PURPOSE: This study was conducted to assess optimal needle length for gluteal intramuscular injections (IM) via simple skinfold thickness (SFT). METHODS: For this study, 190 healthy adults were recruited and grouped into eight groups according to gender and body mass index (BMI) (kg/m2). The Korean Society for the Study of Obesity criteria defines a BMI under 20 as underweight, 20.1-22.9 as normal, 23-24.9 as overweight and over 25 as obese. For each participant, the SFT of dorsoguteal (DG) and ventrogluteal (VG) sites were measured using a caliper. Subcutaneous tissue thickness was acquired through ultrasonic images. RESULTS: For men in the overweight and obese groups at the DG site, for the obese group at the VG site, and for women in the normal weight, overweight and obese groups at both sites, the mean subcutaneous tissue thickness exceeded 1.84 cm, the minimal length for a 1 inch needle used for IM. At the DG site, optimal intramuscular needle length (OINL) was 1.4 times in women and 1.0 times in men compared to SFT. At the VG site, OINL was 1.3 times in women and 0.9 times in men compared to SFT. CONCLUSION: The results of this study suggest that SFT is a reliable index to determine optimal needle length with minimal effort prior to IM.
Adolescent ; Adult ; Aged ; Body Mass Index ; Equipment Design ; Female ; Humans ; Injections, Intramuscular/*instrumentation ; Male ; Middle Aged ; Needles ; Republic of Korea ; Sex Factors ; *Skinfold Thickness ; Subcutaneous Fat/ultrasonography

OBJECTIVES: The objective of this study is to assess the reliability and validity of the Korean version of the Tobacco Craving Questionnaire (K-TCQ), a multidimensional, self report instrument evaluating tobacco craving in a population of current smokers. METHODS: The Korean version of TCQ was administered to 216 current cigarette smokers. RESULTS: The Cronbach's alpha coefficient of the K-TCQ was high (0.95) which provided the evidence for the internal consistency. The test-retest reliability of K-TCQ was 0.66 (correlation coefficient, p<0.01). The correlation coefficients between the K-TCQ and each five VAS questionnaires were high (0.50-0.59, p<0.01). Inter-correlations of K-TCQ, VAS, FTQ, BDI, STAI-I and STAI-II were significant (p<0.01). CONCLUSION: The Korean version of TCQ is a valid and reliable scale for evaluating tobacco craving.
Surveys and Questionnaires ; Reproducibility of Results ; Self Report ; Smoking ; Tobacco ; Tobacco Products ; Tobacco Use Disorder

We experienced five cases of solitary fibrous tumor; two in the pleura, two in the orbital soft tissue, and one in the lung parenchyma. Three patients were male, and the age of the patients ranged from 38 to 71 years (mean age: 53.6). Grossly, the masses were well circumscribed and had varying sizes from 2.5 to 30.0 cm. The cut surfaces were grayish-yellow firm with focal variegated hemorrhage, necrosis, cystic change, and myxoid area. Microscopically, these were characterized by a haphazard proliferation of spindle cells or polygonal cells separated by variable amounts of hyalinized collagen and showed a prominent vascular channels reminiscent of hemangiopericytoma in foci. Immunoperoxidase stains showed a strong reactivity for CD34, and were weakly positive for vimentin. Electron microscopical examination revealed features of fibroblast; spindle to round tumor cells were arranged in groups and surrounded by collagen. Nucleoli were seldom prominent. The cytoplasm contained many microfilaments and a moderate number of cisternae of rough endoplasmic reticulum.
Actin Cytoskeleton ; Collagen ; Coloring Agents ; Cytoplasm ; Endoplasmic Reticulum, Rough ; Fibroblasts ; Hemangiopericytoma ; Hemorrhage ; Humans ; Hyalin ; Lung ; Male ; Necrosis ; Orbit ; Pleura ; Solitary Fibrous Tumors* ; Vimentin

OBJECTIVE: Using the standardization of disease diagnosis of disease, and surgical procedures, the authors have made a clinical application for the analysis of inpatient data with the ability to search for information pertinent for writing of clinical articles. METHODS: A client-server system and database software was developed for networking. For clinical application, a computerized daily report has been developed. Data from Neurosurgical patients admitted at Soonchunyang University Hospital from January to December 1998 were analyzed with this system. Data for clinical articles was obtained using the search mode, information such as orbital infarction syndrome following intracranial aneurysm surgery and epidemiological analysis or geriatric neurosurgical patients. RESULTS: For the daily report it takes approximately 10 minutes to input the patients demographic information, name of disease, diagnosis and surgical procedure. The daily report also numbers and sorts the inpatients according to large categories of diagnosis, reports the ratio between inpatients and operative patients. The annual report that was obtained was very accurate and gave rapid statistics for the one year. By retrospective study for the past 18 years, we calculated the incidence of orbital infarction syndrome following intracranial aneurysm surgery as 1.4%, and also estimated the population of geriatric inpatients as 18.3% by retrospective study. CONCLUSIONS: It has been found to be most useful to make a daily and annual report for tracking and research purposes. For use in clinical articles, it can be possible to do a search of the patients using the standardized disease, diagnosis and neurosurgical procedures application and obtain pertinent information in a timely manner.
Diagnosis ; Epidemiology* ; Humans ; Incidence ; Infarction ; Inpatients ; Intracranial Aneurysm ; Neurosurgical Procedures* ; Orbit ; Retrospective Studies ; Writing

OBJECTIVE: The the international classification of disease and surgical procedure has been found to be a lengthy and time-consuming text for use by neurosurgeons. A more subject matter related classification system is needed for use by this specialty. The author has developed a more comprehensive and standardized classification system specified for diagnosis of neurological disease and neurosurgical procedures. METHODS: Standardization of disease was completed by modifying the name of disease according to that which was used for daily report past 10 years, and from textbook of neurosurgery. The fields of international coding are continued in each. Neurosurgical procedures were designated and modified according to Current Procedure Terminology 96. Client-server system will be used for networking and database software applications have been developed. RESULTS: Disease was classified in 14 large categories and 379 subcategories. Diagnosis was classified in 12 large categories and 43 subcategories. Neurosurgical procedure has 20 large and 202 subcategories. The international coding system such as ICD-10 and ICD-9CM is maintained for the diagnosis and procedures to each category. CONCLUSIONS: It could be possible to make and use a standardized database model of disease, diagnosis and neurosurgical procedures to be used by physician.
Classification ; Clinical Coding ; Diagnosis ; Epidemiology* ; International Classification of Diseases ; Neurosurgery ; Neurosurgical Procedures*

PURPOSE: This study quantitatively evaluated the apoptosis in human peripheral blood lymphocytes using flow cytometry, and investigated the possibility of using this method, with a small amount of blood, and the time and dose dependence of radiation-induced apoptosis. MATERIALS AND METHODS: Peripheral blood lymphocytes were isolated from the heparinized venous blood of 11 healthy volunteers, 8 men and 3 women, with each 10 ml of blood being divided into 15 samples. The blood lymphocytes were irradiated using a linear accelerator at a dose rate of 2.4 Gy/min, to deliver doses of 0.5, 1, 2 and 5 Gy. The control samples, and irradiated cells, were maintained in culture medium for 24, 48 and 72 hours following the irradiation. The number of apoptotic cells after the in vitro X-irradiation was measured by flow cytometry after incubation periods of 24, 48 and 72 hours. We also observed the apoptotic cells using a DNA fragmentation assay and electron microscopy. RESULTS: The rate of spontaneous apoptosis increased in relation to the time interval following irradiation (1.761+/-0.161, 3.563+/-0.564, 11.098+/-2.849, at 24, 48, and 72 hours). The apoptotic cells also increased in the samples irradiated with 0.5, 1, 2 and 5 Gy, in a radiation dose and time interval after irradiation manner, with the apoptosis being too great at 72 hours after irradiation. The dose-response curves were characterized by an initial steep increase in the number of apoptotic cells for irradiation doses below 2 Gy, with a flattening of the curves as the dose approached towards 5 Gy. CONCLUSION: The flow cytometric assay technique yielded adequate data, and required less than 1 mL of blood. The time and dose dependence of the radiation-induced apoptosis, was also shown. It is suggested that the adequate time interval required for the evaluation of apoptosis would be 24 to 48 hours after blood sampling.
Apoptosis* ; DNA Fragmentation ; Female ; Flow Cytometry ; Healthy Volunteers ; Heparin ; Humans ; Lymphocytes* ; Male ; Microscopy, Electron ; Particle Accelerators

BACKGROUND: Echocardiographic examination is universally considered as an established method for the diagnosis of congenital heart disease, and as a result of many technological advancements in information processing, its utility is being emphasized much more. Cardiac catheterization, by comparison, is usually performed in the past for the purpose of diagnosis and preoperative assessment of infants with isolated ventricular septal defect (VSD), and the risks and complications of cardiac catheterization have been more frequent in the younger ages. Accordingly, we present in this study the effectiveness and safety of echocardiography on the diagnosis and treatment of infants who met the indications of early correction and underwent operations. METHODS: Between May 1994 and April 1997, 66 infants with isolated VSD were submitted for primary correction in the Yonsei Cardiovascular Center. Among the 66 infants (36 males and 30 females), 33 (group 1) underwent surgery on the basis of echocardiography alone and another 33 (group 2), on the basis of cardiac catheterization in addition to echocardiography. The two groups were compared for the diagnostic sensitivity, specificity, complication after surgical correction and frequency of re-operation. RESULTS: 1) The average age was 5.4+/-3.3 months in group 1 and 5.7+/-2.2 months in group 2. 2) There was no significant difference between the two groups in terms of the sensitivity and specificity of diagnostic tools. 3) There was no post-operative death in either group and no significant difference in postoperative hospital stay between the two groups. 4) There was no significant difference between the two groups in complications such as sepsis, pneumonia after surgical correction. CONCLUSION: We concluded that after an accurate selection, most infants with isolated VSD can safely undergo primary repair on the basis of echocardiography alone.
Automatic Data Processing ; Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Echocardiography* ; Heart Defects, Congenital ; Heart Septal Defects, Ventricular* ; Humans ; Infant ; Length of Stay ; Male ; Pneumonia ; Sensitivity and Specificity ; Sepsis

BACKGROUND AND OBJECTIVES: The histologic difference of the traumatic nasal septal cartilage from that of non-traumatic has not been extensively studied. The aim of this study was to identify histologic difference in the nasal septal cartilage between traumatic and non-traumatic nasal septal deviation and to find its implication for surgical intervention. SUBJECTS AND METHOD: Nasal septal cartilage was obtained from 23 patients who had undergone septoplasty or septorhinoplasty for the nasal septal deviation. The septal cartilage without trauma (7 patients, Group I) and with the history of the trauma at the age under 10-15 years old (8 patients, Group II), and over 25 years old (8 patients, Group III) between May 2003 to February 2005 were included in this study. An approximately 1 x 1 cm sized piece of the septal cartilage was harvested from the site deviated the most. The histologic difference of the septal cartilage by hematoxylineosin staining under a light microscope was performed. RESULTS: The chondrocyte densities were significantly higher in the convex side than in the concave side of the septal cartilage in Group I, II, III. Especially, the increased chondrocyte ratio (convex/concave) were more evident in the septal cartilage traumatized at the age of 10 to 15 years, and the cartilage plate was thicker than the other groups (p<0.001). Also, dystrophic changes of the chondrocytes as representing the chondrocyte differentiation and chondroblast ratio (convex/concave) were significantly higher in the group II than in the other groups (p<0.005). CONCLUSION: This study demonstrated that age dependent changes in septal cartilage with nasal trauma showed distinctive histologic characteristics. We suggest that these observations will help determine surgical treatment modality for cases of nasal septal deviations with and without trauma.
Adult ; Cartilage* ; Chondrocytes ; Humans

OBJECTIVE: The video head impulse test (vHIT) is useful for evaluation of high frequency vestibulo-ocular reflex. There are a few reports regarding the recovery of head impulse test in vestibular neuritis (VN) but the factors for the recovery were not studied. The study aimed to identify the recovery patterns of vHIT in VN and the factors influencing the recovery. METHODS: Among 31 patients with acute VN, 18 patients with identified recovery pattern were selected. We conducted serial checks of subjective vertigo and spontaneous nystagmus until discharged (1-8 days), and scheduled vHITs. We found three patterns in serial vHITs during follow-ups and analyzed the relationship of initial vestibular function tests, serial check-ups of subjective vertigo, bedside neuro-otologic tests, and vHITs. RESULTS: Five patients showed normal vHIT gain in acute stage (non-damaged pattern) and 8 patients' gains were recovered after 30 days after symptom onset (early recovered pattern). Poor recovery pattern was found in 5 patients (poorly recovered pattern). There were relationship between vHIT recovery patterns and the severity of vestibular dysfunctions. Duration of spontaneous nystagmus (until grade 1), degree of subjective visual vertical tilt, ocular vestibular myogenic potential abnormalities, and abnormality of rotatory chair test were all related to poorly recovered vHIT patterns. All poor recovery patients had residual symptom at 30 days after symptom onset. CONCLUSION: The vHIT may give clinicians useful hints in predicting prognosis in VN, and the recovery of vHIT would be delayed if the damage were more extensive.
Follow-Up Studies ; Head Impulse Test ; Head ; Humans ; Prognosis ; Reflex ; Reflex, Vestibulo-Ocular ; Vertigo ; Vestibular Function Tests ; Vestibular Neuronitis

Background: and PurposeWe aimed to determine the patterns and mechanisms of persistent nystagmus (PN) lasting >1 year in lateral medullary infarction (LMI). Methods: We recruited 13 patients with PN due to LMI and another 13 with transient nystagmus (TN) (<1 year) as control. All patients underwent oculography, rotatory chair test, caloric test, bedside head impulse test, dizziness handicap inventory (DHI), and brain MRI. Results: All patients had spontaneous, contralesional, horizontal-torsional nystagmus during the acute phase. Although two patients exhibited consistent contralesional torsional nystagmus, most patients (11/13, 85%) with PN evolved from the initial contralesional to ipsilesional nystagmus. During horizontal gaze, the patterns of ipsilesional PN were diverse; torsional (n=5), torsional-downbeat (n=2), horizontal (n=2), and horizontal nystagmus while looking at the lesion side, and torsional nystagmus while looking at the opposite side (n=2). During rotatory chair test, the gains of the vestibulo-ocular reflex in the PN group were lower than those in the TN group to the lesion side at 0.02 and 0.64 Hz. The caudal and ventrolateral parts of the vestibular nuclei were mostly involved in patients with PN. The DHI score did not differ between the groups. Conclusions PN patterns frequently change in LMI. Resultant vestibular asymmetry after vestibular afferents or cerebellar inhibitory pathway damage and/or inappropriate vestibular compensation may be responsible for PN in LMI. Impairment of the horizontal or vertical neural integrators may be another cause. The presence of PN does not necessarily indicate more severe dizziness in LMI.