In vivo 31P NMR spectroscopic study of forearm wrist flexor muscles was performed in two groups of volunteers composed respectively of 6 sedentaries and 6 canoe athletes. A continuous isometric contraction of endurance exercises was adopted in oder to assess the endurance capacity and recovery potential of skeletal muscles. Differences in high energy phosphorus metabolism between the sedentaries and athletes were evaluated with and emphasis on the intracellular pH and Pi/PCr ratio as indicators of high energy phosphorus metabolism. There were no differences of baseline pH and Pi/PCr ratio between the two groups. The athletes sustained the exercise at more acidic intracellular pH and at a higher Pi/PCr ratio of intracellular conditions for an all-out than did the sedentaries. The recovery rate of pH showed no difference between the two groups. There was a tendency of faster recovery of Pi/PCr in athletes showing half recovery time(T1/2) of 39.0±3.0 seconds as compared to that of sedentaries (55.7±7.5 seconds). The recovery rate of Pi/PCr as a function of Pi/PCr ratio at a given period of time was significantly faster in athletes than in sedentaries (P<0.001). The correlation coefficient of the recovery rate of Pi/PCr against the Pi/PCr ratio was 0.985 and 0.914 respectively for the athletes and sedentaries. The pH and the Pi/PCR ratio at an all-out state can be used as indicators of endurance capacity and the recovery rate of Pi/PCr, as a reovery potential of skeletal muscles.
Athletes* ; Exercise ; Forearm ; Humans ; Hydrogen-Ion Concentration ; In Vitro Techniques* ; Isometric Contraction ; Metabolism ; Muscle, Skeletal* ; Muscles ; Phosphorus ; Volunteers ; Wrist

OBJECTIVES: In the third trimester hypertensive pregnancies, we would like to evaluate effects of white coat hypertension, severity of hypertension and diurnal variation of blood pressure on the fetal outcome by using 24- hour ambulatory blood pressure monitoring. METHODS: Hypertensives(n=50) and normotensives (n=14) in the third trimester of the pregnancy underwent 24-hour ambulatory blood pressure monitoring. We excluded hypertensives(n=5) who became pre-eclampsia patients. Hypertensives(n=45) were classified as white coat hypertensives(n=14, mean ambulatory blood pressure <139/87mmHg) and sustained hypertensives(n=31). Sustained hypertensives(n=31) were divided as moderate to severe hypertensives(n=5, systolic blood pressure >160 mmHg or diastolic blood pressure >100mmHg) and mild hypertensives(n=26). Sustained hypertensives were also divided into two groups which had diurnal variation of blood pressure or not. To exclude effects of hypertension severity, effects of diurnal variation were evaluated in hypertensives with similar mean arterial blood pressure. Gestational age, body weight, body weight for gestational age were used as parameters of the fetal outcome. RESULTS: 1) The prevalence of white coat hypertension was 28%(14/50). 2) There were no significant differences in the fetal outcome between normotensives(n=14) and white coat hypertensives(n=14). 3) Body weight of fetus and body weight for gestational age in moderate to severe hypertensives(n=5) were less than those of mild hypertensives(n=26), but gestational age was not significantly different between two groups. 4) Body weight of fetus and body weight for gestational age in sustained hypertensives without diurnal variation(n=10) were less than those with diurnal variation(n=8), but gestational age was not significantly different between two groups. 5) All hypertensives who became pre-eclampsia (n=5) were severe hypertensives and had no diurnal variation of blood pressure. CONCLUSION: White coat hypertension in the third trimester was quite often and did not affect on the fetal outcome. The more severe hypertension and/or absence of diurnal variation of blood pressure caused poor fetal outcome. Patients who became pre-eclampsia were severe hypertensives and had no diurnal variation of blood pressure. Ambulatory blood pressure monitoring may have several roles in the antenatal management of hypertenison.
Arterial Pressure ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory* ; Body Weight ; Female ; Fetus ; Gestational Age ; Humans ; Hypertension ; Pre-Eclampsia ; Pregnancy Trimester, Third ; Pregnancy* ; Prevalence ; White Coat Hypertension

PURPOSE: This article aims at evaluating the results of treatment which excise the intradural extramedullary tumor using surgical microscope, mainly concerned by the field of orthopaedic surgery. MATERIALS AND METHODS: A retrospective review was carried out on 11 cases who were operated on for the excision of intradural extramedulary tumor in two hospitals from June 2001 to May 2007. Of the 11 cases, there were 3 males, and 8 females with an average age of 62.4 (33-78) years. Average follow-up period is 18.8 (1-78) months. Patients were diagnosed by MRI and pathological diagnosis was analyzed. The clinical evaluation was made by the index of VAS (visual analogue scale) and Cooper- Epstein grade. RESULTS: 7 cases were Schwannoma and 4 cases were meningioma. The VAS take a favorable turn from average 9.4 before practice to final follow-up 2.4, and the Cooper-Epstein grade take a favorable turn from average 2.4 to final follow-up 0.7 CONCLUSION: A fine result of excision of the intradural extramedullary tumor with using surgical microscope could be acquired even in the field of orthopedic surgery.
Female ; Follow-Up Studies ; Humans ; Male ; Meningioma ; Neurilemmoma ; Orthopedics ; Retrospective Studies

BACKGROUND/AIMS: Various magnifying endoscopic classifications have been introduced in esophageal and gastric lesions. However, studies on an agreement between observers according to the form classification of magnifiying endoscopic findings have not been performed yet. The aim of this study was to determine the interobserver agreement for magnifying endoscopic classifications. METHODS: The patients were divided into 3 groups. The first group of patients had post-EMR ulcer scar (50 cases), the second group, elevated gastric lesion (38 cases), and the third group, gastritis (43 cases). Two mucosal patterns were used in the post-EMR ulcer scar group, 6 mucosal patterns in the elevated gastric lesion group, and 3 patterns of the collecting venule in the gastritis group. Three experienced observers (A, B, C) blinded to the patients' data participated in this study. The agreement between observers was evaluated by calculated kappa. The kappa value of 0.75 or greater was rated excellent, 0.4~0.74, fair to good, and 0.4 or less, poor. RESULTS: Regarding 2 mucosal pattern in post-EMR ulcer scar, agreements between A and B, A and C, and B and C were 0.896, 0.793, and 0.901, respectively (p<0.01). Regarding 6 mucosal patterns in elevated gastric lesion, agreements between A and B, A and C, and B and C were 0.607, 0.458, and 0.557, respectively (p<0.01). Regarding 3 collecting venule pattern in gastritis, agreements between A and B, A and C, and B and C were 0.822, 0.823, and 0.751, respectively (p<0.01). CONCLUSIONS: Interobserver agreement is good to excellent in mucosal pattern and collecting venule by magnifying endoscopy. However magnifying endoscopic classification needs to be refinded in order to improve an agreement between observers.
Cicatrix ; Classification ; Endoscopy* ; Gastritis ; Humans ; Ulcer ; Venules

Differentiation of renal(RH) and non-renal(NRH) hematuria is important in the diagnosis and treatment of the patients with hematuria. Recently, urine RBC immunoperoxidase(IPx) staining method was developed, but there was no report on the usefulness of IPx in Korea. We validated the usefulness of IPx by comparing with the PCM. Both PCM and IPx were performed at the same time in 26 patients with RH confirmed by renal biopsy and 23 patients with NRH confirmed by radiologic and/or pathologic studies who were admitted to Chungbuk National University Hospital from January 1996 to December 1996. The age of RH and NRH group were 36.6+/-15.0 and 56.5+/-22.2 years. 35.7+/-30.4% of urine RBC were stained by IPx in RH group and only 1.6+/-4.4% were stained in NRH group(P<0.001). 23.4+/-29.9% of urine RBC by PCM were counted as dysmorphic RBC in RH group and 5.7+/-13.6% were counted in NRH group(P<0.05). At the cut-off value of 20%, the sensitivity and specificity of IPx were 57.7% and 100%. At the cut-off value of 30%, those of PCM were 30.9% and 95.7%, respectively. When comparing overall test performance by calculating AUCs of ROC(receiver operating characteristics) curve, IPx was better than PCM. IPx was better than PCM in localizing the origin of hematuria. The NRH might be excluded when IPx(+) cells are more than 20% of total urine RBC.
Area Under Curve ; Biopsy ; Chungcheongbuk-do ; Diagnosis ; Hematuria* ; Humans ; Korea ; Microscopy, Phase-Contrast* ; Sensitivity and Specificity ; Uromodulin

Background/Aims: Idiopathic multicentric Castleman disease (iMCD) comprises approximately 30% of all cases of Castleman disease. It is characterized by constitutional symptoms, enlarged lymph nodes at multiple anatomical sites, and laboratory test abnormalities, which are primarily related to the overproduction of interleukin 6 (IL-6). Siltuximab is a human-mouse chimeric immunoglobulin G1κ monoclonal antibody against human IL-6. In view of the limited treatment options for iMCD, this study aimed to evaluate the efficacy and safety of siltuximab in the management of this condition. Methods: In this real-world retrospective study, we administered siltuximab to 15 patients with iMCD who previously received conventional chemotherapy and/or steroid pulse therapy. The median time to a durable symptomatic response was 22 days (range, 17 to 56). The serum hemoglobin and albumin levels and erythrocyte sedimentation rates significantly normalized after the first 3 months of siltuximab treatment. Lymph node involution, assessed using imaging, was relatively gradual, demonstrating a complete or partial response at 6 months. Results: On an average, the improvements in clinical, laboratory, and radiologic parameters of iMCD in responders were observed after one, three, and eight cycles of siltuximab treatment, respectively. Siltuximab demonstrated a favorable safety profile, and prolonged treatment was well-tolerated. Conclusions Despite the small sample size of the present study, the results are encouraging and demonstrate the potential of siltuximab as the first-line treatment of iMCD. Further large multicenter studies are needed to evaluate the clinical outcomes and adverse events associated with siltuximab.

Background: Arsenic trioxide (ATO) is the standard treatment for relapsed acute promyelocytic leukemia (APL). However, consensus on post-remission therapies is still lacking. Methods: We evaluated 52 patients who experienced relapse following initial treatment of APL between 2000 and 2019 at Catholic Hematology Hospital. Among them, 41 patients received reinduction treatment, 30 with ATO-based regimen, whereas 11 with conventional intensive chemotherapy (IC). Results: The ATO reinduction group showed a significantly higher second molecular complete remission (mCR2) rate, superior neutrophil and platelet recovery, and a lower infection rate than the IC reinduction group. No significant differences were observed in survival outcomes after post-remission treatment among the ATO-based (N=19), autologous (N=12), and allogeneic (N=6) hematopoietic stem cell transplantation (HSCT) groups. In the ATO-based and autologous HSCT groups, among patients with mCR2 after ATO reinduction, nine and five patients experienced a second relapse, respectively (50.7% vs. 41.7%, P =0.878). Among these patients, seven received salvage allogeneic HSCT; six remained alive. The other seven patients received ATO without HSCT. Five died from disease progression, and two survived and have been in mCR2 since. Conclusion Post-remission treatment outcomes of patients with relapsed APL were not significantly different, regardless of the treatment option, suggesting the feasibility of ATO-based treatment without HSCT in mCR2. Allogeneic HSCT may be an effective salvage treatment modality for patients with a second relapse. Owing to a few cases of relapsed APL, multicenter prospective studies may help elucidate the efficacy of each post-remission treatment.