OBJECTIVE: To compare the reliability and validity of the Korean range of motion standard protocol (KRSP) for measuring joint range of motion (ROM) with those of the conventional ROM measurement using a goniometer.METHODS: We conducted a randomized controlled trial involving 91 healthy elderly individuals. We compared two strategies of measuring joint ROM to evaluate the reliability and validity of each standardized protocol: first, the KRSP based on the Chungnam National University guidelines and second, handheld goniometric measurement. In the first strategy, 3 examiners (1 rehabilitation doctor, 1 physical therapist, and 1 physical therapy student) independently measured joint ROM in 46 randomly selected subjects; in the second strategy, another 3 examiners (1 rehabilitation doctor, 1 physical therapist, and 1 physical therapy student) measured joint ROM in 45 randomly selected subjects. The reliability of each protocol was calculated using intraclass correlation coefficient, ICC(2,1), and root mean square error (RMSE).RESULTS: Both protocols showed good to excellent intra-rater reliability. With goniometer use, the inter-rater reliability was low—ICC(2,1), 95% confidence interval ranged from 0.643 (0.486–0.783) to -0.078 (-0.296–0.494)— and RMSE was high. With the KRSP, the inter-rater reliability ranged from 0.846 (0.686–0.931) to 0.986 (0.972–0.994) and RMSE was low.CONCLUSION: ROM measurements using the KRSP showed excellent reliability. These results indicate that this protocol can be the reference standard for measuring ROM in clinical settings as an alternative to goniometers.
Aged ; Chungcheongnam-do ; Humans ; Joints ; Methods ; Physical Therapists ; Range of Motion, Articular ; Rehabilitation ; Reproducibility of Results

No abstract available.
Esophagus* ; Granular Cell Tumor*

PURPOSE: To reduce beam hardening artifacts caused by the shoulder joint, we explored new and unique methods to improve the quality of images, such as varying the injection site and changing the position of patients (swimmers position). MATERIALS AND METHODS: Fifth-four patients underwent neck CT examinations performed in routine and swimmers position and with a 64-slice MDCT scanner in spiral scanning. To examine the difference due to the injection sites of contrast material, subjects were divided into right- and left-side groups. For the evaluation of images, we carried out a subjective and objective assessment based on radiologists' ratings and noise measurement. RESULTS: Images of the lower neck in the swimmers position exhibited less hardening and streak artifacts. The subjective and objective evaluations showed that the swimmers position received higher rating by radiologists and had lower noise level than that of routine position. The swimmers position was the most effective for the diagnosis of the cervico-thoracic junction area. As for the injection site, we obtained better images by an injection of contrast material in the right arm than in the left. CONCLUSION: CT examination of the lower neck in the swimmers position may improve the quality of image and the effectiveness of diagnosis. The injection of a contrast material to the right side rather than the left side reduced foreign body artifacts.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Middle Aged ; Neck/*radiography ; Radiography, Thoracic/*methods ; *Thorax ; Tomography, X-Ray Computed/*methods

There are several methods with which 6-hydroxy-dopamine is injected into the nigrostriatal pathway in rats for making models of Parkinson's disease. One is a complete lesion model in which A9 and A10 dopamine cells are destroyed, and the other one is a partial lesion model in which only A9 dopamine cells are destroyed. The aim of this study is to establish the model most suitable for transplantation of neural tissue. First, the behavioral change was investigated after dopamine releasing(amphetamine) or dopamine agonist(apomorphine) substances were injected. And then, immunohistochemical staining for tyrosine hydroxylase(TH) of the striatum and the substantia nigra was performed. Sixteen complete lesion models of Brundin, 4 complete lesion models of Perese, and 5 partial lesion models of Perese were made. The rotation response to amphetamine injection(5mg/kg, intraperitoneally) was checked 2 weeks after lesion making. For 6 rats, which showed rotation more than 7 turns/minute with amphetamine, the rotation response to subcutaneous injection of apomorphine was examined. Five complete lesion model of Brundin, 1 partial lesion model of Perese and 4 complete lesion model of Perese demonstrated rotation above 7 turns/minute in amphetamine test. Immunohistochemical staining of substantia nigra and corpus striatum for TH was faint on the lesioned side in rats which showed rotation above 7 turns/min in amphetaine-induced rotation test, irrespective of the kinds of model, while those ares of the normal side showed dense staining for TH. However, the results of immunohistochemical staining did not coincide with the results of rotation test by apomorphine.
Amphetamine ; Animals ; Apomorphine ; Corpus Striatum ; Dopamine ; Injections, Subcutaneous ; Models, Animal* ; Oxidopamine* ; Parkinson Disease* ; Rats* ; Substantia Nigra ; Tyrosine

OBJECTIVES: In order to understand the biological basis of neurodevelopmental perspectives of mental disorders, the authors investigated the developmental and regional changes in the phosphorylation of the transcription factor CREB following the electroconvulsive shock(ECS) in rat brain. METHODS: Rats of various age groups (7, 14, 21 days postnatal and adults) were given ECS and their hippocampi and cerebella were dissected at specified time points. The content of CREB and phosphorylated CREB were measured by immunoblot analysis. RESULTS: The amount of CREB increased in the hippocampus and decreased in the cerebellum according to the age. Baseline levels of CREB phosphorylation in both tissues were increased from postnatal 14 days, and it was proportional to the amount of CREB protein in the cerebellum. In the hippocampus, ECS increased the phosphorylation of CREB at postnatal 21 days, but in the cerebellum, ECS did not increased the phosphorylation of CREB in any age group. CONCLUSION: CREB mediated signal transduction pathways showed developmental and tissue-specific changes. ECS increased the phosphorylation of CREB in the hippocampus by postnatal 21 days, but not in the cerebellum. CREB activation is supposed to be related with the inducdion of c-fos after ECS in the hippocampus. However, the Ser-133 phosphorylation of CREB could not completely explain the developmental and tissue specificity of c-fos induction.
Animals ; Brain* ; Cerebellum ; Cyclic AMP Response Element-Binding Protein ; Electroshock* ; Hippocampus ; Humans ; Mental Disorders ; Organ Specificity ; Phosphorylation* ; Rats* ; Signal Transduction ; Transcription Factors

Cutaneous metastasis of internal malignancies is rare and the incidence of metastatic skin lesions as the first symptom of disease is only 0.8% for patients with all types of malignancies. Furthermore, cutaneous metastasis from advanced gastric cancer is exceedingly rare. A 43-year-old man presented with a single, symptomatic, erythematous nodule on the chest wall. A biopsy taken from the nodule showed an adenocarcinoma of the poorly differentiated type. An endoscopic examination and biopsy was done and these showed the same histologic findings. We reported here on this unusual case of advanced gastric cancer and the patient's first symptom was a skin lesion.
Adenocarcinoma ; Adult ; Biopsy ; Humans ; Incidence ; Neoplasm Metastasis ; Skin ; Stomach Neoplasms ; Thoracic Wall

OBJECTIVE: We observed the developmental pattern of activation of MAPK signal transduction pathways known to be activated by electroconvulsive shock(ECS) in young rat hippocampus after kainic acid(KA)-induced seizure. METHODS: We used the method of immunoblotting for examining the basal protein amount and basal level of phosphorylation of MAPK kinase(SAPK/ERK kinase -1, SEK-1), MAPK(c-Jun N terminal protein kinase, JNK), transcription factor(c-Jun) and immediate early gene proteins(Fos) in rat hippocampus at postnatal day 7, 14, and 21, respectively. We also examined the changes of phosphorylation of those proteins after kainic acid-induced seizure in the same way. RESULTS: The basal protein amounts of SEK-1, JNK, and c-Jun did not show age-dependent changes and basal level of phosphorylation of JNK and c-Jun remains unchanged throughout the early developmental period. The basal level of phosphorylation of SEK-1 was peaked at postnatal 7 days and then decreased with aging. After kainic acid-induced seizure, the change of phosphorylation of JNK was not observed but those of SEK-1 and c-Jun increased after postnatal day 14. The expression of Fos was observed at postnatal day 7 and also increased with aging. CONCLUSION: These results show that the MAPK signal transduction system in rat hippocampus matures in accordance with aging, but the process of maturation differs depending specific proteins. This study suggests the signal transduction cascade(SEK-1 - JNK - c-Jun - Fos) which is well established in cell line studies may not be applied to rat hipposcampus because we could not observe the activation of JNK after KA-induced seizure in young rat hippocampus.
Aging ; Animals ; Cell Line ; Hippocampus* ; Immunoblotting ; Kainic Acid ; Phosphorylation ; Phosphotransferases ; Protein Kinases ; Rats* ; Seizures* ; Signal Transduction*

OBJECTIVES: In order to search for new parameters for the evaluation of the adequacy of electroconvulsive therapy (ECT) the authors performed a non-linear analysis of electroencepha-logram(EEG)recorded during the course of electroconvulsive therapy(ECT)in a single female patient with depression. METHODS: Digitized EEG recordings from two ECT sessions spaced one week were analyzed at five different stages; pretreatment stable, postanesthetic-preictal, ictal, postictal suppression and posttreatment stable stages. RESULTS: Our analysis showed that 1)EEG signals had low dimensional (below 10 dimensions) deterministic characteristics 2) although EEG was nonstationary signal, non-linear parameters could reliably differentiate between various stages we examined. 3)the deterministic property of ictal EEG increased according to the progression of sessions and 4)the primary Lyapunov exponent(PLE)and correlation dimension of pre- and post-treatment stable stage EEG increased according to the progression of sessions. CONCLUSION: In this single case study, results of various non-linear analyses suggested that non-linear variables extracted from EEG recordings during ECT may have utilities as tools for the quantitative evaluation of ECT.
Depression ; Electroconvulsive Therapy* ; Electroencephalography* ; Evaluation Studies as Topic ; Female ; Humans ; Nonlinear Dynamics

OBJECTIVE: Histopathologic evaluation has been used to evaluate the degree of hepatic fibrosis. This method may have limitations because percutaneous liver biopsy is invasive and histopathologic change shows heterogenicity in the liver. It has been reported that the biochemical markers may have an important role in evaluating the degree of hepatic fibrosis. This study was performed to evaluate the clinical significances of serum hyaluronic acid (HA) and type IV collagen (IV-C) levels on hepatic fibrosis in the patients with chronic viral hepatitis B and liver cirrhosis. METHODS: This study included fifty eight patients with chronic viral liver diseases caused by HBV. Scheuer's classification was used to determine the degree of hepatic fibrosis. The levels of hyaluronic acid and type IV collagen was evaluated by one-step sandwich binding protein assay and one-step sandwich enzyme immunoassay respectively. RESULTS: The level of hyaluronic acid and type IV collagen in stage III (HA:589.4+/-193.7ng/ml, IV-C:444.5+/- 221.3ng/ml) and IV (727.5+/-306.1ng/ml, IV-C:519.2+/-210.5 ng/ml) were higher than stage I (HA:207.2+/-206.8ng/ml, IV-C:210.0+/-92.0ng/ml) and II (HA:223.7+/-172.9ng/ml, IV- C:209.6+/-70.7ng/ml) in the patients with chronic viral hepatitis and cirrhosis. At cutoff value of 500ng/ml for HA and 250ng/ml for IV-C in chronic hepatitis B patients, the sensitivities were 85% and 85%, and specificities were 89.5% and 78.9%, and diagnostic efficiencies were 87.9% and 81% respectively for discriminating patients with advanced hepatic fibrosis (stageIII-IV) from those with mild hepatic fibrosis (stageI-II). CONCLUSION: The serum levels of hyaluronic acid and type IV collagen correlated significantly with the degree of hepatic fibrosis in the patients with chronic viral hepatitis B and cirrhosis. The serum hyaluronic acid and type IV collagen is useful biochemical markers for evaluating hepatic fibrosis and follow up of the patients with chronic viral hepatitis B and cirrhosis.
Biomarkers ; Biopsy ; Carrier Proteins ; Classification ; Collagen Type IV* ; Fibrosis ; Hepatitis B ; Hepatitis B, Chronic ; Hepatitis* ; Humans ; Hyaluronic Acid* ; Immunoenzyme Techniques ; Liver Cirrhosis* ; Liver Diseases ; Liver*

PURPOSE: The survival of composite graft is dependent on three steps, (1) plasmatic imbibitions, (2) inosculation, and (3) neovascularization. Among the many trials to increase the survival rate of composite graft, prostaglandin E1 (PGE1) has beneficial effects on the microcirculatory level with vasodilating, antithrombotic, anti-inflammatory and neoangiogenic properties. Lipo-PGE1 which is lipid microspheres containing PGE1 had developed to compensate the systemic and local side effects of PGE1. This study was proposed to determine whether Lipo-PGE1 administration enhanced the survival of composite graft through neovascularization quantitatively in a rabbit ear model. METHODS: Fourteen New Zealand White Rabbits each weighing 3~4 kg were divided in two groups: (1) intravenous Lipo-PGE1 injection group and (2) control group. A 2 x 1 cm sized, full-thickness rectangular composite graft was harvested in each auricle. Then, the graft was reaaproximated in situ using a 5-0 nylon suture. For the experimental group, 3 microgram/kg/day of Lipo-PGE1 (5 microgram/mL) was administered intravenously through the marginal vein of the ear for 14 days. The control group was received no pharmacologic treatment. On the 14th postoperative day, composite graft of the ear was harvested and immunochemistry staining used Monoclonal mouse anti-CD 31 antibody was performed. Neoangiogenesis was quantified by counting the vessels that showed luminal structures surrounded by the brown color-stained epithelium and counted from 10 random high-power fields (400x) by independent blinded observer. Statistical analysis (Wilcoxon Signed Ranks test for nonparametric data) was performed using SPSS v12.0, with values of p<0.05 considered significant. RESULTS: The mean number of the microvessels was 15.48 +/- 8.65 in the experimental group and 9.82 +/- 7.25 in the control group (p=0.028). CONCLUSION: The use of Lipo-PGE1 facilitated the neoangiogenesis, resulted in the improvement of the survival rate of graft. On the basis of this results, we could support wider application of Lipo-PGE1 for more effective therapeutic angiogenesis and successful survival in various cases of composite graft in the human.
Alprostadil ; Animals ; Ear ; Epithelium ; Humans ; Immunochemistry ; Mice ; Microspheres ; Microvessels ; Nylons ; Phenobarbital ; Rabbits ; Survival Rate ; Sutures ; Transplants ; Veins