BACKGROUND: The concept of "double crush syndrome (DCS)"-a proximal compressive lesion making the distal nerve more vulnerable to injury-is an intriguing hypothesis. However, recent studies did not show unitary results. This study was preliminarily undertaken in order to clarify the causal relationship of proximal compressive lesion and carpal tunnel syndrome (CTS) in an electrophysiologic aspect. METHODS: In the period between June 1998 and June 1999 there were 24 patients with CTS(33 limbs with CTS). With these CTS patients, thorough electrodiagnostic studies were performed to discover coexisting proximal compressive lesions along the median nerve and its corresponding cervical root lesions. RESULTS: In 10 of these limbs (30%), there was a electrodiagnostically-proven coexisting proximal compressive lesion(all cervical radiculopathies). But only 1 limb (3%) had an anatomically responsible association. Finally only 1 limb (3%) with CTS had a possibility of DCS. CONCLUSIONS: CTS and cervical radiculopathy are common disorders, so there is a high possibility of coexisting as a double primary lesion without a pathophysiological relationship. Our results do not support the double crush hypothesis. However, the possibility of a reversed double crush syndrome is suggested.
Carpal Tunnel Syndrome* ; Crush Syndrome* ; Extremities ; Humans ; Median Nerve ; Radiculopathy

OBJECTIVEThis study was aimed to investigate the diagnostic value of combined determination of Epstein-Barr virus (EBV) antibodies for nasopharyngeal carcinoma (NPC), including immunoglobulin (Ig) A against EBV capsid antigens (VCA), IgA against early antigens (EA), IgG against BRLF1 transcription activator (Rta) and IgA against EBV nuclear antigen-1 (EBNA1), assessed with receiver operating characteristic (ROC) curve based on logistic regression.

METHODSSerum samples derived from 211 untreated patients with NPC and 203 non-NPC ENT patients were examined for the presence of VCA/IgA and EA/IgA by immunoenzymatic assay, Rta/IgG and EBNA1/IgA by enzyme-linked immnunosorbent assay (ELISA). The different Logistic regression models were established for various combined determinations of antibodies, respectively. Using the predicted probability as the analyzed variable, ROC curve was applied to evaluate the diagnostic accuracy of different combined determinations.

RESULTSThe sensitivity of VCA/IgA (98.1%) and the specificity of EA/IgA (98.5%) were the highest while detecting solely. The results which were analyzed by ROC curve based on Logistic regression showed that the sensitivity and specificity were improved. In two-marker combinations, VCA/IgA + Rta/IgG whose area under ROC curve (AUC) was 0.991 had the highest diagnostic accuracy, and its sensitivity, specificity and Youden index were 94.8%, 98.0% and 0.928 respectively. No significant difference of AUC were found comparing VCA/IgA + Rta/IgG with VCA/IgA + Rta/IgG + EBNA1/IgA and four-marker combination( P > 0.05), of which sensitivity, specificity and Youden index were 94.8%, 98.5%, 0.933 and 96.7%, 97.0%, 0.937, respectively.

CONCLUSIONThe approach of ROC curve based on Logistic regression can improve synthetic efficiency for combined determination of multiple markers. The combined determination of VCA/IgA and Rta/IgG with a complementary effect is optimal for NPC serodiagnosis.

Adult ; Aged ; Aged, 80 and over ; Antibodies, Viral ; blood ; immunology ; Carcinoma ; diagnosis ; immunology ; virology ; Enzyme-Linked Immunosorbent Assay ; methods ; standards ; Female ; Herpesvirus 4, Human ; immunology ; Humans ; Logistic Models ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; diagnosis ; immunology ; virology ; Viral Proteins ; immunology ; Young Adult

OBJECTIVEThis study was aimed to investigate the clinical value of Epstein-Barr virus (EBV) Rta/IgG in the diagnosis of nasopharyngeal carcinoma (NPC).

METHODSSerum samples derived from 211 untreated patients with NPC, 413 subjects including 203 non-NPC ENT patients and 210 healthy volunteers as control were examined for the presence of antibodies directed against Rta/IgG by using enzyme-linked immnunosorbent assay (ELISA). Receiver operating characteristic (ROC) curve was applied to perform methodical evaluation of this tumor marker.

RESULTSThe rA value median of Rta/IgG in NPC group was significantly higher than one in control group (P < 0.001). The area under ROC was 0.933. The sensitivity and specificity of this marker were 90.5% and 90.1%, respectively, when the best cutoff value was defined.

CONCLUSIONRta/IgG detected with ELISA method is a new target of EBV, and may be one of important marker for NPC diagnosis.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antibodies, Viral ; blood ; Carcinoma ; blood ; diagnosis ; immunology ; virology ; Case-Control Studies ; Child ; Diagnostic Tests, Routine ; methods ; Epstein-Barr Virus Infections ; blood ; diagnosis ; immunology ; virology ; Female ; Herpesvirus 4, Human ; immunology ; isolation & purification ; Humans ; Immediate-Early Proteins ; blood ; immunology ; Immunoglobulin G ; blood ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; blood ; diagnosis ; immunology ; virology ; Trans-Activators ; blood ; immunology ; Young Adult

OBJECTIVETo evaluate the relationship between the clinical stages of nasopharyngeal carcinoma (NPC) and Epstein-Barr virus (EBV) antibodies Rta/IgG, EBNA1/IgA, VCA/IgA and EA/IgA.

METHODSSerum samples obtained from 211 untreated patients with NPC categorized by the project of 92' stage were examined for the presence of the EBV antibodies Rta/IgG and EBNA1/IgA by enzyme-linked immnunosorbent assay (ELISA) and for VCA/IgA and EA/IgA by immunoenzymatic assay. The positive rates and antibody levels in the NPC patients in different TNM stages and clinical stages were analyzed statistically.

RESULTSNo significant difference in Rta/IgG rA value was found in the NPC patients in different TNM or clinical stages (P>0.05). The EBNA1/IgA rA value was significantly lower in stage T1, N0, and clinical stage I than in the other corresponding T stages, N stages and other clinical stage (P<0.05). The antibody titers of VCA/IgA and EA/IgA differed significantly between the N stages and the clinical stages (P<0.05).

CONCLUSIONThe expression of EBV Rta/IgG is not associated with NPC stage. The expression of EBNA1/IgA is relatively low in early NPC. The antibody level of VCA/IgA and EA/IgA are significantly correlated to the degree of neck lymph node metastasis, and might be helpful to classify the clinical stages of NPC.

Adult ; Aged ; Aged, 80 and over ; Antibodies, Viral ; blood ; immunology ; Antigens, Viral ; immunology ; Capsid Proteins ; immunology ; Epstein-Barr Virus Nuclear Antigens ; immunology ; Female ; Herpesvirus 4, Human ; immunology ; Humans ; Immediate-Early Proteins ; immunology ; Immunoglobulin A ; blood ; Immunoglobulin G ; blood ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; immunology ; pathology ; virology ; Neoplasm Staging ; Trans-Activators ; immunology ; Young Adult

Objective To investigate the methods and efficacy of microscopic surgical treatment in patients with anterior communicating artery aneurysm. Methods The clinical data of 35 patients with ruptured anterior communicating artery aneurysm, admitted to our hospital from January 2008 to January 2011 and performed microneurosurgical treatment via pterional approch, were retrospective analyzed; their surgical techniques and efficacy were concluded. Results All the aneurysms in 35 patients were successfully clipped. Follow-up was performed for 3-6 months: complete recovery was achieved in 19 patients, good recovery in 11, and mild disability in 3 (including 1 with psychiatric symptom); death appeared in 2 patients. Conclusion The microsurgery via pterional approach is an effective method in treating anterior communicating artery aneurysms,resulting from its full exposure of aneurysms and few complications; adequate dissection and exposure of the entire H shaped complex body of anterior communicating artery are the keys to a successful clipping of aneurysm neck; and the selection of aneurysm clip suitable for the aneurysm and the preservation of the perforating arteries should be specially emphasized.

OBJECTIVES: This study aimed to investigate how sleep quality affects quality of life in the elderly of rural communities. METHODS: 877 elderly people aged 60 or over living in C towns participated in the study. They responded to the Pittsburgh Sleep Quality Index, EuroQol-5 dimension, Korean version of the short from of Geriatric Depression Scale, Mini-Mental State Examination for Dementia Screening and the presence of urinary incontinence. RESULTS: Most scores of the items of the quality of life index, except self-management, showed significant correlations with the total score of the sleep quality test. Statistically significant differences were found between the positives and the negatives of the sleep quality test in the scores of all the detailed items of the quality of life index. Among the detailed items of quality of sleep, subjective quality of sleep showed the highest correlation. CONCLUSION: The present study found that the subjective indicators such as subjective sleep quality and sleep disturbance affected quality of life in the rural lives of elderly people more than the objective indicators such as sleep durations or sleep latency periods. Based on the results of these studies, we concluded that a methodological approach and a management model to treating insomnia to improve the quality of life of the elderly would need to be developed and applied.
Aged ; Dementia ; Depression ; Humans ; Latency Period (Psychology) ; Mass Screening ; Quality of Life ; Rural Population ; Self Care ; Sleep Initiation and Maintenance Disorders

We experienced a case of thymolipoma that is a rare benign mediastinal tumor, composed of normal thymic tissue and matured adipose tissue. A 46-years-old woman was admitted to the department of medicine due to lower abdominal pain. Simple chest PA showed a large mass shadow at right cardiac border. Chest CT scanning showed well defined large fatty mass at right cardiac border which was suggested thymolipoma. The mass was resected and confirmed as thymolipoma histopathologically.
Abdominal Pain ; Adipose Tissue ; Female ; Humans ; Mediastinal Neoplasms ; Thorax ; Tomography, X-Ray Computed

PURPOSE: To evaluate the effect of dose reduction on image quality in digital radiography using a flat-panel detector. MATERIALS AND METHODS: Digital radiographs of 30 rabbits were obtained at two different dose levels (33.23 µGy for the standard dose group and 20.09 µGy for the reduced dose group). The amorphous selenium-based flat-panel detector system had a panel size of 7x8.5 inches, a matrix of 1280x1536 (pixels?), and a pixel pitch of 138 µm. Four observers evaluated the soft-copy images on a high-resolution video monitor (2560x2048x8 bits) in random order. The observers rated the visibility of 13 different anatomic structures on a 5-point scale, viz. the retrocardiac lung, subdiaphragmatic lung, heart border, diaphragmatic border, proximal airway, unobscured lung, liver border, kidney border, bowel gas, flank stripe, ribs, and vertebrae in the mediastinal and abdominal regions. Statistical significance was determined using Wilcoxon's signed rank test. RESULTS: There was no statistically significant difference in the visibility of the anatomic structures on digital radiography between the standard and reduced dose groups. CONCLUSION: Digital radiography using an amorphous selenium-based flat-panel detector can preserve the image quality, even though the does is reduced to 40% of the standard level.
Heart ; Kidney ; Liver ; Lung ; Rabbits* ; Radiographic Image Enhancement* ; Ribs ; Selenium ; Spine

BACKGROUND: To evaluate the prevalence and clinical characteristics of metabolic syndrome as defined by the NCEP-ATP III criteria in middle aged Korean rural people. METHODS: Cross-sectional study including 5330 participants (2197 males, 3133 females), over the age 40. Metabolic syndrome according to NCEP-ATP III criteria was defined if three or more of the following criteria were satisfied: 1) Abdominal obesity: Waist circumference (WC) in men > 102 cm and in women > 88 cm. 2) Hypertriglyceridemia: >or= 150 mg/dL. 3) Low HDL cholesterol: < 40 mg/ dL in men and < 50 mg/dL in women. 4) High blood pressure: >or= 130/85 mmHg. 5) High fasting glucose: >or= 110 mg/dL. We also applied WHO-APR (Asian Pacific Region) criteria for abdominal obesity (WC in men > 90 cm and in women > 80 cm) instead of NCEP-ATP III criteria. Insulin resistance was analysed by HOMA-IR. RESULTS: Age-adjusted overall prevalence of metabolic syndrome by NCEP-ATP III criteria was 24.8% (17.6% in men, 30.0% in women). The prevalence of metabolic syndrome for each age group in men was as follows: age 40 through 49 (18.8%), 50 through 59 (17.4%), 60 through 69 (18.3%), and over 70 (14.5%). In women: age 40 through 49 (22.3%), 50 through 59 (32.7%), 60 through 69 (39.9%), and over 70 (39.3%). In men, the prevalence decreased with aging, but not in women with consistent increment. Age-adjusted prevalence of abdominal obesity was 1.6% (men) and 25.3% (women) by NCEP-ATP III criteria, but 22.5% (men) and 55.6% (women) by WHO-APR criteria. Among various components of metabolic syndrome, the prevalence of hypertriglyceridemia was well correlated with the changing pattern of the prevalence of metabolic syndrome. Relative risk of metabolic syndrome increased as HOMA-IR and fasting insulin levels did. CONCLUSION: In middle aged Korean adults, metabolic syndrome defined as NCEP-ATP III criteria was strongly correlated to the degree of insulin resistance. The peak age of metabolic syndrome in men was age 40 through 49, and the prevalence decreased with aging. Therefore, early intervention for risk factors of metabolic syndrome might be required in men. On the other hand, prevention for cardiovascular disease will be needed for perimenopausal women due to considerably increased prevalence in the age 50 through 59.
Adult* ; Aging ; Cardiovascular Diseases ; Cholesterol, HDL ; Cross-Sectional Studies ; Early Intervention (Education) ; Fasting ; Female ; Glucose ; Hand ; Humans ; Hypertension ; Hypertriglyceridemia ; Insulin ; Insulin Resistance ; Male ; Middle Aged ; Obesity, Abdominal ; Prevalence* ; Risk Factors ; Waist Circumference

BACKGROUND: The aim of this study was to analyze the prevalence and clinical characteristic of the metabolic syndrome of adults, over 40 years old, living in Korea. METHODS: This study was carried out for 2 years, 2003-2004, on total 5, 330 individuals (2, 197 men and 3, 133 women) selected by the stratified random cluster sampling among adults over 40 years old. Metabolic syndrome was defined based on both the NCEP-ATP III criteria and Modified ATP III criteria applying the WHO-APR (Asian Pacific Region) 's abdominal obesity criteria (waist circumference > 90 cm in men, 80 cm in women) instead of NCEP-ATP III criteria. RESULTS: Using NCEP-ATP III criteria, the age-adjusted overall prevalence of metabolic syndrome was 24.8% (17.6% in men, 30.0% in women). Age-adjusted overall prevalence of metabolic syndrome as defined by modified-ATP III criteria was 34.3% (26.3% in men, 40.1% in women). The prevalence of metabolic syndrome for each age group (40-49, 50-59, 60-69, > or= 70) in men was as follows: 18.8%, 17.4%, 18.3%, 14.5%. In women: 22.3%, 32.7%, 39.9%, 39.3%. The prevalence of hypertriglyceridemia (triglycerides > or= 1.7 mmol/l) was well correlated with the changing pattern of the prevalence of metabolic syndrome both in men and women. CONCLUSIONS: The peak age of metabolic syndrome in men was age 40 through 49, and the prevalence decreased with aging. Therefore, early intervention for risk factors of metabolic syndrome might be required in men. On the other hand, prevention for cardiovascular disease will be needed for perimenopausal women due to considerably increased prevalence in the age 50 through 59.
Prevalence ; Middle Aged ; Metabolic Syndrome X/*diagnosis/*epidemiology ; Male ; Korea/epidemiology ; Humans ; Female ; Aged ; Age Distribution ; Adult