PURPOSE: The purpose of this study was to evaluate the correlation between the clinical symptoms of temporomandibular disorder and findings in the magnetic resonance imaging (MRI). MATERIALS AND METHODS: Clinical data and MRI images were collected from a total of 240 German patients. Clinical symptoms were briefed as joint clicking, crepitus and pain. MRI findings were further defined according to the condyle position, condyle degeneration, disc positon, disc degeneration and the presence of osteophyte/sclerosis/synovitis. Hypermobility was separately recorded. Correlation analysis between parameters was performed. RESULT: Joint clicking had a positive correlation with unilateral disc degeneration, osteophyte, sclerosis and synovitis. Crepitus had a significant correlation with bilateral osteophyte. Pain was not correlated with any MRI findings except hypermobility. CONCLUSION: Selective correlations between the MRI findings and clinical symptoms were elucidated. The results of this study imply that condyle-disc deformities could be advanced without pain, and that joint clicking and crepitus could be clinical symptoms of condyle-disc degeneration.
Congenital Abnormalities ; Humans ; Intervertebral Disc Degeneration ; Joints ; Magnetic Resonance Imaging* ; Osteophyte ; Sclerosis ; Synovitis ; Temporomandibular Joint Disorders ; Temporomandibular Joint*

BACKGROUND: Efficacy of epidural test dose for detecting inadvertent intravascular injection during general anesthesia with volatile anesthetics, has not been clearly determined. The object of this study is to see the efficacy of simulated intravenous test dose in adult patients anesthetized with O2-N2O- enflurane or isoflurane. METHODS: Sixty eight adults were evenly divided into enflurane group and isoflurane group. In enflurane group(n=34), patients were alternatively assigned to group I(n=17) and group II(n=17). After induction of general anesthesia, anesthesia was maintained with O2-N2O(50%)-enflurane(end-tidal concentration 1 vol%). After vital signs were stabilized, normal saline 3 ml was injected intravenously to group I, while 2% lidocaine 3 ml containing 15 mcg epinephrine to group II. Heart rate(HR) and systolic blood pressure(SBP) were measured at 10-seconds intervals for 4 minutes. Study procedure for isoflurane group(group III-normal saline injection vs group IV-test dose injection) was identical to enflurane group except using isoflurane(end-tidal concentration 1 vol%). RESULTS: 1. Enflurane 1 vol% group: When maximum HR increase > or =20 beats/min is regarded as positive test, sensitivity is 71% and specificity is 100%. While SBP increase > or =15 mmHg is regarded as positive test, sensitivity is 94% and specificity is 100%. 2. Isoflurane 1 vol% group: Based on the same criteria, sensitivity is 18% and specificity is 100% for HR, and sensitivity is 94% and specificity is 100% for SBP. CONCLUSIONS: When epidural analgesia is combined with O2-N2O-enflurane /isoflurane anesthesia, it's better to observe changes in SBP than HR after epidural test dose injection.
Adult* ; Analgesia, Epidural ; Anesthesia ; Anesthesia, General ; Anesthetics ; Enflurane* ; Epinephrine ; Heart ; Humans ; Isoflurane* ; Lidocaine ; Sensitivity and Specificity ; Vital Signs

PURPOSE: To investigate the change in mitogen-activated protein kinase pathways in the brain tissue after therapeutic hypothermia in the swine cardiac arrest model. METHODS: After the return of spontaneous circulation by cardiopulmonary resuscitation, following a 6 min of no-flow time induced by ventricular fibrillation, pigs (n=24) were randomly assigned to one of four groups (sham, normothermia, 24 hr of therapeutic hypothermia, 48 hr of therapeutic hypothermia). After 24 or 48 hr of therapeutic hypothermia (core temperature 32-34℃), the pigs were then rewarmed to 36℃ for a period of 8 hr. At 60 hr upon the return of spontaneous circulation, the pigs were sacrificed and brain tissues were harvested. RESULTS: We measured the tissue levels of p38, JNK, and ERK pathway expressions from the hippocampus of the swine brain in all four groups. The phosphorylated p38-to-p38 ratio and phosphorylated JNK-to-JNK ratio were significantly increased in all of the intervention groups compared with the sham group. The phosphorylated ERK-to-ERK ratio was increased only in the therapeutic hypothermia groups (p-value=0.026 in the 24 hr of therapeutic hypothermia group and p-value=0.002 in the 48 hr of therapeutic hypothermia group, compared with the sham group). CONCLUSION: The p38 and JNK pathways were also activated during therapeutic hypothermia and normothermia. However, the ERK pathway was activated only in therapeutic hypothermia. Therapeutic hypothermia activated the ERK pathway in ischemia-reperfusion injury of the brain tissue after cardiac arrest, which seemed to be dependent on the duration of therapeutic hypothermia.
Brain* ; Cardiopulmonary Resuscitation ; Heart Arrest* ; Hippocampus ; Hypothermia, Induced* ; MAP Kinase Signaling System ; Mitogen-Activated Protein Kinases ; Protein Kinases* ; Reperfusion Injury ; Swine* ; Ventricular Fibrillation

No abstract available.
Histiocytoma, Malignant Fibrous* ; Lung*

OBJECTIVES: This study was performed to identify the effect of physical activity at work on obesity and to analyze the contribution of socioeconomic factors and health behaviors to this association, which has been relatively little studied. METHODS: From the Korean National Cancer Center Community Cohort, a total of 5,587 adults (2,125 men; 3,462 women) aged more than 30 years living in rural areas were enrolled. Information on socio-demographic factors, health behaviors, and body mass index was gathered using face-to-face interviews and measurements of height and weight. RESULTS: Inverse associations were identified between vigorous-intensity physical activity at work and obesity in both men and women, while no association was found between vigorous-intensity physical activity during leisure time and obesity. High household income was independently associated with a lower risk of obesity among those who had low levels of vigorous-intensity physical activity at work. Vigorous physical activity at work showed an inverse association with obesity in rural areas where heavy manual labor is common. CONCLUSIONS Our findings indicate the necessity to account for various types of physical activity to improve the assessment and prevention of obesity.

OBJECTIVES: This study was performed to identify the effect of physical activity at work on obesity and to analyze the contribution of socioeconomic factors and health behaviors to this association, which has been relatively little studied. METHODS: From the Korean National Cancer Center Community Cohort, a total of 5,587 adults (2,125 men; 3,462 women) aged more than 30 years living in rural areas were enrolled. Information on socio-demographic factors, health behaviors, and body mass index was gathered using face-to-face interviews and measurements of height and weight. RESULTS: Inverse associations were identified between vigorous-intensity physical activity at work and obesity in both men and women, while no association was found between vigorous-intensity physical activity during leisure time and obesity. High household income was independently associated with a lower risk of obesity among those who had low levels of vigorous-intensity physical activity at work. Vigorous physical activity at work showed an inverse association with obesity in rural areas where heavy manual labor is common. CONCLUSIONS Our findings indicate the necessity to account for various types of physical activity to improve the assessment and prevention of obesity.

PURPOSE: Therapeutic hypothermia is an important treatment strategy for control of the overwhelming inflammatory reactions of cardiac arrest patients. Rapid rewarming is related to poor outcome, however the kinds of inflammatory processes that occur during the rewarming period are not well understood. Our aim in the current study was to evaluate the changes in inflammatory cytokine levels during cardiac arrest patients' rewarming period. METHODS: This study was conducted in an emergency intensive care unit of a tertiary referral hospital. Blood samples were collected on admission (0 h) and 24, 26, 28, and 32 h after return of spontaneous circulation. Eight inflammatory cytokines (E-selectin, soluble ICAM, interleukin-10, interleukin-1ra, interleukin-6, interleukin-8, monocyte chemotactic protein-1, and tumor necrosis factor-α) were measured. RESULTS: Twenty-eight patients were enrolled and completed a protocol of 24 h hypothermia and 8h rewarming. Eight patients were of the good cerebral performance category (CPC) and 20 of the bad. The IL-1Ra level in the good CPC group was statistically changed at 26 (p=0.039) and 28 (p=0.003) but not at 32 h (p=0.632) when compared with the 24 h level. The IL-10 levels of the bad CPC group were decreased at 26 (p=0.017) and 28h (p=0.013) but not at 32 h (p=0.074) when compared with 24 h. None of the other cytokines showed meaningful differences during the rewarming period. CONCLUSION: Change in inflammatory-cytokine-level change during the rewarming period is not significant.
Chemokine CCL2 ; Cytokines* ; Emergencies ; Heart Arrest ; Humans ; Hypothermia ; Hypothermia, Induced* ; Intensive Care Units ; Interleukin 1 Receptor Antagonist Protein ; Interleukin-10 ; Interleukin-6 ; Interleukin-8 ; Necrosis ; Prognosis ; Rewarming* ; Tertiary Care Centers

Piroplasms are tick-transmitted, intracellular, hemoprotozoan parasites that cause anorexia, fever, anemia, and icterus. Theileriosis is caused by Theileria sergenti and causes major economic losses in grazing cattle in Japan and Korea. In May 2003, we examined the antigenic diversity of the major piroplasm surface protein (MPSP) gene in 35 healthy Jeju black cattle that were born and raised at the National Institute of Subtropical Agriculture. On microscopic examination of Giemsa-stained blood smears, 9 of 35 cattle had intra-erythrocytic piroplasms. Hematological data were within normal range for all 35 cattle. Amplification of DNA from all blood samples using universal MPSP gene primers showed mixed infections with C, I, and B type Theileria spp. Type C was identified in 20 of 35 blood samples, and type B was identified in 17 samples. Allelic variation was seen in type B.
Animals ; Antigens, Protozoan/*genetics ; Base Sequence ; Cattle ; DNA Primers/genetics ; *Genetic Variation ; Korea ; Molecular Sequence Data ; *Phylogeny ; Protozoan Proteins/*genetics ; Sequence Analysis, DNA ; Theileria/*genetics ; Theileriasis/*parasitology

Cryptococcal pneumonia usually occurs in immunocompromised patients with malignancy, acquired immune deficiency syndrome, organ transplantations, immunosuppressive chemotherapies, catheter insertion, or dialysis. It can be diagnosed by gaining tissues in lung parenchyma or detecting antigen in blood or bronchoalveolar lavage fluid. Here we report an immunocompetent 32-year-old male patient with diabetes mellitus diagnosed with cryptococcal pneumonia after a ultrasound-guided percutaneous supraclavicular lymph node core needle biopsy. We treated him with fluconazole at 400 mg/day for 9 months according to the guideline. This is the first case that cryptococcal pneumonia was diagnosed from a percutaneous lymph node biopsy in South Korea.
Acquired Immunodeficiency Syndrome ; Adult ; Biopsy* ; Biopsy, Fine-Needle ; Biopsy, Large-Core Needle ; Bronchoalveolar Lavage Fluid ; Catheters ; Cryptococcosis* ; Diabetes Mellitus ; Dialysis ; Drug Therapy ; Fluconazole ; Humans ; Immunocompromised Host ; Korea ; Lung ; Lymph Nodes* ; Male ; Organ Transplantation ; Pneumonia ; Transplants

Nontuberculous mycobacteria (NTM) is widely present in environment but it rarely causes infections in human. However, when NTM infects humans, it can cause pulmonary infection, lymphadenitis, skin infections, disseminated infection, etc. Of theses disease, pulmonary infection occurs most frequently while osteomyelitis is rare. In addition, osteomyelitis caused by Mycobacterium abscessus, an acid-fast bacillus classified as a pathogenic "rapid growing" NTM, is even rare and has never been reported in Korea. Although no consensus guidelines concerning the treatment of osteomyelitis caused by M. abscessus exist, prolonged antibiotics therapy in combination with surgical debridement is generally recommended. Herein, we reported the first case of knee joint osteomyelitis caused by M. abscessus in Korea. The patient experienced significant improvement after antibiotic treatment without recourse to surgery.
Anti-Bacterial Agents ; Bacillus ; Consensus ; Debridement ; Humans ; Knee ; Knee Joint ; Korea ; Lung Diseases ; Lymphadenitis ; Mycobacterium ; Nontuberculous Mycobacteria ; Osteomyelitis ; Skin