BACKGROUND: Paraquat is widely used herbicide. But if it is ingested by accident or by suicidal attempt it causes severe toxicity. And in emergency room, it is a big problem that there is no effective treatment modality for paraquat intoxication. It is reported that the mechanism of toxicity is by oxygen fee radical. And Vitamin C is known as potent antioxidant. This study was designed to evaluate the antioxidant effect of Vitamin C to lipid peroxidaton in paraquat intoxication. METHODS: 24 rats were divided to 6 groups after paraquat injection(20mg/kg), and each groups 4 rats. In 2 control groups we only observed until 6 hours and 24 hours. And Vitamin C of 10 mg per kilogram body weight on the low dose group and 100 mg per kilogram body weight on the high dose group were infected simultaneously. And in 6 hours group, after 6 hours of paraquat and vitamin C injection biochemical levels of malondialdehyde, superoxide dismutase and catalase were measured in liver and lung. And in 24 hours group after 24 hours the same measures were done. The stasistical methods used were ANNOVA and Mann-Whitney test and P-value was 0.05. RESULTS: Malondialdehyde level of high dose Vitamin C group was significantly low compared to that of the control groups in liver tissues after 24 hours(p<0.05). And in lung tissues both low dose and high dose vitamin C groups show significantly low level of malondialdehyde level after 24 hours(p<0.05). On the superoxide dismutase activity, only high dose Vitamin C group shows significantly high level in 24hours both in liver and lung tissues. And the catalase activity is significantly elevated in high dome Vitamin C group after 24hours both in liver and lung tissues. (p<0.05) CONCLUSION: High dose Vitamin C suppresses lipid peroxidation, increases catalase activity and superoxide dismutase activity in paraquat intoxiation. It is thought to by antioxidant elect of vitamin C but it's effect is observed only in 24 hours after intoxication.
Animals ; Antioxidants* ; Ascorbic Acid* ; Body Weight ; Catalase ; Emergency Service, Hospital ; Fees and Charges ; Lipid Peroxidation ; Liver ; Lung ; Malondialdehyde ; Oxygen ; Paraquat* ; Poisoning* ; Rats ; Superoxide Dismutase ; Vitamins*

Purpose: We aimed to analyze changes in suprascapular nerve (SSN) position within the suprascapular notch during in vivo shoulder abduction. Materials and Methods: Three-dimensional models of the shoulder complex were constructed based on magnetic resonance imaging of the brachial plexus (BP-MR) in a patient diagnosed with SSN dysfunction but normal scapular movement. Using BP-MR in neutral position and computed tomography data on shoulder abduction, shoulder abduction was simulated as the transition between two positions of the shoulder complex with overlapping of a neutral and abducted scapula. SSN movement during abduction was evaluated using the finite element method. Contact stress on the SSN was measured in the presence and absence of the transverse scapular ligament (TSL). Results: In the neutral position, the SSN ran almost parallel to the front of the TSL until entering the suprascapular notch and slightly contacted the anterior-inferior border of the TSL. As shoulder abduction progressed, contact stress decreased due to gradual loss of contact with the TSL. In the TSL-free scapula, there was no contact stress on the SSN in the neutral position. Towards the end of shoulder abduction, contact stress increased again as the SSN began to contact the base of the suprascapular notch in both TSL conditions. Conclusion We identified changes in the position of the SSN path within the suprascapular notch during shoulder abduction. The SSN starts in contact with the TSL and moves toward the base of the suprascapular notch with secondary contact. These findings may provide rationale for TSL release in SSN entrapment.

BACKGROUND: Cytokeratins are epithelial markers whose expressions are not lost during malignant transformation. The utility of cytokeratin fragment (Cyfra) 21-1, a new tumor marker, was investigated in 110 patients with lung cancer. The aims of this study were to confirm sensitivity of Cyfra 21-1 in detecting non-small cell cancer, to assess the potential relationship between Cyfra 21-1 and disease stage of the lung cancer. METHODS: We measured serum levels of four tumor marker (NSE, CEA, SCC Ag, Cyfra 21-1) in 110 patients with lung cancer. The measurement of serum level of Cyfra 21-1 was performed with a cut off value of 3.3 ng/mL. An immunoradiometric assay was used to detect a fragment of the cytokeratin 19. The patients were grouped according to the stage of the disease and tumor type. RESULTS: Overall sensitivity of Cyfra 21-1 was relatively high (51.8%) than others tumor markers. Sensitivity of this marker was especially high for adenocarcinoma (63.2%) and squamous cell carcinoma (54.1%). In contrast, sensitiviy of Cyfra 21-1 was relatively low for small cell lung carcinoma (40.0%). Serum levels of Cyfra 21-1 were higher in advanced nonsmall cell lung cancer than early stage disease. CONCLUSION: We conclude that Cyfra 21-1 is a sensitive tumor marker of nonsmall cell lung cancer, especially adenocarcinoma and also may be a useful adjunctive marker for disease monitoring.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Humans ; Immunoradiometric Assay ; Keratin-19 ; Keratins ; Lung Neoplasms* ; Lung* ; Small Cell Lung Carcinoma ; Biomarkers, Tumor

PURPOSE: To evaluate the changes of differential counts and lymphocyte subsets in cancer patients' leukocyte before and after radiotherapy. METHODS AND MATERIALS: From Dec. 1994 to May 1995, the changes of leukocyte and its subsets in 16 patients who received radiotherapy in the Dept. of Radiation Oncology of Dong-A University Hospiatal were investigated. Radiation was delivered from 2700 cGy to 6660 cGy with median dose of 5400 cGy. The results of pre- and post-radiotherapy were analyzed by paired T-test. The results of patients who received < 50 Gy and > or = 50 Gy were analyzed by wilcoxon test. RESULTS: Before and after radiotherapy, there was not any significant differences in the counts of leukocyte, granulocyte and monocyte. A remarkable decrease was noted in lymphocyte counts after radiotherapy(p=0.015). T cells, B cells and natural killer cells were also decreased in number after radiotherapy but it was not significant statistically. T helper cells and T suppressor cells were also decreased in number(p>0.05). The ratio of T helper/suppressor cell was decreased from 1.52 to 1.11 and it was significant statistically(p=0.016). The portion of T suppressor cell among all T cells was increased after radiotherapy (p=0.0195). No significant difference was observed in the analysis of leukocyte and its subsets between patients who reveived < 50 Gy and > or = 50 Gy. CONCLUSION: Radiotherapy caused remarkable decrease in lymphocyte count and its subsets. Among all lymphocyte subsets, T helper cell might be the most vulnerable to radiation, considering decreased ratio of T helper/surppressor cell count after radiotherapy.
B-Lymphocytes ; Cell Count ; Granulocytes ; Humans ; Killer Cells, Natural ; Leukocytes ; Lymphocyte Count ; Lymphocyte Subsets* ; Lymphocytes* ; Monocytes ; Radiation Oncology ; Radiotherapy* ; T-Lymphocytes ; T-Lymphocytes, Helper-Inducer

STUDY DESIGN: A prospective study. PURPOSE: To assess postoperative changes in cerebral glucose metabolism in anxiety patients with lumbar spinal stenosis (SS). OVERVIEW OF LITERATURE: Although an association between preoperative anxiety and abnormal cerebral glucose metabolism may exist, only a limited number of studies using F-18 fluorodeoxyglucose positron emission tomography (FDG PET) have evaluated preoperative to postoperative changes in cerebral glucose metabolism in SS patients in detail. METHODS: The present study was designed to assess preoperative to postoperative changes in cerebral glucose metabolism in anxiety patients with SS. F-18 FDG PET with statistical parametric mapping analyses was used to compare preoperative and postoperative regional brain glucose metabolism in 18 SS patients. RESULTS: F-18 FDG PET scans showed postoperative activation of several brain clusters in gray matter. These included left parahippocampus, left cerebellar tonsil, left inferior semi-lunar lobule, and right cerebellar tonsil. Areas that were deactivated postoperatively were the right insula, left fusiform gyrus, left orbitofrontal cortex, left inferior frontal gyrus, left middle frontal gyrus, left precuneus, and left inferior frontal gyrus. CONCLUSIONS: SS patients with preoperative anxiety showed altered cerebral glucose metabolism at postoperative follow-up.
Anxiety ; Brain ; Follow-Up Studies ; Glucose ; Humans ; Palatine Tonsil ; Positron-Emission Tomography ; Prospective Studies ; Spinal Stenosis

PURPOSE: For the first time, a nationwide survey in the Republic of Korea was conducted to determine the basic parameters for the treatment of esophageal cancer and to offer a solid cooperative system for the Korean Pattern of Care Study database. MATERIALS AND METHODS: During 1998~1999, biopsy-confirmed 246 esophageal cancer patients that received radiotherapy were enrolled from 23 different institutions in South Korea. Random sampling was based on power allocation method. Patient parameters and specific information regarding tumor characteristics and treatment methods were collected and registered through the web based PCS system. The data was analyzed by the use of the Chi-squared test. RESULTS: The median age of the collected patients was 62 years. The male to female ratio was about 91 to 9 with an absolute male predominance. The performance status ranged from ECOG 0 to 1 in 82.5% of the patients. Diagnostic procedures included an esophagogram (228 patients, 92.7%), endoscopy (226 patients, 91.9%), and a chest CT scan (238 patients, 96.7%). Squamous cell carcinoma was diagnosed in 96.3% of the patients; mid-thoracic esophageal cancer was most prevalent (110 patients, 44.7%) and 135 patients presented with clinical stage III disease. Fifty seven patients received radiotherapy alone and 37 patients received surgery with adjuvant postoperative radiotherapy. Half of the patients (123 patients) received chemotherapy together with RT and 70 patients (56.9%) received it as concurrent chemoradiotherapy. The most frequently used chemotherapeutic agent was a combination of cisplatin and 5-FU. Most patients received radiotherapy either with 6 MV (116 patients, 47.2%) or with 10 MV photons (87 patients, 35.4%). Radiotherapy was delivered through a conventional AP-PA field for 206 patients (83.7%) without using a CT plan and the median delivered dose was 3,600 cGy. The median total dose of postoperative radiotherapy was 5,040 cGy while for the non-operative patients the median total dose was 5,970 cGy. Thirty-four patients received intraluminal brachytherapy with high dose rate Iridium-192. Brachytherapy was delivered with a median dose of 300 cGy in each fraction and was typically delivered 3~4 times. The most frequently encountered complication during the radiotherapy treatment was esophagitis in 155 patients (63.0%). CONCLUSION: For the evaluation and treatment of esophageal cancer patients at radiation facilities in Korea, this study will provide guidelines and benchmark data for the solid cooperative systems of the Korean PCS. Although some differences were noted between institutions, there was no major difference in the treatment modalities and RT techniques.
Brachytherapy ; Carcinoma, Squamous Cell ; Chemoradiotherapy ; Cisplatin ; Drug Therapy ; Endoscopy ; Esophageal Neoplasms* ; Esophagitis ; Female ; Fluorouracil ; Humans ; Korea* ; Male ; Photons ; Radiotherapy ; Republic of Korea ; Tomography, X-Ray Computed

BACKGROUND: The purpose of this study was to evaluate the screw-home movement at the tibiofemoral joint during normal gait by utilizing the 3-dimensional motion capture technique. METHODS: Fifteen young males and fifteen young females (total 60 knee joints) who had no history of musculoskeletal disease or a particular gait problem were included in this study. Two more markers were attached to the subject in addition to the Helen-Hayes marker set. Thus, two virtual planes, femoral coronal plane (P(f)) and tibial coronal plane (P(t)), were created by Skeletal Builder software. This study measured the 3-dimensional knee joint movement in the sagittal, coronal, and transverse planes of these two virtual planes (P(f) and P(t)) during normal gait. RESULTS: With respect to kinematics and kinetics, both males and females showed normal adult gait patterns, and the mean difference in the temporal gait parameters was not statistically significant (p > 0.05). In the transverse plane, the screw-home movement occurred as expected during the pre-swing phase and the late-swing phase at an angle of about 17degrees. However, the tibia rotated externally with respect to the femur, rather than internally, while the knee joint started to flex during the loading response (paradoxical screw-home movement), and the angle was 6degrees. CONCLUSIONS: Paradoxical screw-home movement may be an important mechanism that provides stability to the knee joint during the remaining stance phase. Obtaining the kinematic values of the knee joint during gait can be useful in diagnosing and treating the pathological knee joints.
Adolescent ; Adult ; Biomechanical Phenomena/physiology ; Female ; Fiducial Markers ; Gait/*physiology ; Humans ; Imaging, Three-Dimensional ; Knee Joint/*physiology ; Male ; Range of Motion, Articular/*physiology ; Sex Factors ; Walking/physiology ; Young Adult

This study was conducted to measure the lead, cadmium and mercury levels in the scalp hair, cerebellum, cerebrum, heart, kidney, liver, lung, and spleen of the 60 Korean autopsy subjects and assess the relationship among those samples. The mean lead level in the scalp hair was 12.29+/-12.51 microgram/g and no significant difference was detected in lead concentrations between the two sexes. Among the internal organ tissues the cerebrum contained the highest level of lead. This is followed by the cerebellum, spleen and liver respectively. After which the kidney and lung showed a close similarity at relatively low concentrations and the heart contained the lowest concentration. There was also no significant variation found between sexes in a comparison of lead in the internal organ tissues. The concentrations of cadmium in kidney were 127.33+/-89.36 microgram/g and considerably higher than those in the other internal organs. The liver contained the next highest level of cadmium. In both sexes, the consistent difference was noted in the cadmium concentrations of the kidney, heart and spleen. Yet female cadmium level was higher than the male's. The concentrations of mercury in the kidney and liver were 1.26+/-2.89 microgram/g, 0.59+/-0.54 microgram/g and considerably higher than those in the other internal organs. The mean mercury level in the scalp hair was 1.29+/-0.64 microgram/g and no marked difference was noted in both sexes. The lead concentration in the spleen increased with advancing age, though not statistically significance, and most of the internal organ tissues that were examined showed no evidence of increased lead concentration with age. The kidney, cerebrum, spleen and cerebellum showed increased cadmium concentrations with age. Also as well as the internal organ tissues that were examined showed no evidence of increased mercury concentration with age. The lead concentrations in the liver and lung were higher in the urban area than in the rural area, but the lead concentration in the kidney was higher in the rural area. No difference was noted in tissue cadmium and mercury concentrations as to the area of residence either. The physical workers had greater concentrations of lead in cerebellum than did housewives or the unemployed. Yet no difference was noted in the other tissues between the two groups. In the cerebellum, cerebrum, heart, and spleen, the physical workers had greater concentrations of cadmium than students or mental workers. Also physical workers had greater concentrations of cadmium in lung than housewives or the unemployed. In contrast to lead and cadmium, both the housewives and the unemployed had higher concentrations of mercury in cerebellum and cerebrum than physical workers, but there was no difference was noted in the other tissues between the two groups. In the lead concentration, there was no statistically significant correlation between the scalp hair and examined internal organ tissues. There was a close relationship between lead levels in cerebellum and cerebrum (r=0.465, p<0.01), as well as a relationship between the cerebellum and the kidney(r=0.300, p<0.05). There was no statistically significant correlation between the cadmium levels in the scalp hair and in the examined internal organ tissues. Positive correlations were found between the cadmium concentrations in the cerebellum and the cerebrum(r=0.5543, p<0.01), heart(r=0.480, p<0.01), kidney(r=0.376, p<0.01) and spleen(r=0.408, p<0.01). Also positive correlation was found between in the cerebrum and the heart(r=0.377, p<0.01), kidney(r=0.484, p<0.01), liver(r=0.265, p<0.05), lung(r=0.458, p<0.01) and spleen (r=0.483, p<0.01). There was also no statistically significant correlation between the mercury levels in the scalp hair and in the examined internal organ tissues. Positive correlation was found between the mercury concentrations in the cerebellum and cerebrum(r=0.760, p<0.01), heart(r=0.270, p<0.05), liver(r=0.425, p<0.01), lung (r=0.488, p<0.01) and spleen (r=0.534, p<0.01), and also positive correlation was found between in the cerebrum and heart(r=0.376, p<0.01), liver(r=0.350, p<0.01), lung(r=0.554, p<0.01) and spleen (r=0.489, p<0.01). Various epidemiological studies reported usefulness and reliability of using scalp hair as a monitor of a environmental pollutants. In this study, there was statistically significant correlation of lead, cadmium and mercury levels in most of the tissues that were examined, but there was no statistically significant correlation between the lead, cadmium and mercury levels in the scalp hair and most of examined internal organ tissues. The findings of this study would suggest that it is still uncertain to using scalp hair as a biological monitoring.
Autopsy* ; Cadmium* ; Cerebellum* ; Cerebrum* ; Environmental Monitoring ; Environmental Pollutants ; Epidemiologic Studies ; Female ; Hair* ; Heart* ; Humans ; Kidney* ; Liver* ; Lung* ; Scalp* ; Spleen*

STUDY DESIGN: A prospective study. PURPOSE: To evaluate the reliability and validity of the adapted Korean version of the Neck Pain and Disability Scale (NPDS). OVERVIEW OF LITERATURE: The validity of Korean version of NPDS has not been completely demonstrated yet. METHODS: Translation/retranslation of the English version of NPDS was conducted, and all steps of the cross-cultural adaptation process were performed. The Korean version of the visual analog scale (VAS) measure of pain, NPDS and the previously validated Short Form-36 (SF-36) were mailed to 91 patients, who had been surgically treated for degenerative cervical disease. Eighty-one patients responded to the first mailing of questionnaires and 69 of the first time responder returned their second survey. Factor analysis and reliability assessment by kappa statistics of agreement for each item, the intraclass correlation coefficient and Cronbach's alpha were conducted. Concurrent and construct validity were also evaluated by comparing the responses of NPDS with the results of VAS and responses of SF-36. RESULTS: Factor analysis extracted 3 factors. All items had a kappa statistics of agreement greater than 0.6. The NPDS showed excellent test/re-test reliability. Internal consistency of Cronbach's alpha was found to be very good. The NPDS was correlated with the VAS. The Korean version of NPDS showed good significant correlation with SF-36 total score and with single SF-36 domains scores. CONCLUSIONS: The adapted Korean version of the NPDS was successfully translated and is considered suitable for outcome assessments in the Korean-speaking patients with neck pain.
Humans ; Neck ; Neck Pain ; Prospective Studies ; Reproducibility of Results ; Surveys and Questionnaires

STUDY DESIGN: This is a prospective study. PURPOSE: We compared the outcomes of segmental decompression and wide decompression in patients who had multilevel lumbar foraminal stenosis with back pain. OVERVIEW OF LITERATURE: Wide decompression and fusion in patients with multilevel lumbar foraminal stenosis may increase the risk of perioperative complications. METHODS: From March 2005 to December 2007, this study prospectively examined 87 patients with multilevel lumbar foraminal stenosis and who were treated by segmental or wide decompression along with posterior fusion using pedicle screw fixation, and these patients could be followed-up for a minimum of 2 years. Of the 87 patients, 45 and 42 patients were assigned to the segmental decompression group (group 1) and the wide decompression group (group 2), respectively. We compared the clinical and radiological outcomes of the patients in these two groups. RESULTS: There were no significant differences between groups 1 and 2 in terms of the levels of postoperative pain based on the visual analogue scale, the Oswestry Disability Score, the clinical results based on the Kirkaldy-Willis Criteria, the complication rate or the posterior fusion rate. On the other hand, the mean operating times in groups 1 and 2 were 153 +/- 32 minutes and 187 +/- 36 minutes, respectively (p < 0.05). The amount of blood loss during surgery and on the first postoperative day was 840 +/- 236 ml and 1,040 +/- 301 ml in groups 1 and 2, respectively (p < 0.05). CONCLUSIONS: These results suggest that segmental decompression offers promising and reproducible clinical and radiological results for patients suffering from multilevel lumbar foraminal stenosis.
Constriction, Pathologic ; Decompression ; Hand ; Humans ; Pain, Postoperative ; Prospective Studies ; Stress, Psychological