OBJECTS: It has been reported that the incidence of tardive dyskinesia(TD), the remarkable abnormal involuntary movement, was higher in the schizophrenics with high blood sugar levels and that TD had been improved by small amount of insulin-injection for 90 days. And also it was generally known that the blood lipids were higher in the schizophrenics with tardive dyskinesia. Thus, we tried to replicate the correlations of abnormal involuntary movements with blood sugar levels and blood lipids in chronic schizophrenics treated with antipsychotics. METHODS: Thirty-eight male schizophrenic inpatients who were stable in clinical state with medications, were included. The patients who had been already diagnosed as diabetes mellitus(DM), organic brain disorder, substance-related disorder, physical illness were excluded and also we excluded female patients to remove the hormonal effect on TD. Eleven patients who ranked higher(above five) in the Abnormal Involuntary Movement Scale(AIMS) were assigned into 2 groups, a dibenese group and a placebo group. Diabinese or placebos were administrated for 3 weeks with antipsychotics and AIMS was rechecked. RESULTS: There were no correlations between the total AIMS scores and blood sugar and lipids levels in all subjects. The means of total and subscale scores(objective, face, and extremity) of AIMS did not reveal statistical significances between diabinese and placebo groups. However(total, jaw, face, upper arm, and objective feeling), were statistically higher in the diabinese group than those in the placebo group. And correlations of total cholesterol(TC) with fast blood sugar(FBS), weight with body mass index(BMI) and waist, total glycerol (TG) with BMI were statistically significant. CONCLUSION: In this study, there were statistical significances in the changes in ratings of AIMS scores between the diabinese group and the placebo group. Application of oral hypoglycemic agent might be a way of improving abnormal involuntary movements in schizophrenics with abnormal involuntary movements or TD. Althogugh it was not certain that there were correlations of abnormal involuntary movement with blood sugar and lipids, correlations of TC/TG with AIMS, of FBS with AIMS cautiously suggest that the regular check of HbA1C, waist, and weight are recommended for schizophrenics.
Antipsychotic Agents ; Arm ; Blood Glucose* ; Brain Diseases ; Chlorpropamide ; Dyskinesias* ; Female ; Glycerol ; Humans ; Hyperglycemia ; Hyperlipidemias ; Incidence ; Inpatients ; Jaw ; Male ; Movement Disorders ; Placebos ; Schizophrenia

Conventional angiography still remains the procedure of choice in evaluation of cerebral aneurysm. However, MRI and MR angiography can play different roles in vizualizing cerebral aneurysm. A 43-year-old male was evaluated for recurrent seizure attacks. The brain MRI showed non-enhancing iso-signal mass on T1WI, signal voiding mass with stalk-like structure on coronal T2WI in the right temporal region. MRA also revealed dark round signal. However, the conventional cerebral angiography failed to visualize it. Finally, the mass was confirmed as a huge aneurysm filled with intraluminal thrombus on operation. It should seem that contrast media could not fill the aneurysmal sac because of intraluminal thrombus in conventional angiography. But aneurysmal sac seemed to be visible on MRA as paramagnetic artifact of thrombus. So, it can be assumed that MRA is superior to the conventional angiography in some cases of cerebral aneurysm, especially when it is associated with intraluminal thrombus.
Adult ; Aneurysm ; Angiography* ; Artifacts ; Brain ; Cerebral Angiography ; Contrast Media ; Humans ; Intracranial Aneurysm* ; Magnetic Resonance Imaging ; Male ; Seizures ; Thrombosis

Six cases of nasal septum perforation were found among welders during periodic physical checkup in 1997. Considering the size, shape and margin, the perforations were assumed to have been occurred several years before of which the diameter were 8~15 mm. To investigate the cause of perforation, we reviewed the past history of preemployment, the results of annual working environment survey and the material safety data sheets of welding rods and steels with which they have dealt, and analyzed the concentration of several metals of welding fume and the concentration of blood and urinary chromium. In the result, we presupposed that the nasal septum perforations of welders were due to chronic exposure to low level hexavalent chromium and/or nickel, and report these cases with literatures review.
Chromium ; Material Safety Data Sheets ; Metals ; Nasal Septal Perforation* ; Nasal Septum* ; Nickel ; Steel ; Welding

PURPOSE: In western society, prophylaxis for venous thromboembolism (VTE) is the standard treatment under colorectal surgery for colorectal cancer. However, the incidence of VTE after colorectal surgery and the effect of prophylactic methods are not well known in Korea. The aim of this study is to evaluate the incidence of VTE and assess the efficacy and safety of low molecular weight heparin (enoxaparin) after major colorectal surgery in Korean patients with compression stockings. METHODS: From Jan. 2006 to Dec. 2008, 1,727 consecutive patients underwent major colorectal surgery. Thirty-six were excluded due to the therapeutic use of enoxaparin. A final number of 1,691 patients were included. Graduated compression stockings were used in all patients and 654 were perioperatively given enoxaparin. Only compression stocking group (group A) and compression stocking with enoxaparin group (group B) were compared in terms of VTE. The event of VTE within 6 months after surgery was counted by clinical symptoms, then imaging findings were used for confirmation. RESULTS: Total VTE developed in 10 patients (0.6%). Three with deep vein thrombosis had pulmonary embolism. Two had only pulmonary embolism. The rates of VTE were not different between group A and B (0.8% vs. 0.3%, P=0.333). Also, postoperative major bleeding was not significantly different. However, postoperative transfusion was higher in group B (P<0.001). CONCLUSION: The incidence of VTE was very low after colorectal surgery in Korean patients with compression stockings. The additional use of enoxaparin for colorectal cancer patients with compression stockings seems to have little benefit for VTE prophylaxis.
Colorectal Neoplasms ; Colorectal Surgery ; Enoxaparin ; Hemorrhage ; Heparin, Low-Molecular-Weight ; Humans ; Incidence ; Korea ; Pulmonary Embolism ; Stockings, Compression ; Venous Thromboembolism ; Venous Thrombosis

OBJECTIVE: The purpose of this study was to analyze the clinical study for patients with cervical cancer who had undergone radical hysterectomy. METHOD: The subjects of this study were one hundred and sixty two patients with cervical cancer who had undergone radical hysterectomy at Eulji Medical College Hospital, Taejon, Korea, from January 1983 to December 1992. We reviewed the medical record retrospectively and analyzed the data. RESULT: The distribution of patients by age was found in the order of 50 decade and 60 decade, 40 decade. Those by the clinical stages were as follows: Stage Ia, 12 cases(7.4%); Stage Ib, 84 cases(51.9%); Stage IIa, 39 cases(24.1%); Stage IIb 27 cases(16.7%). The results of histopathologic type were distributed as follows: squamous cell carcinoma was 91.9%, adenocarcinoma was 4.9% and adenosquamous cell carcinoma was 3.1%. The histologic subtypes of squamous cell carcinoma(149 cases) were as follows: Large cell non-keratinizing type was 75.9%, large cell keratinizing type was 14.8% and small cell type was 1.2%. The frequancy of lymph node metastasis was 22.9% in stage I and 31.8% in stage II. The overall incidence of lymph node metastasis was 26.4%. The frequency of external radiation therapy done after radical hysterectomy was 63.5% in stage I and 75.8% in stage II. The 5-year survival rate was as follows: The Ia was 100%; Stage Ib, 95.2%(4cases); Stage IIa, 87.2%(5cases); Stage IIb, 77.8%(6cases). The incidence of recurrence was 7.4% and recurrent sites were vaginal stump , rectum and pelvic wall. CONCLUSION: The highest incidence of cervix cancer in age distribution was 50 decade(30.9%) and 60 decade(30.9%). The most common clinical stage was Ib(51.9%) and most frequent pathologic type was squamous cell carcinoma(91.9%). The overall incidence of lymph node metastasis was 26.4% and The most common site of recurrence was vaginal stump. The 5-year survival rate was 100% in the stage Ia, 95.2% in the stage Ib, 87.2% in the stage IIa, 77.8% in the stage IIb.
Adenocarcinoma ; Age Distribution ; Carcinoma, Squamous Cell ; Daejeon ; Humans ; Hysterectomy* ; Incidence ; Korea ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis ; Rectum ; Recurrence ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms*

Purpose: The purpose of this study was to compare the concurrent validity and test-retest reliability of ‘KPIMT Torticollis Protractor’, a smart phone and I-pad application for convenient range of motion measurement, and ‘Image J’, an analysis software with high reliability and validity, according to head tilt and active cervical rotation angle. This was done to determine the clinical utility of ‘KPIMT Torticollis Protractor’. Methods: Head tilt and active cervical spine rotation angles of 40 children with congenital muscular torticollis were measured using Image J and KPIMT Torticollis Protractor, respectively. The level of concurrent validity and inter-rater and intra-rater reliability between the two measurement methods were analyzed. Results: For forty participants, the concurrent validity between Image J and KPIMT Torticollis Protractor showed very high validity with ICC of ICC 0.977 (0.995-0.999), 0.994 (0.994-0.998), CVME% 0.71-0.72%, SEM% 0.31-0.34%, MDC% 0.86-0.94%. The test-retest intra-rater reliability showed very high reliability ICC 0.911 (0.911-0.966), CVME% 0.71%, SEM% 0.34-0.36%, MDC% 0.81-0.94%. The test-retest inter-rater showed very high reliability ICC 0.936 (0.933-0.957), CVME% 0.70%, SEM% 0.34-0.35%, MDC% 0.81-0.83%. Conclusion The KPIMT Torticollis Protractor, a smart phone and IPD application, is a highly reliable and valid device for angle measurement in children with congenital myotonia and can be easily used in clinical practice.

OBJECTIVE: To evaluate the usefulness of serum concentrations of macrophage migration inhibitory factor (MIF) of patients with ovarian cysts for differential diagnosis of endometrioama. METHOD: From Jan. 2003 to Dec. 2004, preoperative serum MIF levels were assessed in 28 women with endometrioma, 32 with benign epithelial tumor, 23 with functional and simple cysts, 22 with benign mature cystic teratoma, and 25 women without ovarian tumor as control. MIF levels were determined using an ELISA (Quantikine Human MIF immunoassay, R&D Systems, Inc., USA). RESULTS: Mean MIF levels were higher in all groups with benign tumors than control (all p<0.01), but there was no significant difference between benign tumor groups (p=0.95). There was no significant correlation between MIF levels and tumor volume, body mass index (BMI) (p=0.635, 0.674 respectively) Serum MIF level had significant correlation with count of WBC and neutrophils (p=0.008, 0.024 respectively), but had no correlation with count of lymhocytes and monocytes (p=0.688, 0.294 respectively). CONCLUSIONS: This study showed a marked increase in MIF concentrations in the peripheral blood of patients with endometrioma, but there was no significant difference with other benign tumors. Serum MIF level had significant correlation with count of WBC and neutrophils. These suggest serum MIF level has no usefulness for differential diagnosis of endometrioma from other benign ovarian cysts.
Body Mass Index ; Diagnosis, Differential* ; Endometriosis* ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoassay ; Macrophages* ; Monocytes ; Neutrophils ; Ovarian Cysts* ; Teratoma ; Tumor Burden

BACKGROUND: In hypertensive patients, who show abnormal blood pressure(BP) response during exercise, more excessive blood pressure response may occur in the daily life, and cause end organ damage. However, previous studies about exaggerated BP response during exercise were not enough to investigate its significance and role in left ventricular hypertrophy. The purpose of this study was to determine the relation between exaggerated BP response during exercise and left ventricular hypertrophy. METHODS: The treadmill exercise test and echocardiography were performed in 117 patients with hypertension. Sixty six patients showed normal BP response, fifty one patients showed exaggerated BP response. Exaggerated BP response was defined as elevation of peak exercise systolic BP over 210 mmHg or >10 mmHg elevation of peak exercise diastolic BP from baseline. The correlation between BP response and left ventricular mass index were evaluated in two groups. RESULT: The results were as follows; 1. The peak systolic and diastolic BP were significantly higher in patients with exaggerated BP response than that in patients with normal BP response (p<0.05). 2. There was weakly significant relation between peak exercise systolic BP and left ventricular hypertrophy, but diastolic BP showed no significant correlation with left ventricular hypertrophy. 3. The left ventricular mass index was significantly increased in patients with exaggerated BP response (normal BP response: 12025 gm/m2, exaggerated BP response: 16946 gm/m2 , p=0.04). CONCLUSION: These results indicate that, as compared with resting BP, exercise BP response seems to be important in the treatment of hypertension and more strict blood pressure control may be needed in hypertensive patients with exaggerated BP response. Further study is needed to understand the significance of exaggerated BP response in hypertension.
Blood Pressure* ; Echocardiography ; Exercise Test ; Humans ; Hypertension* ; Hypertrophy, Left Ventricular*

STUDY DESIGN: An in vitro experiment. OBJECTIVES: To evaluate the mRNA expressions of matrix components, and analyze the cellular proliferation and proteoglycan synthesis of human intervertebral disc cells in response to dexamethasone and TGF-beta1 SUMMARY OF LITERATURE REVIEW: Corticosteroids are responsible for the regulation of a diverse range of biological processes through modulation of the expression of target genes. The direct injection of methylprednisolone to the intervertebral disc (IVD) has been shown to cause degeneration and calcification of the disc in rabbits. Systemic administration of hydrocortisone induced degeneration of notochordal cells, which accelerated the aging process of the disc in mice. Transforming growth factor beta-1 (TGF-beta1) is known as a potent agent for the proliferation, differentiation and matrix synthesis of IVD. MATERIALS AND METHODS: IVD cells were isolated from ten patients, and subsequently cultured. Various doses of dexamethasone (DEX) and/or TGF-beta1 were administered to the IVD cultures. DNA and proteoglycan syntheses were measured by the incorporation of [3H]-thymidine and [35S]-sulfate, respectively. RT-PCRs were performed for the expressions of aggrecan, collagen types I and II, and osteocalcin mRNA. RESULTS: Cultures with DEX showed increased cellular proliferation and decreased proteoglycan synthesis (p<0.05). TGF-beta1 potentiated the proliferative effect of DEX, but failed to stimulate proteoglycan synthesis in the cultures containing DEX. There were no recognizable changes in the mRNA expressions of aggrecan, collagen types I and II, and osteocalcin in response to DEX and TGF-beta1. CONCLUSIONS: DEX demonstrated a proliferative effect on human IVD cells, with the combination of DEX and TGF-beta1 showing potentiation of the proliferative effect, while at high doses(100 and 1000nM, the DEX was shown to down-regulate the proteoglycan synthesis. Caution should be exercised in the use of corticosteroid in the therapeutic approaches for the treatment of disc disease or in the regenerative matrix of the IVD.
Adrenal Cortex Hormones ; Aggrecans ; Aging ; Animals ; Biological Processes ; Cell Proliferation ; Collagen ; Dexamethasone* ; DNA ; Humans* ; Hydrocortisone ; Intervertebral Disc* ; Methylprednisolone ; Mice ; Notochord ; Osteocalcin ; Proteoglycans ; Rabbits ; RNA, Messenger ; Transforming Growth Factor beta1 ; Transforming Growth Factors

STUDY DESIGN: An in vitro experiment. OBJECTIVES: To assess the effect of pulsed sinusoidal EMF on human intervertebral disc (IVD) cells. LITERATURE REVIEW SUMMARY: Electromagnetic field (EMF) is known to modify some relevant physiological parameters of cells cultured in vitro, such as proliferation, synthesis, secretion of growth factors and transcription. EMF induces bone formation in delayed, non union and spinal fusion models. Also, the exposure of EMF has been shown to protect against the hazardous effect of smoking in the rabbit IVD. MATERIALS AND METHODS: Human IVD cells were three-dimensionally cultured in alginate beads and exposed to a 650 omega, 1.8millitesla magnetic flux density, 60Hz sinusoidal wave of EMF. The cultures were divided into the control and EMF groups, with various exposure times. The cytotoxicity, and DNA and proteoglycan syntheses were measured by the MTT assay, and [3H]-thymidine and [35S]-sulfate incorporation, respectively. RT-PCRs were performed for aggrecan, and collagen types I and II mRNA expressions. RESULTS: There was no recognizable cytotoxicity in the EMF group, but cellular proliferation was stimulated (p<0.05). Newly synthesized proteoglycan, normalized by DNA synthesis, was decreased in the EMF group (p<0.05) as were the expressions of aggrecan (48hour exposure) and type II collagen (72 hours exposure) mRNA compared to the control group. CONCLUSIONS: EMF seems to be hazardous in the synthesis of the chondrogenic matrix, while marginally beneficial in the cellular proliferation of human IVD cells.
Aggrecans ; Cell Proliferation ; Collagen ; Collagen Type II ; DNA ; Electromagnetic Fields* ; Humans* ; Intercellular Signaling Peptides and Proteins ; Intervertebral Disc* ; Magnets* ; Osteogenesis ; Proteoglycans ; RNA, Messenger ; Smoke ; Smoking ; Spinal Fusion