No abstract available.
Ischium ; Osteomyelitis

Controlled hypotension induced with sodium nitroprusside (SNP) has been most widely used to facilitate the surgical procedure and to reduce blood loss. However, major problem with its clinical use is cyanide toxicity, which is dose related. And resitance and tachyphylaxis, probably being mediated by sympathoadrenal response to lowered blood pressure, is known to increase dose requirements. Accordingly, several attempts have been made to attenuate sympathetic activity and therefore to reduce dose requirement of SNP. Verapamil, a representative calcium channel blocker, exerts inotropic and chronotropic effect, as well as vasodilation. And it is, also, known to impair pulmonary gas exchange. The purpose of these experiments was to evaluate hemodynamic and gas exchange effects of verapamil, and also its efficacy for reducing the amount of SNP during induced hypotension in patients anesthetized with isoflurane and N2O. Twenty five patients, scheduled to undergo general anesthesia with hypotension, were randomly assigned to two groups. Twelve patients were pretreated with verapamil (160mg, SOD: verapamil group) and the other thirteen were not (control group). The results were as follows: 1) Cardiac index remained unchanged in both groups and did not differ significantly between groups at all times. 2) Heart rate was significatly lower in verapamil group than in control group in the hypotensive period. (113+/- 3.3 vs 103+/- 2.7, p < 0.05) 3) Hypotension induced by SNP resulted from a marked decrease in systemic vascular resistance in both groups. 4) MPAP, PCWP, CVP, SVR and PVR significantly decreased after SNP infusion in both groups, but they did not differ significantly between the groups at all times. 5) SNP dose requirements to attain the same MAP reduction did not differ significantly between groups. (5.5+/-0.8vs 4.1+/-0.8mcg/kg/min, NS) 6) Verapamil pretreatment produced no significant change in intrapulmonary shunt fraction at all times. 7) SNP caused a signficant decrease in arterial oxygen tension in both group, but there were no significant difference between groups at all times. From the above results, it might be concluded 1) that verapamil, in clinical doses, does not blunt a reflex increase in sympathetic activity in response to SNP induced vasodilation, since it produced only a minor influence on SNP induced hemodynamics and the SNP dose requirements, and that verapamil does not inhibit hypoxic pulmonary vasoconstriction during isoflurane-N2O anesthesia. Thus, verapamil could not be a valuable adjunct of SNP in enhancing the hypotensive effect in spite of preserved arterial oxygenation.
Anesthesia ; Anesthesia, General ; Blood Pressure ; Calcium Channels ; Heart Rate ; Hemodynamics* ; Humans ; Hypotension* ; Hypotension, Controlled ; Isoflurane ; Nitroprusside* ; Oxygen ; Pulmonary Gas Exchange* ; Reflex ; Sodium* ; Tachyphylaxis ; Vascular Resistance ; Vasoconstriction ; Vasodilation ; Verapamil*

BACKGROUND: To access the clinical usefulness of MicroScan(R) Synergies plus Combo Panels (Siemens, USA) for the identification and antimicrobial susceptibility test (AST) of Gram-negative bacteria (GNB) and Gram-positive cocci (GPC), we compared MicroScan(R) Synergies plus Combo Panels with MicroScan(R) conventional Combo Panels. METHODS: One-hundred four isolates of GNB were simultaneously tested with MicroScan(R) Synergies plus Neg Combo Type 2 Panel (SINC2) and MicroScan(R) Neg Combo Panel Type 44 (NC44). One-hundred isolates of GPC were simultaneously tested with MicroScan(R) Synergies plus Pos Combo 3 Panel (SIPC3) and MicroScan(R) Pos Combo 1A (PC1A). RESULTS: Of the GNB isolates, agreement rate of identification between SINC2 and NC44 were 92.3% to the species level and 93.3% to the genus level. Of the GPC isolates, agreement rate of identification between SIPC3 and PC1A were 85.0% to the species level and 100% to the genus level. Of the GNB isolates, agreement rate of AST according to antimicrobial agents between SINC2 and NC44 ranged from 86.5% to 100%. Among GPC isolates, agreement rate of AST according to antimicrobial agents between SIPC3 and PC1A were higher than 96.0% with the exception of gentamicin and quinupristin-dalfopristin. CONCLUSION: Compared with MicroScan(R) conventional Combo Panels (NC44, PC1A), MicroScan(R) Synergies plus Combo Panels (SINC2, SIPC3) showed high agreement rate of identification and AST, and had the advantage of more rapid reporting.
Anti-Infective Agents ; Gentamicins ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Gram-Positive Cocci ; Imidazoles ; Nitro Compounds ; Virginiamycin

We usually accept 1 : 1 ratio soft tissue change in mandibular set-back surgery. But we cannot sure whether we can use this ratio as a long term predictor after surgery. We investigated the change of hard tissue and its effects to soft tissue and examined the predictability of cephalometric analysis in short term and long term follow-up periods in mandibular set-back surgery. Subjects were 15 patients (5 male, 10 female) performed mandibular set-back procedure only by BSSRO with rigid fixation. Cephalometric data were obtained before orthodontic treatment, immediate before surgery and immediate after surgery, 6 months, and 18 months after surgery consecutively. Differences in soft and hard tissue changes among the time intervals were examined using analysis of variance (ANOVA) ; the association between immediate surgical change in chin landmarks and subsequent short and long term soft and hard tissue changes were examined using linear regression analysis 1. Soft tissue mandibular structures were positioned posteriorly and superiorly after surgery. Average mandibular set-back were 8.17mm at Pog. The horizontal and vertical hard tissue mandibular changes were stable for 18 months after surgery. Although there was a small degree of change, soft tissue and hard tissue remain relatively stable after surgery and there was no clinically discernable changes between 6 months and 18 months post-operatively. 2. Some part of upper lip (Ls & stms)and most part of mandibular soft tissue moves postero-superiorly after mandibular set-back. The ratio of horizontal changes of hard tissue to soft tissue at Inf. labial sulcus(B'), Pogonion(Pog') were 84.7%, 74.7% after 18 months. respectively. 3. Predictability of the soft tissue change is less certain than hard tissue and this predictability is decreased over time. These result suggests that we cannot predict the surgical outcomes exactly. It is recommendable that the oral surgeon should be careful in using the computerized surgical prediction software program as a predictor of long term soft tissue change.
Chin ; Follow-Up Studies ; Humans ; Linear Models ; Lip ; Male

Background: Estrogen status is important for maintaining the homeostasis of bone. Estrogen has direct effects on bone cells, through binding to the high-affinity estrogen receptor. Several recent studies suggest that there might be genetically determined variations in biosynthesis and function of estrogen receptor in postmenopausal osteoporosis. Also the main cause of postmenopausal osteoporosis is decreased level of serum estrogen, whereas there had been some suggestion that the remaining estrogen have some effect on bone metabolism after menopause. We investigated the relationship between estrogen receptor gene PvulI polymorphism and bone mineral density(BMD), and the relationship between 18 urinary metabolites of estrogen and BMD in Korean postmeno- pausal osteoporosis. Methods: We examined the PvuII polymorphism of the estrogen receptor gene in 5' upstream region and the first intron by restrietion frapnent length polymorphism analysis in 62 postmeno- pausal wornen, BMD was measured by DEXA. The urinary estrogen metabolites were determined by GC/MS(Gas Chromatography-Mass Spectrometry) at Korean Institute of Science and Techno- logy Doping Control Center. Results: BMD of the spine and the femoral neck correlated with body weight, height, body mass index as we expected. There was no polymorphism of PvuII restriction site on 5 upstream region of estrogen receptor gene. Whereas the prevalen~ee of the PP, Pp, pp genotype in the first intron of estrogen receptor was 12.9%, 45.2%, 41.9%, respectively. But, there was no correlation between PvuII genotype and the spinel and femoral neck BMD. 2(OH)E2 among 18 urinary metabolites of estrogen, showed a negative correlation with the spinal and femoral neck BMD(r =-0.2551, p<0.05, and r =-0.3341, p<0.01, respectively), and the ratio of 16a(OH)E2/2(OH)E1> revealed a positive correlation with the spinal BMD(r =0.3057, p<0.05). In stepwise multiple regression analysis, body weight, 2(OH)E2, 16a(OH)E1, 2(Meo)E1 were independent predictors of the spinal bone density, and body weight and 2(OH)E2 were independent predictors of the femoral neck bone density. Conclusion: These results suggested that restrietion fragment length polymorphism analysis of the estrogen receptor gene with PvuII restriction enzyme was not helpful for early detection of patients at risk of developing osteoporosis. However, the ratio of 16-hydroxylation to 2-hydroxylation of estrogen metabolism was reduced in postmenopausal women and high catecholestrogen formation might be a greater risk factor for osteoporosis.
Body Height ; Body Weight ; Bone Density ; Estrogens ; Female ; Femur Neck ; Genotype ; Homeostasis ; Humans ; Introns ; Menopause ; Metabolism ; Miners ; Osteoporosis ; Osteoporosis, Postmenopausal ; Risk Factors ; Spine

BACKGROUND: As an endemic area of viral hepatitis B, many studies on hepatitis B and C have been reported in Korea, but no on all five viral types, A, B, C, D, and E. We surveyed ten serologic markers for the five different viral hepatitis and reviewed the seropositivity of each viral hepatitis and concurrent infection. METHODS: Ten serologic markers of five viral hepatitis (anti-HAV IgM, anti-HAV IgG, HBsAg, anti-HBs, anti-HBc, HBeAg, anti-HBe, anti-HCV, anti-HDV, and anti-HEV IgM) were tested for 260,488 samples requested for viral marker studies at three hospitals of Korea University Medical Centers from January through December, 2003. Anti-HAV IgM, anti-HAV IgG, anti-HDV, and anti-HEV IgM were tested by RIA and HBsAg, anti-HBs, anti-HBc, HBeAg, anti-HBe, and anti-HCV were analysed by ELISA or RIA method. RESULTS: Anti-HAV IgM and IgG seropositivity was 1.2% and 88.0%, respectively. Anti-HAV IgM seropositivity was high in a patient group 20 to 29 years of age. The overall seropositivity of HBsAg was 10.4% and for anti-HBs 60.4%. The seropositivity was 1.3% for anti-HCV, 1.1% for anti-HDV, and 22.2% for anti-HEV IgM. The concurrent positivity of HBsAg and anti-HBs was 4.0%. HBsAg was positive in 7 (0.1%) of anti-HCV positive patients; anti-HEV IgM was positive in 2 (25%) of anti-HAV IgM positive patients. CONCLUSIONS: Hepatitis A infection was rare in children but increased in patient group 20 to 29 years of age. The concurrent infection rate of hepatitis A with hepatitis E was high, suggesting that hepatitis E should be considered in hepatitis A patients. In view of the finding that the concurrent infection of hepatis B and C was detected, though at a relatively low rate, patients with viral hepatitis need to be assessed for the possibility of concurrent infection with other types of hepatitis.
Academic Medical Centers* ; Biomarkers ; Child ; Coinfection ; Enzyme-Linked Immunosorbent Assay ; Hepatitis A ; Hepatitis A Antibodies ; Hepatitis B ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis E ; Hepatitis* ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Korea

BACKGROUND: For the efficient management of clinical pathology laboratory, not only the economic side but also the quality of test should be considered. Therefore, the authors investigated the status of laboratory in the management point including the status of technical personnel by survey and tried to find out the fundamental status of work environment, laboratory automation, computerization, and to evaluate the efficiency of management of clinical pathology laboratories in Korea. METHOD: The questionnaires included those for investigating laboratory management status, qualities of laboratory personnels, workloads, test items and numbers of tests performed annually. It contained 22 items with 32 detailed sub-questionnaires for laboratory personnel survey, and 9 items with 106 detailed sub-questionnaires for facilities. We sent those three times to 400 laboratories that were participating in the National External Quality Assessment Scheme in Korea and analysed the answers by descriptive statistics, ANOVA, t-test and correlation analysis. RESULTS: The replies were from 96 laboratories and 326 technical personnels. Among the 96 laboratories, there were 71 full time employed clinical pathologists. The annually performed number of tests were increased with the increased the size of laboratory, that was classified by number of personnels. As the laboratory size was increased, part time personnels, cases of test per technical personnel, automation and computerization, satisfaction for their work (58,2%) were increased but decreased satisfaction of salaries. CONCLUSIONS: We surveyed the present employee status of laboratory personnels and status of laboratory and offered fundamental data of clinical laboratory management in Korea.
Automation ; Automation, Laboratory ; Humans ; Korea* ; Laboratory Personnel ; Pathology, Clinical ; Surveys and Questionnaires ; Salaries and Fringe Benefits

BACKGROUND: The prevalence of neonatal group B streptococcal infection depends mainly on the colonization rate of pregnant women by group B streptococci (GBS). Although the colonization rate of Korean women by GBS is considered lower than in other countries, recent data on the maternal colonization rate of GBS are sparse. METHODS: From August 2008 to June 2009, swab specimens from the anorectus, vagina, and urethral orifice of a sample of 234 pregnant Korean women were placed in new Granada medium (NGM-H), tube medium (NGM-T), commercial NGM (NGM-B), and selective Todd-Hewitt broth (S-THB) for 18~24 hours in 5% CO2 at 35degrees C. Agar dilutional antimicrobial susceptibility tests, serotyping, and PCR were performed for GBS isolates. RESULTS: The colonization rate of GBS in pregnant women was 11.5% (27/234). Of the specimen cultures, 9.8% of anorectal cultures were positive, 8.1% of urethral orifice cultures were positive, and 7.3% of vagina cultures were positive. The detection rate of GBS in the different culture media was S-THB (96.3%), NGM-B (92.6%), NGM-H (88.9%), and NGM-T (85.2%). The distribution of GBS serotypes was as follows: III (29.6%), V and VI (22.2%), Ib and II (11.1%), and Ia (3.7%). 33.3% of GBS isolates were resistant to erythromycin and 44.4% to clindamycin. Among the nine erythromycin-resistant isolates, eight were serotype V and VI, which are erm(B) positive serotypes. CONCLUSION: The colonization of pregnant women by GBS, and the incidence of resistance of the GBS isolates to erythromycin and clindamycin were higher than those previously reported. Serotypes V and VI, GBS serotypes that carry the erm(B), are novel serotypes that have not previously been identified in pregnant Korean women.
Agar ; Clindamycin ; Colon ; Culture Media ; Erythromycin ; Female ; Humans ; Incidence ; Polymerase Chain Reaction ; Pregnant Women ; Prevalence ; Serotyping ; Streptococcal Infections ; Vagina

BACKGROUND: Positive correlations between bone mass and androgen levels have been observed in premenopausal and postmenopausal women as well as in men. Androgen production was decreased in women with osteoporosis compared to that in age-matched controls. We hypothesized that androgen metabolism might be also deranged in osteoporosis. To clarify our hypothesis, we investigated the relationship between urinary metabolites of androgen and bone mineral density (BMD) in Korean postmenopausal osteoporotics. METHODS: We examined the anthropometry and bone turnover marker in 67 postmenopausal women. BMD was measured by dual energy X-ray absorptiometry (DEXA). Serurn levels of estrone, estradiol, free testosterone were measured by radioirnmunoassay and serum level of sex hormone binding globulin (SHBG) was measured by two site immunoradiometric assay. The urinary metabolites of androgen were determined by gas chromatography-mass spectrometry (GC-MS) at Korean Institute of Science and Technology Doping Control Center. RESULTS: 1. Spinal BMD had a positive correlation with height (r 0.3049, p<0.05), weight (r=0.4114, p<0.001) and body mass index (BMI, r=0.2638, p<0,05). 2. Spinal and femoral neck BMD had no correlation with serum levels of estrone, estradiol and ten major urinary metabolites of androgen, but serum free testosterone had positive correlation with spinal BMD (r=0.3622, p<0.01) and SHBG had negative correlation with femoral neck BMD (r=-0.2625, p< (0.05). 3. Serum free testosterone in osteoporotics was lower than non-osteoporotics with spinal BMD (p<0.05) and SHBG in patients with osteopenia was higher than non-osteopenic subjects with femoral neck BMD (p <0.05). 4. In multiple stepwise regression analysis, weight and serum free testosterone were statistically significant for spinal BMD (R =0.3072). As for femoral neck BMD, weight was the independent determinant (R 0.1307). 5. Serum level of osteo#ealcin and urinary deoxypyridinoline/creatinine had a positive correlation with urinary 11-ketoandrosterone (p<0.05). SHBG was positive correlation with osteocalcin (r=0.3190, p<0.05). 6. Serum free testosterone (r=-0.2740, p<0.05) decreased with aging. CONCLUSION: Our data suggest that androgen metabolism is not deranged in osteoporotics, but serum free testosterone is important than estrogen on postmenopausal osteoporosis after 5-10 years menopause.
Absorptiometry, Photon ; Aging ; Anthropometry ; Body Mass Index ; Bone Density* ; Bone Diseases, Metabolic ; Estradiol ; Estrogens ; Estrone ; Female ; Femur Neck ; Gas Chromatography-Mass Spectrometry ; Humans ; Immunoradiometric Assay ; Male ; Menopause ; Metabolism ; Osteocalcin ; Osteoporosis ; Osteoporosis, Postmenopausal ; Sex Hormone-Binding Globulin ; Testosterone

OBJECTIVE: Upper-body fat distribution, hyperhomocysteinemia and a depletion in antioxidant status are considered risk factors for atherosclerosis and these factors are related to alcohol consumption and cigarette smoking. The purpose of this study was to determine the influence of alcohol consumption and smoking habits on cardiovascular risk factors in healthy men by using a cross-sectional design. METHODS: Smokers were defined as heavy smokers when they smoked more than 15 cigarettes per day. Group subdivision of drinkers were none, moderate (10-25g alcohol/d) and heavy(>25g alcohol/d) alcohol consumption. Subjects were divided into 6 groups: nondrinker-nonsmoker(n=33), nondrinker-heavy smoker (n=11), moderate drinker-nonsmoker (n=46), moderate drinker- heavy smoker(n=33), heavy drinker-nonsmoker (n=14) and heavy drinker-heavy smoker(n=15). Adipose tissue and muscle areas were calculated from computed tomography scans made at four body levels, first and forth lumbar vertebrae, mid portion of thigh and calf. Fasting serum levels of lipids, proteins, hormones and antioxidants and plasma level of homocysteine were determined. RESULTS: Heavy drinker-heavy smokers showed similar intake of daily calorie and protein to other groups and 65% of them supplemented their diet with synthetic vitamin preparation. Heavy drinker-nonsmokers(36g/d) consumed nearly twice as much alcohol as moderate drinkers(16-18g/d) and heavy drinker-heavy smokers (53g/d) nearly three times as much. In comparison with non and moderate drinker-heavy smokers, heavy drinker-heavy smokers smoked more cigarettes(19 vs 26 cigarettes/d, p<0.05). Although there were no differences among 6 groups in means of age, body mass index, blood pressure and serum GOT and GPT levels, heavy drinkers showed the highest mean value of waist to hip ratio and subcutaneous fat area at first and forth lumbar vertebrae. Heavy drinker-heavy smokers showed higher serum levels of triglyceride and HDL-cholesterol but lower serum levels of transferrin and IGF-1, compared with nondrinkers. Plasma homocysteine level was higher in heavy drinker-heavy smokers than in nondrinker- nonsmokers. Serum levels of beta-carotene, cryptoxanthin and lycopene in heavy smokers or heavy drinkers showed a decrease by about 50% of those in men who did not drink and smoke and these levels were the lowest in heavy drinker-heavy smokers among 6 groups. CONCLUSION: Our results show that heavy alcohol consumption can result in abdominal obesity, hypertriglyceridemia and a decrease in serum carotenoid levels, even though it can cause an increase in HDL-cholesterol level. In addition, a further decrease in serum carotenoids and an increase in plasma homocysteine level in heavy drinker-heavy smokers indicate the increased risk for atherosclerosis in the simultaneous heavy consumption of alcohol and cigarette.
Adipose Tissue ; Alcohol Drinking* ; Antioxidants ; Atherosclerosis ; beta Carotene ; Blood Pressure ; Body Mass Index ; Carotenoids ; Diet ; Fasting ; Homocysteine ; Humans ; Hyperhomocysteinemia ; Hypertriglyceridemia ; Insulin-Like Growth Factor I ; Lumbar Vertebrae ; Male ; Obesity, Abdominal ; Plasma ; Risk Factors* ; Smoke* ; Smoking* ; Subcutaneous Fat ; Thigh ; Tobacco Products ; Transferrin ; Triglycerides ; Vitamins ; Waist-Hip Ratio