BACKGROUND: There are many suggested methods for the indirect determination of anaerobic threshold(AT) using the changes of ventilatory parameters in respones to ventilatory load accompanying the increase of blood lactic acid level during exercise and the threshold derived from them is called ventilatory threshold( VT). They include ventilatory equivalent method(VEM), End-tidal PO2 method(PETO2), V-slope method(VSM), and respiratory quotient method(RQ). But in the patients with chronic airway ohstruction(CAO), the AT determined by ventilatory methods may not reflect true AT because the patients with GAO show inadequate ventilatory response to the increase of blood lactic acid level during excercise. METHODS: For the investigation of detection rate and reliability of above four VT determination methods in the patients with GAO, we performed the symptom-limited and maximal incremental exercise test in 17 patients with GAO and 12 normal controls. The incremental workload was 10 W/min in GAO group and 25 W/min in control group. The reliability of VT in each group was investigated by the calculation of Spearman correlation coefficient. RESULTS: The detection rates of VT were 100% by RQ, 91.7% by both VEM and POETO2, and 83.3% by VSM in normal control group, while 94.1% by RQ, 64.7% by VEM and PETO2, and 83.3% by VSM in GAO group. Good correlations were noted among VEM, PETO2, and VSM except RQ in normal control group. But there was no significant correlation except between VEM and PETO2 in GAO group. CONCLUSIONS: RQ is very sensitive but crude and VEM is near similar to PETO2. The clinical usefulness of VT determined by ventilatory method might be limited in patients with severe GAO.
Airway Obstruction* ; Exercise Test ; Humans ; Lactic Acid

There has been much interest in the involvement of wind-up in the hyperalgesia and allodynia of chronic pain syndrome. For investigating the hehaviorml parallels of this wind-up phenomenon, it was limed to evaluate the changes of neurotransmitters(aspartate. lutamate, and taurine) in central sensitization after formalin-induced peripheral nerve injurv in the rats. The experiment was divided into two subexperiments; One was the formalin test.;and the other was microdialysis for evaluation of neurotransmitters. In formalin test (n=7), 50 microliter of 5% formalin was injected suhcutaneously in the foot dorsum of the right hind limb with a 30 G neeclle. To cluantify the formilin response. the number of spontaneous t1inches was counted at 1-2 minutes and 5-6 minutes and at 5 minutes intervals during the period 10- 60 minutes after formalin injeclion. In microdialysis study. the experimental animals were divided randomly into two groups. In experimentl group (n=10). the microdialysis catheter was perfused with artificial cerehrospinal fluid by 3 microliter/min for one hour. Then. the two beseline dialysis samples were collected and 50 microliter of 5% formalin was injected .iuhcutaneously in thc plantar surface of the right hind paw with a 30 G needle. Three 10 minutes dialysate samples were collected after formalin injection. In control group(n=10), the normal saline instead of formalin was used. The results were as followed: In formalin test, there was a biphasic pattern of flinchine after formalin injection. The peak in phase I was shown at 2 minutes after formalin injection. The second peak was shown at 35 minutes alter formalin injection during phase II. In microdialysis study, thcre were statistically significant increascs of aspartate and lutamate concentrations, excitatory neuro transmitters, during the first 10 minutes after formalin injection. After lhen, all values of these neurotransmitters were rcturned to baseline values. The concentrations of taurine, an inhihitory neurotransmitter, was shown a tendency of an increase after formalin injection but, it was not statistically significant. From these results, it secms that the excitatory amino acid ncurotransmitter may partly play a role to triqer the central sensitization after peripheral nerve injury.
Animals ; Aspartic Acid ; Catheters ; Central Nervous System Sensitization* ; Chronic Pain ; Dialysis ; Dronabinol ; Excitatory Amino Acids ; Extremities ; Foot ; Formaldehyde ; Hyperalgesia ; Microdialysis ; Needles ; Neurotransmitter Agents* ; Pain Measurement ; Peripheral Nerve Injuries* ; Peripheral Nerves* ; Rats* ; Taurine

The incidence of herniated lumbar disc under the age of 19 years is increasing due to increased sports activity of teenager and development of diagnostic methods. 33 cases of herniated lumbar disc of the teenager was analyzed at Department of Orthopaedic Surgery, Dong-A College of Medicine from March 1990 to May 1994. The results were obtained as follows: 1) Among 413 patients, 33 patients(7.9%) were teenagers and the sex ratio was 2.3:1 in male to female. 2) Average intervals between the onset of clinical symptoms and the admission were 13.2 months. 3) 20 cases(60.6%) had a definite trauma history, and among these cases, 14 cases(70.0%) were associated with sports activity. 4) The most common level of herniation was L4-5 in 29 cases(64.4%), straight leg raising test was positive in 32 cases(97.0%), sensory change in 13 cases(39.4%), motor weakness in 10 cases(30.3%). 5) Among positive MRI findings(32 cases), 17 cases(53.1%) were the protruded type. 6) Among 23 operative cases, 21 cases had excellent or good results.
Adolescent ; Female ; Humans ; Incidence ; Intervertebral Disc ; Leg ; Magnetic Resonance Imaging ; Male ; Sex Ratio ; Spine ; Sports

The purpose of this study is to evaluate the correlation between the operative indications and the MRI findings in the herniated lumbar disc. We reviewed the lumbar spine MRI and medical records in the 158 patients of the herniated lumbar disc which were removed by open discectomy. We assessed the herniated lumbar disc in the MRI by the Steinmetz s classification and the operative findings with postoperative results at least 6 months. 170 levels of the operated lumbar discs in these patients consisted of protruded discs in 41 levels, extruded subligamentous discs in 91 levels, extruded transligamentous discs in 27 levels, sequestered discs in 11 levels. We recognized especially in the operated protruded discs that were combined with the lateral recess stenosis in most cases. Postoperatively, 139 patients (88%) had excellent and good results. We concluded that the clinical operative indications were correlated with the cases which were more severe than extruded subligamentous discs or protruded discs combined with lateral recess stenosis in MRI findings.
Classification ; Constriction, Pathologic ; Diskectomy* ; Humans ; Magnetic Resonance Imaging* ; Medical Records ; Spine

The aseptic loosening has emerged as one of the most common and serious long term complications, which requires the revision of total hip replacement arthroplasty. We studied the radiologic finding of the aseptic loosening in 79 patients of uncemented total hip replacement arthroplasty which had been performed in our hospital from March 1991 to December 1994. We evaluated the white reaction lines, osteolysis state, translation and migration in postoperative and last follow-up radiographies. The white reactive lines around the femoral stem and the acetabular cup were most frequent in zone IV and zone II. But it was not progressive and need more long term follow-up evaluations to confirm whether these lines are related to loosening or not. In assessment for stable state, the more stable at initial fixations, the better state of long term stability. Some patients have pain without loosening but all patients with loosening have pain. Press fit is the most important factor of the late stability. The osteolysis is not directly proportional to femoral loosening in this study, but it might be due to short follow up time.
Acetabulum ; Arthroplasty* ; Arthroplasty, Replacement, Hip* ; Follow-Up Studies ; Hip ; Humans ; Osteolysis

PURPOSE: Ataxia Telangiectasia (AT) is a hereditary multi-systemic disease resulting from mutations of AT gene and is characterized by progressive neurodegeneration, cancer, immune system defects, and hypersensitivity to ionizing radiation. AT gene has a homologue sequence of PI3-kinase. The activity and cellular function of PI3-kinase in AT gene remains unclear. This study was undertaken to evaluate the function of AT gene through the effect on cell survival and differentiation by the inhibition of AT gene expression. MATERIALS AND METHODS: NH2-terminal portion of AT gene was isolated from MCF-7 cells by RT-PCR. The isolated DNA fragment was ligated in reverse orientation in pcDNA3. This antisense ATM expression vector was transfected to PC-12 cells by calcium phosphate method, and the transformed cells were selected using G418 and immunohisto- chemistry. To analyze the cell survival and differentiation, cells were cultured in serum free medium supplemented with/without NGF. We performed the immunoprecipitation for the p53 induction of cells after ionizing radiation, and the FACS for the apoptosis of cells after the exposure of wortmanin. RESULTS: PC-12 cells which down-regulated AT gene (like ATM, AT mutated) showed decreased survival and ceased differentiation with NGF. Also, PC-12 (ATM) cells showed increased apoptosis with wortmanin and reduced or delayed p53 induction after ionizingradiation. CONCLUSION: Results obtained from these studies suggest that AT gene regulates survival and differentiation of PC-12 cells through PI3-kinase activity. It seems that apoptosis is induced by the inhibition of AT gene expression.
Apoptosis ; Ataxia Telangiectasia ; Calcium ; Cell Survival ; Chemistry ; DNA ; Gene Expression ; Hypersensitivity ; Immune System ; Immunoprecipitation ; MCF-7 Cells ; Nerve Growth Factor ; Phenotype* ; Phosphatidylinositol 3-Kinases ; Radiation, Ionizing

BACKGROUND: Malignant thyroid tumors may mimic the clinical symptoms and signs of a non-malignant tumor in the early course of the disease. The choice of the treatment modality for a thyroid tumor can be based on exact interpretation of FNAC (fine needle aspiration cytology) and frozen section. METHODS: We have experienced 237 cases of thyroid tumors during the past ten years at St. Columban hospital. From September 1988 to August 1998, subjects were selected and a retrospective study was done. RESULTS: (1) Of the 237 cases in this study, 194 had non-malignant lesions and 43 had malignant lesions, a ratio of 4.5:1. (2) The female to male ratio was 9.2:1 with non-malignant lesions (female: 195/male: 19) and 9.8:1 with malignant lesions (female: 39/male: 4). (3) The age distribution was the 4th to the 6th decades, regardless of the nature of the lesions. (4) The duration of disease was within 3 months with 42.2% of subjects, and 71.8% of subjects came within first year of disease, regardless of the nature of lesions. (5) Thyroid function tests showed no abnormality with most of the patients, regardless of the nature of lesions. (6) Fine needle aspiration cytology biopsy showed a sensitivity of 32.7%, a specificity of 100%, and an accuracy of 90.8%, and revealed preoperative diagnostic validity. (7) Ultrasonography of the neck, showed a sensitivity of 32.7%, a specificity of 88.1%, and an accuracy of 77.4%, and had no diagnostic value. (8) With benign lesions, adenomatous goiters were most common (96 cases), and with malignant lesions papillary carcinomas were predominant (36 cases). CONCLUSIONS: FNAC and frozen section are valuable preoperative and intraoperative diagnostic tool for thyroid tumors.
Age Distribution ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Papillary ; Female ; Frozen Sections ; Goiter ; Humans ; Male ; Neck ; Needles ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Function Tests ; Thyroid Gland* ; Ultrasonography

No abstract available.
Acetabulum*

Among the 413 patients of the lumbar herniated nucleus pulposus(HNP) who were admitted and treated at Dong-A University Hospital from March 1990 to May 1994, we analyzed 387 patients who checked magnetic resonance imaging(MRI). MRI study followed by open disectomy was carried out on 127 patients of the lumbar HNP, and we analyzed the clinical and operative findings of the lumbar HNP and compared these with MRI findings. The following results were obtained. 1. MRI findings of 387 patients consisted of bulging discs in 107 cases(27.6%), protruded discs in 165 cases(42.6%), extruded subligamentous discs in 73 cases(18.9%), extruded transligamentous discs in 34 cases(8.8%) and sequestered discs in 8 cases(2.1%). 2. MRI findings of 127 patients who had been treated with open discectomy consisted of protruded discs in 53 cases(41.7%), extruded subligamentous discs in 47 cases(37.0%), extruded transligamentous discs in 19 cases(15.0%) and sequestered discs in 8 cases(6.3%). 3. Operative findings revealed the protruded discs: 49 cases(38.6%), extruded subligamentous discs: 52 cases(40.9%), extruded transligamentous discs: 18 cases(14.2%) and sequestered discs: 8 cases(6.3%). 4. In sequestered disc, we could get the highest sensitivity, specificity and accuracy with MRI in distinguishing from another type of lumbar HNP. MRI can be available for accurate assessment of type and location of the lumbar HNP and it can show the high specificity, sensitivity and accuracy in preoperative diagnostic method.
Diskectomy ; Humans ; Magnetic Resonance Imaging ; Methods ; Sensitivity and Specificity

The management of distal femur fractures are difficult because of many complications including nonunion, delayed union, infection, loss of fixation, joint stiffness and angular deformity. Until 1960s, conservative management was considered superior to operative treatment in distal femur fracture. But, with advancement of new fixation devices and techniques, open reduction and internal fixation is recent trend. For the purpose of analyzing the factors effecting the results, we studied the 36 cases of distal femur fracture treated surgically from may, 1991 to May, 1994. By AO classification nineteen cases were type C fracture and seventeen cases were type A. According to Schatzker and Lambert criteria, excellent results were in 10 cases, good in 16, fair in 6 and fail in 4. We have analysed the results by fixation device, age, osteoporosis degree, fracture classification, open or closed fracture, operative approach in type C fracture and bone graft. Fair and fail results were more common in the cases of severe osteoporotic bone, type C with lateral approach and open fracture. Excellent and good results were more common in the cases of using the anatomical plate and dynamic condylar screw. We concluded that treatment device should be decided by fracture type, degree of communication, degree of osteoporosis and soft tissue state, and then satisfactory results will be obtained by accurate anatomical reduction, rigid internal fixation and early exercise.
Classification ; Congenital Abnormalities ; Femur ; Fractures, Closed ; Fractures, Open ; Joints ; Osteoporosis ; Transplants