BACKGROUND: Cardiovascular disease is the major cause of morbidity and mortality. It is well known that androgen and sex hormone-binding globulin(SHBG) in women were associated with risk factors for cardiovascular disease such as obesity, central fat accumulation and atherogenic lipid profile. High resolution B-mode ultrasonography can visualize directly both luminal and vessel wall characteristics, and ultrasonic measurement of carotid intima-medial thickness(IMT) can be used to investigate the atherosclerosis of coronary, cerebral and peripheral arteries. The aim of this study was to evaluate the relationship between the serum dehydroepiandrosterone sulfate(DHEA-S) and SHBG, and body fat distribution pattern, cardiovascular risk factor and carotid atherosclerosis in women. METHODS: Blood pressure, fasting serum glucose, insulin, lipid profile, SHBG and DHEA-S were measured. Body fat distribution pattern was assessed by waist to hip ratio, waist to thigh ratio and subscapular to triceps skin fold thickness ratio, faf mass measured by bioelectric impedance analyzer, subcutaneous fat area, visceral fat area, and visceral to subcutaneous fat area ratio(VSR) at the level of umbilicus using the computed tomography. The IMT of the carotid artery was measured by high resolution B mode ultrasound as a marker of atherosclerosis. RESULTS: 1) There was no significant difference of age-adjusted values of carotid IMT among subjects with NGT(0.426+/-0.09mm), IGT(0.46+/-10.09mm) and NIDDM(0.453+/-0.11mm). 2) In postrnenopausal women, carotid IMT was greater(0.484+/-0.11mm, p=0.05) than premenopausal women(0.426+/-0.08mm), but it was not significant after age adjustment. Serum SHBG and DHEA-S levels in postmenopausal women were significantly lower(p<0.05) than premenopausal women, but they were not significant after age adjustment. 3) Carotid IMT was significantly correlated with age(r=0.37, p<0.01), fasting serum glucose (r=0.32, p<0.01), total cholesterol(r= 0.25, p<0.05), LDL-cholesterol(r=0.26, p<0.05), visceral fat area(r=0.35, p<0.01) and VSR(r=0.31, p<0.05). 4) By the stepwise multiple regression analysis, carotid IMT was positively and significantly associated with age(p<0.01) and serum DHEA-S concentration(p<0.05) in dent of age, body mass index, waist to hip ratio, fasting serum glucose. CONCLUSION: Carotid IMT was associated with age and serum DHEA-S concentration in women without cardiovascular disease. Therefore, serum DHEA-S may be one of risk factors for cardiovascular disease in women. However, we could not conclude its cause-result relationship because of cross sectional nature of our study, and prospective study will be needed.
Arteries ; Atherosclerosis ; Blood Glucose ; Blood Pressure ; Body Fat Distribution ; Body Mass Index ; Cardiovascular Diseases ; Carotid Arteries ; Carotid Artery Diseases* ; Dehydroepiandrosterone Sulfate* ; Dehydroepiandrosterone* ; Electric Impedance ; Fasting ; Female ; Humans ; Insulin ; Intra-Abdominal Fat ; Mortality ; Obesity, Abdominal ; Phenobarbital ; Risk Factors ; Sex Hormone-Binding Globulin* ; Skin ; Subcutaneous Fat ; Thigh ; Ultrasonics ; Ultrasonography ; Umbilicus ; Waist-Hip Ratio

PURPOSE: The purpose of this study was to determine the effects of auricular acupressure on menstrual pain, difficulties in daily life, negative feelings and autonomic nervous responses among college students. METHODS: A Randomized Controlled Trial design was used. The treatment group A (n=12) receivedauricular acupressure therapy on the first or second day of their menstrual period. Treatment group B (n=18) regularly received an auricular acupressure therapy once a week for a month. The control group (n=19) received no auricular acupressure therapy. An independent t-test was used to examine pre-post test differences in the group. The ANOVA and Scheffe test were used to examine pre-post test differences among the group. RESULTS: Subjects in treatment group A showed significantly less menstrual pain, difficulties in daily life, and negative feelings than the control group did. The participants in treatment group B also showed significantly less difficulties in daily life and negative feelings than the control group. CONCLUSION: The findings support that auricular acupressure therapy on menstrual periods is effective in controlling menstrual pain, difficulties in daily life, and negative feelings. As the method is simple, it would be useful for female students to learn to use this method to alleviate the symptoms related to menstruation through self care.
Acupressure* ; Complementary Therapies ; Dysmenorrhea* ; Evaluation Studies as Topic ; Female ; Female* ; Humans ; Menstruation ; Self Care

Background: Postoperative sore throat is a complaint after general anesthesia of multifactorial etiology. The laryngeal mask airway (LMA) reduces sore throat and discomfort during maintenance of the airway and make patients more comfortable. The purpose of this study was to compare effect of patient's position during operation on postoperative sore throat after the use of LMA. Methods: The fifty three patients were randomly divided into two groups. Group 1 (n=30) was underwent general anesthesia with supine position and group 2 (n=23) with prone position. After the LMA was positioned in the hypopharynx and the cuff inflated, fiberoptic laryngoscope was immediately passed down through the LMA. Number of attempts, degree of postoperative sore throat and other complications were also noted. Results: The incidence of postoperative sore throat after the use of LMA was 10% in supine position and 4% in prone position. But the difference between the groups was not statistically significant. All of the reported sore throats were rated as mild. Conclusions: Postoperative sore throat after the use of LMA is mild and the incidence is not affected by the prone position during the operation.
Anesthesia, General ; Humans ; Hypopharynx ; Incidence ; Laryngeal Masks* ; Laryngoscopes ; Pharyngitis* ; Prone Position* ; Supine Position

In the case of brachial plexus block, mixtures of local anesthetics can combine better features of both components, rapid onset and long duration. Combining effects may influence the onset and duration of neural blockade. Our study was undertaken in order to compare the onset time (time of injection to time of loss of pain on pin prick) and duration of analgesia (time of return of sense of pain on pin prick minus time required for onset of analgesia) of a lidocaine and bupivacaine mixture with 5 minutes interval injection of lidocaine and bupivacaine. The patients admitted to our hospital for hand or forearm operations were divided into three groups. In Group 1, 9 patients were injected with 0.5% bupivacaine 150 mg only, in Group 2, 11 patients were injected with a mixture of 29: lidocaine 200 mg and 0.5% bupivacaine 100 mg, in Group 3, 10 patients were injected with 2% lidocaine 200 mg and 5 minutes later, 0.5% bupivacaine 100 mg was injected through the same needle. Group 3 had the shortest onset time (7.2+/-0.2 minutes) with moderately long duration (9.4+/-2.4hours). Group 2 had a moderately rapid onset time (9.4+/-2.3 mintes) with the shortest duration (8.6+/-1.6 hours). Group 1 had the slowest onset time (14.8+/-4.3 minutes) with the longest duration (11.3+/-2. 4 hours). The time for analgesia to reach the C7 dermatome was the slowest in group 1 and Group 2, but in Group 3, there was no difference in the time needed to achieve analgesia in all dermatomes.
Analgesia ; Anesthetics, Local* ; Brachial Plexus ; Bupivacaine ; Forearm ; Hand ; Humans ; Lidocaine ; Needles

PURPOSE: To assess the clinical results of surgical treatment for established nonunion of the lateral humeral condyle and to determine the factors necessary for successful outcome. MATERIALS AND METHODS: 12 patients with nonunion of the lateral humeral condyle underwent open reduction, autogenous iliac bone graft and internal fixation with two smooth or treated K-wires between 1994 and 1999. Mean age was 16 years and the mean follow-up period was 2 years and 8 months. RESULTS: All of the patients achieved solid union at the nonunion site and were free of pain in the elbow upon strenuous activities. Average union time was 7.2 weeks after the surgery. Aggressive anatomical reduction of the fragment must not be undertaken because it may disturb a well adapted joint congruity in adults. Rigid internal fixation with iliac bone graft and preservation of the blood supply of the distal fragment are important factors for a successful outcome. The range of motion of the elbow joint decreased 10.5 degrees on average after surgery. Valgus deformity improved in four of six patients. CONCLUSION: The patients with symptomatic established nonunion are good candidates for surgery, even adults.
Adult ; Congenital Abnormalities ; Elbow ; Elbow Joint ; Follow-Up Studies ; Humans ; Joints ; Range of Motion, Articular ; Transplants

BACKGROUND: The laryngeal tube is a variant of the esophageal obturator airway. We compared laryngeal tube (LT), laryngeal mask airway classicTM (LMA) and laryngeal mask airway ProsealTM (PLMA) as a airway management device during general anesthesia. METHODS: Forty-five fasted healthy adult patients were enrolled in this study into one of three groups in a randomized, single-blinded protocol. Group 1 was to receive LT for airway management, LMA for Group 2, and PLMA for Group 3. General anesthesia was induced identically in three groups with thiopental sodium 5 mg/kg followed rocuronium 0.6 mg/kg. 90 seconds later, LT, LMA or PLMA was placed for airway management. Blood pressure and heart rate were measured immediately pre-induction control value, post-insertion of device 0 min, 1 min, 3 min and 5 min. We also compared times of insertion, the amounts of secretion, blood stain, and postoperative sore throat. RESULTS: There was no significant change of SBP, DBP and HR within three groups. All the groups showed stable hemodynamic results. The success rate on the first attempt was 93.6% (14/15, Group 1), 93.6% (14/15, Group 2) and 86.6% (13/15, Group 3). Minimum cuff volume to prevent gas leakage was 69.9+/-0.5 ml (Group 1), 11.1+/-4.3 ml (Group 2) and 11.9+/-3.2 ml (Group 3). The corresponding cuff pressure was 61.6+/-22.0 cmH2O (Group 1), 4.8+/-0.9 cmH2O (Group 2) and 4.6+/-1.5 cmH2O (Group 3). Moderate, severe sore throat was 20% (3/15, Group 1), 6.6% (1/15, Group 2) and 6.6% (1/15, Group 3). Moderate, profuse secretion was 40% (6/15, Group 1), 20% (3/15, Group 2) and 13.3% (2/15, Group 3). There was a 20% (3/15, Group 1) and 13.3% (2/15, Group 3) blood stain. But there was no blood stain for the Group 2. There was a 20% (3/15) gas leakage in Group 1, so we had to insert gas intermittently, but there were no gastric distension, regurgitation, aspiration, hypoxia, airway obstruction and laryngospasm in all three groups. CONCLUSIONS: All the groups revealed stable hemodynamics, no serious complications such as regurgitation, aspiration, hypoxia and airway obstruction during general anesthesia. But we did not find any evidence that LMA and PLMA have the remarkable advantages than laryngeal tube. So we suggested that laryngeal tube could be an alternative airway management device, even though further study will be needed.
Adult ; Airway Management ; Airway Obstruction ; Anesthesia, General* ; Anoxia ; Blood Pressure ; Blood Stains ; Heart Rate ; Hemodynamics ; Humans ; Laryngeal Masks* ; Laryngismus ; Pharyngitis ; Thiopental

BACKGROUND: Irregular antibodies are antibodies that are not regularly present in the serum of particular blood groups and its presence results in many problems including HDN (hemolytic disease of newborn) in transfusion medicine. Column agglutination test was recently introduced and has been widely used for advantages of standardized working procedures, standard reactions, stable reactions for hours and Coombs test without washing steps. We tested irregular antibodies in cord blood by column agglutination test and investigated its incidence and relation with HDN. METHODS: We tested the cord blood collected during delivery from 200 pregnant women. Column agglutination test was done on DiaMed ID MicroTyping System (DiaMed, Switzerland) and both LISS/Coombs and NaCl/Enzyme ID-cards were used. The antibody screening test was done first and antibody identification test was done to positive cases in same way. The cell typing and Rh phenotyping for cord blood of positive cases were also done. RESULTS: 2 cases of 200 samples (1%) were positive in the antibody screening test and each was identified as anti-D and anti-E antibody. CONCLUSIONS: Irregular antibody screening in cord blood by column agglutination test is thought to be helpful in early diagnosis and treatment of HDN.
Agglutination Tests* ; Agglutination* ; Antibodies ; Blood Group Antigens ; Coombs Test ; Early Diagnosis ; Erythroblastosis, Fetal ; Female ; Fetal Blood* ; Humans ; Incidence ; Infant, Newborn ; Mass Screening* ; Pregnant Women ; Transfusion Medicine

OBJECTIVE: The role of obesity in the pathogenesis of NIDDM has long been recognized. However, the relation between weight change and risk for diabetes has been less well defined and earlier studies have shown inconsistent results. We conducted a cross-sectional study to evaluate the relationship between weight change after 20 years of age and the risk of NIDDM in the Korean urban population. METHODS: From April 1997 to February 1998, we examined 642 subjects among a total of 776 persons aged over 30 years living in Mokdong apartment area selected using a random cluster sampling method for the survey of the prevalence of diabetes in urban area. After 75g oral glucose tolerance test, they were diagnosed with normal glucose tolerance or diabetes by WHO criteria. We excluded the subjects with impaired glucose tolerance. We obtained the data about weight change since 20 years of age and measured the current weight, height and waist-hip ratio. RESULTS: 1) Among 642 subjects, 46 were diabetic and the prevalence of diabetes was significantly increased with the increase of BMI in both men and women but with the increase of waist-hip ratio only in women. 2) The weight gain between 25 and 30 years of age was significantly greater in the subjects aged 30-39 than the older age groups. 3) In both men and women, weight gain of greater than 10 kg after 30 years of age increased the risk of diabetes. In women, weight gain greater than 20 kg between 20 years of age and the time of maximal obesity also increased the risk of diabetes. However, the significant risk factors for diabetes were age in men, whereas age and waist-hip ratio in women by multiple logistic regression analysis. 4) In women, weight gain less than 10kg after 30 years of age decreased the risk of diabetes, independent of age, BMI and family history of diabetes. CONCLUSION: Moderate weight gain after 30 years of age in women reduced the risk of diabetes. Extreme weight gain after 30 years of age in both men and women is related with high prevalence of diabetes. And in women, weight gain associated with pregnancy and otherwise after 20 years of age increased the risk of diabetes. However, the significance was disappeared after adjustment for age, BMI and family history of diabetes. The prospective study about the relationship between weight changes and the risk of diabetes would be needed.
Cross-Sectional Studies ; Diabetes Mellitus, Type 2* ; Female ; Glucose ; Glucose Tolerance Test ; Humans ; Logistic Models ; Male ; Obesity ; Pregnancy ; Prevalence ; Risk Factors ; Urban Population ; Waist-Hip Ratio ; Weight Gain

Forty patients with preeclampsia, undergoing general anesthesia for Cesarean section were studied. They were allocated randomly to receive either propofol 2.5 mg/kg and laryngeal mask insertion or thiopental sodium 4 mg/kg and endotracheal intubation for induction of anesthesia. All patients receiving thiopental sodium and tracheal intubation showed potentially dangerous reflex cardiovascular instability. There was a average 48.7 mmHg increase in systolic blood pressure after intubation. The patients receiving propofol and laryngeal mask insertion showed only 10.7 mmHg increase in systolic blood pressure. It is concluded that thiopental sodium induction and traeheal intubation of patients with preecalmpsia produces an increase in blood pressure which can lead to a risk of significant complication. Thus propofol induction and laryngeal mask seems to be a suitable anesthetic method in preeclampsia.
Anesthesia ; Anesthesia, General ; Blood Pressure ; Cesarean Section* ; Female ; Humans ; Intubation ; Intubation, Intratracheal ; Laryngeal Masks* ; Pre-Eclampsia* ; Pregnancy ; Propofol* ; Reflex ; Thiopental

BACKGROUND: In post-menopausal women, osteoporosis and cardiovascular diseases which are partly due to estrogen deficiency, occur more common than in pre-menopause women. Estrogen action is supposed to be mediated by an estrogen receptor (ER) and two polymorphisms of the ER gene in particular, Pvu II and Xba I, have been described for several years for genetic association studies. Authors have investigated the frequencies and patterns of the ER gene polymorphisms and their association with bone markers and lipid levels. METHODS: For 121 women who visited the health promotion center of Kyungpook National University Hospital, the ER gene polymorphisms were determined by the Pvu II and Xba I restriction enzymes following polymerase chain reaction. RESULTS: The distributions of ER Pvu II and Xba I restriction fragment length polymorphisms were as follows: PP 15.7%, Pp 47.9%, pp 36.4% and XX 5.8%, Xx 31.4%, xx 62.8%, respectively. And in a combination of two polymorphisms, ppxx was the most common, followed by PpXx, Ppxx, PPXx, PPXX and PPxx in that order. No significant genotypic differences were found in bone mineral density, bone markers and menopausal status. LDL cholesterol and triglyceride levels were significantly different by genotypes in premenopausal women (P<0.05). CONCLUSIONS: The results suggest that ER polymorphisms might be associated with LDL cholesterol and triglyceride levels. Further evaluation in a larger population would be helpful to determine the effects of ER polymorphisms on lipid metabolism and therapeutic trial for cardiovascular diseases in women.
Bone Density ; Cardiovascular Diseases ; Cholesterol, LDL ; Estrogens* ; Female ; Genetic Association Studies ; Genotype ; Gyeongsangbuk-do ; Health Promotion ; Humans ; Lipid Metabolism ; Osteoporosis ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Premenopause ; Triglycerides