The accepted radiographic method to determine cervical spinal stenosis is the direct measurement of the sagittal diameter of the spinal canal on the routine lateral view of the cervical spine. The reported normal and abnormal values for this measurement are inconsistent because of various methods of obtaining the roentgenograms and different body types which affect the size of the X-ray image. According to Pavlow, the ratio method of determining crevical spinal stenosis, in which the sagittal diameter of the spinal canal is divided by the sagittal diameter of the corresponding vertebral body, is independent of technical factor variables and is a reliable method for determining cervical spinal stenosis. In order to determine the Pavlov's ratio of normal Koreans, and compare it with that of radiculopathic group, we measured the diameter of cervicl canal in 47 normal persons(28 male, 19 female), and 32 patients( 9 male, 23 female) who had transient tingling sensation and radiculopathic symtom from the second to fifth decades. The results were as follows :1) The average Pavlov's ratio from C3 to C7 in normal Korean men are 0.906(0.70–1.13), 0.899 (0.070–1.13),0.948(0.70–1.67) and 0.948(0.67–1.17), respectively, and those of normal Korean women are 0.977(0.83–1.15), 1.021(0.83–1.13), 1.014(0.84–1.33) and 1.055(0.88–1.18), respectively. 2) The average Pavlov's ratio from C3 to C7 in radiculopathic Korean men are 0.88(0.65–1.12), 0.90(0.68–1.12), 0.95(0.79–1.12) and 0.95(0.78–1.06), respectively, and those of radiculopathic Korean women are 0.902(0.70–1.27), 0.905(0.69–1.27), 0.939(0.70–1.33) and 0.931(0.70–1. 18), respectively. 3) There are not statistically differences of the Pavlov's ratio between the control group and the radiculopathic group. 4) We believe that the Pavlov's ratio is an effective method in detection of cervical stenosis and is able to eliminate technical factor such as body position, target and object-to-film distanc.
Asian Continental Ancestry Group ; Constriction, Pathologic ; Female ; Humans ; Male ; Methods ; Sensation ; Somatotypes ; Spinal Canal ; Spinal Stenosis ; Spine

No abstract available.

PURPOSE: A number of longitudinal studies have tracked blood pressure over time in children and adults. Although there are a few blood pressure tracking studies for Asian populations, they are all relatively short-term studies with around only 10 years of follow-up. Accordingly, we assessed the stability of blood pressure tracking from childhood to adulthood over a 24-year follow-up period among participants in the Kangwha Study. MATERIALS AND METHODS: The Kangwha Study was a community-based prospective cohort study that started in 1986 in Kangwha County, South Korea. The study dataset included 14 blood pressure measurements over a 24-year period from 266 (123 male and 143 female) participants who completed the 2010 examination. All participants were 7 years old when the study began and were followed for the next 24 years. RESULTS: The tracking coefficient (95% confidence interval) for systolic blood pressure was 0.81 (0.52-1.11) in men and 0.72 (0.51-0.92) in women; diastolic blood pressure was 0.53 (0.26-0.80) in men and 0.33 (0.15-0.52) in women. After adjusting for body mass index, the tracking coefficient for systolic blood pressure was 0.68 (0.39-0.97) in men and 0.67 (0.44-0.89) in women; diastolic blood pressure was 0.51 (0.24-0.78) in men and 0.33 (0.15-0.51) in women. All tracking coefficients were statistically significant (p<0.001). CONCLUSION: In this 24-year longitudinal study, we confirmed the stability of blood pressure tracking from childhood to adulthood for participants in the Kangwha Study.
Adult ; Asian Continental Ancestry Group ; Blood Pressure* ; Body Mass Index ; Child ; Cohort Studies ; Dataset ; Female ; Follow-Up Studies* ; Humans ; Korea* ; Longitudinal Studies ; Male ; Methods ; Prospective Studies ; Republic of Korea ; Track and Field*

During ischemia-reperfusion injury, brief pre-exposure to oxidative stress renders organs resistant to subsequent severe damage. NF-kappaB is a transcription factor that is involved in reperfusion-induced inflammatory and immune responses. The activity of NF-kappaB has been shown to be modulated by oxidative stress in various cell types through different pathways. We studied the effect of pre-exposure to oxidative stress on subsequent NF-kappaB activation in TNFalpha-stimulated HEK293 cells. The cells were transiently exposed to 0.5 mM H2O2 for 20 min, prior to stimulation with TNFalpha, and the subsequent expression of NF-kappaB-dependent genes and the levels of NF-kappaB signaling molecules were measured. Pre-exposure to H2O2 significantly delayed the TNFalpha-induced expression of an NF-kappaB reporter gene and inflammatory proteins (intercellular adhesion molecule-1 and IL-1beta). The degradation of inhibitor of NF-kappaB alpha (IkappaBalpha) and the nuclear translocation of NF-kappaB were also delayed by H2O2 treatment, whereas IkappaBalpha phosphorylation and IkappaB kinase activity were not changed. When we examined the ubiquitin/proteosome pathway in H2O2-treated cells, we could not detect significant changes in proteosomal peptidase activities, but we were able to detect a delay of IkappaBalpha poly-ubiquitination. Our results suggest that transient exposure to oxidative stress temporally inhibits NF-kappaB-dependent gene expression by suppressing the poly-ubiquitination of phosphorylated IkappaBalpha in HEK293 cells.
Active Transport, Cell Nucleus ; Cell Nucleus/metabolism ; Enzyme Activation/drug effects ; HEK293 Cells ; Humans ; Hydrogen Peroxide/*pharmacology ; I-kappa B Kinase/antagonists & inhibitors/*metabolism ; Phosphorylation/drug effects ; Protein Transport ; Tumor Necrosis Factor-alpha/*pharmacology ; Ubiquitination/*drug effects

Syringomyelia is a relatively uncommon, chronic, slowly progressive, degenerative process characterized by cavitation and gliosis within the substance of the spinal cord and/or the medulla. There have been only a few case reports in Korea. The authors reviewed 17 patients with syringomyelia diagnosed by delayed metrizamide spinal CT and/or MR imaging at Seoul National University Hospital from January, 1983 to June, 1987. Eleven were male and the age of onset was less than 40 in 16 (mean 23.4). The mean duration of symptoms was 87.1 months (range 3-276). Clinical features were similar to classical cases except sphincter involovement and abnormal sweating were more common in this report. The syrinx cavity which showed dye collection within spinal cord in delayed metrizamide spinal CT and low signal intensity in T1 weighted MR imaging was located mainly at cervicothoracic junction. The causes were the hindbran abnormality in 5, intramedullary cord tumor in 5, trauma in 3, adhesive arachnoiditis in 1 and unknown in 3. The cases with sensory dissociation had shorter duration of symptoms than those without sensory dissociation and showed normal results in SEPs study. Eleven patients were treated surgically and nine of them improved. MRI and SEPs are thought to be good aids for the understanding of the mechanism and course of syringomyelia.
Adhesives ; Age of Onset ; Arachnoid ; Arachnoiditis ; Gliosis ; Humans ; Korea ; Magnetic Resonance Imaging ; Male ; Metrizamide ; Seoul ; Spinal Cord ; Sweat ; Sweating ; Syringomyelia*

PURPOSE: Anesthesia and surgery commonly cause hypothermia, and this caused by a combination of anesthetic-induced impairment of thermoregulatory control, a cold operation room environment and other factors that promote heat loss. All the general anesthetics markedly impair normal autonomic thermoregulatory control. The aim of this study is to evaluate the effect of two different types of propofol versus inhalation anesthetic on the body temperature. MATERIALS AND METHODS: In this randomized controlled study, 36 patients scheduled for elective laparoscopic gastrectomy were allocated into three groups; group S (sevoflurane, n=12), group L (lipid-emulsion propofol, n=12) and group M (micro-emulsion propofol, n=12). Anesthesia was maintained with typical doses of the study drugs and all the groups received continuous remifentanil infusion. The body temperature was continuously monitored after the induction of general anesthesia until the end of surgery. RESULTS: The body temperature was decreased in all the groups. The temperature gradient of each group (group S, group L and group M) at 180 minutes from induction of anesthesia was 2.5+/-0.6degrees C, 1.6+/-0.5degrees C and 2.3+/-0.6degrees C, respectively. The body temperature of group L was significantly higher than that of group S and group M at 30 minutes and 75 minute after induction of anesthesia, respectively. There were no temperature differences between group S and group M. CONCLUSION: The body temperature is maintained at a higher level in elderly patients anesthetized with lipid-emulsion propofol.
Aged ; Aging ; Anesthesia, General/*methods ; Anesthetics, Combined/administration & dosage ; Anesthetics, Inhalation/*administration & dosage ; Anesthetics, Intravenous/*administration & dosage ; Body Temperature/*drug effects ; Body Temperature Regulation/drug effects ; Fat Emulsions, Intravenous ; Female ; Humans ; Male ; Methyl Ethers/*administration & dosage ; Middle Aged ; Propofol/*administration & dosage

BACKGROUND: Epidural and intravenous (IV) administration of opioids are commonly used for postoperative pain management. However, studies that compare the epidural and IV routes of opiate administration show conflicting results. The purpose of this study was to determine the superior route of analgesics by comparing the effect of epidural fentanyl-bupivacaine with IV morphine using patient-controlled analgesia (PCA) system in the management of posterior thoracic surgery pain. METHODS: Sixty patients undergoing elective thoracic surgery were randomly assigned to receive either Epiural-PCA (Epi-PCA, n=30) or IV-PCA (n=30) when postoperative pain first increased to 40/100 mm (by visual analogue scale; VAS). Epi-PCA group received epidural bolus of 0.1% bupivacaine 10 ml containing fentanyl 100 microgram and then followed by Epi-PCA with 0.1% bupivacaine 100 ml containing fentanyl 800 microgram (basal infusion 2 ml/hr, PCA dose 1 ml, lock-out interval 30 min), IV-PCA group received repeated IV boluses of 3 mg of morphine until postoperative pain decreased to 40/100 mm and then followed by a IV-PCA with morphine (basal infusion 0.005 mg/kg/hr, PCA dose 0.02 mg/kg, lock-out interval 8 min). Analgesic efficacy, degree of patient satisfaction and pain, analgesics consumptions, forced vital capacity (FVC), forced expired volume in one second (FEV1) and side effects were evaluated. RESULTS: There were no significant differences in analgesic efficacy and degree of patient satisfaction and pain in both group. But the PHS were significantly lower (p<.05), and FEV1 higher (p<.05) in Epi-PCA group, signifying better analgesia during movement (cough and deep breaths). CONCLUSIONS: We concluded that an epidural PCA with mixture of fentanyl and bupivacaine administration is superior to that of intravenous PCA with morphine in the management of pain after thoracic surgery.
Analgesia ; Analgesia, Patient-Controlled* ; Analgesics ; Analgesics, Opioid ; Bupivacaine ; Fentanyl ; Humans ; Hydrogen-Ion Concentration ; Morphine* ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Patient Satisfaction ; Thoracic Surgery* ; Vital Capacity

To elucidate some DNA adducts as a biological marker for workers of chromate pigment, the effects of chromium exposure on the formation of 8-hydroxydeoxyguanosine(8-OH-dG) and sister chromatid exchanges(SCEs) frequency in 38 workers of a pigment plant in Bucheon which utilized lead chromates, were examined. The chromium contents of venous blood and urine were measured as working environmental exposure level. The concentrations of 8-OH-dG in DNA isolated from lymphocytes were determined with high performance liquid chromatography and electrochemical detector and denoted as a molar ratio of 8-OH-dG to deoxyguanosine(dG). The SCEs frequency were analyzed in DNA isolated from lymphocytes. A significant correlation was found between creatinine adjusted urine chromium concentration and the molar ratio of 8-OH-dG to dG(r=0.47, p<0.01). After adjusting the current smoking habit, the correlation coefficient was increased(r=0.62, p<0.05). However, there was no significant correlation between the SCE frequency and chromium exposure. This significant results between molar ratio of 8-OH-dG to dG and chromium exposure are in good agreement with in vitro studies that support the importance of DNA adduct formation for the carcinogenic effect of chromium.
Biomarkers ; Chromates ; Chromatids ; Chromatography, Liquid ; Chromium* ; Creatinine ; DNA ; DNA Adducts ; Environmental Exposure ; Gyeonggi-do ; Humans ; Lymphocytes ; Molar ; Plants ; Siblings* ; Sister Chromatid Exchange* ; Smoke ; Smoking

PURPOSE: To find the optimal values of total arc degree to protect the normal brain tissue from high dose radiation in stereotactic radiotherapy planning. METHODS AND MATERIALS: With Xknife-3 planning system & 4 MV linear accelerator, the authors planned under various values of parameters. One isocenter, 12, 20, 30, 40, 50, and 60 mm of collimator diameters, 100degrees, 200degrees, 300degrees, 400degrees, 500degrees, 600degrees of total arc degrees, and 30degrees or 45degrees of arc intervals were used. After the completion of planning, the plans were compared each other using V50 (the volume of normal brain that is delivered high dose radiation) and integral biologically effective dose. RESULTS: At 30degrees of arc interval, the values of V50 had the decreased pattern with the increase of total arc degree in any collimator diameter. At 45degrees arc interval, up to 400degrees of total arc degree, the values of V50 decreased with the increase of total arc degree, but at 500degrees and 600degrees of total arc degrees, the values increased. At 30degreesdegreesof arc interval, integral biologically effective dose showed the decreased pattern with the increase of total arc degree in any collimator diameter. At 45degrees arc interval with less than 40 mm collimator diameter, the integral biologically effective dose decreased with the increase of total arc degree, but with 50 and 60 mm of collimator diameters, up to 400degrees of total arc degree, integral biologically effective dose decreased with the increase of total arc degree, but at 500degrees and 600degrees of total arc degrees, the values increased. CONCLUSION: In the stereotactic radiotherapy planning for brain lesions, planning with 400degrees of total arc degree is optimal. Especially, when the larger collimator more than 50 mm diameter should be used, the uses of 500degrees and 600degrees of total arc degrees make the increase of V50 and integral biologically effective dose. Therefore stereotactic radiotherapy planning using 400degrees of total arc degree can increase the therapeutic ratio and produce the effective outcome in the management of personal and mechanical sources in radiotherapy department.
Brain ; Humans ; Particle Accelerators ; Radiotherapy*

A patient, 59 years old male, with paroxysmal AV reentrant tachycardia utilizing a concealed left lateral accessory pathway with long VA conduction time is presented. During tachycardia P waves were negative in leads I, aVL, and V6 and positive in leads aVR and V1. The R-P/P-R ratio was 1.6. Radiofrequency catheter ablation was successful to interrupt the VA conduction through the accessory pathway.
Catheter Ablation ; Humans ; Male ; Middle Aged ; Tachycardia*