PURPOSE: To obtain the findings of normal variant types of lower cervical body configuration for the purpose of differention from compression fracture. MATERIALS AND METHODS: We retrospectively analysed simple true lateral radiographs of cervical spine from C3 to C7 in 157 pediatric patients who did not have definitive clinical symptoms of cervical spinal injury. We classified the variations of normal cervical spine into 5 types by their configuration. In case of rounded upper corner or anteriorly wedged type, we measured the height and the width of vertebral body to classify these types, and undertook ANOVA test and multiple range test to determine the correlation between the gross configuration and the measured values. RESULTS: Type 1 was similarly observed at each of C3 to C7 in age of 1-4 group but the frequency was markedly decreased in age of 5-8 group. Type 2a was frequently observed at both age groups, and its incidence increased considerally at C3 and C4 with advancing age. Type 2b was more frequently observed at C3 body and Type 3 was observed only at C3 body in age group 1-4. Type 4 was markedly increased at 5-8 age group. Type 2b and 3 were seen mostly at C3, but sometimes at C4 body. Height of body was statistically more significant than width of body in classification of type 2a, 2b and 3. CONCLUSION: The configuration of lower cervical spine in infants and children changes from immature oval type(type 1) to mature rectagular type(type 4) with increasing age. Among the 4 types, the rounded upper corner type or anterior wedging type of lower cervical spine should be differentiated from compresson fracture. We concluded that the height of cervical body is more significant than the width of body in simple radiographic classification of types 2a, 2b and 3.
Child* ; Classification ; Fractures, Compression ; Humans ; Incidence ; Infant* ; Retrospective Studies ; Spinal Injuries ; Spine

BACKGROUND: In a circle system, gas that is to be reused is cleared of carbon dioxide by passing through a canister containing a chemical CO2 absorbent. In anesthesia textbooks the utilization time of carbon dioxide is nearly always specified to last about 5 hours. The soda lime used was noted to regenerate its efficiency for CO2 absorption after being exhausted. Two different types of soda lime (a ROK product and USA product) were analyzed in patients for their duration of carbon dioxide absorption from the anesthetic closed circle system and re-use time after being exhausted. METHODS: General inhalation anesthesia was performed using a PhysioFlex anesthesia machine. To determine the duration of carbon dioxide absorption by soda lime and the re-use time after being exhausted, twenty seven (ROK; 20 and USA; 7) and fifty (ROK; 22 and USA; 28) adult patients were studied. Duration of CO2 absorption was determined as the time for the inspired CO2 concentration to reach 0.5%. The color change of ethyl violet in soda lime was observed throughout the study. Duration of CO2 absorption was compared by unpaired t-test. Re-use time of each group was analysed by simple regression; p less than 0.05 was considered significant. RESULTS: Duration of CO2 absorption was 2.67 +/- 2.12 hrs for the ROK product and 9.52 +/- 0.68 hrs of USA product, and they were different significantly (P < 0.05). Regression equations of ROK- and USA-products werey (min) = 5.761x + 45.701 (r2 = 0.0438, P = 0.3496, x means day after being exhausted) and y = 0.6x + 33.179 (r2 = 0.0158, P = 0.5233) respectively. A color change of ethyl violet in ROK soda lime was not observed throughout the chemical reaction. CONCLUSIONS: From the above results we suggest that ROK soda lime is not effective yet to use for CO2 absorption in clinical anesthesia. It is marked shorter than that of the USA soda lime. A color change of ethyl violet was not observed throughout the chemical absorption reaction in ROK soda lime. Re-use time of both soda limes were not related with the duration after being exhausted.
Absorption* ; Adult ; Anesthesia ; Anesthesia, Inhalation ; Carbon Dioxide ; Citrus aurantiifolia ; Humans ; Viola

BACKGROUND: Detection of antibodies to extractable nuclear antigens (ENAs) and dsDNA is needed for the diagnosis of and predicting prognosis in systemic autoimmune diseases. Recently introduced line immunoassay (LIA) has the advantage of detecting several autoantibodies simultaneously, and we evaluated its usefulness in the diagnosis of autoimmune diseases in comparison with enzyme-linked immunosorbent assay (ELISA). METHODS: Samples were collected from 437 patients referred by rheumatologists. FANA (fluorescent antinuclear antibody) test and LIA for the detection of 13 different autoantibodies, including 6 ENAs and dsDNA were performed. LIA-positive samples for ENA or dsDNA antibodies were further tested with ELISA. Final diagnosis was made by rheumatologists according to the diagnostic criteria. Agreement of results between LIA and ELISA was analyzed in 53 selected patients with systemic autoimmune diseases. RESULTS: The LIA detected antibodies to ENA and dsDNA in 118 and 22 patients, respectively, and ELISA detected 70.3% (83/118) and 45.5% (10/22) of LIA positive samples. Especially, 60.2% (71/118) of patients with positive ENA antibody on LIA was diagnosed as systemic autoimmune diseases. Patients having strong FANA titer and homogenous/speckled pattern showed higher prevalence of autoantibodies, but a small proportion of FANA negative patients also showed positive reactivity (LIA 10.8%, ELISA 5.2%). LIA showed a good agreement with ELISA for the anti-ENA antibodies (> or =80%), and a lower agreement for the anti-dsDNA antibody (67.9%). CONCLUSIONS: LIA detecting several autoantibodies simultaneously might replace ELISA for anti-ENA antibodies, but not for anti-dsDNA antibodies. When LIA is performed considering clinical manifestations and FANA, it could contribute to the diagnosis of systemic autoimmune disease.
Antibodies, Antinuclear/*analysis ; Antigens, Nuclear/immunology ; Autoimmune Diseases/*diagnosis ; DNA/*immunology ; Enzyme-Linked Immunosorbent Assay ; Female ; Fluorescent Antibody Technique, Indirect ; Humans ; *Immunoassay ; Male ; Middle Aged ; Reagent Kits, Diagnostic ; Reproducibility of Results

BACKGROUND: Obesity is defined as an excess accumulation of body fat. To measure body fat accurately is difficult, but body mass index (BMI, kg/m2) is easily available for routine clinical use. METHODS: A total of 4,966 (male; 2,580, female; 2,386) patients from January to September in 1997 and aged up to 90 years old were studied for BMI. Among these subjects, obstetric patients were excluded in our study. We calculated the BMI as weight (kg) per height squared (m2). The heights and weights of study subjects were obtained from anesthesia records. The BMI was analyzed by 4 different age groups: group 1 (less than 3 years), group 2 (between 3 to 7 years), group 3 (between 8 to 17 years), and group 4 (18 years or more), decade of age, 4 obesity categories according to BMI levels: underweight (less than 18 kg/m2), normal weight (19-24.9 kg/m2), overweight (25-29.9 kg/m2), and obese (30 kg/m2 or more), and surgical departments. RESULTS: Mean BMI values of group 1, 2, 3, and 4 were 16.1+/-2.9 kg/m2, 16.2+/-2.4 kg/m2, 19.2+/-3.7 kg/m2 and 23.3+/-4.6 kg/m2 in males and 15.7+/-3.9 kg/m2, 15.8+/-2.7 kg/m2, 19.4+/-3.5 kg/m2 and 23.6+/-3.7 kg/m2 in females, respectively. According to generations, the BMI under teen-age was 16.3+/-2.7 kg/m2 and 14.3+/-2.9 kg/m2 in males and females respectively while it was between 20.4+/-3.3 kg/m2 to 25.0+/-3.6 kg/m2 from 1st to 7th decade patients in both sex. The prevalence of overweight and obesity were nearly zero in group 1 and 2, but males in group 3 had them of 4.6% and 1.4% while 6.9% and 0.8% in females, respectively. In group 4 they were 25.3% and 2.2% in males and 28.8% and 4.8% in females, respectively. Obese patients increased in the order of neurosurgery, gynecology, orthopedic surgery, urology, and general surgery departments. CONCLUSIONS: This study revealed the guidelines of BMI of operating patients. We recognized that the prevalence of overweight and obesity of preschool aged and adolescent patients were nearly zero. Adult patients were the highest at 4th decade in males and 6th decade in females and the obesity rates were 27.4% and 33.6% in males and females, respectively.
Adipose Tissue ; Adolescent ; Adult ; Aged, 80 and over ; Anesthesia ; Body Mass Index* ; Family Characteristics ; Female ; Gynecology ; Humans ; Male ; Neurosurgery ; Obesity ; Orthopedics ; Overweight ; Prevalence ; Thinness ; Urology ; Weights and Measures

OBJECTIVE: This study was done to propose a new method of determining the cutoff frequency against measurement noise in fetal heart rate signal and to analyze the discriminating value for normal fetus (pH>7.15) and abnormal fetus (pH< or =7.15) by nonlinear method. METHODS: The patients were classified by umbilical artery pH (7.15) or base excess (-10 mEq/L). After removing the high frequency noise components at the cutoff frequency determined in this study, we calculated correlation dimension as a discriminating value for the normal and abnormal fetuses. RESULTS: After low pass filtering of fetal heart rate signal at the cutoff frequency, the numerical result of embedding dimension was 5.47+/-0.67 (normal), 4.43+/-0.60 (abnormal) (p<0.001), and correlation dimension was 2.51+/-0.43 (normal), 1.79+/-0.15 (abnormal). CONCLUSION: We could determine the cutoff frequency from the different fluctuation level between high frequency noise and principal signal according the cutoff frequency function. The detection of fetal distress was done objectively by this method. We could discriminate between normal fetus and abnormal fetus by correlation dimension as indicator for the nonlinear complexity.
Female ; Fetal Distress ; Fetal Heart* ; Fetus ; Heart Rate, Fetal* ; Humans ; Hydrogen-Ion Concentration ; Noise* ; Pregnancy ; Umbilical Arteries

BACKGROUND: Bacterial extract consisting of immuno-stimulating components derived from 18 Escherichia coli (E. coli) strains has been used for the prophylaxis of recurrent cystitis. Catechin, extract of green tea, has antimicrobial effect against uropathogens. To evaluate the anti-inflammatory effect of E. coli extract and green tea, we measured the cytokine levels from bladder tissue after oral administration and analyzed bladder inflammation by histopathologic examination in a model of lipopolysaccharide (LPS)-induced cystitis in mice. MATERIALS AND METHODS: After 10-day administration of E. coli extract or catechin, cytokine [interleukin-6 (IL-6), IL-10, monocyte chemoattractant protein-1 (MCP-1), interferon-gamma (IFN-gamma), Tumor necrosis factor-alpha (TNF-alpha), IL-12p70] levels in the bladder of female BALB/c mice were measured using cytometric bead array. Bladder macrophage inflammatory protein-2 (MIP-2) level was also measured using sandwich enzyme immunoassay. After immunization with E. coli extract and catechin E. coli LPS was instilled into the bladders. Twenty-four hours later, mice were sacrificed and inflammation of the bladder were quantified using the bladder inflammatory index (BII). RESULTS: Significant increases of IL-6 and IFN-gamma in bladder tissue were observed after treatment with E. coli extract and catechin. IL-12p70 level was only elevated in bladder tissue of the catechin group. Bladder instilled with LPS showed high inflammation scores for edema, leukocyte infiltration, and hemorrhage in saline treated control mice. In contrast, E. coli extract and catechin treated mice exhibited mild inflammation with significant reduction of BII scores compared to controls. CONCLUSION: These results demonstrate that immunization using oral E. coli extract and green tea provides protection from inflammatory responses in a mouse model of LPS-induced cystitis.
Administration, Oral ; Animals ; Catechin ; Chemokine CCL2 ; Cystitis* ; Edema ; Escherichia coli* ; Escherichia* ; Female ; Hemorrhage ; Humans ; Immunization ; Immunoenzyme Techniques ; Inflammation ; Interferon-gamma ; Interleukin-10 ; Interleukin-6 ; Leukocytes ; Macrophages ; Mice* ; Tea* ; Tumor Necrosis Factor-alpha ; Urinary Bladder

BACKGROUND: Bacterial extract consisting of immuno-stimulating components derived from 18 Escherichia coli (E. coli) strains has been used for the prophylaxis of recurrent cystitis. Catechin, extract of green tea, has antimicrobial effect against uropathogens. To evaluate the anti-inflammatory effect of E. coli extract and green tea, we measured the cytokine levels from bladder tissue after oral administration and analyzed bladder inflammation by histopathologic examination in a model of lipopolysaccharide (LPS)-induced cystitis in mice. MATERIALS AND METHODS: After 10-day administration of E. coli extract or catechin, cytokine [interleukin-6 (IL-6), IL-10, monocyte chemoattractant protein-1 (MCP-1), interferon-gamma (IFN-gamma), Tumor necrosis factor-alpha (TNF-alpha), IL-12p70] levels in the bladder of female BALB/c mice were measured using cytometric bead array. Bladder macrophage inflammatory protein-2 (MIP-2) level was also measured using sandwich enzyme immunoassay. After immunization with E. coli extract and catechin E. coli LPS was instilled into the bladders. Twenty-four hours later, mice were sacrificed and inflammation of the bladder were quantified using the bladder inflammatory index (BII). RESULTS: Significant increases of IL-6 and IFN-gamma in bladder tissue were observed after treatment with E. coli extract and catechin. IL-12p70 level was only elevated in bladder tissue of the catechin group. Bladder instilled with LPS showed high inflammation scores for edema, leukocyte infiltration, and hemorrhage in saline treated control mice. In contrast, E. coli extract and catechin treated mice exhibited mild inflammation with significant reduction of BII scores compared to controls. CONCLUSION: These results demonstrate that immunization using oral E. coli extract and green tea provides protection from inflammatory responses in a mouse model of LPS-induced cystitis.
Administration, Oral ; Animals ; Catechin ; Chemokine CCL2 ; Cystitis* ; Edema ; Escherichia coli* ; Escherichia* ; Female ; Hemorrhage ; Humans ; Immunization ; Immunoenzyme Techniques ; Inflammation ; Interferon-gamma ; Interleukin-10 ; Interleukin-6 ; Leukocytes ; Macrophages ; Mice* ; Tea* ; Tumor Necrosis Factor-alpha ; Urinary Bladder

Adenoid basal carcinoma of the cervix is very rare tumor. It is slow-growing and locally invasive tumor amenable to simply hystrectomy. It is common to be associated with severe dysplasia and carcinoma in situ(CIS) of cervix Occasionally, concommitant microinvasive squamous cell carcinoma or adenocarcinoma may also be seen. Differential diagnosis includes adenoid cystic carcinoma, which is more aggressive tumor associated with regional lymph node involvement and late pulmonary metastasis. We have recently experienced a case of adenoid basal carcinoma of the cervix in 61 years-old woman, which is presented with a brief review of the literature.
Adenocarcinoma ; Adenoids* ; Carcinoma, Adenoid Cystic ; Carcinoma, Squamous Cell ; Cervix Uteri* ; Diagnosis, Differential ; Female ; Humans ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis

PURPOSE: Glucosamine (UDP-N-acetyl)-2-epimerase/N-acetylmannosamine kinase (GNE) myopathy is an autosomal recessive neuromuscular disorder characterized by early adult-onset weakness of the distal muscles of the lower limbs. The clinical spectrum of GNE myopathy varies, and it is not clear how the same GNE gene mutations can result in different phenotypes. Here, we present clinical, pathological and genetic characteristics of twenty-one Korean patients with GNE myopathy. MATERIALS AND METHODS: Twenty-one GNE myopathy patients were included in this study, conducted from 2004 to 2011. Based on medical records, patients' gender, onset age, family history, clinical history, serum creatine kinase (CK) level, neurologic examination, findings of muscle biopsy, muscle imaging findings and electrophysiologic features were extensively reviewed. Mutation of the GNE gene (9p13.3) was confirmed by DNA direct sequencing analysis in all patients. RESULTS: The mean onset age was 23.8+/-8.8 years (mean+/-SD). Patient serum CK levels were slightly to moderately elevated, ranging from 41 to 2610 IU. Among the patients, twelve patients were female and nine patients were male. Except for eight patients, all of the patients presented initially with only distal muscle weakness in the lower extremities. The most common mutation was V572L, followed by C13S. CONCLUSION: The clinical manifestations of our patients with GNE mutations varied. Among twenty-one patients, thirteen patients showed the typical GNE myopathy phenotype. There was no relationship between clinical features and site of mutation. Therefore, we suggest that neither homozygous nor compound heterozygous models are correlated with disease phenotype or disease severity.
Adolescent ; Adult ; Creatine Kinase/blood ; Distal Myopathies/diagnosis/*genetics/pathology ; Female ; Humans ; Male ; Multienzyme Complexes/*genetics ; Republic of Korea ; Sequence Analysis, DNA

Local epidemiologic data on the etiologies of patients hospitalized with community-acquired pneumonia (CAP) is needed to develop guidelines for clinical practice. This study was conducted prospectively to determine the proportion of atypical bacterial pathogens in adults patients hospitalized with CAP in Korea between October 2001 and December 2002. Microbiological diagnosis was determined by serology for antibodies to Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneu-mophila. Nucleic acid of M. pneumoniae and C. pneumoniae in respiratory samples and Legionella antigen in urine samples were detected. The study population consisted of 126 patients (71 males, 55 females), averaging 54.6 yr (SD+/-17.8), whose paired sera were available. An etiologic diagnosis for atypical pathogens was made in 18 patients (14.3%): C. pneumoniae 9 (7.1%), M. pneumoniae 8 (6.3%), and L. pneumophila 3 patients (2.4%). Streptococcus preumoniae and other typical pathogens were isolated from 36 patients (28.6%). Of 126 patients, 16 (12.7%) were admitted to intensive care unit and atypical pathogens were identified in 5 patients (31.3%). Initial clinical features of patients with pneumonia due to atypical, typical or undetermined pathogens were indistinguishable. We conclude that atypical pathogens should be seriously considered in hospitalized patients with CAP, when initiating empiric treatment in Korea.
RNA, Ribosomal, 16S/genetics ; Prospective Studies ; Polymerase Chain Reaction ; Pneumonia, Bacterial/blood/*microbiology/urine ; Mycoplasma pneumoniae/genetics/immunology/*isolation & purification ; Middle Aged ; Male ; Legionella pneumophila/genetics/immunology/*isolation & purification ; Korea ; Humans ; Hospitalization/statistics & numerical data ; Female ; Community-Acquired Infections/microbiology ; Chlamydophila pneumoniae/genetics/immunology/*isolation & purification ; Antigens, Bacterial/urine ; Antibodies, Bacterial/blood ; Aged ; Adult