BACKGROUND: Increased left ventricular mass in patients with essential hypertension, coronary artery disease, chronic renal failure or in general population has been suggested as a useful predictor of increased cardiovascular morbidity and mortality. Many studies have reported that left ventricular mass is correlated postively with body size. Thereafter normalization of left ventricular studies, but it is uncertain which is appropriate. This study was designed to determine the appropriate method for normalization of left ventricular mass to exclude influence of body size in normal adults. METHODS: We measured left ventricular mass 100 normal adults by M-mode echocardiogram using ASE cube method without(Devereux and Reichek's method) and with correction(Devereux and Alonso's method). Left ventricular mass were normalized for body weight, height, body surface area, body surface area1.5, height2.0 and height2.7 RESULTS: 1) Left ventricular mass by Devereux and Reichek's method correlated well with that by Devereux and Alonso's method(r=1.0,p<0.001). 2) Corrected left ventricular mass correlated well with weight(r=0.64, p<0.001), height(r=0.49, p<0.05), body surface area(r=0.53, p<0.01) and body mass index(r=0.58, p<0.001). 3) Correlation coefficients of left ventricular mass/weight with weight, of ventricular mass/height with height, of ventricular mass/height2.0 with height, of ventricular mass/height2.7 with height, of ventricular mass/body surface area with body surface area and of ventricular mass/body surface area1.5 with body surface area were 0.12, -0.05, -0.29, -0.42, 0.13 and -0.11 respectively. 4) Peak systolic wall stress correlated with age and left ventricular mass, but end systolic wall stress did not correlated with left ventricular mass. CONCLUSIONS: The current indexation method of left ventricular mass for height may reduce the variability associated with body size. Furthermore, it could be used reliably in normal Korean adults.
Adult* ; Body Height ; Body Size* ; Body Surface Area ; Body Weight ; Coronary Artery Disease ; Echocardiography ; Humans ; Hypertension ; Kidney Failure, Chronic ; Mortality

Informed consent (IC) should be a form of communication between a physician and patient in which information regarding all options of a medical procedure and the patient's preference is shared. The aim of this study was to create a standard for communication by IC for physicians. The IC standard was developed based on an analysis of a dialogue in our previous experience with a medical communication program and a review of the literature. The dialogue pattern of the IC standard had the following six elements: opening; orientation; disclosure of information; conforming and complementing; shared decision making; and closing. Factors that influenced effective IC-based communication included preparation, attitude, empathy, listening, a psychosocial factor, nonverbal communication, explanation, and understanding. The IC communication standard will be useful in improving the quality of communication between a physician and patient in obtaining IC. It will also be used as a guideline for communication educators and medical students. Innovative strategies and rigorous studies are needed to improve IC counseling to establish effective patient-centered interviews.
Complement System Proteins ; Counseling ; Decision Making ; Disclosure ; Empathy ; Humans ; Informed Consent* ; Nonverbal Communication ; Psychology ; Students, Medical

PURPOSE: Vascular smooth muscle cells (VSMCs) migration and proliferation are important for neointimal formation after arterial injury. Migration of VSMCs requires degradation of basement membrane and extracelluar matrix surrounding the cell, and there is increasing evidence that VSMCs produce extracelluar matrix-degradating proteinases, such as matrix metalloproteinases (MMPs) after arterial injury. To assess the role of MMPs in VSMCs proliferation, migration and intimal thickening, we measured the expression of MMP-2 and MMP-9 in the balloon-injured rat aorta model. METHOD: Twenty-five male Sprague-Dawley rats weighting of 250~300 gm were underwent aortic intimal denudation with 2F balloon catheter. Aorta was harvested at various time intervals of 1, 3, 5, 7, 21 days and then analyzed the MMP expression used by gelatin zymography. Intimal hyperplasia caused by balloon injury was confirmed by microscopic examination. RESULT: MMP-2 (72 kD) was constitutively expressed in the normal aorta and was not increased substantially after injury. But the expression of 62 kd forms, which is activated form of MMP-2, was significantly increased during the period of 5 through 7 days after injury (P<0.05). The expression of MMP-9 (92 kD) was significantly increased at 1st day after injury and diminished thereafter (P<0.05). CONCLUSION: These results suggest that activated MMP-2 (62 kD) and MMP-9 (92 kD) may play an important role in VSMCs migration and formation of intimal hyperplasia after arterial injury. And the activated form of MMP-2 (62 kD) seems to be involved mainly in degradation of basement membrane and matrix.
Animals ; Aorta* ; Basement Membrane ; Catheters ; Gelatin ; Humans ; Hyperplasia* ; Male ; Matrix Metalloproteinases* ; Muscle, Smooth, Vascular ; Peptide Hydrolases ; Rats* ; Rats, Sprague-Dawley

OBJECTIVE: The purpose of this study was to evaluate the physicochemical properties and cytocompatibility of microporous, spherical biphasic calcium phosphate(BCP) ceramics with a 60/40 hydroxyapatite/beta-tricalcium phosphate weight ratio for application as a bone graft substitute. MATERIALS AND METHODS: Microporous, spherical BCP granules(MGSB) were prepared and their basic characteristics were compared with commercially available BCP(MBCP; Biomatlante, France) and deproteinized bovine bone mineral(Bio-Oss; Geistlich-Pharma, Switzerland, BBP; Oscotec, Korea). Their physicochemical properties were evaluated by scanning electron microscopy, X-ray diffractometry, Fourier-transform infrared spectroscopy, inductively coupled plasma atomic emission spectrometer, and Brunauer-Emmett-Teller method. Cell viability and proliferation of MC3T3-E1 cells on different graft materials were evaluated. RESULTS: MGSB granules showed a chemical composition and crystallinity similar with those in MBCP, they showed surface structure characteristic of three dimensionally, well-interconnected micropores. The results of MTT assay showed increases in cell viablity with increasing incubation times. At 4d of incubation, MGSB, MBCP and BBP showed similar values in optical density, but Bio-Oss exhibited significantly lower optical density compared to other bone substitutes(p < 0.05). MGSB showed significantly greater cell number compared to other bone substitutes at 3, 5, and 7d of incubation(p < 0.05), which were similar with those in polystyrene culture plates. CONCLUSION: These results indicated the suitable physicochemical properties of MGSB granules for application as an effective bone graft substitute, which provided compatible environment for osteoblast cell growth. However, further detailed studies are needed to confirm its biological effects on bone formation in vivo.
Bone Substitutes ; Calcium* ; Cell Count ; Cell Survival ; Ceramics* ; Crystallins ; Microscopy, Electron, Scanning ; Osteoblasts ; Osteogenesis ; Plasma ; Polystyrenes ; Spectrum Analysis ; Switzerland ; Transplants*

PURPOSE: To evaluate the possible role of DNA content abnomrality in solid tumors as a diagnostic indicator in Korean patients, the incidence of aneuploidy in the major organs were analyzed and compared with the incidences which have been reported in the literatures. MATERIALS AND METHODS: Flow cytometric analysis of DNA content were performed on the 1673 fresh tissues of neoplastic lesions which were obtained for the last five years in Hospital. RESULTS: The frequency of aneuploidy was more than 50% in the primary malignant tumors of the stomach, colon, esophagus, liver, biliary tract, pancreas, head and neck organs, salivary gland, lung, breast, ovary, CNS and urinary tract. However, the frequency of aneuploidy was as low as 7% in papillary carcinoma of thyroid and about 30% in renal cell carcinoma and malignant lymphomas. High frequency of aneuploidy (more than 70%) was seen in the metastatic tumors in liver, brain, ovary and lymph nodes. Aneuploidy was also found in benign tumors of salivary gland, adenomas of endocrine organs, meningiomas, smooth muscle tumors and schwannomas. CONCLUSION: The results of present study were in concordant with those of the other domestic and foreign studies. Although aneuploidy can be observed in some benign tumors, DNA ploidy pattern is considered to be an important diagnostic and prognostic factors in malignant lesions of the various organs.
Adenoma ; Aneuploidy ; Biliary Tract ; Brain ; Breast ; Carcinoma, Papillary ; Carcinoma, Renal Cell ; Colon ; Diploidy ; DNA* ; Esophagus ; Female ; Head ; Humans ; Incidence ; Liver ; Lung ; Lymph Nodes ; Lymphoma ; Meningioma ; Neck ; Neurilemmoma ; Ovary ; Pancreas ; Ploidies* ; Salivary Glands ; Smooth Muscle Tumor ; Stomach ; Thyroid Gland ; Urinary Tract

OBJECTIVE: To investigate whether an audible cracking sound during shoulder manipulation following distention arthrography is clinically significant in patients with adhesive capsulitis of the shoulder. METHODS: A total of 48 patients (31 women, 17 men) with primary adhesive capsulitis of the shoulder completed the study. All participants underwent C-arm-guided arthrographic distention of the glenohumeral joint with injections of a corticosteroid and normal saline. After distention, we performed flexion and abduction manipulation of the shoulder. The patients were grouped into sound and non-sound groups based on the presence or absence, respectively, of an audible cracking sound during manipulation. We assessed shoulder pain and disability based on a Numeric Rating Scale (NRS), the Shoulder Pain and Disability Index (SPADI), and passive range of motion (ROM) measurements (flexion, abduction, internal and external rotation) before the procedure and again at 3 weeks and at 6 weeks after the intervention. RESULTS: The patients were divided into two groups: 21 were included in the sound group and 27 in the non-sound group. In both groups, the results of the NRS, SPADI, and ROM assessments showed statistically significant improvements at both 3 and 6 weeks after the procedure. However, there were no significant differences between the two groups except with respect to external rotation at 6 weeks, at which time the sound group showed a significant improvement in external rotation when compared with the non-sound group (p<0.05). CONCLUSION: These findings showed that manipulation following distention arthrography was effective in decreasing pain and increasing shoulder range of motion. In addition, the presence of an audible cracking sound during manipulation, especially on external rotation, was associated with better shoulder range of motion.
Adhesives* ; Arthrography* ; Bursitis* ; Female ; Humans ; Range of Motion, Articular ; Shoulder Joint ; Shoulder Pain ; Shoulder*

Purpose: To evaluate the clinical and radiographic results of primary bipolar arthroplasty during average 9.8-year period, using a non-cemented Multilock femoral stem and a biarticular acetabular cup. Materials and Methods: This study included 24 patients (29 hips) who underwent primary bipolar hemiarthroplasties with Multilock femoral stems and biarticular cups and who could be followed for more than seven years. Clinically, we evaluated the Harris Hip scores and patient complaints of thigh and inguinal pain. We also evaluated the radiographic measurements around the femoral stems and the bipolar cups. Results: The average Harris Hip score improved from 57.4 points to 91.6 points; and 3 (10.3%) hips were associated with thigh pain and 4 (13.8%) hips with inguinal pain. Around the femoral stem there was a non-progressive radiolucent line less than 1 mm in length in 4 (13.8%) hips and osteolysis was present in 6 (20.6%) hips. With respect to the stability of the fixations, there was osseous ingrowth in 26 (89.7%) hips and fibrous ingrowth in 3 (10.3%) hips. Around the acetabulum there was osteolysis in 5 (17.2%) hips, proximal migration of the cup in 2 (6.9%) hips, and erosion of the acetabular cartilage in 10 (34.5%) hips. There were 3 (10.3%) biarticular cups, which were converted to total hip arthroplasties, but no femoral stems were revised. The overall failure rate of the primary operations was 10.3%. Conclusion: The current study demonstrated favorable results after bipolar hemiarthroplasties with Multilock femoral stems. However, the osteolysis that occurred around the femoral stems and the acetabula emerged as a problem after the total hip arthroplasties. In particular, it is expected that the osteolysis would increase over time and become the main cause for the need for surgical revision.
Acetabulum ; Arthroplasty ; Cartilage ; Follow-Up Studies* ; Hemiarthroplasty* ; Hip ; Humans ; Osteolysis ; Reoperation ; Thigh

PURPOSE: Minocycline appears to reduce the mortality rate of patients with myocardial infarction. Therefore, the cardioprotective effects of minocycline through reduction of apoptosis were studied in a rat myocardiac cell culture induced by hypoxia. METHODS: Cultured cells from the hearts of Sprague-Dawley rats were divided into two sets of groups: normoxia groups treated with 5% O2 and hypoxia groups treated with 1% O2. After several days of incubation, the control groups were not treated with minocycline, while the sample groups were treated with 1 mug/mL of minocycline. The damaged cells were observed under a microscope, while apoptosis was detected using a Tdt-mediated dUTP nick and labeling(TUNEL) assay control-stained with 4'-6'-diamidino-2-phenylindole-2HCl(DAPI). RESULTS: In normoxia, the control group showed a statistically significant difference from the sample group treated with 1 mug/mL of minocycline. In addition, in hypoxia, there was also a statistically significant difference between the two groups. When comparing the normoxia and hypoxia groups to each other, there was a statistically significant difference between the control groups and sample groups. CONCLUSION: Minocycline was found to be protective for heart in normoxia and in hypoxia in the model of rat myocardiac cell culture.
Animals ; Anoxia* ; Apoptosis ; Cell Culture Techniques* ; Cells, Cultured ; Heart ; Humans ; Minocycline* ; Mortality ; Myocardial Infarction ; Rats* ; Rats, Sprague-Dawley

OBJECTIVE: To evaluate the risk of phrenic nerve injury during ultrasound-guided stellate ganglion block (US-SGB) according to sonoanatomy of the phrenic nerve, and determine a safer posture for needle insertion by assessing its relationship with surrounding structure according to positional change. METHODS: Twenty-nine healthy volunteers were recruited and underwent ultrasound in two postures, i.e., supine position with the neck extension and head rotation, and lateral decubitus position. The transducer was placed at the anterior tubercle of the C6 level to identify phrenic nerve. The cross-sectional area (CSA), depth from skin, distance between phrenic nerve and anterior tubercle of C6 transverse process, and the angle formed by anterior tubercle, posterior tubercle and phrenic nerve were measured. RESULTS: The phrenic nerve was clearly identified in the intermuscular fascia layer between the anterior scalene and sternocleidomastoid muscles. The distance between the phrenic nerve and anterior tubercle was 10.33±3.20 mm with the supine position and 9.20±3.31 mm with the lateral decubitus position, respectively. The mean CSA and skin depth of phrenic nerve were not statistically different between the two positions. The angle with the supine position was 48.37°±27.43°, and 58.89°±30.02° with the lateral decubitus position. The difference of angle between the two positions was statistically significant. CONCLUSION: Ultrasound is a useful tool for assessing the phrenic nerve and its anatomical relation with other cervical structures. In addition, lateral decubitus position seems to be safer by providing wider angle for needle insertion than the supine position in US-SGB.
Fascia ; Head ; Healthy Volunteers ; Muscles ; Neck ; Needles ; Phrenic Nerve* ; Posture* ; Skin ; Stellate Ganglion* ; Supine Position ; Transducers ; Ultrasonography

Although central catheter-related complications are frequently reported and are inevitable in the neonatal care unit, the incidence of pericardiac tamponade is low but may be fatal. Index of suspicion, prompt diagnosis, and urgent pericardiocentesis are crucial for lifesaving. We encountered two premature cases of central venous catheter-related pericardial tamponade. The first case was a 4-day-old male premature infant (gestational age [GA], 33(+5) weeks; birth weight [BW], 1,864 g), and the second case was a 4-day-old female premature infant (GA, 28(+6) week; BW, 1,050 g). Each infant had an indwelling central venous catheter since birth and at the third day of hospitalization. The conditions of the babies suddenly deteriorated, but both babies were successfully resuscitated with urgent echocardiography and prompt pericardiocentesis.
Birth Weight ; Cardiac Tamponade* ; Central Venous Catheters ; Diagnosis ; Echocardiography ; Female ; Hospitalization ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature* ; Male ; Parturition ; Pericardiocentesis