The primary overaction of the inferior oblique(IO) muscle is of unknown cause, whereas the secondary overaction of IO is usually related to the palsy of the ipsilateral superior oblique or contralateral superior rectus. To understand the cause of the primary overaction of the IO, an ultrastructural study on primary and secondary overacting IO muscles was performed by electron microscopy. The most striking abnormalities were aggregations of mitochondria, degeneration of mitochondrial profiles, and increased vacuolization in primary and secondary overacting muscles. These changes were more severe in cases of primary overaction thitn in those of secondary overaction. Many muscle fibers were in different stages of atrophy. Hypertrophy and regeneration of muscle fibers were sometimes visible. The primary and the secondary overacting IO muscles showed similar morphologic alterations. These results suggest that the primary overacting IO muscle might be the result of a paresis of the superior oblique muscle.
Atrophy ; Hypertrophy ; Microscopy, Electron ; Mitochondria ; Muscles* ; Paralysis ; Paresis ; Regeneration ; Strikes, Employee

The primary overaction of the inferior oblique(IO) muscle is of unknown cause, whereas the secondary overaction of IO is usually related to the palsy of the ipsilateral superior oblique or contralateral superior rectus. To understand the cause of the primary overaction of the IO, an ultrastructural study on primary and secondary overacting IO muscles was performed by electron microscopy. The most striking abnormalities were aggregations of mitochondria, degeneration of mitochondrial profiles, and increased vacuolization in primary and secondary overacting muscles. These changes were more severe in cases of primary overaction thitn in those of secondary overaction. Many muscle fibers were in different stages of atrophy. Hypertrophy and regeneration of muscle fibers were sometimes visible. The primary and the secondary overacting IO muscles showed similar morphologic alterations. These results suggest that the primary overacting IO muscle might be the result of a paresis of the superior oblique muscle.
Atrophy ; Hypertrophy ; Microscopy, Electron ; Mitochondria ; Muscles* ; Paralysis ; Paresis ; Regeneration ; Strikes, Employee

Post-menopausal osteoporosis is known to be related to estrogen deficiency. The purpose of this experimental study is to investigate whether or not estrogen administration can prevent or retard the process of osteoporosis induced by oophorectomy in rats. Fifty-two Sprague-Dawley rats, aged five months, were separated into three groups. Group 1 (4 rats) was control group that had sham operation without oophorectomy. Goup 2 (32 rats) was another control group that had bilateral oophorectomy alone. Group 3 (16 rats) was experimental group that had estradiol administration from the fourth week through the eighth week after bilateral oophorectomy. In group 1, all the rats were killed at the fourth week after sham operation. In group 2 and group 3, four rats in each group were killed weekly until the eighth week after oophorectomy. All the animals were subjected to radiological, histological studies on the tibia, ilium, skull, and the sixth lumbar vertebra. Also, histomorphometric measurements were 1. Osteoporotic changes were evident from the fifth week after oophorectomy and increased with time on the radiologic examination in group 2. In contrast, osteoporotic changes were evident from the second week after oophorectomy and progressed with time on the histological and histomorphometric studies in group 2. 2. After administration of estradiol, osteoporotic changes which include thinning of the cortex, decrease of the amount of trabeculae were partially restored on the radiological, histological studies in group 3. 3. Histomorphometric study revealed that the trabecular area percent (the proportion of total area of the trabeculae from the whole metaphyseal area), decreased progressively through the eight week after oophorectomy in gorup 2. Whereas the trabecular area percents of group 3 were higher than those of group 2, but still lower than initial value before oophorectomy. Based on the above observations, estradiol administration appeared to delay the progression of the osteoporotic changes induced by oophorectomy in rats.
Animals ; Estradiol ; Estrogens ; Female ; Humans ; Ilium ; Osteoporosis ; Osteoporosis, Postmenopausal ; Ovariectomy ; Rats ; Rats, Sprague-Dawley ; Skull ; Spine ; Tibia

PURPOSE: To evaluate the usefulness of three-dimensional(3D) Fourier transform(FT) gradient refocused acquisition in steady state(GRASS) technique for MR imaging of the knee. MATERIALS AND METHODS : Sixty-three kneesin 61 patients were imaged on the 1.5T MR system. We compared 3DFT GRASS technique with 2D spin echo(SE) techniquein terms of conspicuousness of the lesions of internal knee structures based on the results of arthroscopy or open surgery. As a SE technique, sagittal T1-and T2-weighted, and coronal fat-suppressed T2-weighted sequences were performed. Sixty contiguous axial scans with 0.7 or 1mm section thickness were performed using 3D GRASS technique, and we also evaluated arbitrarily reformatted images produced from the original axial voxel images. RESULTS: For the depiction of the tear, 3DFT GRASS was superior to 2D SE in three cases of medial meniscus, one of later almeniscus, and two of anterior cruciate ligament. Specificity of 3D GRASS was also higher than that af 2D SE inevaluation of lateral meniscus and anterior cruiciate ligament. There was no significant difference in MR diagnosis for tears of the posterior cruciate, medial collateral, and lateral collateral ligaments. 3D GRASS was superior in evaluating the extent and morphology of the torn menisci. CONCLUSION: The 3DFT GRASS technique was comparable or even superior to the 2D SE technique in the evaluation of the internal structure of the knee, andcan be expected to supplement standard MR knee techniques, especially in complicated cases of meniscal orligamentous tears.
Anterior Cruciate Ligament ; Arthroscopy ; Fourier Analysis* ; Humans ; Knee* ; Lateral Ligament, Ankle ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Poaceae* ; Sensitivity and Specificity

OBJECTIVES: This study attempted to identify the factors that contribute to successful telemedicine service. This was done by analyzing the operational state of successful telemedicine services offered in Gangwon Province of Korea and their outcome for the last fifteen years. METHODS: A comparative analysis was made based on reports and a thesis on the satisfaction rate of patients and providers, patient compliance to treatment, and economic assessment of Gangwon telemedicine service, which were carried out in three periods: the years 2006, 2010, and 2012. RESULTS: The satisfaction surveys in all three periods showed similar results for patients (4.46+/-0.70 point) and healthcare practitioners, including nurses (3.82+/-0.62 point) and physicians (3.60+/-0.56 point), in decreasing order from the year 2012. Through the survey of patients' compliance with treatment, it was confirmed that telemedicine services increased patients' compliance with drug administration, facilitated improvement of lifestyle habits, improved glycated hemoglobin for patients with diabetes mellitus, and enhanced the rate of blood pressure control. In the survey conducted on patients' willingness to pay for telemedicine services in 2007, it was found that those patients were willing to pay about $3.5 for services. CONCLUSIONS: The telemedicine services of Gangwon Province increased patients' compliance with drug administration, improved blood glucose control, enhanced blood pressure control for patients with hypertension, and provided economic advantage.
Blood Glucose ; Blood Pressure ; Compliance ; Cost-Benefit Analysis ; Delivery of Health Care ; Diabetes Mellitus ; Gangwon-do* ; Hemoglobin A, Glycosylated ; Humans ; Hypertension ; Korea* ; Life Style ; Patient Compliance ; Patient Satisfaction ; Rural Health Services ; Telemedicine*

BACKGROUND: Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) are major pathogens in community and hospital. And they sometimes cause the outbreak in hospital in the immunocompromised patients. Pulsed-field gel electrophoresis (PFGE) has been regarded as a standard method for genotyping in epidemiologic studies, but it is laborious and time-consuming. Infrequent restriction site-polymerase chain reaction (IRS-PCR), a new genotyping methods, was performed to compare the applicability with PFGE. METHODS: We performed PFGE and IRS-PCR on S. aurues (n=120) and E. coli (n=117) which were collected clinically in 4 different hospitals. We assessed each method in terms of discriminatory power, quality, and efficiency. RESULTS: In E. coli, the discriminatory power of IRS-PCR was 46.7apprx86.7%, and that of PFGE was 88.9apprx96.7% according to hospital. But in S. aurues, the discriminatory power of IRS-PCR was 20apprx56.7%, and that of PFGE was 40apprx90% according to hospital. The typicality and reproducibility of IRS-PCR were 100% of each. PFGE needed four days to complete the procedure, but IRS-PCR could be performed within one day, IRS-PCR showed better resolution than PFGE. CONCLUSION: In case of gram negative bacteria (like E. coli), IRS-PCR could be a reliable alternative for epidemiologic typing due to better efficiency and comparable discriminatory power. But in the case of gram positive bacteria (like S. aureus), IRS-PCR does not seem to be suitable for the strain-to-strain differentiation. More trials and changes of restriction enzymes or primers could reveal the efficacy of IRS-PCR in the field of molecular typing.
Electrophoresis, Gel, Pulsed-Field* ; Escherichia coli* ; Escherichia* ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Immunocompromised Host ; Molecular Typing* ; Staphylococcus aureus* ; Staphylococcus*

BACKGROUND: In Anesthetic state, many hemodynamic parameters including blood pressure, heart rate and arterial compliance are changed. Moreover pulse transit time (PTT) is influenced by heart rate, blood pressure changes, and the compliance of the arteries. METHODS: In this study, we investigated PTT changes in patients under enflurane anesthesia. PTT of the finger was measured by photoplethysmography (PPG) and electrocardiography (ECG). PTT values were calculated as the time interval between the peak of the ECG R wave and the peak of the second derivatived of the PPG in the finger tip. RESULTS: ECG amplitude and heart rate increased reflecting hemodynamic chnages after enflurane anesthesia, and the PTT increased after enflurane anesthesia treatment by 16.68 ms (n = 24). Moreover, PTT was found to be inversely proportion to aging. CONCLUSIONS: The increase of PTT in the finger due to relaxation of the arterial wall muscle after enflurane anesthesia was used as an indicator of sympathetic block on muscle tone. This result suggests that PTT is strongly related with anesthetic state. And PTT may be one of useful surrogative methods for anesthetic monitoring, but PTT is unfortunately only qualitative.
Aging ; Anesthesia ; Arteries ; Blood Pressure ; Compliance ; Electrocardiography ; Enflurane* ; Fingers ; Heart Rate ; Hemodynamics ; Humans ; Photoplethysmography ; Pulse Wave Analysis* ; Relaxation

Eosinophilic cholangiopathy is a rare disease characterized by dense transmural eosinophilic infiltration of the gallbladder and bile duct. It's clinical and laboratory manifestations are not different from those of other causes of cholangiopathy, and the diagnosis is usually made based on pathologic findings after cholecystectomy. Moreover, the occurrence of eosinophilic cystitis accompanied by cholangiopathy is extremely rare. We report a rare case of hypereosinophilic syndrome manifested as eosinophilic cholangiopathy accompanied with eosinophilic cystitis, for the first time in Korea, in a 49-year-old woman who presented with persistent right upper quadrant pain. After performing imaging study to validate the diagnosis of acute acalculous cholecystitis and cholangitis, an urgent cholecystectomy was performed. Pathologic examination of the excised gallbladder was consistent with eosinophilic cholecystitis. The patient underwent bladder biopsy because there was persistant irritative voiding symptoms combined with constant mild peripheral eosinophilia even after cholecystectomy, and the pathologic findings revealed eosinophilic cystitis. Symptoms and peripheral eosinophilia were improved after steroid therapy for an indicated period.
Acalculous Cholecystitis ; Bile Ducts ; Biopsy ; Cholangitis ; Cholecystectomy ; Cholecystitis ; Cystitis* ; Diagnosis ; Eosinophilia ; Eosinophils* ; Female ; Gallbladder ; Humans ; Hypereosinophilic Syndrome* ; Korea ; Middle Aged ; Rare Diseases ; Urinary Bladder

OBJECTIVE: The electric analog circuit model can be used to analyse the various function of the cardio vascular system and the dynamic characteristics on each part of human body. According to the previous studies, viscous resistance, flow inertia, and vascular compliance in the cardiovascular system are analogous to resistance, inductance, and capacitance in electric circuit, so the cardiovascular system models have been represented by the electric circuit models. These approaches were to propose suitable models for the interested part of body and to simulate the various characteristics on the cardiovascular system. METHODS: This paper tried to put the characteristics of morphologic structure into the suggested electric circuit model. After setting parameter values of the model the dynamic characteristics of the cardio vascular system is simulated using VisSim, which is one of the simulation tools. RESULTS: The derived simulation results have represented major cardiovascular functions of normal adults. Also simulation results reflect the variation due to the pathophysiological state. CONCLUSION: The controller by baroreceptor, which is one of controllers to control the cardiovascular system, is appended in the model. The dynamic response characteristics and the procedure to restore blood pressure to normal state was observed by simulation lasted a certain period of bleeding.
Adult ; Blood Pressure ; Cardiovascular System* ; Compliance ; Hemorrhage ; Human Body ; Humans ; Pressoreceptors

To determine the effect of the tumor necrosis factor-α (TNF-α) in odontoclast formation, we administrated a TNF-α inhibitor in rats with diabetes rats with periodontitis. The rats included in the study were divided into three groups: control rats without diabetes or periodontitis (the C group), rats with periodontitis and diabetes (the PD group), and rats with periodontitis and diabetes treated by infliximab, the TNF inhibitor (the PD+infliximab group). The PD and PD+ infliximab groups received intravenous administrations of streptozotocin (STZ, 50 mg/kg) to induce diabetes. After 7 days of STZ injections, the mandibular first molars were ligatured to induce periodontitis. The PD+infliximab group was intrapenitoneally administrated by infliximab (5 mg/kg). On days 3 and 20 after the ligature administration, odontoclast formation along root surfaces was evaluated by tartrate resistant acid phosphatase (TRAP) staining and cathepsin K immunohistochemistry. On day 3, the number of TRAP- and cathepsin K-positive cells increased more so in the PD group than in the C group. The PD+infliximab group showed a lower number of positive cells than the PD group. There was no difference in all the groups on day 20. On day 3, the cathepsin-K positive multinucleated and mononucleated cells were higher in the PD group than in the C group. The number of cathepsin-K positive multinucleated cells was lower in the PD+infliximab group than in the PD group. The PD group showed more cathepsin K-positive cells in the furcation and distal surfaces than the c group. The Cathepsin K-positive cells of the PD+infliximab group were lower than that of the PD group in furcation. These results suggest that TNF-α stimulates odontoclast formation in diabetes with periodontitis.
Acid Phosphatase ; Administration, Intravenous ; Animals ; Cathepsin K ; Cathepsins ; Immunohistochemistry ; Infliximab ; Ligation ; Molar ; Necrosis ; Osteoclasts* ; Periodontitis* ; Rats* ; Streptozocin