OBJECTIVES: Acrylamide is a neurotoxin inducing central-peripheral distal axonopathy. The authors evaluated several neurologic tests to screen the early effect of occupational acrylamide exposure. METHODS: Fifty-two males working either in the production of acrylamide monomer or in the handling of acrylamide in Ulsan, Korea, were selected and subcategorized into the high-exposure group (n=10, mean age of 30. 4 years) and the low-exposure group (n=42, mean age of 28.9 years). Twenty-three males (mean age 29.4 years) from medical professionals and students were chosen as a non-exposed reference group. Symptom questionnaire, neurologic examination, electrodiagnostic test, vibrotactile threshold test, and Lanthony desaturated 15 panel test (LD-15D) were done. RESULTS: The high-exposure group showed more number of specific symptoms on questionnaire and more abnormal two point discrimination test. High-exposure group showed a significant difference in the median motor conduction velocity, peroneal nerve motor latency, sensory amplitude of median nerve action potential, and sensory latency of sural nerve. The vibrotactile threshold of the high-exposure group was significantly higher in both hands and feet than that of the low-exposure group and the reference group. Average color confusion index on the LD-15D was significantly higher in the high-exposure group (median 22.7, range 0-135.7) than in the reference group (median 2.4, range 0-33.2). CONCLUSIONS: The symptom questionnaire, vibrotactile threshold test, and color discrimination test are sensitive in detection of the early acrylamide-induced neuropathy, and the combination of these tests would further facilitate the effectiveness of the screening.
Acrylamide* ; Action Potentials ; Discrimination (Psychology) ; Foot ; Hand ; Humans ; Korea ; Male ; Mass Screening ; Median Nerve ; Neurologic Examination ; Peroneal Nerve ; Questionnaires ; Sural Nerve ; Ulsan

Osteoporosis causes a decrease in bone mineral density. To overcome the decrease in fixation strength, a variety of techniques and devices have been developed, including cement augmentation of pedicle screws. Polymethyl methacrylate (PMMA), is commonly known as bone cement, and is widely used for implant fixation in various orthopaedic and spine surgery. In general, PMMA augmentation of pedicle screws is simple and safe if performed with technical precautions. PMMA is a safe agent, but it may rarely lead to significant foreign body reactions. In this report, we present a patient who developed bone cement-related epidural space foreign body granuloma
Osteoporosis

Gastric emptying in patients after several upper gastrointestinal surgeries was studied using the acetaminophen method. The subjects consisted of 23 gastric cancer patients, 2 duodenal ulcer patients, 5 periampullary cancer patients and 4 normal subjects. As an indicator of the gastric emptying rate, the serum acetaminophen concentration was measured by fluorescence polarization immunoassay, in units of g/ml, at 0, 30, 60, 120, and 180 minutes after ingestion of a liquid meal with 1.5 g of acetaminophen. In the normal subjects, the acetaminophen concentrations were 0, 16.35+/-5.06, 18.71+/-5.58, 16.38+/-4.82, and 11.09+/-3.62 g/ml at time 0, 30, 60, 120, and 180 min, respectively. The concentration peaked at 60 min after ingestion of the test meal in the normal subjects. We observed significant delayed gastric emptying after pancreas preserving pancreaticoduodenectomy (PPPD) and a standard Whipple's operation in the early postoperative period. In all patients with a subtotal gastrectomy, a truncal vagotomy was done. However, in patients with a pancreaticoduodenectomy, the vagus nerves were preserved. The gastric emptying pattern was different between the patients with a subtotal gastrectomy and the patients with a pancreaticoduodenectomy, despite similar reconstructions of the gastroenterostomy (Billroth I or Billroth II type reconstruction). There was more rapid gastric emptying in patients with a truncal vagotomy and pyloroplasty than in the normal subjects. Hence, we speculate that the truncal vagotomy was the main cause of the different gastric emptying between the patients with a pancreaticoduodenectomy and the patients with a subtotal gastrectomy.
Acetaminophen* ; Duodenal Ulcer ; Eating ; Fluorescence Polarization Immunoassay ; Gastrectomy ; Gastric Emptying* ; Gastroenterostomy ; Humans ; Meals ; Pancreas ; Pancreaticoduodenectomy ; Postoperative Period ; Stomach Neoplasms ; Vagotomy, Truncal ; Vagus Nerve

A 19-year-old man had a good neurologic recovery from a severe hypothermia(19 degrees C) and a prolonged coma following active infernal rewarming. From inhaling hydrocarbons, he was left unconscious on the cold floor for 24 hours. As soon as the patient was brought into the emergency medical center, he was early evaluated arid treated aggressively. ECG showed Osborn(J) wave on all leads. The temperature o( patient was increased by 2-3 degrees C per hour through active external rewarming (by heating blankets and warm bag) and active infernal rewarming (by airway rewarming, warmed IV fluids, gastrointestinal tract irrigation, and bladder irrigation). The temperature reached 36 degrees C after 6 hours. Active infernal rewarming provides rapid core rewarming with the additional benefit of circulatory support during the period of cardiac instability.
Coma ; Electrocardiography ; Emergencies ; Gastrointestinal Tract ; Heating ; Hot Temperature ; Humans ; Hydrocarbons* ; Hypothermia* ; Inhalation ; Rewarming ; Unconsciousness* ; Urinary Bladder ; Young Adult

Double-orifice mitral valve is a rare congenital anomaly. Most cases of double-orifice mitral valve are hemodynamically normal and remain symptomless, so that it is usually discovered incidentally in autopsy or during surgical correction of a cardiovascular abnormality. Recently, however, it is increasingly recognized as such, since the echocardiography has gained wide acceptance as a non-invasive diagnostic tool by the M-mode, two-dimensional and color Doppler echocardiogram. Two separate mitral valve apparatuses can be used on the M-mode echocardiogram. In the two-dimensional echocardiography, the parasternal and subcostal short-axis views can show two separate glass-like orifices in the left ventricle, and the parasternal long-axis view as well as the apical four-chamber view can show the anomaly. And the color Doppler echocardiogram can visualize two mosaic-pattern flows between the left atrium and ventricle. We present herewith two cases of double-orifice mitral valve, as diagnosed by means of echocardiography. The first case was an isolated one with mitral stenosis, showing two parachute mitral valves. The second was associated with perimembranous ventricular septal defect, and showed the accessory mitral valve directly attached to the ventricular septum, with the chordae crossing the ventricular outflow tract.
Autopsy ; Cardiovascular Abnormalities ; Echocardiography* ; Heart Atria ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Mitral Valve Stenosis ; Mitral Valve* ; Ventricular Septum

No abstract available.
Fallopian Tubes* ; Female

PURPOSE: This study was aimed to identify whether total mesorectal excision (TME) is a valid prognostic factor for recurrence following curative surgery for rectal carcinoma. METHODS: For 110 high-risk rectal carcinoma patients, recurrence rate and patterns of recurrence were compared between patients undergoing TME and those with classical dissection. RESULTS: Both local recurrence and distant metastasis were significantly lower in TME group than those in classical dissection group. Time interval from operation to the initial recurrence was also significantly delayed in TME group. By comaparing with other prognostic variables, TME was found to be a significant prognostic factor for the recurrence. CONCLUSIONS: We think TME is an important prognostic factor for the recurrence following curative resection in rectal carcinoma.
Humans ; Neoplasm Metastasis ; Recurrence*

Since after first report of percutaneous transluminal coronary angioplasty in 1977, improved operator technique and advanced equipment designs have resulted in an increase in primary success rate from 67% to 92% in recent days. Despite these improvement, acute closure and restenosis remain as serious limitations to both the short and long-term success of PTCA. Coronary artery stents have been proposed as a method of treating acute closure and preventing restenosis. We implanted 21 balloon expandable Palmaz-Schatz Stent in selected 21 Patients(mean age 62+/-8 years, M/F : 16/5) with atherosclerotic coronary artery disease. The indications were elective stenting in 17, acute dissection postangioplasty in 2 and restenosis following angioplasty in 2. The clinical diagnosis of the subjects was unstable angina in 12 pts(57%), stable angina in 1, and post infarction angina in 8 including 6 acute myocardial infarction. The target vessel was right coronary artery In 12(57%), left anterior descending artery in 6(29%) and left circumflex in 3(14%). The size of implanted stent was 3mm in 15, 3.5mm in 5 and 4.0mm in 1. The morphology of attempted lesion was AHA/ACC classification type A in 1, type B in 17(B1 ; 1, B2 ; 16) and type C in 3. Angiographic findings were 1-vessel disease in 16 patients, 2-vessel disease in 4 and 3-vessel disease in 1. Coronary artery stenting wast technically successful in 21 all patients(100%) and complications included subacute total occlusion 1 week after stenting in 1, which was recanalized successfully by repeat PTCA without myocardial infarction, prolonged sinus arrest after stenting due to microembolism in 1 and puncture site bleeding requiring transfusion in 1. CONCLUSION: Coronary artery stenting was a safe and effective procedure to obtain adequate coronary blood flow in selected patients but long-term efficacy of primary elective coronary stenting should be evaluated prospectively.
Angina, Stable ; Angina, Unstable ; Angioplasty ; Angioplasty, Balloon, Coronary ; Arteries ; Classification ; Coronary Artery Disease ; Coronary Vessels* ; Diagnosis ; Equipment Design ; Hemorrhage ; Humans ; Infarction ; Myocardial Infarction ; Punctures ; Stents

Since after first report of percutaneous transluminal coronary angioplasty in 1977, improved operator technique and advanced equipment designs have resulted in an increase in primary success rate from 67% to 92% in recent days. Despite these improvement, acute closure and restenosis remain as serious limitations to both the short and long-term success of PTCA. Coronary artery stents have been proposed as a method of treating acute closure and preventing restenosis. We implanted 21 balloon expandable Palmaz-Schatz Stent in selected 21 Patients(mean age 62+/-8 years, M/F : 16/5) with atherosclerotic coronary artery disease. The indications were elective stenting in 17, acute dissection postangioplasty in 2 and restenosis following angioplasty in 2. The clinical diagnosis of the subjects was unstable angina in 12 pts(57%), stable angina in 1, and post infarction angina in 8 including 6 acute myocardial infarction. The target vessel was right coronary artery In 12(57%), left anterior descending artery in 6(29%) and left circumflex in 3(14%). The size of implanted stent was 3mm in 15, 3.5mm in 5 and 4.0mm in 1. The morphology of attempted lesion was AHA/ACC classification type A in 1, type B in 17(B1 ; 1, B2 ; 16) and type C in 3. Angiographic findings were 1-vessel disease in 16 patients, 2-vessel disease in 4 and 3-vessel disease in 1. Coronary artery stenting wast technically successful in 21 all patients(100%) and complications included subacute total occlusion 1 week after stenting in 1, which was recanalized successfully by repeat PTCA without myocardial infarction, prolonged sinus arrest after stenting due to microembolism in 1 and puncture site bleeding requiring transfusion in 1. CONCLUSION: Coronary artery stenting was a safe and effective procedure to obtain adequate coronary blood flow in selected patients but long-term efficacy of primary elective coronary stenting should be evaluated prospectively.
Angina, Stable ; Angina, Unstable ; Angioplasty ; Angioplasty, Balloon, Coronary ; Arteries ; Classification ; Coronary Artery Disease ; Coronary Vessels* ; Diagnosis ; Equipment Design ; Hemorrhage ; Humans ; Infarction ; Myocardial Infarction ; Punctures ; Stents

A clinical trial was done to evaluate the antihypertensive efficacy and side effects of manidipine, a new calcium antagonist, in 30 patients with mild to moderate essential hypertension. 1) The study patients consisted of 19 men and 11 women, and the mean age was 51.8 years. 2) Blood pressure dropped significantly in 2 weeks and in 4 weeks, and well maintained throughout the study period. The mean-pressure drop was 26.2/14.9mmHg after 10 weeks. 3) Heart rate did not change significantly with manidipine therpy. 4) Optimal dose for effective pressure-drop was between 10 and 20 mg in 86% of patients. Overall good antihypertensive effect was achieved in 83% of patients. 5) All of the laboratory parameters including blood chemistry, glucose, lipid and electrolytes did not change, but serum calcium increased from 9.2% mg/dl (p=0.001) in 10 weeks. 6) Side effects were mild in nature(palpitation in 3, dry mouth in 1, weakness in 1 and impotence in 1 patient). In conclusion, manidipine monotherapy with 10 to 20 mg once a day regimen is effective and well tolerated in the patients with mild to moderate essential hypertension.
Blood Pressure ; Calcium ; Chemistry ; Electrolytes ; Erectile Dysfunction ; Female ; Glucose ; Heart Rate ; Humans ; Hypertension* ; Male ; Mouth