No abstract available.
Graves Disease* ; Hypothyroidism*

OBJECTIVE: Intraoperative monitoring using somatosensory evoked potential (SEP) study has been used increasingly to monitor neurological function during scoliosis surgery and other high-risk spinal surgeries. However, there are few studies related to this intraoperative monitoring, particularly in severe spinal deformity surgery, in Korea. So we evaluated the clinical efficacy of intraoperative SEP monitoring and considered the risk factors related to spinal surgery. METHOD: We performed a posterior tibial nerve somatosensory evoked potential study for intraoperative monitoring during surgical procedures in 101 patients (male 46, female 55). RESULTS: Neurologic damage occurred in 16 patients (10 congenital scoliosis cases, 5 tuberculous kyphosis cases, and 1 degenerative spondylosis case) after surgical procedures. Delayed postoperative neurologic damage occurred in 4 patients (2 mild damage cases, 2 severe damage cases) among 85 cases which showed normal responses during surgical procedures. Sensitivity of this study was 75%, and specificity was 95.3%. CONCLUSION: Somatosensory evoked potential study for intraoperaive monitoring is a sensitive and very useful method to detect iatrogenic lesions during spinal deformity surgery with satisfactory specificity. However, to improve the sensitivity and specificity of the intraoperative monitoring, combination of motor evoked potentials is recommended.
Congenital Abnormalities* ; Evoked Potentials, Motor ; Evoked Potentials, Somatosensory* ; Female ; Humans ; Korea ; Kyphosis ; Monitoring, Intraoperative* ; Risk Factors ; Scoliosis ; Sensitivity and Specificity ; Spondylosis ; Tibial Nerve

To provide the information about overall test reliability and test improvement, we analyzed the first fundamental medical sciences examination at the Kon-Kuk University College of Medicine on August 23, 1997. The results are as follows: 1. The number of the items in the test is 230. The range of the scores is from 32.5 to 61.3(average percentage score: 50.0+/-6.1). Among the 39 students, three(7.7%) passed the examination with percentage scores of higher than 60. 2. The correlation coefficients between the fundamental medical sciences examination and academic records are 0.4682(the first semester in 1st grade), 0.5933(the second semester in 1st grade), and 0.6538(the first semester of 2nd grade), respectively. 3. Among the 230 items, 47(20.4%) are too difficult or too easy. Therefore these items are recommended to be discarded. 4. Among the 230 items, 115(50%) have lower discriminative indices(lower than 0.14) and 55(23.9%) have higher discriminative indices(higher than 0.23). 5. Among the 230 items, overall acceptable items are 101; the range of difficulty is 0.15~0.84 and discriminative indices are higher than 0.15. Good acceptance is shows in pharmacology and microbiology.
Humans ; Pharmacology

No abstract available.
Thyrotoxicosis*

STATEMENT OF PROBLEM: The joints of removable partial denture alloys have failed frequently after routine usage. PURPOSE: The purpose of this study was to evaluate the mechanical properties of the laser welded Co-Cr alloys. MATERIAL AND METHOD: For this study, 20 Co-Cr specimens were casted and 10 of them were seperated on the middle area and laser welded with Alpha laser welding machine(Siro Lasertec, Pforzheim, Germany). Rest of them which were as cast, were used as a control group. For the section of the experimental specimens, wire cutting machine was used to make a even gap of the all specimens. Laser welding was done with manufacturer's instrunction and tested each specimen by Instron Machine. Tensile strength, 0.2% yield strength and % elongations were recorded. Fractured surfaces were investigated with SEM. RESULTS: The results were as follows : 1. The tensile strength of the laser welded group(617.7MPa) was about 75% of the as cast group(820.4MPa). It had stastically singnificant diffrences(p<0.05). 2. The % elongation of the experimental group was 6.6 which was lower than the control group(14.3). 3. Fracture of the experimental group occured in the welded surface and showed many voids. In contrast, the fracture surface of the control group was showed rough surfaces without any voids. CONCLUSION: The tensile strengths of the as-cast joints were higher than those for the laserwelded joints, and the % elongation of the experimental group was lower than the control group. Porosity was found in laser-welded joints.

Ocular disturbances related to cranial nerve lesion or increased intracranial pressure are well known in cryptococcal meningitis, but internuclear ophthaloplegia is very rare and only two cases have been reported to our knowledge. We report the third patient of internuclear ophthalmoplegia in cryptococal meningitis. The internuclear ophthalmoplegia in our case persisted for one year with a demonstrable lesion in brain MRI, in contrast to the other cases in which intranuclear ophthalmoplegia was transient and no responsible lesion was observed.
Brain ; Cranial Nerves ; Cryptococcosis* ; Humans ; Intracranial Pressure ; Magnetic Resonance Imaging ; Meningitis ; Meningitis, Cryptococcal ; Ocular Motility Disorders ; Ophthalmoplegia

OBJECTIVES: The purpose of this study is to evaluate the incidence of secondary T wave changes in WPW syndrome and the relation between the incidence of the secondary T wave changes and sex, age (duration of preexcitation), mean and maximal QRS duration (from the onset of delta wave to the end of S wave) of standard 12 lead electrocardiogram (ECG) and the site of accessory pathway (AP). The secondary purpose of this study is to evaluate the relation between the site of secondary T wave changes and the location of the AP. METHODS: Of the total 128 patients (pts) with WPW syndrome, standard 12 lead ECGs of 125 pts (mean age 35, male 71 pts) who were free from bundle branch block (n=2) and myocardial ischemia (n=1) were analyzed. The locations of Aps were divided into 4 categories (anterior, left lateral, posterior and right lateral) by intracardiac mapping. RESULTS: 82 (66%) pts of 125 pts showed secondary T wave changes. The incidence of secondary T wave changes was not related to sex or duration of preexcitation, but mean QRS duration (<0.12: 46%, 0.12: 88%, p<0.001), maximal QRS duration (<0.12: 32%, 0.12: 73%, p<0.001) and the site of AP (right: 80%, left: 54%, p=0.003). The most frequent lead showing secondary T wave changes in ECG was lateral (lead I, aVL) in pts with anterior (43%, 9 out of 21), posterior (50%, 25 out of 50) and right lateral (86%, 6 out of 7) AP. But, no secondary T wave change was found in most pts with left lateral (n=47) AP. CONCLUSION: The incidence of the secondary T wave changes in pts with WPW syndrome is high (66%). These changes are not related to sex and duration of preexcitation, but to the mean and maximal QRS duration during preexcitation and the location of the AP. The ECG lead showing secondary T wave changes in pts with WPW syndrome appears to be related to the location of the AP and the most frequent lead is I and aVL.
Bundle-Branch Block ; Electrocardiography ; Humans ; Incidence ; Male ; Myocardial Ischemia ; Wolff-Parkinson-White Syndrome

Isolated cranial neuropathies involving the facial nerve are very rare manifestations of pontine infarction, and have not been described in paramedian pontine infarction. We report a 67-year-old woman who developed sudden and long-lasting right facial nerve paralysis accompanied by transient ipsilateral abducens nerve palsy. Brain magnetic resonance imaging showed two discrete simultaneous infarctions in the right inferior paramedian pontine area, which seemed to correspond to the facial nerve fascicle and the abducens nerve fascicle, respectively. Paramedian pontine infarction can be one of the causes of facial nerve palsy and present as an isolated or predominant sign.
Abducens Nerve Diseases* ; Abducens Nerve* ; Aged ; Brain ; Cranial Nerve Diseases ; Facial Nerve ; Female ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Paralysis

Tomb with lime-soil mixture barrier (LSMB) was constructed by the people from upper class people of Joseon Dynasty. The coffin of LSMB was surrounded by hard concrete barriers, being successfully protected from outside invasions until the archaeological excavation begins. The human remains were extremely preserved well, providing important information on the health and illness of the people of Joseon dynasty. Recent investigation into human skeletons from LSMB in Yong-in city was another forensic anthropological case that was very meaningful to our research. During the examination on the elderly Joseon female bones, we discovered unusual saw-marks on the shaft of both tibiae. We could not find any osteological evidences suggestive of healed bone process. Considering archaeological and anthropological findings altogether, the occurrence time of saw-marks was considered to be perimortem period. However, as for why such a saw mark was made on the tibiae, we did not get any information about it. We expect that this report facilitate other researcher to do explore the usefulness of forensic anthropology examination on the similar human skeleton cases identified in various archaeological ruins.
Aged ; Female ; Forensic Anthropology ; Gyeonggi-do ; Humans ; Skeleton* ; Tibia*

BACKGROUND/AIMS: Multiple myeloma (MM)–associated cardiac damage, particularly according to the type of monoclonal (M) protein has not been elucidated. We sought to investigate relationship between elevated serum M protein levels and echocardiographic indices of cardiac structure and function in patients with MM. METHODS: We evaluated a total of 184 consecutive MM patients who underwent echocardiography for bone marrow pre-transplant screening. Serum levels of intact immunoglobulin M protein and free light chain kappa/lambda (FLC-κ/-λ) were measured. RESULTS: One hundred thirty-nine patients were non-light chain MM (non-LCMM) and 45 patients belonged to LCMM. In patients with non-LCMM, significant correlations were found between serum M protein and left atrial volume index (LAVi; r = 0.720, p < 0.0001), E/e’ (r = 0.511, p < 0.0001), and systolic pulmonary arterial pressure (r = 0.485, p < 0.0001). In patients with LCMM, log-transformed FLC-λ (log-λ) was correlated with left ventricular ejection fraction (LVEF, r = –0.536, p = 0.010), left ventricular (LV) end-systolic dimension (r = 0.500, p = 0.018), and LV end-systolic volume (r = 0.444, p = 0.038). On multivariate analyses, hematocrit and serum M protein were independent predictors of LAVi in patients with non-LCMM. In patient with LCMM, FLC-λ isotype was only found to be an independent determinant of LVEF. CONCLUSIONS: An increase in serum M protein was associated with LV diastolic dysfunction, whereas an increase in serum FLC-λ concentration showed a negative correlation with the echocardiographic parameters of LV systolic function. These findings also suggest that serum M protein has different effects on LV function according to the type of paraproteins in patients with MM.
Arterial Pressure ; Bone Marrow ; Echocardiography ; Hematocrit ; Humans ; Immunoglobulin M ; Mass Screening ; Multiple Myeloma* ; Multivariate Analysis ; Paraproteins ; Stroke Volume ; Ventricular Function, Left*