No abstract available.
Seizures*

No abstract available.
Child* ; Encephalitis* ; Humans

Open long bone fracture is frequently difficult to reduce and maintain, especilly when there is extensive soft tissue damage. Infection, instability, malalignment and soft tissue complication often result in prolonged mobidity or failure. The Hoffmann's apparatus have merits, that can easily correct distracted, angular or rotational deformity of fracture site during early post-operative period, and stable fixation facilitates easily to the care of soft tissue injury. In addition, the affected limb can be elevated with balanced suspension, possible early exercise of neighboring joints. But we have exerienced some problems during treatment of fracture with Hoffmann's transfixation method. From February 1980 to December 1981, Hoffmann's transfixation method was employed in treatment of twenty-one patients that considered to have a poor prognosis with conversional forms of treatment. The results were obtained as follows; 1. For correction of distracted, angular, or rotational deformity, the fracture site should be reduced accurately. 2. Hoffmann pins should be transfixed as one plane and parrallel to each other. 3. Rigidity of fixation can be increased by increasing number of pins, actually three or more pins should be applied at each fragment of fracture. 4. Hoffmann's apparatus is more complex for management, more expensive and requires skillful technique compared with other external fixation apparatus. 5. The lateral view of fracture site could not be confirmed accurately due to overlapping of Hoffmann's adjustable connecting rod and bony shadow. 6. The main cause of injuries was due to traffic accidents in 17 cases (81%), involving tibia in 18 cases, femur in 2 cases and humerus in 1 case. 7. In the sixteen cases which could be assessed, the average times for external transfixation was 13.9 weeks and then followed by early weight bearing with P.T.B. cast or brace. The average time of bony union was 26.4 weeks. 8. The final result was excellent in 7 cases, good in 5 cases, acceptable in 3 cases, poor in 1 case.
Accidents, Traffic ; Braces ; Congenital Abnormalities ; Extremities ; Femur ; Fractures, Bone ; Fractures, Open ; Humans ; Humerus ; Joints ; Methods ; Prognosis ; Soft Tissue Injuries ; Tibia ; Weight-Bearing

BACKGROUND: Prospective studies suggest that C-reactive protein (CRP) is a novel and indepen-dent risk factor of coronary heart disease. High-sensitivity methods for CRP (hs-CRP) measurement are needed for this purpose. In this study, we evaluated the performance of Cobas Integra 700 (Roche Diagnostics, Basel, Switzerland) and aimed to establish the distribution of serum CRP concentrations in healthy Koreans with the hs-CRP method. METHODS: The subjects of this study were 853 males (age; 45.9 +/- 9.8 years) and 546 females (age; 45.7 +/- 10.8 years) who visited the Health Promotion Center of the Asan Medical Center for routine health checks. Hs-CRP was measured with the Cobas Integra 700. The within-day precision, the between-day precision, the degree of correlation, the linearity, and the detection limit of hs-CRP were also analyzed with the Cobas Integra 700. RESULTS: The within-day coefficients of variation (CVs) were 0% and 1.3%. The between-day CVs were 4.0% and 3.0%. The percentage of relative nonlinearity was 0.78%. The correlation coefficient of the Cobas Integra 700 with the Behring Nephelometer was 0.994. The lower detection limit was 0.064 mg/L and the functional detection limit was 0.472 mg/L. The geometric mean concentration of CRP in Koreans was 0.69 mg/L. The mean CRP of the male population was 0.79 mg/L, which was higher than that of Korean females (0.54 mg/L) (P<0.0001). There was a significant trend to higher CRP values with increasing age (P<0.05). CONCLUSIONS: The linearity, the precision, the correlation, the detection limit of the Cobas Integra 700 were satisfactory. The age and sex-specific guidelines for hs-CRP would make the early intervention for coronary heart disease possible.
C-Reactive Protein* ; Chungcheongnam-do ; Coronary Disease ; Early Intervention (Education) ; Female ; Health Promotion ; Humans ; Limit of Detection ; Male ; Risk Factors

BACKGROUND: Postmenopausal osteoporosis is the main problem in women, but senile osteoporosis is believed to occur after 65 years and affects men and women equally. Measurement of biochemical markers in conjunction with bone mineral density (BMD) determination can detect individual patients at the greatest risk of developing osteoporosis. METHODS: We measured serum osteocalcin levels as a bone formation marker, and urinary deoxypyridinoline (DPD) levels as a bone resorption marker, in 2190 men (from 22 to 83 year-old), and 1209 women (from 25 to 80 year-old). The age and sex related variations of serum osteocalcin and urinary DPD levels were analysed. The serum osteocalcin and urinary DPD levels were compared with BMD. These biochemical bone turnover markers were compared with each other. RESULTS: In women, serum osteocalcin and urinary DPD levels were increased with age from forties to sixties, after then showed decrease from seventies. In men, serum osteocalcin levels were slightly decreased with age, but DPD levels were slightly increased with age in men. These biochemical bone markers and BMD showed negative correlations. Osteocalcin and DPD levels showed positive correlations, especially in women. Osteocalcin levels were higher in men than women, age before fifth decades but lower in men than women after fifties. DPD levels was higher in women than men through all the age. CONCLUSION: Osteocalcin and DPD levels showed age and sex related variations in healthy Koreans. In management of patients with a risk of osteoporosis, consideration of variations according to the age and sex should be given.
Biomarkers ; Bone Density ; Bone Resorption ; Female ; Humans ; Male ; Middle Aged* ; Osteocalcin* ; Osteogenesis ; Osteoporosis ; Osteoporosis, Postmenopausal

BACKGROUND: The structure of lipoprotein(a) [Lp(a)] includes a low-density lipoprotein cholesterol (LDL-C) component and apolipoprotein(a) [apo(a)] linked to apolipoprotein B-100 of LDL-C with a disulfide bond. Liver cirrhosis is the only disease in which the decrease of serum Lp(a) concentra-tion is observed as a secondary effect. In this study, we tried to investigate the mechanisms for the Lp(a) decrease in cirrhotic patients. METHODS: Forty Child 's class A cirrhotic patients, 40 Child 's class C patients from Asan Medical Center, and 80 healthy controls were recruited. Serum concentrations of interleukin-6 (IL-6), LDL-C, Lp(a), and free apo(a) were measured. RESULTS: The serum concentrations of Lp(a) in the Child 's class C patients were significantly lower than those in class A and the control group (P < 0.05). The apo(a) concentrations in the Child 's class C patients were significantly lower than those in class A and the control group (P < 0.05). The LDL-C concentrations of Child 's class C patients were significantly lower than those in class A and the con-trol group (P < 0.01). The IL-6 concentrations of Child 's class C patients were significantly higher than those in class A and the control group (P < 0.005). Serum concentrations of Lp(a) showed positive correlations with those of LDL-C (r=0.42, P < 0.0001) and with those of the free apo(a) (r=0.68, P < 0.0001). But serum concentrations of IL-6 had no correlation to those of the Lp(a) or the free apo(a). CONCLUSIONS: Considering the positive correlation between Lp(a) and LDL-C, the decrease in the serum Lp(a) in cirrhotic patients could be due mainly to the decrease in the LDL component, although we could not suggest the mechanism for the LDL decrease.
Apolipoprotein B-100 ; Apolipoproteins* ; Apoprotein(a)* ; Child ; Cholesterol ; Cholesterol, LDL* ; Chungcheongnam-do ; Humans ; Interleukin-6 ; Lipoprotein(a)* ; Lipoproteins* ; Liver Cirrhosis* ; Liver*

BACKGROUND AND PURPOSE: Variant alleles of CYP2C9 and VKORC1 account for differences in anticoagulation response. We sought to establish a warfarin dosing formula for individualized target International Normalization Ratio of Prothrombin Times (INRs) using data from single nucleotide polymorphisms (SNPs) in VKORC1 and CYP2C9 in Korean patients. METHODS: Ischemic stroke patients displaying stable target INR for at least 3 months before enrollment were analyzed. Warfarin and vitamin K levels were measured to adjust for confounders. Phenotypes were defined using the 'warfarin response index' (WRI) defined as INR divided by the daily maintenance warfarin dose. We tested SNPs in CYP2C9 (3 sites: 430C>T (rs1799853), 1075A>C (rs1057910), 1076T>C) and VKORC1 (14 sites: 381C>T, 861C>A (rs17880887), 2653G>C, 3673A>G, 5496G>T, 5808T>G (r17882154), 6009C>T, 6484T>C (rs9934438), 6853C>T (rs17886369), 7566T>C, 8767G>C, 8814T>C, 9041G>A (rs17880624), and 9071G>T) using a standard sequencing method. Multivariate linear regression analysis was applied to establish the formula for warfarin dosage. RESULTS: All 204 patients had excellent drug compliance. The mean INR was 2.22 (+0.56) and mean daily maintenance dose of warfarin was 3.92 mg (+1.54). Patients with low WRI were younger (P<0.001) with high body mass index (P=0.003), high prevalence of wild-type CYP2C9 polymorphism (1075A>C, P<0.001), and six heterozygote SNPs in VRORC1 (P<0.001), which were tightly interlinked (381T>C, 3673G>A, 6484T>C, 6853C>G. 7566C>T, 9041G>A) (r2=1). Based on these data, a warfarin dosing formula was established. CONCLUSIONS: WRI is influenced by age, body mass index and SNPs in VKORC1 and CYP2C9 in Korean stroke patients. The obtained warfarin dosing formula may be clinically applicable.
Alleles ; Body Mass Index ; Compliance ; Genotype ; Heterozygote ; Humans ; International Normalized Ratio ; Linear Models ; Phenotype ; Polymorphism, Single Nucleotide ; Prevalence ; Prothrombin Time ; Stroke ; Vitamin K ; Warfarin

PURPOSE: To date, the risk factors for central venous port-related bloodstream infection (CVP-BSI) in solid cancer patients have not been fully elucidated. We conducted this study in order to determine the risk factors for CVP-BSI in patients with solid cancer. MATERIALS AND METHODS: A total of 1,642 patients with solid cancer received an implantable central venous port for delivery of chemotherapy between October 2008 and December 2011 in a single center. CVP-BSI was diagnosed in 66 patients (4%). We selected a control group of 130 patients, who were individually matched with respect to age, sex, and catheter insertion time. RESULTS: CVP-BSI occurred most frequently between September and November (37.9%). The most common pathogen was gram-positive cocci (n=35, 53.0%), followed by fungus (n=14, 21.2%). Multivariate analysis identified monthly catheter-stay as a risk factor for CVP-BSI (p=0.000), however, its risk was lower in primary gastrointestinal cancer than in other cancer (p=0.002). Initial metastatic disease and long catheter-stay were statistically significant factors affecting catheter life span (p=0.005 and p=0.000). Results of multivariate analysis showed that recent transfusion was a risk factor for mortality in patients with CVP-BSI (p=0.047). CONCLUSION: In analysis of the results with respect to risk factors, prolonged catheter-stay should be avoided as much as possible. It is necessary to be cautious of CVP-BSI in metastatic solid cancer, especially non-gastrointestinal cancer. In addition, avoidance of unnecessary transfusion is essential in order to reduce the mortality of CVP-BSI. Finally, considering the fact that confounding factors may have affected the results, conduct of a well-designed prospective controlled study is warranted.
Case-Control Studies* ; Catheter-Related Infections ; Catheters ; Drug Therapy ; Fungi ; Gastrointestinal Neoplasms ; Gram-Positive Cocci ; Humans ; Mortality ; Multivariate Analysis ; Risk Factors*

BACKGROUND AND PURPOSE: Charcot-Marie-Tooth disease (CMT) type 1A (CMT1A) is the demyelinating form of CMT that is significantly associated with PMP22 duplication. Some studies have found that the disease-related disabilities of these patients are correlated with their compound muscle action potentials (CMAPs), while others have suggested that they are related to the nerve conduction velocities. In the present study, we investigated the correlations between the disease-related disabilities and the electrophysiological values in a large cohort of Korean CMT1A patients. METHODS: We analyzed 167 CMT1A patients of Korean origin with PMP22 duplication using clinical and electrophysiological assessments, including the CMT neuropathy score and the functional disability scale. RESULTS: Clinical motor disabilities were significantly correlated with the CMAPs but not the motor nerve conduction velocities (MNCVs). Moreover, the observed sensory impairments matched the corresponding reductions in the sensory nerve action potentials (SNAPs) but not with slowing of the sensory nerve conduction velocities (SNCVs). In addition, CMAPs were strongly correlated with the disease duration but not with the age at onset. The terminal latency index did not differ between CMT1A patients and healthy controls. CONCLUSIONS: In CMT1A patients, disease-related disabilities such as muscle wasting and sensory impairment were strongly correlated with CMAPs and SNAPs but not with the MNCVs or SNCVs. Therefore, we suggest that the clinical disabilities of CMT patients are determined by the extent of axonal dysfunction.
Action Potentials ; Axons ; Charcot-Marie-Tooth Disease ; Cohort Studies ; Humans ; Muscles ; Neural Conduction

The publisher wishes to apologize for incorrectly displaying the author (Seok Beom Gwon) name. We correct his name from Seok Beom Gwon to Seok Beom Kwon.