The clinical and pathological features of a paraganglioma arising in the cauda equina is described and compared with previous reports. The right microscopic fetures were similar to those of paragangliomas from other sites, with a 'Zellballen' pattern of cells containing arzyrophil granules. Immunohistocytochemical stains for neurone specific enolase, S-100 protein, cytokeratin were positive, but stains for glial fibrillary acidic protein were negative. Electron microscopy showed densely staining membrane-bound granules, cilia like structures and fibros bodies in the cytoplasm. The last two features only occur in paragangliomas from this site. The pathological findings suggest that paragangliomas in this site arise from pre-existing paraganglia, possibly of the visceral autonomic group.

The elbow is the most frequent area of complaint in children and adolescent baseball players. The physical stresses associated with repetitive throwing create extra-ordinary forces, which may affect the normal osteochondral and soft tissue developmental process and are the important factors causing the decrease of competitive power and shortening of life as a baseball player in adolescents. We surveyed the 114 baseball players of middle & high school in Taegu in order to evaluate the prevalance of symptoms and radiologic findings of the elbow and correlation of these findings to career & position of the baseball game. The results were as follows. 1. Of 114 players, 83 were non-pitchers and 31 were pitchers. The mean career was 3.8 years (7 months to 6 years). 2. The 77 players (67.7%) had the pain on their elbow during or after daily exercise. Other clinical symptoms were locking (30.7%), limitation of motion (18.4%), swelling (16.6%) and clicks on motion (10.5%). 3. On the radiogram of the elbow, hypertrophy or separation of medial epicondyle were seen in 34% of players, loose bodies in 17%, hypertrophy of the humerus in 12% and cystic change of the capitellum in 11%. 4. The mean career of symptomatic players was 4.4 years but non-symptomatics was 2.7 years. The mean career of players who had abnormal radiologic findings was 5.1 years but 3.1 years in players who had no abnormal radiologic fingings. 5. Symptoms and pathologic changes were more common in the elbow of pitcher' s group due to throwing frequency & pitching style. 6. Among the 77 players who had any kinds of problem of the elbow, 49 players of them had no experience of visiting hospital. 7. To prevent these injuries of the elbow, the following recommendations were made. First, restrict the number of innings pitched per game. Second, avoid throwing the curve ball in this age group. Third, ensue an adequate warm up period before exercise or rest after games. Fourth, inform parents and coaches of possible harmful nature of excessive throwing.
Adolescent* ; Baseball* ; Child ; Daegu ; Elbow* ; Humans ; Humerus ; Hypertrophy ; Parents

Purpose: To investigate chorioretinal vascular changes in the non-surgical eyes of patients who underwent vitreoretinal surgery under general anesthesia using optical coherence tomography angiography (OCTA). Methods: Data from 40 patients who underwent retinal surgery were retrospectively analyzed. Ophthalmologic examinations (including OCTA) were performed in the morning before and after surgery. The presence of intraoperative hypotension (IOH; mean arterial pressure <70 mmHg) was determined based on medical records. The vessel density of superficial and deep retinal capillary plexus layers, choriocapillaris void features, and thickness of the choroid and retina were quantified after image processing. Associations between retinal OCTA parameters and anesthesia profiles were also assessed. Results: DCP vessel density was increased after general anesthesia (p < 0.05). Among the patients who experienced IOH, there was no statistical difference in chorioretinal vessel parameters before and after general anesthesia. Also, we did not observe a difference in chorioretinal vessel parameters after general anesthesia between healthy patients and patients with chronic disease, including hypertension and diabetes (p > 0.05). The duration of anesthesia and average size of the choriocapillaris void (p < 0.05, r = -0.32), and the intraoperative mean arterial pressure (MAP) fluctuation and DCP, showed statistically significant negative linear correlations (p < 0.05, r = -0.38). The choriocapillaris void size and intraoperative MAP fluctuation also displayed a significant negative correlation (p < 0.05, r = -0.37), while the average size signal void showed a weak positive linear correlation (p < 0.01, r = 0.41; and p < 0.01, r = 0.44, respectively). Conclusions This is the first study to assess the effects of general anesthesia on chorioretinal vessels using OCTA. The Vessel density of the DCP was significantly increased in the non-surgical eye after total vitrectomy under general anesthesia. Furthermore, we found a correlation between MAP fluctuation and choriocapillaris void features. More studies are needed to confirm and expand on these observations.

OBJECT: The aim of this study is to determine whether exposure to chlorpromazine causes mutagenicity and genetic disorders. METHOD: Ames (Salmonella typhimurium) test and Rec assay (Bacillus subtilis) were used as indicators for DNA damage. Furthermore, the levels of umu operon expression by measuring the beta-galactosidase activity were monitered with the SOS umu test using S. typhimurium 1535 containing plasmid pSK1002. And the host-mediated assay was used to investigate the muta-genicity of chlorpromazine after the activation with in vivo metabolic systems. RESULTS: From the results, chlorpromazine did not affect DNA of S. typhimurium and B. subtilis strains and showed no mutagenicity at the all concentrations tested. These phenomena was also similar to that after metabolic activation of chlorpromazine in in vivo system. CONCLUSION: These results suggested that chlorpromazine did not show the mutagenicity and genotoxicity by four different methods used in this study.
beta-Galactosidase ; Biotransformation ; Chlorpromazine* ; DNA ; DNA Damage ; Operon ; Plasmids

STUDY DESIGN: A single center, double-blind, randomized, placebo-controlled trial. OBJECTIVES: The aim of this study was to evaluate the efficacy and safety of Ultracet(TM) compared with a placebo in the treatment of acute pain after spinal surgery. SUMMARY OF LITERATURE REVIEW: Ultracet(TM) is a combination drug of Tramadol and Acetaminophen, and the synergistic effect in pain control was demonstrated by animal experiments. MATERIALS AND METHODS: Seventy-six patients who satisfied the selection and exclusion criteria after spinal surgery were enrolled in this study. The patients measured perceptible pain relief time and meaningful pain relief time using a two stopwatch technique. The pain intensity (PI) and pain relief (PAR) were recorded at 30 minutes and then hourly over a 4 hour period, and the pain intensity difference (PID), the sum of the pain intensity difference (SPID), and the total pain relief (TOPAR) were also checked. RESULTS: The study and control group comprised of 56 and 20 patients, respectively. The baseline pain intensity was an average of 5.9+/-1.2 in the study group and 6.1+/-1.4 in the control group (p=0.683). The final pain intensity was 2.5+/-2.4 and 4.1+/-2.2 in the study and control group, respectively. The study group was superior to placebo (p=0.008). In addition, the study group was statistically superior in terms of the PID (p=0.025), SPID (p=0.028), and TOPAR (p=0.048), particularly over 2 hours, as well as the overall assessment (p=0.005). The median time of the meaningful pain relief time was 90 and 193 minutes in the study and control group, respectively. CONCLUSIONS: The analgesic efficacy of Ultracet(TM) was superior to the placebo on the SPID, TOPAR, and the subjects' overall assessments over the 4 hour observation period. These results suggest that Ultracet(TM) is an effective therapeutic option for the management of acute pain after spinal surgery without serious complications.
Acetaminophen ; Acute Pain* ; Animal Experimentation ; Humans ; Spinal Diseases ; Tramadol

Head and neck squamous cell carcinoma (HNSCC) is the sixth most common malignancy worldwide. The molecular mechanisms involved in the development and progression of these carcinomas are not well known. Abnormalities of genomic methylation patterns have been attributed a role in carcinogenesis and local de novo methylation at tumor suppressor loci was held to be involved in silencing of tumor suppressor genes. Using Ms APPCR, we previously isolated a hypermethylated fragment corresponded to the 5'end of TPEF gene from primary liver and lung cancer cells. To confirm the inactivation of TPEF gene by hypermethylation in HNSCC, we investigated correlation between methylation pattern and expression of TPEF in 10 HNSCC cell lines. In methylation analysis such as combined-bisulfite restriction analysis(COBRA) and bisulfite sequencing, only RPMI 2650 showed none methylated pattern and another 9 cell lines showed dense methylation. The TPEF gene expression level analysis using RT-PCR showed that these 9 cell lines had not or significantly low expression levels of TPEF as compared with RPMI 2650. In addition, the increase of TPEF reexpression by 5-AzaC as demethylating agent in 9 cell lines also indicated that TPEF expression was regulated by hypermethylation. These results of this study demonstrate that epigenetic silencing of TPEF gene by aberrant methylation could play an important role in HNSCC carcinogenesis.
Carcinogenesis ; Carcinoma, Squamous Cell* ; Cell Line* ; DNA Methylation* ; DNA* ; Epigenomics ; Gene Expression ; Genes, Tumor Suppressor ; Head* ; Liver ; Lung Neoplasms ; Methylation ; Neck*

PURPOSE: Perinatal asphyxia is an important cause of neonatal mortality and subsequent lifelong neurodevelopmental handicaps. Although many treatment strategies have been tested, there is currently no clinically effective treatment to prevent or reduce the harmful effects of hypoxia and ischemia in humans. In the clinical setting, maternal hyperthermia induces adverse effects on the neonatal brain, but recent studies have shown that hyperthermic pretreatment (PT) plays some role in hypoxic-ischemic (HI) injuries of the developing brain. The present study investigated the effect of hyperthermic PT on HI brain injuries in newborn rats. METHODS: HI was produced in 7-day-old neonatal rats by unilateral common carotid artery ligation, followed by hypoxia with 8% oxygen at 38degrees C for 2 hours. Twenty-four hours before HI, one-half of the pups were exposed to a 40degrees C environment for 2 hours. The severity of the brain injury was assessed 7 days after the HI. RESULTS: Hyperthermic PT reduced the gross and histopathologic findings of brain injury from 64.7 to 31.2% (P<0.05). There were no differences in location and severity of injury between the pretreated and control brains. CONCLUSION: These findings indicate that hyperthermic PT provides neuroprotective benefits on HI in the developing brain. Also, these findings suggest maternal hyperthermia may have protective effect on perinatal HI brain injuries.
Animals ; Anoxia ; Asphyxia ; Brain ; Brain Injuries ; Carotid Artery, Common ; Fever ; Humans ; Infant ; Infant Mortality ; Infant, Newborn ; Ischemia ; Ligation ; Oxygen ; Rats

Diabetic neuropathy is one of the most common complications of diabetic mellitus and has myriad clinical presentations. Amitriptyline is an effective drug for painful diabetic neuropathy, but has a wide variety of cardiovascular effects. We report a case of amitriptyline-induced ventricular tachycardia in a patient with painful diabetic neuropathy. A 48-year-old man with no history of heart disease was treated with amitriptyline for the past 2 months. The dosage of this drug was gradually increased and the maximal dose was 170 mg per day. Prior to administration of this drug, his chest X-ray and electrocardiogram were normal. On admission he complained of chest discomfort and palpitation for 3 days, but his vital sign was stable. The electrocardiogram showed a wide QRS complex with a rate of 170 beats per minute. The ventricular tachycardia was successfully treated with electrical cardioversion.
Amitriptyline* ; Diabetic Neuropathies* ; Electric Countershock ; Electrocardiography ; Heart Diseases ; Humans ; Middle Aged ; Tachycardia, Ventricular* ; Thorax ; Vital Signs

PURPOSE: The purpose of this study was to compare changes in learning objectives in Fundamentals of Nursing which were established between 2000 and 2004. METHOD: 2000, 2004 learning objectives were analyzed with frequencies and percents. RESULTS: There was an increase in the total number of learning objectives used in 2004(n=534) over 2000(n=527). In 2004 compared to 2000, there was an increase in learning objectives related to nursing process, need of oxygenation, need of nutrition, need of temperature regulation, need of activity and exercise, need of comfort, medication, preoperative care. According to Bloom's taxonomy, learning objectives established in 2004, mainly consisted of three domains, 35.5% for comprehension, 23.6% for synthesis, 20.4% for knowledge. Changes in learning objectives established in 2004 compared to 2000 decreases in the comprehension domain and increases in the synthesis domain. CONCLUSION: The learning objectives established in 2004 showed remarkable change when compared to those established in 2000. But the learning objective domains in Bloom's taxonomy were distributed unevenly. For better learning objectives in Fundamentals of Nursing, constant revision will be needed.
Classification ; Comprehension ; Learning* ; Nursing Process ; Nursing* ; Oxygen ; Preoperative Care

PURPOSE: The purpose of this study was to explore the content related to nosocomial infection control in the course on Fundamentals of Nursing. METHOD: Participants were 49 faculty who were teaching courses in Fundamentals of Nursing in universities and colleges in Korea. The questionnaire was composed of 55 items related to nosocomial infection control. RESULTS: Eighteen items out of 55 items were taught in more than 80% of the universities and colleges. These included principles of infection control, principles and effect of hand washing, method of hand washing, hand scrubs, and donning sterile gown and gloves. CONCLUSION: The most effective interventions for infection control, including asepsis, hand washing, infection control for urinary catheterization, and infection control for IV sites were taught in most universities and colleges. However, the time assigned for teaching these items and the importance placed on practice were not considered sufficient.
Asepsis ; Cross Infection* ; Education* ; Hand ; Hand Disinfection ; Infection Control ; Korea ; Nursing* ; Surveys and Questionnaires ; Urinary Catheterization ; Urinary Catheters