No abstract available.
Blood Platelets* ; Blood Transfusion*

No abstract available.
Chloroquine* ; Edetic Acid* ; Glycine* ; Immunoglobulin G*

Tethered cord syndrome is a type of spinal dysraphism with a low-lying conus, which is frequently associated with an intraspinal lipoma, diastematomyelia, or fibrous band. The clinical manifestations include spine abnormalities such as the spina bifida or various neurological symptoms involving lower extremities and sphincters. However, the spinal roots are often injured during the detethering procedures which clinically results in a neurological deficit. The continuity of spinal roots should be monitored during detethering surgery for the tethered spinal cord because neural elements are embedded in lipoma or anomalous tissues. Evoked muscle action potentials indicate only motor function, therefore, it is more appropriate to record somatosensory evoked potentials across the operative field at the same time. We used a combined technique of tibial nerve somatosensory evoked potential and compound muscle action potentials stimulated in the spinal roots directly for an intraoperative monitoring during the untethering procedure. We reported good results from three patients with tethered cord syndrome who had taken the intraoperative monitoring during the untethering surgery. We suggest that intraoperative monitoring can prevent the unwanted injury to the neural tissue in the level of the tethering during the detethering surgery.
Action Potentials ; Conus Snail ; Evoked Potentials, Motor* ; Evoked Potentials, Somatosensory* ; Humans ; Lipoma ; Lower Extremity ; Monitoring, Intraoperative* ; Neural Tube Defects* ; Spinal Cord ; Spinal Dysraphism ; Spinal Nerve Roots ; Spine ; Tibial Nerve

Measurements of local shoulder muscle function during shoulder abduction are of a great interest in biomechanics research and in ergonomic applications. There have been so many opinions that the supraspinatus muscle acts in synergy with the deltoid muscle as a single unit throughout the shoulder abduction. However the specific actions of deltoid and supraspinatus muscles have been subjects of controversy. Electromyography is an established evaluation method of biomechanical study. It reflects the electrical activity at the muscle membrane level and indirectly the mechanical output of the muscle. The purpose of this study was to evaluate the role of deltoid and supraspinatus muscles during shoulder abduction by the comparison of motor unit action potentials using a quantitative electromyographic analysis method, to provide a good insight into the biomechanics of shoulder abduction. Motor unit action potentials of deltoid muscle were seen earlier than those of supraspinatus muscle at the time of initiation of shoulder abduction. The Root Mean Square (RMS) voltage of deltoid muscle was increased gradually from 0o to 90o of shoulder abduction, and then decreased gradually above 90o to 180o of shoulder abduction. The RMS voltages of deltoid muscle were significantly higher than those of supraspinatus muscle at each degree of shoulder abduction wholly. There was no differences in the RMS voltages of deltoid muscle, during shoulder abduction between the loading of 1 kg and without loading. However, the RMS voltages of supraspinatus muscle were significantly higher in the loading state than without loading. The Mean Rectified Voltages (MRV) were similar to the RMS voltages of deltoid and supraspinatus muscles during shoulder abduction. Based on these results, we concluded that the deltoid muscle was not only an initiator but also a major contributor in shoulder abduction, where as the supraspinatus muscle acts as a secondary muscle for the initiation of shoulder abduction and a supporting muscle when there is a resistance against shoulder abduction.
Action Potentials ; Deltoid Muscle ; Electromyography ; Membranes ; Muscles* ; Shoulder*

Electrophysiologic monitoring during surgery for the spinal cord tumor is necessary for identification of the nerve root, prevention of the nerve injury, and prediction of postoperative prognosis. In other countries, intraoperative electrophysiologic monitorings are commonly done in various cases such as selective posterior rhizotomy, scoliosis, sponlylolisthesis, lipomeningocele, and spinal cord tumor, but it is not a common procedure in Korea except for the selective posterior rhizotomy. We report 3 cases of electrophysiologic monitoring during sugery for the spinal cord tumor at lower thoracic level. Using multichannel EMG machine, we recorded free-run EMG, somatosensory evoked potential(SSEP) of tibial nerve, and compound motor unit action potential (CMAP) of various regions such as abdomen, lower extremity, and anus, stimulating nerve roots at the lower thoracic level. We identified CMAP from rectus abdominis muscles only in the first case, but in the second case, we identified CMAP from tibialis anterior and gastrocnemius muscles which avoided the injury to lumbosacral roots. In the third case, SSEP improved immediately after we removed the mass at lower thoracic level. We concluded that intraoperative electrophysiologic monitoring combined with recording CMAP is a useful procedure to minimize neural tissue damage during surgery for the spinal cord tumor at lower thoracic level.
Abdomen ; Action Potentials ; Anal Canal ; Korea ; Lower Extremity ; Muscles ; Prognosis ; Rectus Abdominis ; Rhizotomy ; Scoliosis ; Spinal Cord Neoplasms ; Tibial Nerve

This study was conducted to investigate osteopenia and osteoporosis prevalence of radius and tibia using Quantitative Ultrasound (QUS) and to identify affecting factors of osteoporosis. A total of 4,340 women aged 40 - 69 years, living in Ansung (rural) and Ansan (mid-sized) area, and free of illnesses affecting bone metabolism participated in the community-based cohort study. Among them 4,059 subjects measured radius bone density and 4,089 measured tibia. The T-score threshold, defined as < -1.0 and < or = -2.5, was used to identify subjects with osteopenia and osteoporosis by WHO criteria. The crude prevalence of osteoporosis in radius and tibia was 8.4% and 23.3% respectively; after adjustment for age, it changed 6.3% and 18.8%. In simple logistic regression analysis, the prevalence of osteoporosis increased by aging, non-marital status, low education, low income. Otherwise, high intakes of Ca/P, thiamin, riboflavin, vitamin B6, and vitamin E were decreased osteoporosis prevalence. Compared to the normal BMI (body mass index) group (18.5 < or = BMI < 23), the odds ratio (ORs) of the low BMI group (BMI < 18.5), and high BMI groups (BMI 25 - 30, BMI > or = 30) were significantly increased. The OR of osteoporosis decreased across increasing quartiles of intakes of Ca, P and Ca/P. Therefore, maintaining normal BMI and increasing Ca intake and Ca/P ratio may have a beneficial effect on bone health of Korean women.
Aging ; Bone Density ; Bone Diseases, Metabolic ; Cohort Studies* ; Education ; Female ; Genome* ; Gyeonggi-do ; Humans ; Logistic Models ; Metabolism ; Odds Ratio ; Osteoporosis* ; Prevalence* ; Radius* ; Riboflavin ; Tibia* ; Ultrasonography* ; Vitamin B 6 ; Vitamin E ; Vitamins

Endoscopic closure techniques have been introduced for the repair of duodenal wall perforations that occur during endoscopic retrograde cholangiopancreatography (ERCP). We report a case of successful repair of a large duodenal wall perforation by using double endoscopic band ligation (EBL) and an endoclip. Lateral duodenal wall perforation occurred during ERCP in a 93-year-old woman with acute calculous cholangitis. We switched to a forward endoscope that had a transparent band apparatus. A 2.0-cm oval-shaped perforation was found at the lateral duodenal wall. We repaired the perforation by sequentially performing double EBL and endoclipping. The first EBL was performed at the proximal edge of the perforation orifice, and two-thirds of the perforation were repaired. The second EBL, which also included the contents covered under the first EBL, repaired the defect almost completely. Finally, to account for the possible presence of a residual perforation, an endoclip was applied at the distal end of the perforation. The detection and closure of the perforation were completed within 10 minutes. We suggest that double EBL is an effective method for closure.
Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Endoscopes ; Female ; Humans ; Ligation* ; Methods

PURPOSE: This study was designed to examine the effect of aroma massage therapy on lower extremity edema of terminal cancer patients. METHODS: A total of thirty-six terminal cancer patients with lower extremity edema were divided into two groups: the aroma massage group received massage with blending oil which was applied from toes to 10 cm above the knee of the subject for 15 to 20 minutes in each turn, while the control group received sham aroma massage (applied with carrier oil only). The circumferences of the fore-foot, ankle and calf were measured before massage and 30 minutes, 2 hours, and 12 hours after massage. The blood pressure, pulse and body temperature were also measured to find the change of subject's physiologic conditions. RESULTS: There were no significant differences in blood pressure, heart rate, body temperature and lower extremity circumferences between two groups. However, edema at each site was slightly improved in the treatment group after the aroma massage therapy, compared to baseline data (P<0.05). In addition, the reduction of lower extremity circumference was maximal at 2 hours in foot, 30 min in right ankle and 12 hours in right calf after aroma massage therapy (P<0.05). CONCLUSION: Our results suggest that aroma massage therapy is not effective on the lower extremity edema of terminal cancer patients.
Animals ; Ankle ; Aromatherapy ; Blood Pressure ; Body Temperature ; Edema ; Foot ; Heart Rate ; Hospices ; Humans ; Knee ; Lower Extremity ; Massage ; Salicylamides ; Toes

The original article contained an error in Figure and Figure legend.

PURPOSE: We investigated the therapeutic effects of monoclonal anti-TNF antibody (infliximab) on experimental uveitis. METHODS: Twenty New Zealand White rabbits were immunized with Mycobacterium tuberculosis H37Ra antigen and then challenged with intravitreal injection of tuberculin antigen to introduce a uveitis. Then infliximab was injected into rabbit eyes at an intravenous concentration of 5 mg/kg and intravitreal concentrations of 1 mg/0.1mL and 100 microg/0.1mL. As a control, the vehicle was injected intravenously or intravitreally. To evaluate the therapeutic effects, inflammation was assessed by slit lamp biomicroscopy and scored according to the severity of inflammation. The animals were also evaluated by electroretinography and histopathology. RESULTS: Regardless of the administration route, inflammatory activities of anterior chamber and engorgement of vascular structures were reduced in the infliximab treated group compared to control. Different administration routes and different concentrations of infliximab did not affect the therapeutic outcome of the clinical scoring. Intravenous (5 mg/kg) and intravitreal diluted (100 microg/0.1mL) infliximab injection groups showed significant improvement in electroretinographic findings and significant reduction of inflammatory cells with preservation of retinal tissue architecture on histopathologic examination. However, focal loss of the photoreceptor outer segment is observed in intravitreal undiluted (1 mg/0.1 mL) infliximab injected eyes. CONCLUSIONS: Infliximab may be a useful treatment modality to suppress ocular inflammation in experimental uveitis models in rabbits.
Animals ; Anterior Chamber ; Electroretinography ; Inflammation ; Intravitreal Injections ; Mycobacterium tuberculosis ; Necrosis* ; Rabbits ; Retinaldehyde ; Tuberculin ; Tumor Necrosis Factor-alpha ; Uveitis* ; Infliximab