OBJECTIVE: To investigate the relationship between the curvature of the cervical spine and various clinical parameters and to identify the validity of new curvature measurement methods. METHOD: The cervical spine curvature was assessed on lateral view of plain radiographs by three measurement indices. Index 1 is the ratio of length of line drawn by C2-C7 posteroinferior points and the longest length of vertical line to the posterior curve of C2-C7. Index 2 is the angle formed by three points of index 1. Index 3 is the sum of each distance from line drawn by C2-C7 posteroinferior point to C3-C7 posterior mid-points. The difference of each group and the relationship between pain scale and three indices were statistically analyzed by t-test and Pearson's correlation test. RESULTS: Sixty-three percent of control group patients showed a straight or kyphotic curvature and younger women group was more likely to have a straight curvature than other age groups. The newly designed measurement methods reflect the diagnostic significance of cervical curvature type measurement. Cervical lordosis did not exactly correlate with pain scale, symptom duration and the difference of clinical diagnosis. But the patients showing interval changes of pain scale were revealed the correlative change of curvature indices with each correlation coefficient of -0.43, -0.69 and -0.55 respectively. CONCLUSION: The altered cervical curvature is less valuable for the diagnostic significance and did not relate to the pain scale and duration, but cervical curvature reflect the interval change of the pain scale.
Animals ; Diagnosis ; Female ; Humans ; Lordosis ; Neck Pain* ; Spine*

BACKGROUND: Resistance of Mycobacterium tuberculosis to anti-tuberculosis (TB) drugs is almost exclusively due to spontaneous chromosomal mutations in target genes. Rapid detection of drug resistance to both first- and second-line anti-TB drugs has become a key component of TB control programs. Technologies that allow rapid, cost-effective, and high-throughput detection of specific nucleic acid sequences are needed. This study was to develop a high-throughput assay based on allele-specific primer extension (ASPE) and MagPlex-TAG microspheres to detect anti-TB drug resistance mutations. METHODS: DNA samples from 357 M. tuberculosis clinical isolates and H37Rv were amplified by multiplex PCR using four primer sets, followed by multiplex ASPE using 23 TAG-ASPE primers. The products were sorted on the TAG-ASPE array and detected by using the Luminex xMAP system. Genotypes were also determined by sequencing. RESULTS: Genetic drug susceptibility typing by the TAG-ASPE method was 100% concordant with those obtained by sequencing. Compared with phenotypic drug susceptibility testing (DST) as a reference method, the sensitivity and specificity of the TAG-ASPE method were 83% (95% confidence interval [CI], 79-88%) and 97% (95% CI, 90-100%) for isoniazid. For rifampin testing, the sensitivity and specificity were 90% (95% CI, 86-93%) and 100% (95% CI, 99-100%). Also, the sensitivity and specificity were 58% (95% CI, 51-65%) and 86% (95% CI, 79-93%) for ethambutol. CONCLUSIONS: This study demonstrated the TAG-ASPE method is suitable for highly reproducible, cost-effective, and high-throughput clinical genotyping applications.
DNA ; Drug Resistance* ; Ethambutol ; Genotype ; Isoniazid ; Microspheres ; Multiplex Polymerase Chain Reaction ; Mycobacterium tuberculosis ; Rifampin ; Tuberculosis ; Viperidae

The authors applied ADDES-HV parent evaluation scale for the purpose of screeing test to 538 2nd grade elementary school students from March 1994 to May. The results were as follows: There was no differences in scores of ADHD between schools. In comparing the male and female between three school students, male students showed signifieant high scores (p<0.05) than female students in the score of ADDES-HV subscale and total. There was no significant differences in ADDES-HV scale between male students and female students in both ADHD patients and normal controls. In reliability test for test and retest, the reliability coefficient was higher satisfatorily and that of inattention was 0.80, inpulsivity was 0.69, hyperactivity was 0.63 and the total score was 0.82. In reliability test by internal consistancy, the Cronbach a coefficient of patient group was 0.85(p<0.05) and that of normal control was 0.84(p<0.05). The Concurrent validity between ADDES-HV scale and DSM- III -R scale was 0.57(p<0.05) in ADHD patient group and 0.84(p<0.05) in normal control group. In discriminant validity test between ADHD patient group and normal control, the ADHD patient group showed higher score(p<0.05). The total disciminant capacity of the patient group in ADDES-HV scale was 94.44%. When we regard the cut off point as standard deviation 1.5, the male student was 80 score and the female student was 69 score. In this point of view, ADDES-HV scale was proved to be the useful screening test tool for ADHD research and showed higher reliability and validity in applying to Korean subjects.
Attention Deficit Disorder with Hyperactivity* ; Child* ; Daegu* ; Female ; Humans ; Male ; Mass Screening ; Parents ; Reproducibility of Results

OBJECTIVES: Peripheral benzodiazepine receptor has been suggested to be associated with the relief of anxiety response induced by stresses. This study was designed to observe the anxiolytic activity of peripheral benzodiazepine receptor. METHODS: Male Sprague-Dawley rats, weighing 200-250g were forced to suffer an immobilization stress for 2 hours. The level of anxiety by immobilization was performed by an elevated plus maze and was evaluated by the number of [3H]Ro5-4864 binding sites in the olfactory bulb. RESULTS: Saturation experiments followed by scatchard anlayses of the results showed that the density of peripheral benzodiazepine receptor increased and the affinity of the peripheral benzodiazepine receptor remained unchanged. It was found that there was no significant change in the cerebral cortex. Pretreatment with clonazepam, a central benzodiazepine receptor agonist, before an immobilization stress abolished the anxoius response on the performance of plus maze. In this group, upregulation of peripheral benzodiazepine receptor of olfactory bulb was not observed. Ro5-4864, a peripheral benzodiazepine receptor agonist, elicited an increase of anxiolytic response on the performance of plus maze. Progesterone, a precursor of neuroactive steroid, also increased anxiolytic response on the performance of plus maze. Pretreatment with PK11195, a peripheral benzodiazepine receptor antagonist, abolshed the anxiolytic effect of progesterone. CONCLUSIONS: From these results, it could be concluded that peripheral benzodiazepine receptor is closely associated with the relief of acute stress induced anxiety response via an increase of synthesis of neuroactive steroid.
Animals ; Anti-Anxiety Agents ; Anxiety* ; Benzodiazepines* ; Binding Sites ; Cerebral Cortex ; Clonazepam ; Humans ; Immobilization ; Male ; Olfactory Bulb ; Progesterone ; Rats* ; Rats, Sprague-Dawley ; Receptors, GABA-A* ; Up-Regulation

OBJECTIVE: In the management of spasticity, intramuscular neurolysis with small amount of dilute aqueous phenol has proved to be a useful measure. But, considerable problem has taken place in utilization of phenol. This study was attempted to compare the effect of phenol and alcohol for the peripheral nerve blocking in the management of spasticity. METHOD: Intraneural injection of 5% phenol, 50% alcohol and 90% alcohol solution carried out in each group of 10 rats. A total of 30 rat were injected and examined electrophysiologically before and after blocking the nerve (24 hour, 1 weeks, 2 weeks, 4 weeks, 8 weeks). The randomized one rat of each group was sacrificed for the histological examination of the sciatic nerve at every examined day. RESULTS: There was no difference of the distal latencies and amplitudes of compound muscle action potentials among the groups before injection. The latencies were prolonged at 24 hours post-injection and shortened at 1 week post-injection in all the groups. The amplitudes were markedly decreased at 24 hours post-injection and increased at 1 week post- injection and reached the pre-injection value at 8 week post-injection in all the groups. Histologic studies showed necrosis at 1 week post-injection and regeneration at 2 week post- injection in 50% and 90% ethanol groups. Phenol injection group showed necrosis at 4 week post-injection and regeneration after 8 weeks. CONCLUSION: Our preliminary experience with alcohol for peripheral nerve blocking with encouraging result has been described.
Action Potentials ; Animals ; Ethanol ; Muscle Spasticity ; Necrosis ; Nerve Block ; Peripheral Nerves ; Phenol* ; Rats* ; Regeneration ; Sciatic Nerve*

BACKGROUND: Lactate dehydrogenase (LDH) has been reported to be a sensitive indicator of pancreatic necrosis (PN), and some studies suggested that an elevation of the ratio of LDH to AST (LDH/AST ratio) woud be more accurate indicator of PN in acute biliary pncreatitis (BP). However, there were no studies in alcoholic pancreatitis (AP). The aim of this study was to assess the clinical usefulness of LDH/AST ratio in alcoholic pancreatitis (AP) as a indicator of PN. METHODS: On the basis of CT scan findings, the patients were categorized into two groups as having PN or non-PN. The plasma levels of the LDH, AST and LDH/AST ratio over two weeks postadmission period were evaluated and compared with in two groups of patients with BP (consiting of 12 PN and 34 non-PN patients), and with AP (consisting of 14 PN and 38 non-PN patients). RESULTS: In acute BP, on post-admission days 1 and 2, the LDH/AST ratio were low in both groups without significant difference. In the group with PN, thereafter, the LDH/AST ratio increased gradually, reached peak values at the 7th days and decreased. In the non-PN patients, the LDH/AST ratio increased gradually, but remained below the control range. The LDH/AST ratios were significantly higher from post-admission day 3 in the group with PN than in the non-PN group. In acute AP, the LDH levels were significantly higher over two weeks from admission day in the PN patients. The LDH/AST ratios were remained within or below the control range in both groups, though with statistically significnat difference. CONCLUSION: The LDH/AST ratio could be used as an indicator of PN in acute BP. In acute AP, however, LDH was a more useful indicator from the early stage in the course.
Alcoholics* ; Humans ; L-Lactate Dehydrogenase ; Necrosis* ; Pancreatitis, Alcoholic* ; Plasma ; Tomography, X-Ray Computed

Rheumatoid arthritis (RA) mainly affects polyarticular joints and is characterized by inflammation of the synovial membrane leading to joint destruction. We report on an unusual case of RA presenting as an intra-articular mass invading bone of the wrist joint in a patient with chronic monoarthritis. A 43-year-old man presented with left wrist joint pain and swelling lasting several years. A plain radiograph showed a non-specific osteolytic lesion in the distal ulna but a magnetic resonance image demonstrated an intra-articular irregular mass-like lesion with eccentric bone erosion the distal radioulnar joint. Synovial biopsy detected hyperplasia of the synovial lining cell layer and finger-like protrusions of inflamed and edematous fibrovascular stroma containing dense inflammatory infiltrates, mainly plasma cells, B cells, and CD4+ T cells. Rheumatoid factor and anti-citrullinated protein antibody were highly positive. The patient was diagnosed with RA and treated with disease-modifying anti-rheumatic drugs, showing a good response on further follow-up.
Adult ; Antirheumatic Agents ; Arthritis, Rheumatoid* ; B-Lymphocytes ; Biopsy ; Follow-Up Studies ; Humans ; Hyperplasia ; Inflammation ; Joints ; Plasma Cells ; Rheumatoid Factor ; Synovial Membrane ; T-Lymphocytes ; Ulna ; Wrist Joint* ; Wrist*

BACKGROUND AND AIMS: Recently, similar to the anomalous union of the pancreatobiliary duct (AUPBD), a low junction of the cystic duct (LJCD) was reported to be associated with the carcinogenesis of the gall bladder (GB) and other pancreatobiliary diseases. This study was designed to evaluate the clinical significance of the LJCD. METHODS: In this study all cases were performed ERCP. Three hundred and twenty two cases were selected due to their clear identification of the union area between the bile duct and the pancreatic duct, inserted area of the cystic duct, and the duodenal opening of the bile duct. The LJCD was defined that the cystic duct joins the distal bile duct between the upper margin of the pancreas and the duodenal opening of the bile duct. AUPBD was defined as a common channel greater than 15 mm in length. The clinical data was divided into four groups-normal biliary anatomy (Group 1), AUPBD (Group 2), LJCD (Group 3), and combined with AUPBD and LJCD (Group 4), and then analyzed. RESULTS: The mean age of the subjects was 56.6 with 183 male and 139 female cases. Among 322 cases, there were 7.1% (23 of 322) of AUPBD, 11.2% (36 of 322) of LJCD and 0.6% (2 of 322) of combined with AUPBD and LJCD. The clinical symptoms and the laboratory findings of the subjects were no statistical significance among the groups. The incidence of CBD stones was 27.3% (88 of 322) of the patients; 25.3% (66 of 261) of Group 1, 21.7% (5 of 23) of Group 2, 47.2% (17 of 36) of Group 3, and were significantly higher in Group 3 than Group 1 & Group 3 (p=0.038). However, the incidence of GB stones and cystic duct stones was no statistical significance among the groups. Malignant diseases of the biliary trees were 9.65% (31 of 322) of the patients; 6.8% (18 of 261) of Group 1, 26% (6 of 23) of Group 2, 13.8% (5 of 36) of Group 3, and were closely correlated with AUPBD (p<0.001) and LJCD (p=0.017). CONCLUSIONS: LJCD is relatively common in patients undergoing ERCP and closely correlated with the CBD stones and the malignacies of the biliary system. However its role in these condition is uncertain and needs to be further investigated.
Bile Ducts ; Biliary Tract ; Carcinogenesis ; Cholangiopancreatography, Endoscopic Retrograde ; Cystic Duct* ; Female ; Humans ; Incidence ; Male ; Pancreas ; Pancreatic Ducts ; Urinary Bladder

Cerebral venous sinus thrombosis is a rare type of cerebrovascular disease with highly variable clinical features. Although intracranial hemorrhage can occur in a patient with cerebral venous sinus thrombosis, the development of subdural hemorrhage has been infrequently reported. Herein we report a 49-year-old woman with cerebral venous sinus thrombosis who developed subdural hemorrhage. We presumed that the elevation of venous or capillary pressure caused by venous sinus thrombosis played an important role in the development of subdural hemorrhage.
Capillaries ; Female ; Hematoma, Subdural ; Humans ; Intracranial Hemorrhages ; Middle Aged ; Sinus Thrombosis, Intracranial

Pseudomembranous colitis (PMC) is mostly related with the antibiotics and it presents with diarrhea, abdominal pain, fever, hypoalbuminemia and hypovolemia. In the clinical course of pseudomembranous colitis (PMC), ascites is a rare presentation, and high elevation of carcinoembryonic antigen (CEA) associated with PMC is also a very rare presentation. We experienced a case taken cephalosporin group antibiotics for six weeks and presented with fever, abdominal pain, severe diarrhea, and massive ascites. During evaluation, we found low serum-ascites albumin gradient and high level of CEA in both ascites and plasma. With the impression of hidden malignancy, the special studies were done, but PMC was only found without malignancy. After vancomycin therapy, all symptoms were relieved and CEA level declined.
Abdominal Pain ; Anti-Bacterial Agents ; Ascites* ; Carcinoembryonic Antigen ; Diarrhea ; Enterocolitis, Pseudomembranous* ; Fever ; Hypoalbuminemia ; Hypovolemia ; Plasma ; Vancomycin