No abstract available.
Dementia* ; Epidemiologic Studies*

STUDY DESIGN: In a prospective study of 38 patients undergoing lumbar pedicle screw instrumentation 200 pedicle hole were tested intraoperatively using electrical stimulation. OBJECTIVES: To evaluate the searching stimulus intensity at pedicle in Korean and to identify the most vulnerable root in transpedicular screw fixation of lumbosacral spine. MATERIALS AND METHOD: Electromyelogram(EMG) was monitored from eight lower extremity muscles bilaterally. Constant current stimulation pulses(0.2msec duration) were delivered through a ball-tipped nasopharyngeal probe used to evaluate each pedicle hole, and evaluated for searching stimulus intensity, the current necessary to evoked EMG RESULTS: The searching stimulus intensity above 5 mA were 194 cases(97.0%), above 7mA 151cases(75.5%), above 10 mA 107 cases(53.5%) and below 5 mA were 6 cases(3.0%). The vastus medialis muscle is most sensitive in L2(100%), L3(83.3%), tibialis anterior is in L4(68.4%), peroneus longus is in L5(44.2%) and gastrocnemious is in S1(64.5%). CONCLUSIONS: Stimulus-evoked EMG monitoring is a valuable and efficacious adjunct to lumbar pedicle screw instrumentation. A stimulation threshold greater than 5 mA reliably indicates adequate screw position and the root located at infero-medial side of pedicle is most vulnerab18 in transpedicular screw fixation.
Electric Stimulation ; Humans ; Lower Extremity ; Muscles ; Prospective Studies ; Quadriceps Muscle ; Spine

The purposes of the study was to measure the normal value of peak torque of lumbar extensors at various degrees of lumbar flexion and to compare this with the chronic low back pain patient. 100 normal subjects, 70 men(age, 49.0+/-.3) and 30 women(age, 48.1+/-.4), completed isometric lumbar extension strength test. 26 low back pain subjects, 9 men(age, 35.3+/-4.7) and 17 women(age, 42.6+/-0.1), completed isometric lumbar extension strength test. Normal male peak torques of lumbar extensors were 125+/-8 Ft-1bs at 0 degree, 164+/-3 at 12 degree, 200+/-3 at 24 degree, 221+/-6 at 35 degree, 241+/-0 at 48 degree, 257+/-0 at 60 degree, and 262+/-1 at 72 degree of lumbar flexion. Normal female peak torques of lumbar extensors were 78+/-4 at 0 degree, 105+/-7 at 12 degree, 120+/-38 at 24 degree, 135+/-5 at 36 degree, 142+/-7 at 48 degree, 151+/-0 at 60 degree, and 157+/-1 at 72 degree of lumbar flexion. Normal peak torques of lumbar extensors increase as degrees of lumbar flexion increase. Body weight in more correlated with peak torque than body mass index. Male peak torques of lumbar extensors with low back pain were 91+/-7 ft-1bs at 0 degree. 129+/-6 at 12 degree, 156+/-7 at 24 degree, 178+/-1 at 36 degree, 197+/-4 at 48 degree, 217+/-1 at 60 degree, and 218+/-2 at 72 degree of lumbar fiexion. Female peak torques of lumbar extensors with low back pain were 45+/-4 at 0 degree, 73+/-8 at 12 degree, 98+/-2 at 24 degree, 117+/-4 at 35 degree, 130+/-0 at 48 degree, 138+/-1 at 60 degree, and 148+/-6 at 72 degree of lumbar fiexion. Peak torques of lumbar extensors with 1cw back pain increase as degrees of lumbar flexion increase. Comparison of the normal male peak torque of lumbar extensors with low back pain group revealed statistical differences at 48 and 72 degree of lumbar extensors. And the female group revealed statistical difference at 0, 12, and 24 degree of lumbar flexion.
Back Pain ; Body Mass Index ; Body Weight ; Female ; Humans ; Low Back Pain* ; Male ; Reference Values ; Torque

Organic ion transporters are expressed in various tissues that transport endogenous and exogenous compounds including their metabolites. There are organic anion transporter (OAT), organic cation transporter (OCT), organic anion transporter like protein (OATLP) and organic cation transporter like (OCTL). Considering the variety of charged organic ionic compounds, the existence of numerous isoforms of organic ion transporters can be assumed. In the present study, we have searched for a new isoform in the expressed sequence tag (EST) database using human organic anion transporter 4 (hOAT4) amino acid sequence as a "query". We found a candidate clone (BC021449) from the mouse kidney cDNA library. This clone was identified as an ortholog of ORCTL3 or OCTL-1. The mOCTL1 cDNA consists of 2016 base pairs encoding 551 amino acid residues with 12 putative transmembrane domains. The deduced amino acid sequence of mOCTL1 showed 35 to 40% identity to those of the other members of the OATs and OCTs. According to the tissue distribution, examined by Northern blot analysis, about a 2.4-kb transcript of mOCTL1 was observed in the kidney. About a 90-kDa band was detected when Western blot analysis in the mouse kidney was done by using antibody against synthesized oligopeptide of mOCTL1. The immunohistochemical result showed that mOCTL1 was stained at the glomerulus (the parietal epithelial cells and podocytes), pars recta of proximal tubule, distal convoluted tubules, connecting tubules and collecting tubules. From these results, we conclude that mOCTL1 may be a candidate for an organic ion transporter isoform in the mouse kidney.
Amino Acid Sequence ; Animals ; Blotting, Western ; Gene Library ; Humans ; Immunohistochemistry ; Kidney/*metabolism ; Mice ; Molecular Sequence Data ; Organ Specificity ; Organic Cation Transport Proteins/genetics/*isolation & purification ; Organic Cation Transporter 1/genetics/*isolation & purification ; Protein Isoforms/isolation & purification

The purpose of this study was to evaluate the effect of occlusion on the mechanical strength of periodontal fibers during retention periods after experimental tooth movement. In the Sprague-Dawley male rats weighing 200 g or more, the intraoral elastics were inserted into the both right and left interproximal space between upper first and second molars for tooth movement. After 4 days later, the left lower first, second, and third molars were extracted for differentiating the non-occlusal side from the occlusal side in the same mouth. At the same time the elastics were removed and then light cured resin was placed in the space between upper first and second molars following undercut was made for retention bilaterally. From the beginning of retention, 7 rats were sacrificed at 0, 4, 8, 12, 16, 20 days respectively. For evaluating of magnitude on the mechanical strength of periodontal tissue, the maximal shear load of the upper first molars were measured bilaterally during extraction using Instron Universal Testing Machine. The results of this study were obtained as follows : 1. In the occlusal side, the maximal shear load was increased from no retention to retention 20 days group as time was going and statistically difference was shown from retention 12 days group (p < 0.05). 2. In the non-occlusal side, the maximal shear load was increased slightly from no retention to 20 days group as time was going but there was no statistically difference (p > 0.05). 3. The result compared with the maximal shear load between occlusal and nonocclusal side showed no statistically difference until retention 8 day group (p > 0.05), but showed statistically difference from retention 12 day to 20 day group (p < 0.05). These results show that occlusion had an effect on mechanical strength of the periodontal fibers during retention periods after experimental tooth movement; therefore, it is suggested that occlusion should be considered while the retainer types and retention period are planned.
Animals ; Humans ; Male ; Molar ; Molar, Third ; Mouth ; Rats* ; Rats, Sprague-Dawley ; Tooth Movement* ; Tooth*

Ankylosing spondylitis (AS) can involve the eye, gastrointestinal system, cardiopulmonary system, skin, kidneys, and spinal and peripheral joints. It is rarely accompanied by immunoglobulin A (IgA) nephropathy. Although IgA is involved in both AS and IgA nephropathy, the relationship between these diseases remains unclear. We detected hematuria and proteinuria in a 32-year-old male patient with ankylosing spondylitis that remained stable for 4 years through treatment with etanercept, a tumor necrosis factor-α (TNF-α) inhibitor, and diagnosed IgA nephropathy through a renal biopsy. IgA nephropathy seems to be less commonly associated with AS disease activity or specific treatment such as TNF-α inhibitor use.
Adult ; Biopsy ; Etanercept* ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Joints ; Kidney ; Male ; Necrosis ; Proteinuria ; Skin ; Spondylitis, Ankylosing* ; Tumor Necrosis Factor-alpha

BACKGROUND: The 48/6 Model of Care is an integrative care initiative for improving the health outcomes of hospitalized older patients; however, its applicability in community-dwelling older adults as a health screening tool has not been investigated. The present study aimed to examine the applicability of this model, prevalence of dysfunction in 6 care areas, and its relationship with self-reported mobility in community-dwelling older adults.METHODS: This was a cross-sectional survey study of community-dwelling adults aged 65 or older. Participants were screened for problems using 9 items corresponding to the 6 care areas of the 48/6 Model of Care (cognitive functioning, functional mobility, pain management, nutrition and hydration, bladder and bowel management, and medication management). Mobility was assessed via the Life-Space Assessment (LSA). We examined the correlation between each screening item and the LSA.RESULTS: A total of 444 older adults (260 women, 58.6%) participated. The mean number of health problems was 2.3 ± 2.1, with the most common being pain, cognitive impairment, and urinary incontinence. These problems and LSA scores were significantly different by age groups. A multiple regression analysis showed that polypharmacy (β = −10.567, P < 0.001), dysphagia (β = −9.610, P = 0.021), and pain (β = −7.369, P = 0.004) were significantly associated with life-space mobility after controlling for age.CONCLUSION: The 48/6 Model of Care is applicable to community-dwelling older adults, who show high prevalence of dysfunction in the 6 care areas. This study supports the role of the model in screening for the health status of older adults living in the community, and in estimating mobility.
Adult ; Cognition Disorders ; Cross-Sectional Studies ; Deglutition Disorders ; Female ; Humans ; Mass Screening ; Pain Management ; Polypharmacy ; Prevalence ; Urinary Bladder ; Urinary Incontinence

BACKGROUND: The 48/6 Model of Care is an integrative care initiative for improving the health outcomes of hospitalized older patients; however, its applicability in community-dwelling older adults as a health screening tool has not been investigated. The present study aimed to examine the applicability of this model, prevalence of dysfunction in 6 care areas, and its relationship with self-reported mobility in community-dwelling older adults. METHODS: This was a cross-sectional survey study of community-dwelling adults aged 65 or older. Participants were screened for problems using 9 items corresponding to the 6 care areas of the 48/6 Model of Care (cognitive functioning, functional mobility, pain management, nutrition and hydration, bladder and bowel management, and medication management). Mobility was assessed via the Life-Space Assessment (LSA). We examined the correlation between each screening item and the LSA. RESULTS: A total of 444 older adults (260 women, 58.6%) participated. The mean number of health problems was 2.3 ± 2.1, with the most common being pain, cognitive impairment, and urinary incontinence. These problems and LSA scores were significantly different by age groups. A multiple regression analysis showed that polypharmacy (β = −10.567, P < 0.001), dysphagia (β = −9.610, P = 0.021), and pain (β = −7.369, P = 0.004) were significantly associated with life-space mobility after controlling for age. CONCLUSION The 48/6 Model of Care is applicable to community-dwelling older adults, who show high prevalence of dysfunction in the 6 care areas. This study supports the role of the model in screening for the health status of older adults living in the community, and in estimating mobility.

BACKGROUND: Diffusion weighted magnetic resonance imaging (DWI) and single photon emission computed tomography (SPECT) can demonstrate ischemic brain injury within the first several hours after the onset of symptoms. We investigated the utility of combined DWI and SPECT in the assessment of acute cerebral infarction. METHODS: Nineteen patients with acute middle cerebral artery territory infarction underwent DWI and SPECT within 12 hours of symptom onset (mean, 9.6 hour). In SPECT, we defined abnormality as a perfusion defect region (perfusion ??30% compared to a normal cortex) and an ischemic region (perfusion difference ??10% compared to a contralateral normal hemisphere). The initial DWI and SPECT lesion volume ratios (lesion volume / hemispheric volume) were analyzed with subsequent neurological deficits as determined by the National Institutes of Health Stroke Scale (NIHSS) score and Barthel index (BI). RESULTS: There was a high correlation between clinical scores within 7 days and lesion volumes determined by DWI and SPECT respectively (p<0.05). The lesion volumes detected by DWI and SPECT significantly correlated with each other (p<0.01). Ischemic lesions on SPECT were larger in the group (n=10) with ICA occlusions than in the other group (p=0.034). In 15 patients with cortical lesions, the ratio of perfusion defect volumes on SPECT to lesion volumes on DWI was higher in the group with favorable outcome than in the group with unfavorable outcome (p=0.01). CONCLUSIONS: Both DWI and SPECT are highly correlated with the severity of neurological deficit in acute cerebral infarction. Furthermore, combined use of DWI and SPECT would be more powerful than either study alone in predicting clinical outcome. (J Korean Neurol Assoc 19(2):88~95, 2001)
Brain Injuries ; Cerebral Infarction ; Diffusion Magnetic Resonance Imaging* ; Diffusion* ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Middle Cerebral Artery* ; National Institutes of Health (U.S.) ; Perfusion ; Stroke ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: Diffusion weighted magnetic resonance imaging (DWI) and single photon emission computed tomography (SPECT) can demonstrate ischemic brain injury within the first several hours after the onset of symptoms. We investigated the utility of combined DWI and SPECT in the assessment of acute cerebral infarction. METHODS: Nineteen patients with acute middle cerebral artery territory infarction underwent DWI and SPECT within 12 hours of symptom onset (mean, 9.6 hour). In SPECT, we defined abnormality as a perfusion defect region (perfusion ??30% compared to a normal cortex) and an ischemic region (perfusion difference ??10% compared to a contralateral normal hemisphere). The initial DWI and SPECT lesion volume ratios (lesion volume / hemispheric volume) were analyzed with subsequent neurological deficits as determined by the National Institutes of Health Stroke Scale (NIHSS) score and Barthel index (BI). RESULTS: There was a high correlation between clinical scores within 7 days and lesion volumes determined by DWI and SPECT respectively (p<0.05). The lesion volumes detected by DWI and SPECT significantly correlated with each other (p<0.01). Ischemic lesions on SPECT were larger in the group (n=10) with ICA occlusions than in the other group (p=0.034). In 15 patients with cortical lesions, the ratio of perfusion defect volumes on SPECT to lesion volumes on DWI was higher in the group with favorable outcome than in the group with unfavorable outcome (p=0.01). CONCLUSIONS: Both DWI and SPECT are highly correlated with the severity of neurological deficit in acute cerebral infarction. Furthermore, combined use of DWI and SPECT would be more powerful than either study alone in predicting clinical outcome. (J Korean Neurol Assoc 19(2):88~95, 2001)
Brain Injuries ; Cerebral Infarction ; Diffusion Magnetic Resonance Imaging* ; Diffusion* ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Middle Cerebral Artery* ; National Institutes of Health (U.S.) ; Perfusion ; Stroke ; Tomography, Emission-Computed, Single-Photon*