No abstract available.
Gestational Age* ; Humans ; Infant*

No abstract available.
Animals* ; Brain* ; Hypothermia* ; Models, Animal*

BACKGROUND: The bone mineral densities of men decrease with increasing age like women. The incidence of osteoporosis gradually increase according to increasing proportion of older people, but the studies on osteoporosis of men are now beginning. The association between the bone mineral density and behavioral factors among adult men in Korea were studied. METHODS: The study subjects who visited health promotion center of one hospital located in Seoul from April to May 2001, aged 28 to 76 years, were all mearsured bone mineral density at left calcaneus using quantitative ultrasonography (QUS). We interviewed all subjects to get the information about past medical history and behavioral risk factors such as smoking, drinking, intake of dairy food, and exercise patterns. We also checked height, weight, blood chemistry including alkaline phosphatase and Prostate Specific Antigen. We calculated the Pearson's partial correlation coefficient between Speed of Sound (SOS) and each variables after adjusting age and body weight, and compare the mean SOS among each categories of the variables using Analysis of Covariance (ANACOVA). Finally, multiple regression analysis was done, using the model including significant variables of baseline analysis. RESULTS: One hundred six men, who did not have any metabolic disease influencing bone mineral density, were included. Age and smoking amount were negatively correlated and body weight was positively correlated with SOS. In univariate analysis, exercise, past history of fracture and dairy food intake was significantly associated with bone mineral density of men. In multiple regression analysis, body weight and dairy food intake were positively associated, but age and smoking amounts were negatively associated with bone mineral density. CONCLUSION: To increase bone mineral density of men, one should maintain adequate body weight, ingest dairy food regulary and reduce smoking amount or quit smoking.
Adult* ; Alkaline Phosphatase ; Body Weight ; Bone Density* ; Calcaneus ; Chemistry ; Drinking ; Eating ; Female ; Health Promotion ; Humans ; Incidence ; Korea* ; Male ; Metabolic Diseases ; Osteoporosis ; Prostate-Specific Antigen ; Risk Factors ; Seoul ; Smoke ; Smoking ; Ultrasonography

Spontaneous regression of cervical disc herniation is a rare, and such reports are few. A 39 year-old woman complained of severe neck pain associated with tingling and numbness of right upper extremity. The MRI of the cervical spine revealed a posterior disc extrusion at the C4-C5 level in the right para-central location. The patient was treated with conservative management without any surgical treatment. The patient's symptoms were significant improvement. After two years later, we performed follow-up cervical MRI that revealed significant spontaneous regression of the C4-C5 intervertebral disc extrusion.
Female ; Follow-Up Studies ; Humans ; Hypesthesia ; Intervertebral Disc ; Magnetic Resonance Imaging ; Neck Pain ; Spine ; Upper Extremity

Amniotic fluid embolism (AFE) is a rare peripartum complication with a mortality rate of 61 to 86%. The main clinical manifestations include shock, acute pulmonary edema, neurologic signs, and coagulopathies. Most diagnosis of AFE is made on the postmortem examination of the maternal pulmonary vasculature, but antemortem confirmation of amniotic fluid material by aspiration of pulmonary blood is rare. We report the first case in Korea who survived from amniotic fluid embolism confirmed by the identification of amniotic fluid debris in pulmonary artery blood. Serial echocardiographic changes of left ventricle systolic dysfunction are also described with a brief review of literatures.
Amniotic Fluid* ; Autopsy ; Diagnosis ; Echocardiography ; Embolism, Amniotic Fluid* ; Female ; Heart Ventricles* ; Korea ; Mortality ; Neurologic Manifestations ; Peripartum Period ; Pregnancy ; Pulmonary Artery ; Pulmonary Edema ; Shock

Upward migration of the peritoneal catheter of a subgaleo-peritoneal (SP) shunt and coiling into the subgaleal space is an extremely rare complication of a SP shunt. A 32-year-old male patient visited our hospital presenting with a large skull defect due to a prior craniectomy performed elsewhere. The patient underwent a cranioplasty with methylmetacrylate, but subsequently developed progressive pseudomeningocele and subgaleal cerebrospinal fluid (CSF) collection. The patient underwent CSF diversion via a SP shunt. After SP shunting, the pseudomeningocele disappeared completely. Six months later, the patient presented with progressive scalp swelling. Skull X-ray showed migration and coiling of the distal catheter of the SP shunt. The patient was treated by removing the entire shunt catheter and the dura was covered with a subgaleal flap. We would like to report our experience with a very rare complication of subgaleo-peritoneal shunting.
Adult ; Catheters* ; Cerebrospinal Fluid ; Humans ; Male ; Scalp ; Skull

BACKGROUND: Automated counting of reticulocyte introduced new reticulocyte parameters such as immature reticulocyte fraction (IRF). IRF is thought to be more sensitive than absolute or corrected reticulocyte count for detecting recovery of bone marrow function. The aim of this study is to assess the role of IRF for predicting the response of therapy after treatment of iron deficiency anemia. METHODS: Patients with previously untreated iron deficiency anemia (blood hemoglobin <10.0g/dL and serum ferritin <10ng/mL) were enrolled into this study. On the 8th day of iron therapy, Complete blood count (CBC) with reticulocyte count and IRF was assessed by RAM-1 reticulocyte autoanalyzer (Sysmex. Tokyo, Japan). IRF was defined as sum of the reticulocyte fraction of high-fluorescence intensity regions plus the fraction of middle fluorescence intensity regions. After 1 month of iron therapy, CBC was reassessed to evaluate the response of iron therapy. The correlation of the 8th day IRF and the change of hemoglobin level after 4 weeks of therapy was evaluated. The 8th day corrected reticulcyte count was also evaluated. RESULTS: From Jan. 2001 to May 2003, 27 patients with iron deficiency anemia (3 men and 24 women) entered into this study. We evaluated 21 patients, excluding 6 patients who were lost to follow-up or refused blood sampling after 1 month of iron therapy. The range of pretreatment hemoglobin level was 3.3-9.7g/dL (median 7.5g/dL). The 8th day IRF was 0.06-0.39 (median 0.15). Ten patients had the low IRF (IRF < or = 0.15). Four of them (40%) had their hemoglobin level increased by more than 3g/dL. On the other side, 11 patients had high IRF (IRF>0.15) and 10 of them (91%) had their hemoglobin level increased by more than 3g/dL. This difference was significant (P=0.024). However, the 8th day IRF was not correlated with the change of hemoglobin as strongly as the 8th day corrected reticulocyte count (Pearson coefficient 0.420 vs 0.693). CONCLUSION: For the patients with iron deficiency anemia, the 8th day of treatment IRF correlates with the response of iron treatment, but the 8th day of treatment corrected reticulocyte count has a stronger correlation.
Anemia, Iron-Deficiency* ; Blood Cell Count ; Bone Marrow ; Ferritins ; Fluorescence ; Hemoglobin A ; Humans ; Iron* ; Lost to Follow-Up ; Male ; Reticulocyte Count ; Reticulocytes*

BACKGROUND: The endothelium is an important regulator of vascular tone via release of relaxing and constricting substances. The regulatory effect of the endothelium has been shown to be impaired in atherosclerotic arteries in human and animal models of hypertension. But there are some debates on extent and developing time of endothelium dysfunction in patients with hypertension, and the determining factors for endothelium dysfunction also were not defined. The objects of this study are to determine whether endothelial function is impaired in coronary and peripheral arteries, and to investigate the predicting factors for endothelial dysfunction in patients with essential hypertension. METHODS: The study patients comprised 14 patients with essential hypertension(M : 7, Mean age : 50+/-2 year) and 6 normal control (M :2, Mean age : 45+/-4 year). We assessed the vasomotor response to acetylcholine and nitroglycerin by change of arterial diameter during the infusion of acetylcholine, from 10(-9M) to 10(-6M) in coronary artery and 7.5, 15, and 25ug/min in left superficial femoral artery, and on intracoronary injection of 200ug nitroglycerin after acetylcholine infusion. RESULTS: 1) There were no significant differences in sex, age, body mass index and ventricular mass index, except systolic(174+/-5 vs 118+/-7mmHg, p<0.001) and distolic blood pressure(106+/-5 vs 75+/-5mmHg,p<0.001) between patients with hypertension and normal control. 2) There were no significant differences in laboratory date of total cholesterol, HDL-cho-lesterol, lipoprotein(a), microaluminuria and von-Willebrand Factor but Fibrinogen level was raised significantly in patients with hypertension than normal control(299+/-26 vs 192+/-23ng/dl, p=0.04). 3) The vasoconstrictor response to acetylcholine, 10-8 to 10-6 M concentration, at proximal, mid, and distal left anterior descending coronary artery were increased significantly in hypertensive patients than normal control(p<0.05). At rest superficial femoral artery, the vasodilator response to acetylcholine, only 25ug/min, was decreased in patients with hypertension(p<0.05). There was no signficant difference in the vasodilator response to nitroglycerin at coronary artery between two groups but in superficial femoral artery, the vasodilator response to nitroglycerin was decreased significantly in hypertensive patients(p<0.05). CONCLUSIONS: The results of this study suggest that endothelium dependent vascular relaxation is impaired in both coronary and superificial femoral artery and it remained to be investigated the predicting factors for endothelial dysfunction in patients with essential hypertension.
Acetylcholine ; Arteries ; Body Mass Index ; Cholesterol ; Coronary Vessels ; Endothelium ; Femoral Artery ; Fibrinogen ; Humans ; Hypertension* ; Lipoprotein(a) ; Models, Animal ; Nitroglycerin ; Relaxation

BACKGROUND: Percutaneous transluminal coronary angioplasty(PTCA) is one of the most widely used therapeutic procedures in the treatment of patients with coronary artery disease. However, acute closure and late restenosis remain a major limitation of PTCA despite extensive efforts to prevent. Coronary artery stents have been proposed as a treatment modality for acute closure and restenosis. We evaluated the initial success rate, complications, the restenosis rate, and the clinical outcomes after coronary artery stenting. METHODS: We implanted 56 stents(Palmaz-Schatz(PS) stent : 38 ; #3.0-14, #3.5-7, #4.0-17, Gianturco-Roubin(GR) stent : 18 ; #2.5-4, #3.0-10, #3.5-1, #4.0-3) in 51 patients(male : 40, mean age : 58+/-1 year). The clinical characteristics of the subjects were unstable angina in 26(51%), stable angina in 2, and myocardial infarction in 23(45%) patients(acute : 18). Follow-up angiography was done at a mean duration of 5.4 month(1-12) after coronary stenting for 34 lesions(61%) of 30 patients. RESULTS: 1) The indications of stenting(n=56) were De novo in 33(59%), bailout procedure in 15(27%), suboptimal result after PTCA in 6, and restenosis after PTCA in 2 stents. The location of lesions were LAD in 24, RCA in 27, and circumflex artery in 5 lesions. Angiographic morphologic characteristics were type B in 38(BI : 3, B2 : 35) and type C in 18 lesions. 2) The angiographic and clinical success rate was 96%(54/56) and 94%(52/56). There were no significant difference in stent modality, lesion site and morphology, and indication of stent. 3) Procedural complications were 1 acute closure which was recanalized by emergency coronary artery bypass graft(CABG), 1 death with subacute closure, 2 dissection, and 5 hemorrhages requiring transfusion. 4) The overall restenosis rate was 26%(9/34). The restenosis rate was reduced significantly in PS stent[PS : 9%(2/22) vs GR : 58%(7/12), P < 0.05], > or =3.5mm of stent size[> or =3.5mm : 6%(1/18) vs 3.5mm : 50%(8/16), p < 0305], and high pressure ballooning group(poststenting adjunct balloon dilation pressure > 12atm) [High pressure(+) : 7%(1/14) vs High pressure(-) : 40%(8/20), p<0.05]. 5) The restenosis sites were managed with re-PTCA in 4, elective CABG in 1, and medical follow-up in 4 patients. CONCLUSION: Coronary stenting is an effective and safe procedure for the management of coronary artery disease. The PS stent and GR stent are considered as a safe means for bail-out, and the PS stent can reduces the restenosis rate especially.
Angina, Stable ; Angina, Unstable ; Angiography ; Arteries ; Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Vessels* ; Emergencies ; Follow-Up Studies* ; Hemorrhage ; Humans ; Myocardial Infarction ; Stents*

Anti-thrombin III deficiency is known as a disease of autosomal dominant trait and relatively common, but in Korea, exact incidence and mortality is not known, In general, Anti-thrombin III deficiency is expressed to venous thromboembolism like deep vein thrombosis or pulmonary embolism. But, arterial embolism is very rare. We experienced a case of Antithrombin III deficiency expressed as myocardial infarction of inferior wall by huge thrombosis in the mid and distal right coronary artery.
Antithrombin III Deficiency ; Coronary Vessels ; Embolism ; Incidence ; Korea ; Mortality ; Myocardial Infarction* ; Pulmonary Embolism ; Thrombosis ; Venous Thromboembolism ; Venous Thrombosis