BACKGROUNDS: When measuring lung function and response to bronchodilator, MDI(metered-dose inhaler) is commonly used but unfamiliarity of its use and cold sensation by the puffed gas decrease reliability of the result. Spacer can reduce the cold freon effect and undesired oropharyngeal deposition caused by the rapid evaporation of the propellant and there are many studies which showed more effectiveness of spacer on the treatment of children with asthma but no study whether it is effective on the bronchodilator response test in the first medical examination of old age. Therefore, we tested whether the use of spacer can reduce the cold freon effect and improve the bronchodilator response in the first medical examination of old age. METHODS: Two hundred of elderly patients( 65years) who had never used MDI were measured the bronchodilator response. Subjects were randomised to either spacer-user or spacer-nonuser. Twenty minutes after 400 g fenoterol was administered, FEV1 (forced expiratory volume in one second) was measured. Bronchoconstriction was defined as a decrease in FEV1 by 10% or greater after bronchodilator inhalation. We further devided each group into normal or obstructive group, obstructive group was defined as FEV1<80% of predicted and FEV1/FVC<70%. RESULTS: In normal group, spacer-user(n=83) showed greater bronchodilator response than spacer-nonuser(n=66), 6.43% vs 3.81% respectively(p<0.05) and two case of bronchoconstriction occured only in spacer-nonuser. In obstructive group, there is no significant difference in bronchodilator response between spacer-user(n=18) and spacer-nonuser(n=33), 12.32% vs 11.16% respectively(p>0.05) but brochoconstriction(n=1) occured only in spacer-nonuser. CONCLUSION: Spacer improved bronchodilator response and prevented bronchoconstriction, in the first medical examination of old age.
Aged ; Asthma ; Bronchoconstriction ; Child ; Chlorofluorocarbons ; Fenoterol ; Humans ; Inhalation ; Lung ; Sensation

We report a case of Becker's nevus associated with smooth muscle hamartoma, in a 21-year-old male patient, which shows clinically match-head sized, flat topped, round to oval, grouped papules with hairs on the outer surface of the right arm, and microscopically reveals numerous bundles of smooth muscle fiber in the dermis.
Arm ; Dermis ; Hair ; Hamartoma* ; Humans ; Male ; Muscle, Smooth* ; Nevus* ; Young Adult

No abstract available.
Polyps*

No abstract available.
Heart* ; Thoracic Surgery*

To elucidate iron utilization patterns of Staphylococcus aureus according to the growth, we checked the residual iron concentration and the production of siderophores at the indicated times while culturing S. aureus ATCC 6538 and 25923 strains in brain heart infusion broth. By using streptonigrin susceptibility test and investigating growth curves in three culture media of which iron concentration is 0.2, 20, 45 uM, respectively, we found out that iron metabolism of 6538 strain was more active than that of 25923 strain. In point of tendency of iron consumption, 6538 strain steeply consumed iron just before the onset of stationary phase, but 25923 strain did gradually iron throughout the growth phase. Nevertheless, total amount of iron consumed by each strain during the growth was almost no difference between the strains. CAS diffusion assay in detecting siderophores showed that siderophore production followed iron consumption. These results suggest that the siderophores play significant role in iron utilization in vitro.
Brain ; Culture Media ; Diffusion ; Heart ; Iron* ; Metabolism ; Siderophores ; Staphylococcus aureus* ; Staphylococcus* ; Streptonigrin

BACKGROUND AND OBJECTIVES: Fulminant invasive fungal sinusitis (IFS) is an aggressive, destructive disease most commonly affecting the immunocompromised hosts. This study aimed to investigate the clinical features of invasive fungal sinusitis and to determine its prognostic factors. MATERIALS AND METHOD: Fifteen cases of invasive fungal sinusitis were retrospectively reviewed. Prognosis was analyzed according to predisposing factors including the underlying disease, the extent of disease, the mycotic species, and treatment modalities. RESULTS: Overall 5-year survival rate of the patients with IFS was 60%. There was significant survival gain in the group for which underlying disease was well controlled (p=0.04). There was no difference in survival in terms of mycotic species and extent of disease at presentation. No statistically significant difference in survival was observed between the conservative surgery and the radical surgery group. CONCLUSION: Survival is usually determined at the very early period of treatment. The most important prognostic factor is not the surgical modalities including wide surgical resection or conservative debridement, but the optimal control of underlying disease.
Causality ; Debridement ; Fibrinogen ; Humans ; Immunocompromised Host ; Prognosis ; Retrospective Studies ; Sinusitis* ; Survival Rate

Osteoarticular infections due to non-typhoidal Salmonella are rare, occurring with an incidence rate of 0.1-0.2%. An immunocompromised state and the existence of sickle cell anemia are known risk factors for development of septic arthritis due to Salmonella. In this report, we describe a patient with septic arthritis of the left knee caused by non-typhoidal Salmonella . An 82-year-old woman visited the emergency room presenting with left knee pain, fever and dyspnea. The patient had osteoarthritis and was treated with oral analgesics, but not with an intra-articular injection. Upon assessment of the patient's joint fluid and blood culture results, non-typhoidal Salmonella (Salmonella group D) was detected. Arthroscopy-guided irrigation and debridement, and administration of oral antibiotics (fluoroquinolone) over six weeks were required in order to achieve a full recovery from the infection.
Aged, 80 and over ; Analgesics ; Anemia, Sickle Cell ; Anti-Bacterial Agents ; Arthritis, Infectious ; Bacteremia ; Debridement ; Dyspnea ; Emergencies ; Female ; Fever ; Humans ; Incidence ; Injections, Intra-Articular ; Joints ; Knee ; Knee Joint ; Osteoarthritis ; Risk Factors ; Salmonella ; Salmonella Infections

We experienced a case of aldosterone and cortisol secreting adrenal adenoma associated with pregnancy in a 23 year old female patient.The patient complained of severe thoraco-lumbar pain, weight gain, sweating, anxiety, and mild abdominal discomfort. On physical findings, hypertension, tachycardia, facial plethora, moon face, buffalo hump and truncal obesity were found.
Adenoma ; Aldosterone ; Anxiety ; Buffaloes ; Female ; Humans ; Hydrocortisone ; Hypertension ; Moon ; Obesity ; Pregnancy ; Sweat ; Sweating ; Tachycardia ; Weight Gain

We have analyzed two (BclI and XbaI) intragenic restriction fragment length polymorphisms (RFLPs) and St14 (DXS52) variable number of tandem repeats (VNTR) by rapid PCR method in 97 unrelated normal subjects. The incidences for positive Bc1I and XbaI polymorphic sites in the Koreans were 81% and 72%, respectively, which were higher than other ethnic groups but similar to that reported in the Chinese or Japanese, giving the heterozygosity rate of 0.32 and 0.40, respectively. The amplified allele size was 880 bp with no other polymorphism in the analysis of St14 (DXS52) VNTR. This finding should be taken into account in the planning of a prenatal diagnosis program for ethnic Koreans
Base Sequence ; Gene Frequency ; Hemophilia A/epidemiology/*genetics ; *Heterozygote Detection/methods ; Human ; Korea/epidemiology ; Molecular Sequence Data ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Prevalence

BACKGROUND: The recent studies shows that LV relaxation abnormalities are the important factors of heart failure in elders. To determine the association between LV diastolic functions and heart failure, we assessed LV diastolic functions in elderly patients with pulmonary congestion and in asymptomatic elders by using pulsed doppler echocardiography. METHODS: In order to assess LV diastolic function, we performed pulsed doppler echocardiography to elderly patients with pulmonary congestion and asymptomatic elders from Mar.2001 to Sep.2001. The following parameters were used as indices of LV diastolic function; Mitral E wave(E), Mitral A wave(A), Deceleration time(DT), Isovolumic relaxation time(IVRT), Systolic pulmonary venous flow(PVs), Diastolic pulmonary venous flow(PVd). RESULTS: In elderly patients groups, there was significant increase in deceleration time compared with asymptomatic elders(255.83+/-54.41 vs 210.80+/-48.53, p<0.05). There was significant increase in isovolumic relaxation time in elderly patient group compared with asymptomatic elders(123.06+/-25.07 vs 98.78+/-15.12, p<0.01). Although there was no significant difference, decreased E/A ratio and increased PVs/PVd were noted in both groups. CONCLUSIONS: The results shows that the impairments of LV diastolic function were noted in both groups. Especially DT and JVRT were significant increase in elderly patient group with pulmonary congestion. Therefore these parameters, such as DT, IVRT, can be helpful as predictive indices of diastolic heart failure in elders.
Aged* ; Deceleration ; Echocardiography, Doppler, Pulsed ; Estrogens, Conjugated (USP)* ; Heart Failure ; Heart Failure, Diastolic ; Humans ; Relaxation