In order to evaluate the value of vertebral angiography in assessment of hemifacial spasm, we reviewed retrospectively the vertebral angiography of 28 patients(30 cases) with surgically proved hemifacial spasm but normal CT scans of posterior fossa. There were 9 males and 19 females. Angiography revealed vascular focus of hemifacial spasm located at anterior inferior cerebellar artery, posterior inferior cerebellar artery, and vertebral artery in 19, 9, and 2 cases respectively. Right side was involved in 20 cases. All involved vessels were elongated, tortuous, and dilated. In conclusion, vertebral angiography was valuable in evaluating hemifacial spasm of vascular origin in the posterior fossa.
Angiography* ; Arteries ; Female ; Hemifacial Spasm* ; Humans ; Male ; Retrospective Studies ; Tomography, X-Ray Computed ; Vertebral Artery

This study was to investigate the various parts of the mandible related to inferior alveolar nerve conductive anesthesia in 228 dry skulls of Korean adults. Five morphological variations were observed and four measurements were undertaken. The following results were obtained. 1. The Position of coronoid notch in the anterior border of the ramus of mandible is classified into three types and percentage of each type was as follows : Type I (Coronoid notch in the middle part of the anterior border of the ramus of mandible) : 83.3% Type II (Coronoid notch in the inferior part of the anterior border of the ramus of mandible) : 12.7% Type III (No coronoid notch in the anterior border of the ramps of mandible) : 4.0% 2. The position of the lingula of mandible to the imaginary line of the molar occlusal plane is classified into three types and percentage of each type was as follows : Type I (Above the imaginary line of the mandibular molar occlusal plane) : 87.3% Type II (Coincide with the imaginary line of the mandibular molar occlusal plane) : 8.6% Type III (Below the imaginary of mandibular molar occlusal plane) : 4.3% 3. The position of the lingula of the mandible in the internal oblique line-posterior border of the ramus of mandible dimension is classified into three types and percentage of each type was as follows : Type I (Anterior part in the internal oblique line-posterior border of the ramus of mandible dimension) : 82.9% Type II (Middle part in the internal oblique line-posterior border of the ramus of mandible dimension) : 11. 4% Type III (Posterior part in the internal oblique line-posterior border of the ramus of mandible dimension) : 5.7% 4. The position of the apex of the lingula of mandible to the deepest point of the coronoid notch in the anterior border of the ramus of mandible is classified into three types and percentage of each type was as follows : Type I (Coincide with the deepest point of the coronoid notch) : 82.0% Type II (Above the deepest point of the coronoid notch) : 13.2% Type III (Below the deepest point of the coronoid notch) : 4.8% 5. The position of the apex of the lingula of mandible to the imaginary line of the mandibular molar occlusal plane is classified into three types and percentage of each type was as follows : Type I (Above the 8mm) : 65.7% Type II (Above the 5mm) : 18.6% Type III (Above the 10mm) : 15.7% 6. Angle between the line connecting the apex of the lingula of mandible-1-2 premolars in the contralateral side and median line of the mandible is classified into three types and percentage of each type was as follows : Type I (50°) : 67.2% Type II (45°) 21.4% Type III (55°) : 11.4% 7. The averages of the measurement of the various bony landmarks of the mandible related to inferior alveolar nerve conductive anesthesia were as follows : ① Distance from deepest point of the coronoid notch to internal oblique line : 9.2mm ② Distance from internal oblique line to the apex of the lingula of mandible : 11.6mm ③ Distance from deepest point of the coronoid notch to apex of the lingula of mandible : 19.7mm ④ Height of the lingula of mandible : 9.8mm
Adult ; Anesthesia* ; Architectural Accessibility ; Bicuspid ; Dental Occlusion ; Humans ; Mandible* ; Mandibular Nerve* ; Molar ; Skull

Air pollution in the traffic areas in Seoul during the winter season was studied. The average level of sulfur dioxide concentration was 0.24 ppm through the day. Lowest was 0.14 ppm at 2~4 P.M. when the highest vertical temperature gradient was indicated, and 0.33~0.29 ppm during 10 P.M. to 8 A.M. at night. Average level of dust was 4.65 mppcf (2.1~12.8 mppcf) and higher levels were shown at 10 A.M., 6 P.M. and 10 P.M. as 5.44, 4.73 and 5.01 mppcf respectively. The noise level in the main traffic areas was 73.5 db in the average during this survey, 75.1 db in the daytime and 65.6 db in the night (11 P.M. ~7 A.M.) in the average. Various air pollutants in auto-exhaust gases and noise of automobiles were studied, since those are main sources of nuisance in the traffic areas. Carbon monoxide in the "Corona" taxi, formaldehyde in the jeep, and carbon monoxide, formaldehyde and sulfur dioxide in the "Senara" taxi were measured respectively in high concentration and there was no significant difference in other gases among the various type of vehides. As regards average Overall noise level at ordinary driving speeds, heavy vehicles emitted much more noise (30 KPH) (82.2~83.5 db) than light vehicles such as taxi (40~5O KPH) (71.5-80.2 db). The noise level when starting heavy vehicles was higher 88.5 db(94.2 phon) on the average and that of light vehicles was lower 69.4 db (76.2 phon). There were two types of automobile horn noise in the octave band; one was in 1,000 cps and the other 2,000~4,000cps. The average horn noise level of automobiles was 98 db (107.8 phon), with 106 db (11.05 phon) maximum and 88.8db (99.5 phon) minimum. In the epidemiological study of CO poisoning in urban areas, there were 260 deaths out of 532 patients in 201 incidents of poisoning occurring on a total of 128 days during January 1964 to Dec. 1966. The concentration of co in the main living rooms and kitchens was detected as 58 and 112 ppm respectively, and the level of carboxyl-hemoglobin in the blood of housewives was relatively high, 11.2% on the average. In outside air maximal concentration of CO was 80 ppm in Shinchon-Dong an urban area.
*Air Pollution ; Korea ; *Noise

Carbamylated hemoglobin (CarHb) is formed by the reaction of hemoglobin with cyanate derived from the spontaneous dissociation of in vivo urea. Previous studies have shown that formation of CarHb depends upon both the severity and the duration of renal failure. To study the clinical significances of CarHb in Korean patients with chronic renal failure, we measured CarHb levels by high-performance liquid chromatography in 159 CRF patients and 46 normal controls. Patients with CRF had a higher CarHb concentration than normal controls (107.9+/-58.8 vs 35.1+/-14.2 microgramVH/gHb; P<0.001). In patients with CRF, nondialysis group had a higher value than dialysis group (129.8+/-77.9 vs 98.7+/-46.1 microgramVH/gHb; P<0.05). There were no siginificant difference in CarHb levels between hemodialysis (92.0+/-35.8microgramVH/gHb) and peritoneal dialysis (106.7+/-55.3microgramVH/gHb) groups. CarHb levels were not different between diabetic and nondiabetic patients in predialysis and hemodialysis groups. Although there was a significant difference in peritoneal dialysis group, the BUN levels were also lower in diabetic patients than nondiabetic patients. There were no correlation between CarHb and HbA1c percentage in patients with diabetes. CarHb levels were positively correlated with BUN (r=0.489; P<0.001) and creatinine (r=0.458; P<0.01) concentrations. There were negative correlations between CarHb and both Kt/V (r=-0.358; P<0.05) and URR (r=-0.415; P<0.05) in hemodialysis patients. In conclusion, CarHb may be a useful index of uremic control in patients with chronic renal failure, and are independent of the mode of dialysis and the presence of diabetes.
Chromatography, Liquid ; Creatinine ; Dialysis ; Humans ; Kidney Failure, Chronic* ; Peritoneal Dialysis ; Renal Dialysis ; Renal Insufficiency ; Urea

Human caliciviruses (HuCVs) cause sporadic cases and outbreaks of acute gastroenteritis (AGE). Three maior genogrovps of HuCVs have been described including the Norwalk virus (NV)-, the Snow Mountain virus (SMA)-, and the Sapporo-genogroups. This study describes the detection and genetic variation of HuCVs from hospitalized infants with AGE in Korea by RT-PCR and sequencing. The cDNA fragments of 206 to 470bp corresponding to the region of 3 primer pairs (36/35, 35/51 or 3/51) in the polymerase region of NV were generated. Of 185 stools screened, 8% were positive by RT-PCR and their sequences showed that all strains contained the GLPSG and YGDD motifs which are conserved for HuCVs. Amino acid (aa) sequence analysis showed that these strains can be divided into 3 maior genogroups. High conservation was observed in that one strain shares 100% of as sequence with Southampton virus, another shares 99% with the Sapporo virus, and six strains share 90 to 95% with Snow Mountain virus. However, significant sequence variation was also found in other strains. This study indicates that all maior genogroups of HuCVs are circulating in Korea.
Disease Outbreaks ; DNA, Complementary ; Gastroenteritis ; Genetic Variation ; Genotype ; Humans* ; Infant ; Korea* ; Norwalk virus ; RNA Replicase* ; Sapovirus ; Sequence Analysis ; Snow

BACKGROUND: Thyroid status in uremia is still inconclusive due to the complexicity of the system. No single pathogenetic event may explain the thyroid function abnormalities in end stage renal disease (ESRD). Defects at all levels of the hypothalamic-pituitary-thyroid axis have been identified. Regarding the thyroid dysfunction in ESRD it is well recognized that the TSH response to TRH is blunted and serum concentrations of thyroid hormones are decreased in patients with ESRD. Whether or not on maintenance hemodialysis. Restoration of renal function with renal transplantation resulted in normalization of all parameters of thyroid function with exception of blunted TSH response to TRH. We evaluated the long-term changes of the thyroid function in 10 patients to know whether the thyroid function and the hypothalamo-pituitary axis were improved with the recovery of the renal function under maintenance low-dosage steroid administration after renal transplantation. METHODS: These tests were performed during the morning in the fasting state in 10 ESRD patients before, 1 month and 6 years after renal transplantation (RT). Thyroid function tests. Serum T3, T4 were measured by RIA kit and serum TSH was measured by IRMA kit. TRH stimulation test. Serum blood samples were obtained 0, 30, 60, 90, 120 min after TRH (400microgram) administration. Statistical analysis. All grouped data were expressed as mean+/-SD. Student t-test was used to assess the statistical difference between any two means. RESULTS: 1) The mean basal level of serum T3 was reduced in ESRD patients (53.6+/-33.2ng/dL) and increased to the low normal level 1 month after RT (87.8+/-25.4ng/dL), improved to the normal level 6 years after RT (116.3+/-28.8ng/dL). 2) The mean basal level of T4 was within normal range before RT (5.9+/-1.1microgram/dL), after 1 month (6.2+/-1.2microgram/dL) and after 6 years (6.5+/-1.4microgram/dL) of RT. 3) The mean basal level of TSH was within normal range before RT (2.0+/-1.2microU/mL), after 1 month (1.1+/-0.7microU/mL), and after 6 years (0.7+/-0.5microU/mL) of RT. Rut the mean TSH level of 6 years of RT was significantly decreased within the normal range. 4) In ESRD the TSH response to TRH was blunted, had a diminished peak and delayed fall before RT. After 1 month of RT, the TSH response to TRH was persistently blunted, however showed more rapid fall of TSH. After 6 years of RT, the TSH response to TRH normalized, but the absolute level of TSH and the peak level of TSH to TRH were less than before and after 1 month of RT. CONCLUSIONS: The abnormalities of thyroid hormones in uremic patients were improved partially after 1 month of RT and almost completely after 6 years of RT. But the level of T3H and the peak level of TSH to TRH were low within normal range, these results may be a direct consequence of low-dosage and long-term glucorcorticoid administration.
Axis, Cervical Vertebra ; Fasting ; Follow-Up Studies* ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation* ; Reference Values ; Renal Dialysis ; Thyroid Function Tests ; Thyroid Gland* ; Thyroid Hormones ; Uremia

Thromboembolism is the most common serious complication following total hip arthroplasty and most common cause of death after total hip arthroplasty. A prospective randomized study in 170 cases of elective cementless total hip arthroplasty was carried out to examine the incidence of deep vein thrombosis and pulmonary embolism after cementless total hip arthroplasty from Aug. 1993 to May 1995. Laboratory study, clinical symptoms and signs, chest roentgenograph and precipitating factors were analysed. Venography and lung perfusion scan using radionuclide scan were used for this study. The weight, height, sex, habitus of alcohol and smoking, hypertension, diabetes mellitus, previous operation history of ipsilateral lower extremity, etiology of hip joint disease, and transfusion of blood were not precipitating factors, but the age over 40 and previous history of pulmonary embolism had a significant effect on the incidence of deep vein thrombosis. There was no significant relationship between the incidence of deep vein thrombosis and the laboratory assay, clinical symptoms and signs. Deep vein thrombosis was detected in 29 cases(17.0%), pulmonary embolism in 22 cases(12.9%), and fatal pulmonary embolism in 1 case(0.6%). The most common location of deep vein thrombosis was the popliteal area.
Arthroplasty, Replacement, Hip* ; Cause of Death ; Diabetes Mellitus ; Hip Joint ; Hypertension ; Incidence ; Lower Extremity ; Lung ; Perfusion ; Phlebography ; Precipitating Factors ; Prospective Studies ; Pulmonary Embolism* ; Smoke ; Smoking ; Thorax ; Thromboembolism ; Venous Thrombosis*

About 40% of patients with diabetes mellitus develops to diabetic nephropathy, and these patients show increment of glomerular filtration rate and renal volume at early phase. 99mTc-DMSA SPECT (single photon emission computed tomography) can measure a functional renal volume because 99mTc- DMSA it is taken up by the viable proximal tubular cells located in the renal cortex. To evaluate the renal volume in early diabetic nephropathy, we compared functional renal volume between diabetic patients and control, renal transplantation donor. 99mTc-DMSA was injected intravenously and SPECT was done after 2 hours in 15 diabetic patients, 18 renal transplantation donors, and 2 patients with end stage renal disease due to chronic glomerulonephritis. In diabetic patients with creatinine clearance more than 30ml/min and proteinuria, right and left renal volume were 247+/-22ml/BSA(m2), 256+/-37ml/BSA (m2), which were greater than those of diabetic patients with normal renal function and without proteinuria, or renal transplantation donors(P<0.05). In conclusion, we measured the functional renal volume by 99mTc-DMSA SPECT. Renal volume of diabetic patients with proteinuria were larger than the volume of control group or diabetic patients with normal renal function and without proteinuria. 99mTc-DMSA SPECT was thought to be useful test a for the measurement of functioning renal volume.
Creatinine ; Diabetes Mellitus* ; Diabetic Nephropathies ; Glomerular Filtration Rate ; Glomerulonephritis ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Proteinuria ; Succimer ; Technetium Tc 99m Dimercaptosuccinic Acid* ; Tissue Donors ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: Lipoprotein(a)[Lp(a)] is a subspecies of low-density lipoprotein and has been shown to be associated with pathogenesis of thrombosis-related disease. It is already known that patients with diabetic nephropathy are usually complicated by vascular complications such as coronary artery diseases and cerebrovascular accidents. According to the recent data, Lp(a) level tends to be increased as the proteinuria is increased and renal function are decreased. We evaluated the Lp(a) level to know whether its level is correlated to the severity of diabetic nephropathy. METHODS: We investigated Lp(a) levels in eighty-one patients with Type 2 (non-insulin-dependent) diabetic patients. They were divided into four groups according to the level of urinary albumin excretion and serum creatinine level: Group 1 (n=30): normal renal function + urine microalbumin or=1.5mg/dL. Blood samples were obtained during the morning in the fasting state and separated serum from the it and reserved at -70degrees C. Lp(a) concentration was checked by one-step sandwich ELISA test. All grouped data were expressed as mean+/-SD. ANOVA and unpaired t-test was used to assess the statistical difference between any two means. RESULTS: Lp(a) levels were 30.2+/-4.6mg/dL in Group 1, 42.7+/-8.2mg/dL in group 2, 73.4+/-19.7mg/dL in group 3, and 80.7+/-14.8mg/dL in group 4. The level of Lp(a) in group4, group 3, and group 2 was significantly higher than that of group 1 respectively (P=0.009, 0.001, 0.038). However, no significant correlation was observed between the level of Lp(a) and that of total cholesterol, triglyceride and total lipid in all groups. CONCLUSIONS: these results indicate that Lp(a) concentrations are increased in the patients with diabetic nephropathy with microalbuminuria or overt proteinuria. So, the presence of albuminuria may be the important determinant for the elevated Lp(a) level in diabetic nephropathy.
Albuminuria ; Cholesterol ; Coronary Artery Disease ; Creatinine ; Diabetic Nephropathies* ; Enzyme-Linked Immunosorbent Assay ; Fasting ; Humans ; Lipoprotein(a)* ; Lipoproteins* ; Proteinuria ; Stroke ; Triglycerides ; Urinalysis

PURPOSE: The purpose of this narrative study was to understand how family caregivers interpreted themselves life during caring for dying patients with gliobalstoma, and how they integrated these experiences into their personal biographies. METHODS: Three family caregivers were recruited for the study. Data were collected through a series of audio-taped unstructured interviews and conversations with participants. The interviews and observation were conducted between October and November, 2011. Data were analyzed using psychosocial analytical methods that combined case based, in-depth staged analysis of narratives. RESULTS: The life experiences of the family caregivers with a dying family member were summarized as, in their own voices, 'the repetition of gliobalstoma', 'a smart patient', 'being obsessed with rehabilitation treatment', 'the frustration from nothing but just looking at the suffering of the patient', and 'a stubborn son'. CONCLUSION: Caregiving was characterised by various roles and life changes from the moment of diagnosis. Family caregivers of brain tumor reported experiences similar to those described by caregivers of people with other cancers. What differed for this group was the rapidity of change and the need for immediate information and support to assist with caring for a person with high-grade glioma.
Brain Neoplasms ; Caregivers ; Climacteric ; Frustration ; Glioblastoma ; Glioma ; Humans ; Life Change Events ; Stress, Psychological ; Terminal Care ; Voice