OBJECTIVE: The purpose of this study was to determine the knee extension force of healthy Korean adults by using a hand-held dynamometer and evaulate the relationship of knee extension force between each decade. METHOD: One hundred and twenty healthy subjects (60 males, 60 females) between the ages of 20 and 79 years were tested for knee extension force by using Nicholas Manual Muscle Tester (MMT). Data were analyzed for means, standard deviations, test-retest reliability and correlation with variables by using the SPSS(R) software package. RESULTS: The mean value of the knee extension force was 25.9 +/- 5.8 kg in the males and 16.5 +/- 4.1 kg in the females. Significant difference between each decade was found in the males but not in the females. The knee extension force of the males was stastically correlated with all of variables, i.e., age, weight and height, but the knee extension force of the females, was correlated only with weight. Intratester correlation coefficients were high for the Nicholas MMT to measure the knee extension force for healthy adults. Also the difference between the dominant and nondominant side for the knee extensor force was not significant, stastically. CONCLUSION: This MMT may be useful to quickly and objectively evaluate force in the clinical setting.
Adult* ; Female ; Humans ; Knee* ; Male

OBJECTIVE: To evaluate the autonomic nervous system function in chronic renal failure patients compared to normal control and to assess the effect of dialysis method and underlying diseases such as diabetes mellitus and hypertension, on autonomic nervous system function in chronic renal failure patients. METHOD: We checked palm and sole skin temperature with digital thermometer, sympathetic skin responses and heart rate variability in chronic renal failure patients (77 persons) and normal control group (77 persons). RESULTS: The amplitude of sympathetic skin response (SSR) and heart rate variability (RRIV) of patients group showed statistically significant difference compared to control group (p<0.05). The diabetic patient group with chronic renal failure showed prolonged latency of SSR in sole but significant differences were shown in amplitude and RRIV (p<0.05). The hypertensive group with chronic renal failure showed prolonged latency of SSR in both palm and sole (p<0.05) but the amplitude and RRIV of those didn,t show statistical difference (p>0.05). CRF without diabetes mellitus and hypertension showed significant difference on amplitude of SSR and RRIV (p<0.05) but autonomic nervous system function tests showed no difference (p>0.05) between hemodialysis and peritoneal dialysis groups. CONCLUSION: SSR test and RRIV could be valuable measure to evaluate autonomic nervous system functions in the patients with chronic renal failure.
Autonomic Nervous System* ; Diabetes Mellitus ; Dialysis ; Heart Rate ; Humans ; Hypertension ; Kidney Failure, Chronic* ; Peritoneal Dialysis ; Renal Dialysis ; Skin ; Skin Temperature ; Thermometers

OBJECTIVE: To examine the validity of the fuctional reach test (FRT) for evaluation of standing balance in hemiplegic patients. METHOD: Twenty three hemiplegic patients who were capable of standing without assistive devices were assessed on the FRT only with intact upper limb, the one-legged stance, the timed up and go test (TUG), the 10 meter walking time (10 mWT), the 'Hauser' ambulation index (AI), and the standing balance of Bohannon. RESULTS: The forward reach of FRT demonstrated significant correlation with the TUG and the 10 mWT (p<0.01), but no significant relationship with the one-legged stance, standing balance of Bohannon and AI. CONCLUSION: The forward reach of FRT may be simple and useful tool for assessing the clinical balance function and reflecting gait ability and fall-down risk in hemiplegic patients.
Gait ; Gait Disorders, Neurologic ; Humans ; Self-Help Devices ; Upper Extremity ; Walking

INTRODUCTION: To prevent hemodialysis-related infections, it is important to maintain hemodialysis system without microbial contamination. In May 2003, routine surveillance showed that dialysis water from dialysis port was contaminated with bacteria. To identify the causes of the contamination, we conducted an investigation as follows. METHODS: Patients undergoing dialysis were carefully monitored to see whether evidences of pyrogenic reactions or infections were present. Factors that could have influence on bacterial contamination in hemodialysis systems were thoroughly examined. In addition, microbiologic surveillances were done 7 times in 1 month. RESULTS: Although pyrogenic reactions or bacteremia did not occur, R. pickettii was repeatedly isolated above the Association for the Advancement of Medical Instrumentation (AAMI) standards from almost all dialysis units. Bacterial counts of specimens were higher in the proximal part of the water supply tube than the other parts in all dialysis machines. The colony count of R. pickettii exceeded the maximum level of technical limit in the specimens collected from the dialysis machines in the early morning after intermission of 48 hours. The structure of the supply tube was suspected as the origin of the colonization because stagnant water is a reservoir for bacterial multiplication. After remodeling the structure of the water supply tube, neither R. pickettii nor any other bacteria were isolated. CONCLUSION: Our investigation successfully identified the source of R. pickettii contamination of reverse osmosis water. Appropriate corrective measures for water distribution systems of hemodialysis center could prevent outbreak of dialysis-associated illnesses.
Bacteremia ; Bacteria ; Bacterial Load ; Colon ; Dialysis ; Humans ; Osmosis ; Ralstonia ; Ralstonia pickettii ; Renal Dialysis ; Water ; Water Supply

STUDY DESIGN: This is a retrospective study. OBJECTIVES: We wanted to evaluate the effectiveness and safety of a PEEK cage filled with DBM in patients with a distractive flexion injury of the cervical spine. SUMMARY OF LITERATURE REVIEW: AIF of the cervical spine using an autoiliac bone graft and plate fixation is known to be an effective treatment for traumatic injuries. However, the complications arising from the donor site are troublesome, and so fusion with cage is an alternative treatment. MATERIALS AND METHODS: We analyzed 32 cases (22 males and 10 females) with distractive flexion injury of the cervical spine. They underwent anterior decompression and interbody fusion with a PEEK cage and anterior plate fixation. In 18 patients, the cage was filled with autogenous iliac bone (Group I), and for the other 10 the cages were filled with DBM (Group II). RESULTS: All the cases in Group I and Group II achieved fusion except for one case of nonunion in group II. The anterior and posterior vertebral heights of the fused segments of group II were decreased more than those of group I, resulting a statistical difference (p=0.003). The changes of segmental lordosis (p=0.69) and the neurologic status (p=0.22) showed no statistical difference between the two groups. CONCLUSIONS: AIF using a PEEK cage filled with DBM and plate fixation showed no significant clinical differences compared to the case of iliac bone autografting. However, from a radiologic perspective, the time to achieve union was extensive and a case of nonunion was also observed. Therefore, many considerations are necessary when using DBM as a replacement for iliac bone autografting and further research should be done on this subject.
Animals ; Bone Matrix ; Decompression ; Humans ; Ketones ; Lordosis ; Male ; Polyethylene Glycols ; Retrospective Studies ; Spine ; Tissue Donors ; Transplantation, Autologous ; Transplants

BACKGROUND: This study was designed to evaluate the safety and the efficacy of fosinopril(Monopril(R)) in the treatment of mild to moderate essential hypertension. METHOD: Fosinopril(10mg) once a day was administrated as a starting dose in 20 patients with essential hypertension in the morning and a one step upward titration was performed(fosinopril 20mg once a day, after 4 weeks treatment). RESULT: After 2 weeks treatment with dose of 10mg, the systolic blood pressure(SBP) was decreased(183.8+/-28.5 vs, 161.5+/-25.9mmHg, p<0.05) and the diastolic blood pressure(DBP) was also decreased significantly(108.3+/-9.3 vs, 96.6+/-10.3mmHg, p<0.05). The effect of fosinopril were maintained. The SBP an DBP were decreased in 14 out of 20 patients till 8 weeks. There was no significant change in heart rate before and after fosinopril treatment(74.3+/-10 vs, 76.4+/-7.9beats/min). Fosinopril had no significant effects on laboratory findings such as serum creatinin, BUN, AST/ALT, WBC, Platelet and lipid profiles. Mild dry coughing was noticed only in 5 patients and it did not disturb continuing medication. CONCLUSION: Fosinopril is an effective antihypertensive agent, as monotherapy once a day in patients with mild to moderate hypertension.
Blood Platelets ; Cough ; Fosinopril* ; Heart Rate ; Humans ; Hypertension*

BACKGROUND: Recently, epidural anesthesia for elective and emergency cesarean section is increasing in popularity and graudally replacing general anesthesia. However, the complications from the epidural anesthesia such as hypotension, dyspnea, nausea and vomiting have often been reported. This study was designed to estimate the efficacy of crystalloid administration on blood pressure and heart rate change during epidural anesthesia in cesarean section. METHODS: Forty ASAI and II patients scheduled for cesarean section under epidural anesthesia were randomly allocated to receive either only maintained fluid administration(group I) or 15 ml/kg crystalloid solution over 15 minutes(group II). Epidural anesthesia was performed in a lateral decubitus position. According to the patient's height, 20~23 ml of 2% lidocaine was injected through epidural catheter at the L3~4 interspace. RESULTS: Cardiovascular responses and complications after induction of epidural anesthesia were compared and results were as follows. The incidence of hypotension was 14/20 (70%) in the groupI and 4/20(25%) in the group II(p<0.05). Systolic blood pressure after induction of epidural anesthesia in the group I significantly decreased from 6 min to 12 min as compared to the group II. The mean heart rate after induction of epidural anesthesia in the both group was no significant difference to baseline heart rate. CONCLUSIONS: Considering above results, we conclude that a prophylactic crystalloid solution infusion is effective for minimizing and managing hypotension associated with epidural anesthesia in cesarean section.
Anesthesia, Epidural* ; Anesthesia, General ; Blood Pressure* ; Catheters ; Cesarean Section* ; Dyspnea ; Emergencies ; Female ; Heart Rate* ; Heart* ; Humans ; Hypotension ; Incidence ; Lidocaine ; Nausea ; Pregnancy ; Vomiting

PURPOSE: With gold electroforming system for the double crown, the secondary crown is electroformed directly onto the primary crown. An even thick layer of high precision can be acquired. It is thought that the retention of electroformed outer crown is primarily acquired by the adhesive force (surface tension) through the saliva which is interposed between precisely fitted inner and outer crown. The purpose of this study was to investigate the effect of taper and surface area of inner crown on the retentive force of electroformed outer crown according to the presence of saliva. MATERIALS AND METHODS: 32 titanium inner crowns with cervical diameter of 8 mm and cone angles of 0, 2, 4, 6 degrees, which had same surface area by regulated height, were machined on a lathe. Another 32 titanium inner crowns with cone angles of 0, 2, 4, 6 degrees, which had doubled surface area by increased cervical diameter, were fabricated. Eight specimens of each group, for a total of 64 titanium inner crowns, were prepared. The electroformed outer crowns were fabricated directly on the inner crowns by using electroforming machine(GAMMAT free, Gramm Technik, Germany). The tertiary frameworks were waxed-up on the electroformed outer crown and cast using nonprecious alloy(Rexillium(R)III, Jeneric(R)/ Pentronh(R) Inc., USA). The cast metal frameworks were sandblasted with alubimium oxides and cemented using resin cement(Superbond C and B, Sun Medical Co., Japan) over the electroformed copings of each specimen. Then, artificial saliva(Taliva(R), Halim Pharm Co., Korea) was sprayed between the inner and outer crown, and they were connected under 5 kg force. The retentive force was measured by the universal testing machine(Tinius Olsen 1000, Tinius Olsen, USA) with a cross-head speed of 66.67 mm/sec. The direction of cross-head travel was exactly aligned with the path of removal of the respective specimens. This measurement procedures for retentive force of electroformed outer crown with artificial saliva were repeated in the same way without presence of artificial saliva. RESULTS AND CONCLUSION: The following conclusions were drawn: 1. The retentive force of electroformed outer crown was decreased according to increased taper of inner crown(P<.05). 2. The retentive force of electroformed outer crown showed no significant differences according to surface area and the presence of artificial saliva(P>.05).
Adhesives ; Crowns* ; Oxides ; Saliva ; Saliva, Artificial ; Solar System ; Titanium

OBJECTIVE: Elevated cellular retinoic acid binding protein-I (CRABP-I) is thought to be related to the abnormal proliferation and migration of smooth muscle cells (SMCs). Accordingly, a higher CRABP-I level could cause disorganized vessel walls by causing immature SMC phenotypes and altering extracellular matrix proteins which could result in vulnerable arterial walls with inadequate responses to hemodynamic stress. We hypothesized that elevated CRABP-I level in the cerebrospinal fluid (CSF) could be related to subarachnoid hemorrhage (SAH). Moreover, we also extended this hypothesis in patients with vascular malformation according to the presence of hemorrhage. METHODS: We investigated the CSF of 26 patients : SAH, n=7; unruptured intracranial aneurysm (UIA), n=7; arteriovenous malformation (AVM), n=4; cavernous malformation (CM), n=3; control group, n=5. The optical density of CRABP-I was confirmed by Western blotting and presented as mean+/-standard error of the measurement. RESULTS: CRABP-I in SAH (0.33+/-0.09) was significantly higher than that in the UIA (0.12+/-0.01, p=0.033) or control group (0.10+/-0.01, p=0.012). Hemorrhage presenting AVM (mean 0.45, ranged 0.30-0.59) had a higher CRABP-I level than that in AVM without hemorrhage presentation (mean 0.16, ranged 0.14-0.17). The CRABP-I intensity in CM with hemorrhage was 0.21 and 0.31, and for CM without hemorrhage 0.14. Overall, the hemorrhage presenting group (n=11, 0.34+/-0.06) showed a significantly higher CRABP-I intensity than that of the non-hemorrhage presenting group (n=10, 0.13+/-0.01, p=0.001). CONCLUSION: The results suggest that elevated CRABP-I in the CSF could be related with aneurysm rupture. Additionally, a higher CRABP-I level seems to be associated with hemorrhage development in vascular malformation.
Aneurysm ; Arteriovenous Malformations ; Blotting, Western ; Cerebrospinal Fluid* ; Extracellular Matrix Proteins ; Hemodynamics ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Myocytes, Smooth Muscle ; Phenotype ; Rupture ; Subarachnoid Hemorrhage ; Tretinoin* ; Vascular Malformations

No abstract available.
Echocardiography* ; Electrocardiography*