ; Biology ; Dust* ; Erythema ; Histamine ; Hypersensitivity ; Pyroglyphidae* ; Skin ; Skin Tests

There is room for debate in appropriate diagnosis and treatment due to physiological and anatomical differences in pediatric facial bone fractures from that of adult's. The objectives of this article is to analyze for our clinical cases and to suggest the appropriate management of facial bone fracture in children. The study included 56 children who had treatment for the craniofacial fractures form March, 1990 to February, 1998. Their ages ranged from 3 to 15. There were 38 males and 18 females. Physical examination, simple x-rays, ultrasonograms and routine CT scans were used for diagnosis. Materials were classified into 28 nasal bone fractures, 4 nasoethmoidal fractures, 6 orbital fractures, 8 mandible fractures, and 10 zygoma fractures. Patients were treated with conservative treatment in 9 cases, with closed reduction in 28 cases and open reduction only, and 14 patients with open reduction and internal fixation using microplates and screws. 3 patients needed autogenous calvarial bone graft. Plates and screws were removed in postoperative 3-6 months. All patients had successful union of fractured bones without no specific complications, and normal bony growths were noticed during the 7 years follow up. We conclude that surgeons should be careful in diagnosis and management for the pediatric facial fracture due to anatomical variations and differences in fracture aspects. First, it is mandatory for surgeous to get accurate diagnosis and identify children's fracture and displacement through routine CT check up along with physical examination. Second, it is important to perform the minimally invasive technique or conservative treatment for the children with mild displacement so that it reduces the incidence of growth retardation which may be caused by extensive operation. However, application of rigid fixation is necessary in case of extensive bony displacement or bony defects because of poor coorporation in postoperative care. Third, plates and screws which were used for the internal fixation should be removed at 3-6 months after the surgery. Fourth, if bone graft is needed, it is better to use autogenous graft than allogeneous graft. Fifth, care for dentition and follow up for growth are necessary for growing children.
Child ; Dentition ; Diagnosis ; Facial Bones* ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Mandible ; Nasal Bone ; Orbital Fractures ; Physical Examination ; Postoperative Care ; Tomography, X-Ray Computed ; Transplants ; Ultrasonography ; Zygoma

OBJECTIVE: We evaluated the clinical implications of serum ECP and peripheral blood eosinophil counts as indices of airway inflammation during the follow-up of asthmatics (BA). METHODS: We repeatedly measured the serum ECP, peripheral blood eosinophil counts and peak expiratory low rate (PFR) during the follow up of 24 symptomatic BA. RESULTS: Mean serum ECP level of BA at uncontrolled status of airflow limitation was significantly higher than that of controlled state (24.5i3.7 ng/ml rs. 16.2+1.9 ng/ml, p<0.05) and the ECP levels of controlled and uncontrolled status were significantly higher than that of health control subjects (n=10, 10.1+/-2.0 ng/ml, p<0.01 respectively). Pe ripheral blood eosinophils were also significantly increased in uncontrolled status than in controlled status of BA (535.7+/-81.0/1tL vs. 300.4+33.4/micro liter, p < 0.05). In controlled status, 8 BA had higher circulating ECP levels than in uncontrolled status, but with peripheral blood eosinophil counts, only 3 BA had higher levels in controlled status than in uncontrolled status. Variations of PFR correlated with the variations of serum ECP level (r=-0.5370, p<0.01) and variations of peripheral blood eosinophil count (r=-0.6215, p<0.001). CONCLUSION: Measurement of serum ECP and peripheral blood eosinophil count would be useful tools for monitoring the disease activity of asthma, but we could not obtain any more informations from the measureinert of serum ECP levels than from the peripheral blood eosinophil counts.
Asthma* ; Eosinophil Cationic Protein* ; Eosinophils* ; Follow-Up Studies ; Humans ; Inflammation

BACKGROUND: Spontaneous echo contrast(SEC) is known to predict the increased incidence of thromboembolism in a variety of heart diseases. Transesophageal echocardiography can be useful for the detection of SEC due to proximity of the probe to the left atrium. We performed this study (1) to evaluate the incidence of SEC in mitral stenosis and its relation to the past history of thromboembolism and (2) to characterize the echocardiographic and hemodynamic indices in patients with SEC compared with those without SEC. METHODS: Transesophageal and thransthoracic echocardiographies were done in 89 patients with mitral stenosis. Biplane probe was used in transesophageal echocardiography. In 47patients cardiac catheterization and angiography were performed. RESULTS: (1) SEC was found in 56 out of 89 patients(63%), and left atrial thrombus was found in 32 patients. (2) Left atrial dimension was larger in patients with SEC than in patients without SEC(57.3%+/-8.4mm vs 49.3+/-6.8mm, p<0.05) and mitrial valve area was smaller in patients with SEC than in patients without SEC(0.85+/-0.27cm2 vs 0.97+/-0.24cm2) (3) Association of SEC to thrombi or previous history of arterial embolism showed a high sensitivity and negative predictive value. CONCLUSION: SEC was an useful finding to predict the increased risk of thromboembolism in patients with mitral stenosis. Patients with SEC had severe mitral stenosis than patients without SEC.
Angiography ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography ; Echocardiography, Transesophageal* ; Embolism ; Heart Atria ; Heart Diseases ; Hemodynamics ; Humans ; Incidence ; Mitral Valve Stenosis ; Thromboembolism ; Thrombosis

The authors presented a case of gastroschisis with a pedunculated gallbladder embedded in hepatic tissue. The patient was born after fullterm gestation. Due to extensive abdominal wall defect, she succumbed 3 days after birth. There was a pedunculated mass measuring 2.5x1.5x1.5 cm between the liver and distended stomach without any attachment to the liver. The pedicle of the mass was connected to the common bile duct. Cut surface revealed that the mass was an accessory hepatic lobe encircling the gallbladder. The histologic feature of both accessory liver and gallbladder was markedly altered probably due to vascular obstruction. We could find only a single similar case in literlature. That case was associated with Beckwith syndrome and ours was associated with large atrial spetal defect, large patent ductus arteriosus, accessory spleen as well as gastroschisis. The common feature of abdominal wall defect might be a predisposing factor.

Adenoid cystic carcinoma arising from the submucosal glands of the trachea and bronchial tree is rare. The histopathology and natural history of bronchial adenoid cystic carcinoma have been well documented, but detailed descriptions of its cytomorphology are few. We report a case of primary bronchial adenoid cystic carcinoma in a 20-year-old female, diagnosed by bronchial brushing cytology. The cytologic specimens showed large clusters of small cells arranged around cystlike spaces containing globular basophilic material.
Basophils ; Bronchi ; Carcinoma, Adenoid Cystic ; Ependymoma ; Female ; Humans ; Infant* ; Natural History ; Seizures* ; Spinal Cord ; Trachea ; Young Adult