BACKGROUND AND OBJECTIVES: We performed this study to compare the endothelial function of the patients with newly diagnosed essential hypertension(EH) to age and sex-matched normal subjects or patients with known coronary artery disease(CAD) and to evaluate the effect of calcium channel blockers(amlodipine) on the endothelial dysfunction in patients with EH. MATERIALS AND METHOD: The endothelial function, expressed as percent brachial artery diameter changes at hyperemic phase compared to resting state, using high-resolution ultrasound was measured before taking amlodipine and 3 to 4 months after taking amlodipine(5 to 10 mg daily), when the high blood pressure(BP) was well controlled(129/83 mmHg), in patients with EH(mean age; 53 yrs, n=2). We also measured the endothelial function in normal subjects(mean age; 54 yrs, n=5) and patients with proven CAD(mean age; 56 yrs, n=0). RESULTS: The mean BP of the patients with EH, CAD, and normal subjects were 172/108 mmHg, 110/69 mmHg, and 113/72 mmHg, respectively. There were no significant differences among the study groups in regard to the serum glucose and various lipid levels. The endothelial function of the patients with EH(6.6+/-2.3%) was significantly(p=.000) lowered when compared to the normal subjects(14.3+/-3.3%), but did not show any significant differences when compared to the patients with CAD(8.6+/-3.4%). The endothelial function in patients with EH was significantly(p=.007) improved from 6.6+/-2.3 % to 11.0+/-2.7 % 3 to 4 months after taking the amlodipine. CONCLUSION: Calcium channel blockers, especially amlodipine, can improve endothelial dysfunction in patients with EH as well as controlling high BP.
Amlodipine ; Blood Glucose ; Brachial Artery ; Calcium Channel Blockers* ; Calcium Channels* ; Calcium* ; Coronary Vessels ; Humans ; Hypertension* ; Ultrasonography

BACKGROUND AND OBJECTIVES: We performed this study to compare the endothelial function of the patients with newly diagnosed essential hypertension(EH) to age and sex-matched normal subjects or patients with known coronary artery disease(CAD) and to evaluate the effect of calcium channel blockers(amlodipine) on the endothelial dysfunction in patients with EH. MATERIALS AND METHOD: The endothelial function, expressed as percent brachial artery diameter changes at hyperemic phase compared to resting state, using high-resolution ultrasound was measured before taking amlodipine and 3 to 4 months after taking amlodipine(5 to 10 mg daily), when the high blood pressure(BP) was well controlled(129/83 mmHg), in patients with EH(mean age; 53 yrs, n=2). We also measured the endothelial function in normal subjects(mean age; 54 yrs, n=5) and patients with proven CAD(mean age; 56 yrs, n=0). RESULTS: The mean BP of the patients with EH, CAD, and normal subjects were 172/108 mmHg, 110/69 mmHg, and 113/72 mmHg, respectively. There were no significant differences among the study groups in regard to the serum glucose and various lipid levels. The endothelial function of the patients with EH(6.6+/-2.3%) was significantly(p=.000) lowered when compared to the normal subjects(14.3+/-3.3%), but did not show any significant differences when compared to the patients with CAD(8.6+/-3.4%). The endothelial function in patients with EH was significantly(p=.007) improved from 6.6+/-2.3 % to 11.0+/-2.7 % 3 to 4 months after taking the amlodipine. CONCLUSION: Calcium channel blockers, especially amlodipine, can improve endothelial dysfunction in patients with EH as well as controlling high BP.
Amlodipine ; Blood Glucose ; Brachial Artery ; Calcium Channel Blockers* ; Calcium Channels* ; Calcium* ; Coronary Vessels ; Humans ; Hypertension* ; Ultrasonography

No abstract available.
Air Pollution*

No absteact available.
Dermatitis, Atopic* ; Diagnosis*

Ten patients with a thoracolumbar spine fractures were treated with Kaneda internal fixation device through anterolateral approach during last 1 year. In all cases, spinal decompression, internal instrument fixation and bone fusion with rib were performed. No patient showed neurological deterioration after surgery and 6(60%) patients improved postoperatively with entering the next Frankel subgroup. Follwo-up patient evaluation showed the correction of the fracture deformity with good bony fusion, but 3 patient are remained back pain. According to above results we concluded that anterolateral internal fixation combined.with bone fusion using rib was good mechanical stability and decompression of protruding ventral bone fragments above conus medullaris level.
Back Pain ; Congenital Abnormalities ; Conus Snail ; Decompression ; Decompression, Surgical* ; Humans ; Internal Fixators ; Ribs ; Spine

BACKGROUND: The aim of this study was to investigate the correlation between the type of subscapularis tendon tears diagnosed during arthroscopy and the outcomes of physical tests and of isokinetic muscle strength tests. METHODS: We preoperatively evaluated physical outcomes and isokinetic muscle strength of 60 consecutive patients who underwent an arthroscopic rotator cuff repair and/or subacromial decompression. We divided the patients into five groups according to the type of subscapularis tear, which we classified using Lafosse classification system during diagnostic arthroscopic surgery. RESULTS: When we performed a trend analysis between the outcomes of the physical tests and the severity of subscapularis tendon tear, we found that both the incidence of positive sign of the collective physical tests and that of individual physical tests increased significantly as the severity of the subscapularis tear increased (p<0.001). Similarly, the deficit in isokinetic muscle strength showed a tendency to increase as the severity of subscapularis tear increased, but this positive correlation was statistically significant in only the deficit between those with Lafosse type II tears and those with Lafosse type III tears. CONCLUSIONS: Although no single diagnostic test surpasses above others in predicting the severity of a subscapularis tear, our study implies that, as a collective unit of tests, the total incidence of the positive rate of the physical tests and the extent of isokinetic strength deficit may correlate with severity of subscapularis tears.
Arthroscopy ; Classification ; Decompression ; Diagnostic Tests, Routine ; Humans ; Incidence ; Muscle Strength* ; Physical Examination ; Rotator Cuff ; Shoulder ; Tears* ; Tendons

BACKGROUND: We performed this study to evaluate the lower limit of the normal endothelial function, which can differentiate normal values from abnormal ones and to evaluate the changes of the endothelial function according to ages. MATERIALS AND METHODS: Study populations were consisted of four groups: patients (group A) with coronary artery disease (CAD) (n=2, mean age: 55 yrs), patients (group B) with one or more risk factors of atherosclerosis (n=3, mean age: 54 yrs), age- and sex-matched healthy subjects (group C, n=5, mean age: 54 yrs), and healthy young subjects (group D, n=3, mean age: 26 yrs). We measured the flow-mediated endothelium-dependent dilation (FMD) of brachial artery using a high-resolution ultrasound in all subjects. We analyzed the receiver operating characteristic (ROC) curve. RESULTS: The FMD of the A and B group were significantly lowered (8.6+/-3.7% vs 9.9+/-4/5% than C (14.3+/-3.3%, p<0.001) or D group (18.0+/-3.5%, p<0.001). The FMD level of 11.5% had 76.3% of sensitivity and 76% of specificity to differentiate normal endothelial function from abnormal one. The spearman correlation coefficient between ages and FMD in groups C and D was -0.543 (p<0.001). CONCLUSIONS: The endothelial function was decreased in patients with CAD or risk factors of atherosclerosis. We observed the age-related declining tendency of endothelial function in healthy subjects. 11.5% FMD) may be used to identify the person at risk of atherosclerosis.
Atherosclerosis* ; Brachial Artery ; Coronary Artery Disease* ; Coronary Vessels* ; Humans ; Reference Values ; Risk Factors* ; ROC Curve ; Sensitivity and Specificity ; Ultrasonography

No abstract available.

Motor weakness is one of the neurological complication that can occur after aneurysmal subarachnoid hemorrhage (SAH); incidence of motor weakness of 14~29% has been reported. Detailed information on the pathogenic mechanism of motor weakness is essential for brain rehabilitation because it enables estimation of the severity of injury, establishment of scientific rehabilitative strategies, and prediction of motor outcomes by clinicians. However, the exact pathogenic mechanisms of motor weakness following aneurysmal SAH have not been clearly elucidated. In this article, 14 previous studies on pathogenic mechanisms in patients with aneurysmal SAH were reviewed according to the location of the lesion (cerebral cortex, brainstem, spinal cord, and peripheral nerve). The following pathogenic mechanisms have been suggested: vasospasm, cerebral ischemia, hydrocephalus, compression of cerebral cortex, neural injury, spinal cord infarction, and radiculo-neuropathy. Considering the high incidence of aneurysmal SAH and motor weakness following aneurysmal SAH, we believe that the pathogenic mechanisms of motor weakness have been relatively understudied. More effort should be taken to investigate this important topic.
Subarachnoid Hemorrhage

The following case report concerns a rare bone metastasis of malignant melanoma occurring in the 4th and 5th lumbar spines and adjacent iliac crests and sacrum. A 42-year-old woman was admitted with a 6 months history of severe lumbago ar right flank pain radiating to right lower extremity. Preoperative X-ray studies revealed stag horn stone in the right renal pelvis as spondylolisthesis of the 5th lumbar spine with bilateral isthmic defects. On physical examinations, dark brown colored nevus was noted at lower lumbar regio which was removed and subjected for biopsy. Surgical exploration demonstrated a melanoma metastasis to have invaded the spine process, lamina and transverse processes of the 5th lumbar spine, adjacent L4 and sacru and iliac crests. Surrounding soft tissues, however, were apparently normal. Postoperatively course of the patient seemed to follow a rapidly terminal clinical cours.
Adult ; Animals ; Biopsy ; Female ; Flank Pain ; Horns ; Humans ; Kidney Pelvis ; Low Back Pain ; Lower Extremity ; Melanoma ; Neoplasm Metastasis ; Nevus ; Physical Examination ; Sacrum ; Spine ; Spondylolisthesis