No abstract available.
Family Practice* ; Humans

Thirteen patients were operated for cubital tunnel syndrome and followed for an average of 26 months postoperatively. Ten patients had a history of relevant trauma and three patients had degenerative osteoarthritis of the elbow. The average duration of symptoms was 18 months (range, 2 to 96 months). Diagnosis was made by physical examination, electromyography and nerve conduction study. Among these, nerve conduction study was found to be the most valuable diagnostic method for the patients with atypical clinical findings. Most of the operations were performed by anterior transposition of the ulnar nerve. At the most recent follow-up, the result was excellent in two patients, good in eight, and fair in three; thus ten patients(77%) showed satisfactory results. The rating system for ulnar neuropathy based on sensory, motor dysfunction and pain was useful for evaluating the operative results. The postoperative gain of score for pain and sensory function were larger than that of motor function. Factors known to influence the result of the operation (age, duration of symptom, history of trauma, method of operation) did not effect the outcome in this study. For successful operation, the ulnar nerve must be thoroughly examined, all possible levels of compression must be released and new foci of compression must be created.
Cubital Tunnel Syndrome ; Diagnosis ; Elbow ; Electromyography ; Follow-Up Studies ; Humans ; Methods ; Neural Conduction ; Osteoarthritis ; Physical Examination ; Sensation ; Ulnar Nerve ; Ulnar Neuropathies

PURPOSE: This study is designed to evaluate the current situation of interhospital transports of critical ill patients requiring emergency care. METHODS: Using a clinical prospective 162 interhospital transports of ill patients by ambulance were evaluated in 2 hospitals. Patients were divided into severe & mild to moderate group by modified-ESI. We evaluated the state of patients, vital sign, monitoring of patient's state, hospitalization or transportation. Data were collected by mean of comprehensive form filled by a physician at the receiving hospital. RESULTS: The receiving hospital were notified prior to the transport in 57.4%. Pretransport information about the patients were adequate in 75% and no data in 9.9%. In 10.4% of the transports, the patients arrived at the receiving hospital in an agonized state. In 80.8% of the transports admitted and 7.4% of the patients were transfer to the other hospital. CONCLUSION: It appears that there are no established guidelines for the emergency transport of critical ill patients in Korea.
Ambulances ; Emergencies ; Emergency Medical Services ; Felodipine ; Hospitalization ; Humans ; Korea ; Patient Transfer ; Prospective Studies ; Transportation ; Vital Signs

PURPOSE: Patient delays in seeking treatment of stroke and Emergency Department delays are major factors in preventing the use of thrombolytic therapy for stroke. For the achievement of rapid diagnosis and treatment in the emergency center, a unified and systematic confrontation of symptoms and good team cooperation are essential. METHODS: Various departments involved in the management of acute stroke in the ED conferred to discuss ways to minimize door-to-CT and door-to-drug times in the ED. This team formulated the BEST (Brain salvage through Emergent Stroke Therapy) protocol to optimize the treatment of acute stroke patients. Our study employed the BEST protocol for four month during the period from October, 2004 to February, 2005. Inclusion criteria for the protocol were admission to our Hospital's ED with an acute neurologic symptoms and an onset time of less than 12 hours. RESULTS: Ninety-six patients, including fifty-eight men were enrolled in the study. Reasons for acute neurologic changes were ischemic stroke (66 patients), hemorrhagic stroke (22 patients), and metabolic causes (8 patients). Of the 66 ischemic stroke patients, 11 received tissue plasminogen activator (tPA) and 2 were administered Intraarterial Urokinase (IAUK). Door-to-CT times before and after initiation of the BEST protocol were 47+/-19 minutes and 26+/-12 minutes, respectively (p-value=0.024). And door-to-drug times before and after the BEST protocol were 96+/-16 minutes and 67+/-28 minutes, respectively (pvalue=0.035). CONCLUSION: Assembly of a specific "stroke team"and implementation of a well-designed protocol allows the most efficient evaluation and treatment of patients with acute stroke, thus minimizing both door-to-CT and door-to-drug times.
Cerebral Infarction ; Diagnosis* ; Emergencies ; Emergency Service, Hospital ; Humans ; Male ; Medical Records ; Neurologic Manifestations* ; Stroke ; Thrombolytic Therapy ; Tissue Plasminogen Activator ; Urokinase-Type Plasminogen Activator

Although stroke is one of the leading causes of death and disability worldwide, preventive or therapeutic options are still limited. Therefore, a better understanding of the pathophysiological characteristics of this life-threatening disease is urgently needed. The incidence and prevalence of ischemic stroke are increased by exposure to certain types of xenobiotics, including heavy metals, suggesting the possible toxicological contribution of these compounds to the onset or aggravation of stroke. Among the potential targets, we have focused on alterations to cerebral endothelial cells (CECs), which play important roles in maintaining the functional integrity of brain tissue.
Blood-Brain Barrier* ; Brain ; Cause of Death ; Endothelial Cells ; Incidence ; Metals, Heavy ; Prevalence ; Stroke* ; Tight Junctions ; Xenobiotics

Although various studies on predictive markers in the use of PD-1/PD-L1 inhibitors are in progress, only PD-L1 expression levels in tumor tissues are currently used. In the present study, we investigated whether baseline serum levels of IL-6 can predict the treatment response of patients with advanced non-small cell lung cancer (NSCLC) treated with PD-1/PD-L1 inhibitors. In our cohort of 125 NSCLC patients, the objective response rate (ORR) and disease control rate (DCR) were significantly higher in those with low IL-6 (<13.1 pg/ml) than those with high IL-6 (ORR 33.9% vs. 11.1%, p=0.003; DCR 80.6% vs. 34.9%, p<0.001). The median progression-free survival was 6.3 months (95% confidence interval [CI], 3.9–8.7) in the low IL-6 group, significantly longer than in the high IL-6 group (1.9 months, 95% CI, 1.6–2.2, p<0.001). The median overall survival in the low IL-6 group was significantly longer than in the high IL-6 group (not reached vs. 7.4 months, 95% CI, 4.8–10.0). Thus, baseline serum IL-6 levels could be a potential biomarker for predicting the efficacy and survival benefit of PD-1/PD-L1 inhibitors in NSCLC.

With the rapid development of MS technologiesy, the demands for a more sophisticated MS interpretation algorithm haves grown as well. We have developed a new protein fingerprinting method using a binomial distribution, (fBIND). With the fBIND, we improved the performance accuracy of protein fingerprinting up to the maximum 49% (more than MOWSE) and 2% than(at a previous binomial distribution approach studied by of Wool et al.) as compared to the established algorithms. Moreover, we also suggest a the statistical approach to define the significance of transcription factors and motifs in the identified proteins based on the Gene Ontology (GO).
Binomial Distribution ; Fungal Proteins* ; Gene Ontology ; Peptide Mapping ; Transcription Factors* ; Wool ; Yeasts*

PURPOSE: To evaluate the usefulness of plain lateral radiographs processed by the Wintopo(R) program (SoftSoft.netTM, version 1.11, USA)for a picture archiving communication system (PACS) for the diagnosis of bursting fracture. MATERIALS AND METHODS: From January 2001 to April 2002, 24 cases of thoracic and lumbar spine fractures with available computed tomographs were evaluated. Lateral plain radiographs were reviewed by five orthopedic residents, and then were saved as bmp files in a picture archiving communication system. The borderline posterior body in the lateral plain radiographs was defined using the vector image in the Wintopo(R) program. After processing, radiographs were re-evaluated. RESULTS: In all participants, the sensitivity of the diagnosis of bursting fracture was significantly improved after Wintopo(R) program processing. Although the specificity and positive predictive value were improved by processing, this was not statistically significant. CONCLUSION: Wintopo(R) program processing of plain lateral radiographs of the spine could improve the sensitivity of diagnosis for bursting fracture in acute spinal injury.
Diagnosis* ; Orthopedics ; Sensitivity and Specificity ; Spinal Injuries ; Spine*

PURPOSE: We undertook to evaluate the efficacy of C-reactive protein (CRP) determination as a screening test for the detection of malig-nancy in compression fracture patients by comparing simple compression fractures and malignant metastatic compression fractures of spine. MATERIALS AND METHODS: From January 1998 to March 2001, fifty-one patients who had compression fracture of spine with chronic back pain were analysed for CRP levels. The thirty-six patients had simple compression fractures of the spine and fifteen patients malignant metastatic compression fractures. The sensitivity, specificity and positive predictive value of CRP in the screening of benign simple compression fractures were calculated. RESULTS: CRP levels in malignant metastatic compression fracture were significantly higher than in simple compression fracture. The sensitivity of CRP in simple compression fractures was 97%, its specificity 80% and its positive predictive value 92%. CONCLUSION: We consider CRP titer to be a useful screening test for the detection of malignant metastatic compression fractures. In old age, a high titer of CRP needs more precise clinical definition for the detection of malignancy in compression fracture.
Back Pain ; C-Reactive Protein ; Fractures, Compression* ; Humans ; Mass Screening ; Sensitivity and Specificity ; Spine

PURPOSE: The purpose of this study was to find a method of proving cold discomfort in patients who complain during the winter seasons, after receiving an internal fixation with a metal plate, and to determine the different in the developments of cold discomfort according to the type of metal plate used. MATERIALS AND METHODS: Among 26 cases of lateral malleolar fracture, 16 stainless-steel plates and 10 titanium plates were compared. Discomfort was induced by placing ice over both lateral malleoli (ice provocation test), and the side on which discomfort was induced first was recorded. RESULTS: Ten patients who felt discomfort in the winter, among which 8 cases stainless-steel plate and 2 cases titanium plate. The degree of pain was rated as 3.6 on average (ranging 2-4) on the VAS (visual analogue scale). CONCLUSION: Cold discomfort during the winter season can be confirmed by using the ice provocation test (p=0.0004). The frequency of discomfort during the winter season was higher (p=0.126) in cases filted with stainless-steel plate (50%) than in those with a titanium plate (20%).
Ankle ; Humans ; Ice ; Seasons* ; Stainless Steel* ; Titanium*