Transcutaneous electrical nerve stimulation (TENS), acupuncture-needling, and electroacu! Puncture are useful non-ablative methods in medical practice for relief of acute and chronic r pain These procedures appear to work by causing an increased discharge in afferent nerve fibers which in turn modifies the transmission of impulses in pain pathways. The present study was performed to evaluate the analgesic effects of peripheral nerve stimulation with different stimulatory parameters in decerebrated cats and spinalized cats. And we studied the effects of naloxone, a specific opiate antagonist, on analgesia produced by 50 Hz, C intensity conditioning stimulation. The electrical response of.spinal neurons was elicited either by electrical stimulation of the ipsilateral common peroneal nerve or tibial nerve, and then the single unit activity of the dorsal horn cell was recorded with a carbon filament-filled glass microelectrode at the lumbosacral spinal cord. The conditioning stimuli which provoke the pain inhibitory mechanism were applied to the cornmon peroneal nerve or tibial nerve with a relatively high frequency (25, 50, 200Hz) for 15, 30, and 60 seconds at suprathreshold intensity for A delta or C fiber. The results of the experiment are summarized as follows: 1. Peripheral conditioning stimulation at C strength showed larger analgesic effects than those produced by stimulation at A delta strength. And analgesic effects produced by conditioning stimulation for 30sec were greater than those produced by stimulation for 15sec, but showed no statistically significant difference from those produced by stimulation for 60 sec. 2. Analgesic effects produced by 50Hz conditioning stimulation were greater than thoseproduced by 25Hz stimulation. But 200Hz stimulation showed a lesser analgesic effect than 50 or 25Hz conditioning stimulation. 3. The analgesic effect produced by 50Hz conditioning stimulation was only slightly affected by naloxone, a specific opiate antagonist, indicating that involvement of an endogenous opiate system was minimal. 4. The analgesic effect produced by conditioning stimulation in decerebrated cats was nearly the same as in spinal cats suggesting that the neural circuitry responsible for the analgesic action seems to reside mostly within the spinal cord. From the above results, it is concluded that 1) frequency of stimulation is important for an efficient analgesia, i.e., stimulation with excessively high frequency decreases the analgesic effect, 2) the analgesic effect produced by high frequency conditioning stimulation may be minimally mediated by an endogenous opiate system, and 3) the site of analgesic action resides mainly in the spinal cord.
Analgesia ; Animals ; Carbon ; Cats ; Electric Stimulation* ; Glass ; Microelectrodes ; Naloxone ; Nerve Fibers ; Nerve Fibers, Unmyelinated ; Neurons ; Peripheral Nerves* ; Peroneal Nerve ; Posterior Horn Cells* ; Punctures ; Spinal Cord ; Tibial Nerve ; Transcutaneous Electric Nerve Stimulation

An effect of D-phenylalanine on the pain inhibitory mechanism of prolonged electrical stimulation of the peripheral nerve was studied in decerebrate cats and spinal cats. The response of spinal neurons was elicited either by electrical stimulation of the ipsilateral common peroneal nerve and tibial nerve. The single-unit activity of motor neurons which represent the flexion reflex was recorded from a filament of ventral rootlet divided from either the L7, S1 or S2 ventral root, and activity of dorsal horns cells was recorded with a microelectrode at the lumbosacral cord The conditioning stimuli which provocate the pain inhibitory mechanism of the common peroneal or tibial nerve was applied with repetitive, low frequency (2Hz), at a suprathreshold intensity for C fiber, for 30-45 minutes. The results of the experiment are summarized as follows: 1. Applying conditioning stimuli produced a powerful inhibition of the responses which was provocated by noxious stimuli in either the decerebrate or the spinal cat without any statistical difference, and this effect can be observed for 15 minutes after the cessation of the conditioning stlmuli 2. This response was reversed completely by systemic injection of a specific opiate antagonist, naloxone. It suggests that the conditioning stimulus of the peripheral nerve can produce the endogenous opiate related pain inhibitory effect as the spinal mechanism. 3. The conditioning stimuli can produce the analgesic effect by means of supression of the activity of the dorsal horn cell which was related to the pain response in the decerebrate cat. The same result could be observed in flexion reflex. 4. D-phenylalanine, a putative inhibitor of carboxypeptidase which degradates the endogenous opiate-enkephalin, was studied in this experiment under the hypothesis that D-phenylalanine will emphasize or prolongate the action of enkephalin. But, intravenously injected D-phenylalanine did not potentiate the inhibitory effect of the conditioning stimuli of the peripheral nerve. From the above result, it is speculated that the electrical stimulation of the peripheral nerve is directly mediated by an endogenous opiate related analgesia, and the site of the analgesic action resides mainly in spinal cord level. But these data could not support the gypothesis that antinociceptive effect of D-phenylalanine results frm the potentiation of endogenously released enkephalin.
Analgesia* ; Animals ; Cats* ; Electric Stimulation ; Enkephalins ; Horns ; Microelectrodes ; Motor Neurons ; Naloxone ; Nerve Fibers, Unmyelinated ; Neurons ; Peripheral Nerves* ; Peroneal Nerve ; Posterior Horn Cells ; Reflex ; Spinal Cord ; Spinal Nerve Roots ; Tibial Nerve

Condyloma acuminata, an uncommon disease in the pediatric patients, is being reported with increasing frequency in both adults and children. During the last 10 years, we had the opportunity to treat 11 children with condyloma acuminata in anogenital area. Patient age at presentation varied from 9 months to 11 years, and boys were outnumbered girls by a ratio of 2 : 1. The lesions were found in the perianal area in 9 patients, while the remaining had lesions localized to the genitalia. No history of sexual contact or abuse could be elicited. Although the exact mode of transmission of human papillomavirus (HPV) couldn't be defined, maternal-infant transmission at birth and close nonsexual family contact were the main possible causes of HPV infection in our patients. Our experience suggest that fulguration of the warts and concomitant scissors excision for the larger ones are the satisfactory method of treatment in children. However, based on our data we feel that condyloma acuminata has a high recurrence rate despite treatment. Viral typing and careful epidemiological investigation on a larger series of patients may further clarify the causal factors and effective modalities of treatment in childhood anogenital condyloma acuminata.
Adult ; Child* ; Female ; Genitalia ; Humans ; Parturition ; Recurrence ; Warts

In order to establish the predicted normal values of the systolic time intervals the duration of the systolic time intervals measured from simultaneous recordings of the electrocardiogram, the phonocardiogram and the carotid pulse tracing. The subjects studied were 160 healthy males and 160 females. The mean ages of males and females were 29 and 31 years old, respectively. The transformation period was not closely related to heart rate, and its mean values for males and females were 58 and 56 msec., respectively, and the mean for males and females combined was 57 msec. The remainder of the systolic time intervals, however, showed a significant linear and inverse relation to heart rate. Thus, based upon these data regression equations for the prediction of the normal values of electromechanical systole, left ventricular ejection time, mechinical systole, precjection period andisovolumiccontraction time for males, females, and males and females combined were obtained.
Adult ; Electrocardiography ; Female ; Heart Rate ; Humans ; Male ; Reference Values* ; Systole*

Isolated deficiency of 3-methylcrotonyl CoA carboxylase is a rare disorder of the catabolic pathway for leucine and many patients have mild symptoms or no symptom. However, the introduction of tandem mass spectrometry in newborn screening has revealed an unexpectedly high incidence of this disorder. We report an asymptomatic premature infant with isolated 3-methylcrotonyl CoA carboxylase deficiency detected by newborn screening program using tandem mass spectrometry. She was born at preterm, 36 weeks of gestation and her birth weight was 1,912 gm. She was delivered by Cesarian section due to maternal preeclampsia and oligohydramnios. An elevation of 3-hydroxyisovalerylcarnitine in a blood sample obtained at Seven days was detected by tandem mass screening. Massively elevated excretion of 3-hydroxyisovalerate and 3-methylcrotonylglycine was detected in the urine collected at 15 days. L-carnitine(100 mg/kg/day) was administrated orally to correct sencondary carnitine deficiency. Carnitine is conjugated with metabolites, to decrease the potential toxic effects. She is asymptomatic to date, and her growth and development are within normal limits.
Birth Weight ; Carnitine ; Female ; Growth and Development ; Humans ; Incidence ; Infant, Newborn* ; Infant, Premature ; Leucine ; Mass Screening* ; Oligohydramnios ; Pre-Eclampsia ; Pregnancy ; Tandem Mass Spectrometry*

BACKGROUND: Smoking prevention and anti-smoking education in schools must be designed and planned according to age and sex as well as the type of schools and their smoking status. But the current education programs do not consider these factors. This study, therefore, aims to evaluate the actual status of the smoking prevention and anti-smoking education in Korea and to find present recommendations for an effective and, systematic education. METHODS: We surveyed 15,310 teen-age students attending middle schools and high schools in such cities as Seoul, Incheon, Bucheon, Mokpo, and Pohang and smaller areas in the vicinity of these cities from June 1 to 15, 2005. Self-survey was done by the health education teacher of each school. It contained questions about the general disposition of respondents, their smoking habits, and awareness programs on prevention and cessation of smoking. We used SPSS 12.0 for chi-square-test to analyze the collected data. RESULTS: The most prevailing form of anti-smoking education was "video". Most of the students surveyed said that the fourth or fifth grade of elementary school will be a good starting point for anti-smoking education. Only 39.6% of students who were educated by the current smoking prevention and anti-smoking program answered that it was "helpful" and 29.6% was "satisfied". Higher percentage of middle school students said that they either tried to quit smoking ('pre-contemplation') or had no intention of doing it ('termination-fail') after having been involved in the anti-smoking education program, while high school students turned out to be more oriented towards 'contemplation' and 'termination-success'. CONCLUSION: Some students were found to begin smoking even at an early grade in elementary school. Most adolescents knew about the danger of smoking, but current smokers had a low educational satisfaction. The real target of such education programs, however, should be focused on higher grade students in elementary schools and middle school students, because data show that smoking rate increases explosively among these students.
Adolescent ; Surveys and Questionnaires ; Education* ; Gyeonggi-do ; Gyeongsangbuk-do ; Health Education ; Humans ; Incheon ; Intention ; Jeollanam-do ; Korea ; Seoul ; Smoke* ; Smoking Cessation ; Smoking*

Carcinoembriogenic antigen (CEA) was widely used as a marker for staging and detection of recurrence and metastases, and evaluation of response of radical opertion or chemotherapy in colorectal cancer patients. METHODS: We examined 50 patients with sigmoid colon and rectal cancer patients who had a radical operation between 1994 May and 1995 April. We checked the level of CEA of peripheral blood preoperatively and postoperatively, and inferior mesenteric vein, bile of gall bladder and peritoneal fluid during surgery. We review clinical characters of the patients, and analyzed the importance of CEA level. RESULTS: The mean CEA levels of peripheral blood (postoperation), inferior mesenteric vein, bile, peritoneal fluid were 5.35+/-2.65, 13.23+/-2.13, 9.23+/-1.65, 7.42+/-2.34 ng/ml respectlively. The mean CEA level of inferior mesentiric vein (13.23+/-2.13 ng/ml) was significantly higher than that of preoperative peripheral blood (8.13+/-2.34 ng/ml) (p<0.05). Falling of postoperative peripheral blood CEA level was also significantly lower than that of preoperative level (p<0.05). CONCLUSIONS: Level of postoperative peripheral blood was related to recurrence rate and survival rate, but tumor size, tumor location, tumor differentiation, Dukes' stage were not related to the CEA level. Bile and peritoneal fluid CEA levels were related with the liver metastasis or local recurrence respectively. We suggest that CEA was useful indicator for evaluation, management, and prognosis of colorectal cancer not only preoperatively but also postoperatively.
Ascitic Fluid* ; Bile* ; Colon, Sigmoid* ; Colorectal Neoplasms ; Drug Therapy ; Humans ; Liver ; Mesenteric Veins* ; Neoplasm Metastasis ; Prognosis ; Rectal Neoplasms* ; Recurrence ; Survival Rate ; Urinary Bladder ; Veins*

There are some reports showing that an experience of long-enduring pain causes a change in the pain transmission system, suggesting a plastic nature of the nociceptive system. However, most of the studies concerning the analgesic effect of peripheral nerve stimulation dealt with normal animal or human subjects. So, the present study was undertaken to investigate the effect of peripheral nerve stimulation on the dorsal horn cell activity using a tonic pain model, which was made by producing a cutaneous inflammation. The main results are summarized as follows. 1) The evoked activity by electrical or natural stimulation as well as spontaneous activity was enhanced, and the receptive field size was also expanded by the inflammation. 2) Peripheral nerve conditioning stimulation reduced the C-response of the dorsal horn cell in the normal and inflamed group, and the degree of inhibition between the two groups showed no significant difference. 3) Inhibition of the C-response of the dorsal horn cells by peripheral conditioning stimulation was completely reversed by naloxone in the inflamed group whereas there was a partial block in the normal group.
*Analgesia ; Animal ; Cats ; Dermatitis/*physiopathology ; *Electric Stimulation Therapy ; Endorphins/physiology ; Female ; Genes, fos ; Male ; Naloxone/pharmacology ; Nerve Fibers/physiology ; Peripheral Nerves/*physiology ; Support, Non-U.S. Gov't

Although bladder cancers are very common, little is known about their molecular pathogenesis. It is known, that p53 alteration is found in about 60%p of muscleinvasive bladder cancer, necessiating aggressive therapy and poor outcome. We examined the nuclear expression of p53 protein, using D07 monoclonal antibody in the urine samples, from 31 patients with transitional cell carcinoma of the bladder to investigate the correlation of p53 overexpression with histologic grades and depth of invasion. The positive rate of p53 protein was 27%o in superficial bladder tumor, but increased up to 71% in the invasive bladder carcinomas. The overexpression of p53 protein increased according to Mostofi grading system from 18% in grade I, 45% in grade Il, and up to 100% in grade ill. The p53 expression tended to be higher in the invasive and high grade bladder cancers than in the superficial and low grade ones(p<0.05). These results suggest that immunohistochemical analysis of the urine specimen in the bladder cancer patients could be a useful method of screening for the presence of p53 mutant protein. The mutant p53 protein expression may be an indicator of bladder cancer with more proliferative potential and/or aggressive biologic behavior.
Carcinoma, Transitional Cell ; Genes, p53* ; Humans ; Immunohistochemistry ; Mass Screening ; Mutant Proteins ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Abnormalities of p53 gene are common in lung cancers and are associated with immunologically detectable p53 protein. p53 immunoreactivity is uncommon in normal cells but is frequently seen in neoplasia. Therefore, assessment of p53 expression may assist in the cytological diagnosis of malignancy. The usefulness of p53 immunostaining as a marker of malignancy in the cytological analysis of bronchial brush specimens from the patients with lung cancers was investigated in this study. A total of 71 bronchial brush samples submitted for cytologic diagnosis were immunostained with D07, a monoclonal antibody to recombinant p53 protein. Resultant p53 data were correlated with cytologic diagnosis and clinical information. Of the 17 smears with a benign cytodiagnosis, all were p53 negative. Of the 40 cases with a malignant cytodiagnosis(histologically confirmed), 35 were p53 positive and 5 were negative. Of the 14 cases that were cytologically suspicious but nondiagnostic for malignancy, 11 were p53 positive, 9 of which were subsequently proved to be malignant by histologic examination, and the remaining 2 cases were tuberculosis clinically. Forty four of 51 histologically confirmed lung carcinomas were p53 positive, including 25 of 28 squamous cell carcinomas, 13 of 17 small cell carcinomas, 3 of 3 adeno- carcinomas, and 3 of 3 large cell undifferentiated carcinomas. These results suggest that p53 immunostaining could be of value as a marker of malignancy in the cytologic examination of bronchial brush specimens. Furthermore, we have shown the possible clinical utility of p53 immunostaining in cytopathological diagnosis, that is, as a valuable adjunct to morphological assessment in the analysis of cytopathologically suspicious cases.
Carcinoma ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Cytodiagnosis ; Diagnosis ; Genes, p53 ; Humans ; Immunohistochemistry ; Lung ; Lung Neoplasms ; Tuberculosis