The present study was carried out to clarify the anatomical changes of lumbar intervertebral discs by aging. Anterior height, posterior height, anteroposterior diameter of intervertebral discs were measured on 512 normal plain lateral radiographs of lumbosacral spine. And the indices of disc wedging and relative disc height were calculated. There was a cephalocaudal gradient of increase in the indices of disc wedging in all age groups. The indices of relative disc height were constant at all lumbar levels. These suggest that the lower disc is more wedge shaped and the height of discs changes in the constant ratio with that of vertebral body.
Aging* ; Humans ; Intervertebral Disc* ; Spine

PURPOSE: The treatment of a clinically node-positive (cN+) neck is important in the management of oral cavity squamous cell carcinoma (OSCC). However, the extent of neck dissection (ND) remains controversial. The purpose of our study was to evaluate whether level IV or V can be excluded in therapeutic ND for cN+ OSCC patients. MATERIALS AND METHODS: We performed a retrospective chart review of 92 patients who underwent a comprehensive or selective ND as a therapeutic treatment of cN+ OSCC from January 1993 to February 2009. RESULTS: The incidence rate of metastasis to level IV or V was 22% (16 of 72) on the ipsilateral neck. Of 67 cases without clinically suspicious nodes at level IV or V, 11 cases (16%, 11 of 67) had pathologically proven lymphatic metastasis to level IV or V. Only a nodal staging above N2b was significantly relevant with the higher rate of level IV or V lymph node metastasis (p=0.025). In this series, selective ND, combined with proper adjuvant therapy, achieved regional control and survival rates comparable to comprehensive ND in patients under the N stage of cN2a OSCC. CONCLUSION: In conclusion, level IV and V patients can avoid recurrence under cN2a OSCC.
Adult ; Aged ; Carcinoma, Squamous Cell/mortality/*pathology/*surgery ; Chemoradiotherapy ; Disease-Free Survival ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Mouth Neoplasms/mortality/*pathology/*surgery ; Neck/surgery ; *Neck Dissection ; Neoplasm Metastasis ; Radiotherapy, Adjuvant ; Retrospective Studies ; Treatment Outcome

Xanthii Fructus has been traditionally used for the treatment of rhinitis, rheumatoid arthritis, and eczema. In this study, a high-performance liquid chromatography-photodiode array (HPLC-PDA) method was developed and then used for the simultaneous analysis of eight phenylpropanoids in Xanthii Fructus. The analytical column used for this separation was a SunFire™ C₁₈ column, maintained at 40℃. The mobile phase used was 1.0% acetic acid in distilled water and 1.0% acetic acid in acetonitrile with gradient elution. For identify of each component, the mass spectrometer (MS) was used a Waters triple quadrupole mass spectrometer requipped with electrospray ionization (ESI) source. The HPLC-PDA method showed good linearity: correlation coefficients were ≥ 0.9996. The limits of detection and quantification of the eight compounds were 0.02 – 0.04 and 0.06 – 0.14 µg/mL, respectively. The extraction recoveries ranged from 97.51 to 108.67%. The relative standard deviation values of intra- and inter-day precision were 0.06 – 1.55 and 0.09 – 1.68%, respectively. The validated HPLC-PDA method was applied to simultaneously analyse the amounts of eight phenlypropanoids in Xanthii Fructus.
Acetic Acid ; Arthritis, Rheumatoid ; Eczema ; Limit of Detection ; Methods ; Rhinitis ; Water

BACKGROUND: The clinical features of adverse drug reactions are various and the incidence is increasing. However, there has been no published data on the prevalence of adverse reactions to drug in Korea. METHODS: There were 301 adverse drug reactions occurring in 287 patients in Ajou University Hospital from May, 2002 through November, 2003. We analyzed the frequency of each causative drugs and clinical manifestations of adverse drug reactions. RESULTS: The most prevalent causative drug was nonsteroidal anti-inflammatory drugs (NSAIDs) (66.5%), followed by antimicrobials (17.8%), anticonvulsant (3.6%) and anti-cancer drug/immunosuppressant (3.3%). The leading clinical feature was cutaneous manifestations (83.1%), especially urticaria/angioedema, followed by respiratory manifestations (16.3%) and anaphylaxis (4.3%). The most common clinical manifestation of adverse drug reactions to NSAIDs was urticaria and/or angioedema (73.8%). Beta-lactams were the most common antimicrobials causing adverse drug reactions, and maculopapular exanthema (53.1%) was the most frequent manifestation. CONCLUSION: The most common causative drug of adverse drug reactions was NSAIDs and the leading clinical feature was cutaneous manifestations in this hospital. Further epidemiologic studies will be needed to extend the overall incidence of adverse drug reactions in this country.
Anaphylaxis ; Angioedema ; Anti-Inflammatory Agents, Non-Steroidal ; beta-Lactams ; Drug-Related Side Effects and Adverse Reactions* ; Epidemiologic Studies ; Exanthema ; Humans ; Incidence ; Korea* ; Prevalence ; Tertiary Healthcare* ; Urticaria

Dronedarone is a new antiarrhythmic drug for the treatment of nonpermanent atrial fibrillation. Compared with amiodarone, it is regarded as a safe medication due to its structural differences. In this report, we describe a 56-year-old man who developed photosensitivity due to dronedarone. He presented with itchy skin rashes for 1 week. Maculopapular exanthema was localized on the neck, both arms, and both hands, with sparing of the other parts of the body. Dronedarone was prescribed 4 weeks ago when atrial fibrillation occurred. After development of skin rashes, dronedarone was discontinued, and systemic steroid, antihistamine, and topical corticosteroid were administered for 1 week, with improvement in skin rashes. The photopatch test was performed with antiarrhythmic drugs, including dronedarone, amiodarone, and flecainide, 4 weeks after withdrawal of dronedarone. Positive reactions were recorded only to dronedarone at the site exposed to ultraviolet A. He was diagnosed with dronedarone-induced photosensitivity and advised to change the antiarrhythmic medication to others. There have been a few case reports on photosensitivity reactions due to dronedarone, which were diagnosed only by clinical suspicion. However, we suspected photosensitivity and proved it by the photopatch test. Photosensitivity should be considered in patients having skin rashes on the exposed area and taking antiarrhythmic medication, including dronedarone.
Amiodarone ; Anti-Arrhythmia Agents ; Arm ; Atrial Fibrillation ; Exanthema ; Flecainide ; Hand ; Humans ; Middle Aged ; Neck

BACKGROUND: In patients with chronic obstructive pulmonary disease(COPD), several factors have been associated with a poor prognosis. These include old age, low FEV, low diffusing capacity, high alveolar-arterial oxygen pressure difference, and finally cor pulmonale. This study was done to investigate in the ECG signs suggesting cor pulmonale were independent prognostic factors in patients with COPD. METHOD: We analyzed ECG, pulmonary function data and arterial blood gas values in 61 patients who were admitted through the emergency department with an acute exacerbation of COPD. The ECG signs reflecting cor pulmonale were right atrial overloading(RAO), right bundle branch block, right ventricular hypertrophy and low-voltage QRS. The 61 patients were divided into 2 groups, group I with no ECG signs(n=36) and group II with one or more ECG signs(n=25) suggesting cor pulmonale. RESULTS: Poor prognostic factors by univariate analysis were low FEV1, FEV1 % pred., VC% pred., DLco, DLco % pred., PaO2 and SaO2 high PaCO2 presence of ECG signs reflecting cor pulmonale, presence of mental status change, use of mechanical ventilator, and long tern use of glucocorticoid. A multivariate analysis indicated that age(risk ratio=1.13, 95% confidence interval 1.05~1.23), Dlco % pred. (risk ratio=0.97, 95% confidence interval 0.94~0.99), PaO2 (risk ratio=0.95, 95% confidence interval 0.90~0.99) and RAO(risk ratio=5.27, 95% confidence interval 1.40~19.85) were independent prognostic factors of survival. There was a significant difference in survival between the patients with and without RAO(p=0.038). The survival rates at 1, 2, and 5 years were 94.5%. 81.4%, and 50.0% in patients without RAO and 82.4%, 70.6%, and 27.5% in patients with RAO, respectively. CONCLUSION: These results suggest that the presence of ECG signs reflecting cor pulmonale is a predictor of survival and that RAO of these ECG signs is a significant independent predictor of survival in patients with COPD.
Animals ; Bundle-Branch Block ; Charadriiformes ; Electrocardiography* ; Emergency Service, Hospital ; Humans ; Hypertrophy, Right Ventricular ; Multivariate Analysis ; Oxygen ; Prognosis ; Pulmonary Disease, Chronic Obstructive* ; Pulmonary Heart Disease* ; Survival Rate ; Ventilators, Mechanical

Isopropylantipyrine is one of the pyrazolon derivatives which are nonsteroidal anti-inflammatory drugs (NSAIDs) with potent antipyretic and pain-relieving properties. It has been known that pyrazolon-hypersensitive patients, in contrast to ASA-sensitive patients, could safely use other NSAIDs. We describe two Korean patients with isopropylantipyrine hypersensitivity without ASA/NSAID hypersensitivity.
Anti-Inflammatory Agents, Non-Steroidal ; Humans ; Hypersensitivity*

PURPOSE: To describe the imaging findings of traumatic intracranial aneurysms (TICA) in children. MATERIALS AND METHODS: Five boys aged 3-15 (mean, 7) years with surgically confirmed TICA were included in this study. All had a history of nonpenetrating head trauma, and they underwent precontrast CT imaging immediately after the injury and follow-up CT or MRI. In all cases, angiography revealed the presence of aneurysms, which at surgery were shown to be pseudoaneurysms with severe adhesions. RESULTS: Angiography demonstrated that all aneurysms were located in the anterior cerebral artery (ACA) or its branches. The precise locations were the A2 segment of the ACA, the site of origin of the callosomarginal artery or its first branch, or of the anterior internal frontal artery, or between the first and second branch of the pericallosal artery. In all patients, precontrast CT performed immediately after trauma depicted subarachnoid hemorrhage (SAH) in the anterior interhemispheric fissure (AIHF). Follow-up precontrast CT showed nodular high density around the anterior falx in three, recurrent SAH in the AIHF in two, and intracerebral hemorrhage (ICH) with intraventricular hemorrhage in two. In two patients with a nodular high-density lesion, nodular enhancement was demonstrated at postcontrast CT, and in one, follow-up MRI revealed a nodular signal void around the anterior falx; nodular enhancement was seen at postcontrast imaging, and MR angiogram depicted a saccular aneurysm. In one patient, MRI demonstrated infarction in the caudate nucleus and ACA territory. CONCLUSION: If, after head injury, an area of nodular high density is revealed by CT, or a signal void by MRI, or if SAH or ICH is present around the anterior falx, the possibility of TICA should be considered.
Aneurysm ; Aneurysm, False ; Angiography ; Anterior Cerebral Artery ; Arteries ; Caudate Nucleus ; Cerebral Hemorrhage ; Child* ; Craniocerebral Trauma ; Follow-Up Studies ; Hemorrhage ; Humans ; Infarction ; Intracranial Aneurysm* ; Magnetic Resonance Imaging ; Subarachnoid Hemorrhage

Cortical blindness is defined as the partial or complete loss of vision from bilateral lesions to the occipital cortex, with intact pupillary reflexes, normal fundi and extraocular movements. Although cerebrovascular disease is the most common cause of cortical blindness, cardiac surgery, cerebral angiography, eclampsia, head trauma, drug and carbon monoxide poisoning are causes too. Two patients with cortical blindness, following exposure to LNG (Liquefied Natural Gas) and argon gas are presented. Cortical blindness was thought to result from hypoxic or anoxic-ischemic change in the visual cortex, which is due to respiratory arrest from LNG intoxication and asphyxiating atmospheres from inhalation exposure to argon gas. Diagnosis was made with MRI scan showing bilateral occipital infarctions, which are the most valuable in diagnosing cortical blindness.
Argon ; Atmosphere ; Blindness, Cortical* ; Carbon Monoxide Poisoning ; Cerebral Angiography ; Craniocerebral Trauma ; Diagnosis ; Eclampsia ; Female ; Humans ; Infarction ; Inhalation Exposure ; Magnetic Resonance Imaging ; Pregnancy ; Reflex, Pupillary ; Thoracic Surgery ; Visual Cortex

BACKGROUND AND OBJECT: We want to know reference values of mitral annulus velocity by Doppler tissue imaging which has been thought as a new parameter of left ventricular diastolic function. Including mitral inflow parameters, many parameters which have been used in the evaluation of left ventricular diastolic function are affected by several conditions, so sometimes they can not provide information about left ventricular diastolic function. The knowledge of mitral annulus velocity by Doppler tissue imaging will provide new guidelines for evaluation of diastolic function. However, reference values in normal and changes according to an age have not been fully evaluated. METHODS: We examined 246 patients with no symptoms related to the cardiac systolic and diastolic dysfunction and 80 healthy volunteers according to an age. Early ( E ) and late ( A ) transmitral flow velocity and the ratio of early to late peak velocity ( E/A ) were obtained by pulsed Doppler echocardiography. Early diastolic velocity of mitral annulus ( E' ) and peak atrial systolic velocity of mitral annulus ( A' ) were obtained from the medial ( or septal ) corner of the mitral annulus and subsequently from lateral corner by Doppler tissue imaging. We obtained E', A' and the ratio of E' to A' ( E'/A' ) and E/ E' according to an age. RESULTS: E' from medial corner was the highest in subjects in their twenties and declined gradually and A' from medial corner was the lowest in a same age group and increased gradually. E'/A' ratio from medial corner was the highest in subjects in their twenties and declined gradually and reversed in subjects in their forties. E', A' and E'/A' from lateral corner were showed like as medial corner similarly but E'/A' was reversed in the subjects in their fifties. E/ E' from medial and lateral corner was the lowest in subjects in their twenties and increased gradually with age. In comparison between transmitral flow velocity and mitral annulus velocity, there are good relationship in E/A and E'/A' ( p=0.01 ). CONCLUSION: We measured reference values of mitral annulus velocity by Doppler tissue imaging and E/ E' according to an age.
Echocardiography, Doppler, Pulsed ; Healthy Volunteers ; Humans ; Reference Values