BACKGROUND: A tourniquet is commonly used to achieve a bloodless field in surgery of the extremities. However, the anesthesiologist is concerned about the adverse effects of hypertension which occur during general anesthesia. In this study, we assessed the effects of lidocaine infiltration in the tourniquet site on blood pressure and heart rate during tourniquet inflation under general anesthesia. METHODS: Forty patients of ASA class I or II, scheduled for knee surgery, were randomly divided into two groups. In group 1 underwent general anesthesia and in group 2 also underwent general anesthesia and combined with 1% lidocaine infiltration in the tourniquet site. The changes of systolic and diastolic blood pressure and heart rate were measured before and after toumiquet inflation, after skin incision and 30 min after inflation. RESULTS: Comparing group 1 with group 2, there were significant increases after tourniquet inflation to 30 min after inflation in systolic and diastolic blood pressure in group 1 (p<0.05). However, there were no significant changes in heart rates in either group. CONCLUSIONS: The above results demonstrate that patients who received lidocaine infiltration in the tourniquet site showed less increase in blood pressure during tourniquet inflation.
Anesthesia, General ; Anesthetics ; Blood Pressure* ; Extremities ; Heart Rate* ; Heart* ; Humans ; Hypertension ; Inflation, Economic ; Knee ; Lidocaine* ; Skin ; Tourniquets*

Objective tinnitus which may be caused by contraction of the tensor tympani and stapedial muscles is extremely rare. We present a case of middle ear myoclonus with voluntary palatal myoclonus in a musician. Otologic examination demonstrated rhythmic involuntary movement of the tympanic membrane after the exposure of loud sound or blowing of the musical instrument. Impedance audiometry confirmed the motion of tympanic membrane and those movements correlated with a tinnitus perceived by the patient. Palatal myoclonic motion, voluntarily evoked by the patient, was observed by oral examination and heard by Toynbee tube objectively. Medical treatment and directive counseling were effective for voluntary palatal myoclonus. However, the main symptom of tinnitus caused by middle ear myoclonus was not changed. The patient's tinnitus was cured by tympanotomy with sectioning of the tensor tympani and stapedial tendons.
Acoustic Impedance Tests ; Diagnosis, Oral ; Directive Counseling ; Dyskinesias ; Ear, Middle* ; Humans ; Muscles ; Music ; Myoclonus* ; Tendons ; Tensor Tympani ; Tinnitus* ; Tympanic Membrane

BACKGROUND AND OBJECTIVES: The purpose of this study were to evaluate the therapeutic efficacy of canalith repositioning maneuver (CRP) according to accompanying mastoid percussion and to investigate the prognostic factors that may affect successful repositioning maneuver and the recurrence of benign paroxysmal positional vertigo. MATERIALS AND METHOD: A total of 70 patients with canalith type BPPV visiting the dizziness clinic of Kangnam St. Mary's Hospital were included in this study. Variables identified for statistical analysis were patient's age, sex, maneuver method, number of involved canal, number of CRP and dizziness handicap inventory. RESULT: Overall success rate of CRP was 90%. The mean number of maneuver was 1.6 and the recurrence rate was 25.7% during the follow up period. Success rate of CRP (94.9%) was higher than maneuver without mastoid percussion (83.9%) though it was not statistically significant. Successful CRP group showed the significant less number of maneuvers at initial treatment session and less number of involved canal than failed CRP group at the time of one week-follow up visit. Patients with recurrence of BPPV had the more number of CRP during the period of previous BPPV. CONCLUSION: Therapeutic efficacy of CRP with mastoid percussion was higher than CRP without mastoid percussion though it was not statistically significant. Suggesting prognostic factors for effective CRP and recurrence were number of CRP and number of involved canal.
Dizziness ; Follow-Up Studies ; Humans ; Mastoid ; Percussion ; Prognosis ; Recurrence ; Vertigo*

OBJECTIVES: While other cytokines are known to be associated with otitis media with effusion (OME), the involvement of heat shock protein 70 (HSP70) in middle ear effusion (MEE) is unknown. This study was undertaken to investigate the possibility of there being a HSP70 expression in human MEE and to determine its potential role as a cytokine in OME. METHODS: The levels of HSP70, tumor necrosis factor-alpha and interleukin-1beta were measured by enzyme-linked immunosorbent assay in the effusion of different groups of OME patient following collection of the MEE using our new collection system. The clinical characteristics of the OME patients and the MEE status were analyzed. RESULTS: HSP70 was expressed in all the types of MEE. The mucous and seromucous effusions showed higher HSP70 levels than that of the serous effusion. The HSP70 level was correlated with the levels of tumor necrosis factor (TNF)-alpha and interleukin (IL)-1beta in the effusions. The positive correlations between HSP70, TNF-alpha and IL-1beta were statistically significant (P<0.05). CONCLUSION: The highly elevated level of HSP70 in the seromucous and mucous effusions implicates this protein in the chronicity of OME.
Cytokines ; Ear, Middle ; Enzyme-Linked Immunosorbent Assay ; Heat-Shock Proteins ; HSP70 Heat-Shock Proteins ; Humans ; Interleukin-1beta ; Interleukins ; Otitis Media with Effusion ; Tumor Necrosis Factor-alpha

BACKGROUND AND OBJECTIVES: The Chronic Ear Survey (CES) has been known to be a valid, disease-specific measure for the evaluation of health status and treatment effectiveness for chronic otitis media patients. As part of this study, we developed a Korean version by adapting from this CES, determined its reliability and validity. MATERIALS AND METHOD: The development of the Korean version of CES (K-CES) included the processes of standard independent translation and cross-cultural adaptation to check for cultural inconsistency. The finalized K-CES was administered to 166 patients visiting 10 referral hospitals in a prospective manner. K-CES was validated by using the Cronbach's alpha coefficient, confirmatory factor analysis and test-retest analysis for reliability and validity. The 36-Item Short Form Health Survey Instrument (SF-36) was assessed and the result was used to evaluate the criterion validity. RESULTS: The K-CES demonstrated good test-retest reliability and internal consistency (Cron-bach's alpha=0.850). Scale-item correlation coefficient was even higher than 1.0, which shows a very high reliability of K-CES. The validity of K-CES, checked by confirmatory factor analysis, also showed good construct validity. There was high correlation between SF-36 and the scores of K-CES, which indicates high criterion validity. CONCLUSION: We concluded that K-CES is a valid tool for clinical use and research studies in Korean patients with chronic otitis media.
Ear ; Health Surveys ; Humans ; Otitis Media ; Prospective Studies ; Referral and Consultation ; Reproducibility of Results ; Treatment Outcome

BACKGROUND: Several attempts have been made to expand human NK cells from peripheral blood mononuclear cells (PBMCs). This study examined the selective expansion of NK cells using interleukin 2 (IL-2) plus the K562 cell line, the expression of the NK cell receptors, and the cytotoxic activity. METHODS: The PBMCs from seven healthy volunteers were cultured in a medium containing the IL-2 plus the K562 cell line for 14 days. The expression of the activating and inhibitory receptors on the resting NK cells and the 72 hr-expanded NK cells were analyzed. A flow cytometric cytotoxic assay was used to determined the killing activity of the non-expanded NK cells and the 7 day-expanded NK cells against the K562 target cells. RESULTS: The NK cells from PBMCs expanded 4.5-fold after 7 days, and contained 56.5% CD3-CD56+ cells. The IL-2 or IL-2 plus K562 increased the expression levels of CD158b (MFI, mean florescence intensity), CD158e1/e2 (MFI), and NKp44 (MFI), while it decreased the expression levels of NKp30 (%), CD16 (MFI), and 2B4 (MFI). The non-expanded NK cells lysed 9.0% and 27.6% of the K562 target cells in the 1 : 1 and 5 : 1 effector and target ratio, respectively, and the 7-day expanded NK cells lysed 36.9% and 57.2% of the K562 target cells, respectively. CONCLUSION: The selective expansion of CD3-CD56+ NK cells occurred only during 7 days of culture. IL-2 or IL-2 plus the K562 cells altered the expression of various activating and inhibitory receptors of NK cells, and the cytotoxicity of the expanded NK cells was higher than in the non-expanded cells.
Cell Line* ; Healthy Volunteers ; Homicide ; Humans ; Interleukin-2* ; K562 Cells ; Killer Cells, Natural* ; Receptors, Natural Killer Cell

With a purpose to difine risk factors of respective subtypes of cerebrovascular disease, a case-control study was performed in 1,251 cases with cerebrovascular disease who were admitted to twelve large institutions over the country during the year of 1988. All cases were subtype-proven by computerized tomography. Three hundred and eighty three patients were selected as control among the patients who were admitted to the same hospitals during the same period. The variables were collected prospectively and the data were processed by univariate and multiple logistic regression analyses and the significance was tested by chi-square methods. In the univariate analysis, female sex, being a physical worker, history of hypertension either treated or not and previous stroke history were significantly related with cerebral hemorrhage. Male sex, being aged 60 or more, living in city area, being a mental worker, history of hypertension either treated or not, history of stroke, being a diabetic and positive family history of stroke were significantly related with cerebral infarction. In multiple logistic regression analysis hypertension and alcohol drinking were strong independent risk factors for cerebral hemorrhage. Hypertension, being aged 60 or more, and living in urban area were also independent risk facrots for cerbral infarction. Of the other variables analyzed, socioeconomic class, smoking history or body mass index did not constitute significnat risks for either cerebral hemorrhage or cerebral infarction.
Alcohol Drinking ; Body Mass Index ; Case-Control Studies ; Cerebral Hemorrhage ; Cerebral Infarction ; Female ; Humans ; Hypertension ; Infarction ; Korea* ; Logistic Models ; Male ; Prospective Studies ; Risk Factors* ; Smoke ; Smoking ; Stroke

Background: DNA prevalence and type distribution of human papillomavirus (HPV) varies geographically. We investigated HPV prevalence and type distribution in Korean women using the MyHPV DNA chip testing. Methods: A total of 2,368 women from five regions of the country underwent Pap smear examination and MyHPV chip testing. Results: Overall HPV positivity was 15.8% and 78.4% in women with normal and abnormal cytology, respectively. High-risk HPV infection was strongly correlated with cytological atypia. In women with abnormal cytology, the five most common HPV types were 16, 58, 18, 52, and 56/53, and HPV16 was significantly the most common type in most geographical regions. After HPV16, HPV58, and 52 were the next most frequently detected types. Women with normal cytology, in contrast, showed heterogeneity in HPV type distribution. High-grade intraepithelial lesions infected with HPV16, 18, 31 or 45 are more likely to progress to carcinoma. Conclusions: The HPV chip test can provide useful data regarding HPV positivity and type. The most common HPV type in Korean women with abnormal cytology is HPV16, with HPV58 and 52 being frequently present. Our data may have important implications for vaccination programs and the development of cervical screening.
Cervix Uteri ; DNA ; Female ; Genotype ; Humans ; Mass Screening ; Oligonucleotide Array Sequence Analysis ; Population Characteristics ; Prevalence ; Republic of Korea ; Vaccination ; Vaginal Smears

BACKGROUND AND OBJECTIVES: This study has been performed to determine the reliability and validity of the Korean version of Hearing Handicap Inventory for the Elderly (HHIE), which has been adapted to the Korean population. SUBJECTS AND METHOD: For the Korean version of HHIE (K-HHIE), the processes of independent forward translation, backward translation and reconciliation were standardized using subjects older than 65 years old were recruited from the 10 referral-hospitals. Reliability and validity were evaluated by Cronbach's alpha coefficient, confirmatory factor analysis and test-retest analysis. Hearing impairment was assessed using pure tone audiometry, and the result was used as the gold standard. RESULTS: The recruited K-HHIEs were 169. The reliability of K-HHIE, checked by Cronbach's alpha coefficient, was as high as 0.95. Scale-item correlation coefficient was even higher than 0.97, which shows very high reliability of K-HHIE. Test-retest reliability and the correlation coefficients of social/situational, emotional and total scores of K-HHIE were as high as 0.73, 0.82 and 0.78, respectively. The validity of K-HHIE, checked by confirmatory factor analysis, also showed good construct validity. There was high correlation between hearing level and the scores of K-HHIE, which is another indicative result of its high validity. CONCLUSION: We have developed and validated Korean version of HHIE, which has good reliability and validity. It seems to be suitable enough for clinical use and research studies in patients with hearing impairment.
Aged ; Audiometry ; Hearing ; Hearing Loss ; Humans ; Surveys and Questionnaires ; Reproducibility of Results

BACKGROUND: In multiple myeloma (MM), the idiotype (ID) determinant of the paraprotein has been used for immunotherapy using dendritic cells (DCs). However, ID-specific immune responses showed limited clinical responses after the Id vaccination. Therefore, an alternative approach using DCs pulsed with other tumor antigens is required. METHODS: We investigated the possibility of immunotherapy for MM using myeloma cell line-specific cytotoxic T lymphocytes (CTLs), that were stimulated in vitro by monocyte-derived DCs pulsed with the myeloma cell line ysates. CD14+ cells isolated from the peripheral blood of HLA-A0201+ healthy donors were cultured in the presence of GM-CSF and IL-4. On day 6, the immature DCs were pulsed with the myeloma cell line lysates (IM-9: HLA0201+ and ARH-77: HLA0201+), and then maturation of DCs was induced by the addition of TNF- alpha for 2 days. CTL lines were generated by a 2 time stimulation with DCs to the autologous CD3+ T cells. RESULTS: DCs pulsed with myeloma cell lysates showed the production of IL-12p70, but less than that of unpulsed DCs. CTLs lines stimulated with the DCs pulsing, for the myeloma cell line lysates, showed potent cytotoxic activities against autologous target cells, but not against HLA-A2-cell lines (RPMI-8226). Mature DCs pulsed with the myeloma cell line lysates showed a higher stimulatory capacity for autologous CTL when compared with mature non-pulsed DCs. CONCLUSION: These results suggest that DCs pulsed with the myeloma cell line lysates can generate potent myeloma cell line-specific CTLs for the myeloma cell-based immunotherapeutic approach in MM.
Antigens, Neoplasm ; Cell Line* ; Dendritic Cells* ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans ; Immunotherapy ; Interleukin-4 ; Multiple Myeloma ; T-Lymphocytes ; T-Lymphocytes, Cytotoxic* ; Tissue Donors ; Vaccination