OBJECTIVE: To investigate the relationship between the curvature of the cervical spine and various clinical parameters and to identify the validity of new curvature measurement methods. METHOD: The cervical spine curvature was assessed on lateral view of plain radiographs by three measurement indices. Index 1 is the ratio of length of line drawn by C2-C7 posteroinferior points and the longest length of vertical line to the posterior curve of C2-C7. Index 2 is the angle formed by three points of index 1. Index 3 is the sum of each distance from line drawn by C2-C7 posteroinferior point to C3-C7 posterior mid-points. The difference of each group and the relationship between pain scale and three indices were statistically analyzed by t-test and Pearson's correlation test. RESULTS: Sixty-three percent of control group patients showed a straight or kyphotic curvature and younger women group was more likely to have a straight curvature than other age groups. The newly designed measurement methods reflect the diagnostic significance of cervical curvature type measurement. Cervical lordosis did not exactly correlate with pain scale, symptom duration and the difference of clinical diagnosis. But the patients showing interval changes of pain scale were revealed the correlative change of curvature indices with each correlation coefficient of -0.43, -0.69 and -0.55 respectively. CONCLUSION: The altered cervical curvature is less valuable for the diagnostic significance and did not relate to the pain scale and duration, but cervical curvature reflect the interval change of the pain scale.
Animals ; Diagnosis ; Female ; Humans ; Lordosis ; Neck Pain* ; Spine*

OBJECTIVE: Many amputees do not use their prostheses consistently because of the unhelpfulness or discomfort. In this point, this survey was to assess the prosthetic problems in their function and willingness to use. METHOD: We investigated the 18 burn induced upper extremity amputees of Hankang Sacred Heart Hospital Burn Center with the questionnaire or interview. RESULTS: The mean age was 39.6 years at the time of amputation & 43.3 years at the time of survey. Their amputation levels were composed of 72.2% of below elbow and 27.8% of above elbow. The using time of prosthesis was revealed that 'all day long' use in 50%, 'going out' use in 33.3% and 'living activity' use in 11.1%. Their complaint for prosthetic problems were discoloration (38.9%), poor appearance (27.8%), sweating (27.8%) and inadequate function (22.2%). Considerable number of them suffered from residual burn wound or scar in contact with a socket (27.8%) and itching and tingling sensation (22.2%). Employment was not accomplished in 61.1% of the amputees. CONCLUSION: The information thus obtained in this investigation would be expected to be helpful in the prosthetic prescription and rehabilitation training of upper extremity amputees for their welfare.
Amputation ; Amputees* ; Burn Units ; Burns* ; Cicatrix ; Elbow ; Employment ; Heart ; Humans ; Prescriptions ; Prostheses and Implants* ; Pruritus ; Surveys and Questionnaires ; Rehabilitation ; Sensation ; Sweat ; Sweating ; Upper Extremity* ; Wounds and Injuries

The authors applied ADDES-HV parent evaluation scale for the purpose of screeing test to 538 2nd grade elementary school students from March 1994 to May. The results were as follows: There was no differences in scores of ADHD between schools. In comparing the male and female between three school students, male students showed signifieant high scores (p<0.05) than female students in the score of ADDES-HV subscale and total. There was no significant differences in ADDES-HV scale between male students and female students in both ADHD patients and normal controls. In reliability test for test and retest, the reliability coefficient was higher satisfatorily and that of inattention was 0.80, inpulsivity was 0.69, hyperactivity was 0.63 and the total score was 0.82. In reliability test by internal consistancy, the Cronbach a coefficient of patient group was 0.85(p<0.05) and that of normal control was 0.84(p<0.05). The Concurrent validity between ADDES-HV scale and DSM- III -R scale was 0.57(p<0.05) in ADHD patient group and 0.84(p<0.05) in normal control group. In discriminant validity test between ADHD patient group and normal control, the ADHD patient group showed higher score(p<0.05). The total disciminant capacity of the patient group in ADDES-HV scale was 94.44%. When we regard the cut off point as standard deviation 1.5, the male student was 80 score and the female student was 69 score. In this point of view, ADDES-HV scale was proved to be the useful screening test tool for ADHD research and showed higher reliability and validity in applying to Korean subjects.
Attention Deficit Disorder with Hyperactivity* ; Child* ; Daegu* ; Female ; Humans ; Male ; Mass Screening ; Parents ; Reproducibility of Results

OBJECTIVES: Peripheral benzodiazepine receptor has been suggested to be associated with the relief of anxiety response induced by stresses. This study was designed to observe the anxiolytic activity of peripheral benzodiazepine receptor. METHODS: Male Sprague-Dawley rats, weighing 200-250g were forced to suffer an immobilization stress for 2 hours. The level of anxiety by immobilization was performed by an elevated plus maze and was evaluated by the number of [3H]Ro5-4864 binding sites in the olfactory bulb. RESULTS: Saturation experiments followed by scatchard anlayses of the results showed that the density of peripheral benzodiazepine receptor increased and the affinity of the peripheral benzodiazepine receptor remained unchanged. It was found that there was no significant change in the cerebral cortex. Pretreatment with clonazepam, a central benzodiazepine receptor agonist, before an immobilization stress abolished the anxoius response on the performance of plus maze. In this group, upregulation of peripheral benzodiazepine receptor of olfactory bulb was not observed. Ro5-4864, a peripheral benzodiazepine receptor agonist, elicited an increase of anxiolytic response on the performance of plus maze. Progesterone, a precursor of neuroactive steroid, also increased anxiolytic response on the performance of plus maze. Pretreatment with PK11195, a peripheral benzodiazepine receptor antagonist, abolshed the anxiolytic effect of progesterone. CONCLUSIONS: From these results, it could be concluded that peripheral benzodiazepine receptor is closely associated with the relief of acute stress induced anxiety response via an increase of synthesis of neuroactive steroid.
Animals ; Anti-Anxiety Agents ; Anxiety* ; Benzodiazepines* ; Binding Sites ; Cerebral Cortex ; Clonazepam ; Humans ; Immobilization ; Male ; Olfactory Bulb ; Progesterone ; Rats* ; Rats, Sprague-Dawley ; Receptors, GABA-A* ; Up-Regulation

OBJECTIVE: In the management of spasticity, intramuscular neurolysis with small amount of dilute aqueous phenol has proved to be a useful measure. But, considerable problem has taken place in utilization of phenol. This study was attempted to compare the effect of phenol and alcohol for the peripheral nerve blocking in the management of spasticity. METHOD: Intraneural injection of 5% phenol, 50% alcohol and 90% alcohol solution carried out in each group of 10 rats. A total of 30 rat were injected and examined electrophysiologically before and after blocking the nerve (24 hour, 1 weeks, 2 weeks, 4 weeks, 8 weeks). The randomized one rat of each group was sacrificed for the histological examination of the sciatic nerve at every examined day. RESULTS: There was no difference of the distal latencies and amplitudes of compound muscle action potentials among the groups before injection. The latencies were prolonged at 24 hours post-injection and shortened at 1 week post-injection in all the groups. The amplitudes were markedly decreased at 24 hours post-injection and increased at 1 week post- injection and reached the pre-injection value at 8 week post-injection in all the groups. Histologic studies showed necrosis at 1 week post-injection and regeneration at 2 week post- injection in 50% and 90% ethanol groups. Phenol injection group showed necrosis at 4 week post-injection and regeneration after 8 weeks. CONCLUSION: Our preliminary experience with alcohol for peripheral nerve blocking with encouraging result has been described.
Action Potentials ; Animals ; Ethanol ; Muscle Spasticity ; Necrosis ; Nerve Block ; Peripheral Nerves ; Phenol* ; Rats* ; Regeneration ; Sciatic Nerve*

Pseudomembranous colitis (PMC) is mostly related with the antibiotics and it presents with diarrhea, abdominal pain, fever, hypoalbuminemia and hypovolemia. In the clinical course of pseudomembranous colitis (PMC), ascites is a rare presentation, and high elevation of carcinoembryonic antigen (CEA) associated with PMC is also a very rare presentation. We experienced a case taken cephalosporin group antibiotics for six weeks and presented with fever, abdominal pain, severe diarrhea, and massive ascites. During evaluation, we found low serum-ascites albumin gradient and high level of CEA in both ascites and plasma. With the impression of hidden malignancy, the special studies were done, but PMC was only found without malignancy. After vancomycin therapy, all symptoms were relieved and CEA level declined.
Abdominal Pain ; Anti-Bacterial Agents ; Ascites* ; Carcinoembryonic Antigen ; Diarrhea ; Enterocolitis, Pseudomembranous* ; Fever ; Hypoalbuminemia ; Hypovolemia ; Plasma ; Vancomycin

Rheumatoid arthritis (RA) mainly affects polyarticular joints and is characterized by inflammation of the synovial membrane leading to joint destruction. We report on an unusual case of RA presenting as an intra-articular mass invading bone of the wrist joint in a patient with chronic monoarthritis. A 43-year-old man presented with left wrist joint pain and swelling lasting several years. A plain radiograph showed a non-specific osteolytic lesion in the distal ulna but a magnetic resonance image demonstrated an intra-articular irregular mass-like lesion with eccentric bone erosion the distal radioulnar joint. Synovial biopsy detected hyperplasia of the synovial lining cell layer and finger-like protrusions of inflamed and edematous fibrovascular stroma containing dense inflammatory infiltrates, mainly plasma cells, B cells, and CD4+ T cells. Rheumatoid factor and anti-citrullinated protein antibody were highly positive. The patient was diagnosed with RA and treated with disease-modifying anti-rheumatic drugs, showing a good response on further follow-up.
Adult ; Antirheumatic Agents ; Arthritis, Rheumatoid* ; B-Lymphocytes ; Biopsy ; Follow-Up Studies ; Humans ; Hyperplasia ; Inflammation ; Joints ; Plasma Cells ; Rheumatoid Factor ; Synovial Membrane ; T-Lymphocytes ; Ulna ; Wrist Joint* ; Wrist*

The first edition of the Korean clinical practice guidelines for primary stroke prevention reflects evidence published before June 2007. Since then, several clinical studies and meta-analyses have been conducted to determine the efficacy of aspirin for the primary prevention of cardiovascular disease including stroke. The aim of this guideline update is to provide timely recommendations taking into consideration the new evidence. Three clinical studies and four meta-analyses performed between July 2007 and November 2010 were identified and included for updating the guidelines. The main finding was a lack of aspirin efficacy for primary stroke prevention in patients with diabetes or peripheral arterial disease. We have summarized the new evidence and revised our recommendations for aspirin for primary stroke prevention. New evidence will need to be reflected continuously in future guideline updates.
Aspirin ; Cardiovascular Diseases ; Humans ; Peripheral Arterial Disease ; Primary Prevention ; Stroke

Pivotal clinical trials testing the efficacy of new antithrombotics for the prevention of stroke and systemic embolism in patients with atrial fibrillation have been published since the release of the first edition of Korean clinical practice guidelines for primary stroke prevention. From July 2007 to August 2012, 5 clinical studies and update of guidelines in Europe and North America were identified through systematic search. In patients with atrial fibrillation who were unsuitable for warfarin, the combination of clopidogrel and aspirin reduced the risk of stroke at the cost of increased major bleedings as compared to aspirin. In patients with nonvalvular atrial fibrillation and risk factors for stroke, new oral anticoagulants, dabigatran, rivaroxaban and apixaban, were as effective as or more effective than warfarin in preventing stroke or systemic embolism. The risks of major bleeding with novel anticoagulants were similar to or lower than that of warfarin. Particularly, the risk of intracranial bleeding was significantly lower with novel anticoagulants than with warfarin. In this report, we summarized the new evidences and updated our recommendations for primary stroke prevention in patients with atrial fibrillation.
Anticoagulants ; Aspirin ; Atrial Fibrillation ; Benzimidazoles ; beta-Alanine ; Embolism ; Europe ; Hemorrhage ; Humans ; Morpholines ; North America ; Primary Prevention ; Pyrazoles ; Pyridones ; Risk Factors ; Stroke ; Thiophenes ; Ticlopidine ; Warfarin ; Dabigatran ; Rivaroxaban

Extracranial carotid stenosis is a well-established, modifiable risk factor for stroke. Asymptomatic extracranial carotid stenosis is increasingly being detected due to the introduction of less-invasive and more-sensitive advanced diagnostic technologies. For severe asymptomatic stenosis, earlier pivotal clinical trials demonstrated the benefit of carotid endarterectomy over the best medical therapy. Since then, great advances have been made in interventional and medical therapies as well as surgical techniques. The first edition of the Korean Stroke Clinical Practice Guidelines for primary stroke prevention for the management of asymptomatic carotid stenosis reflected evidences published before June 2007. After the publication of the first edition, several major clinical trials and observational studies have been published, and major guidelines updated their recommendation. Accordingly, the writing group of Korean Stroke Clinical Practice Guidelines (CPG) decided to provide timely updated evidence-based recommendations. The Korean Stroke CPG writing committee has searched and reviewed literatures related to the management of asymptomatic carotid stenosis including published guidelines, meta-analyses, randomized clinical trials, and nonrandomized studies published between June 2007 and Feb 2011. We summarized the new evidences and revised our recommendations. Key changes in the updated guidelines are the benefit of intensive medical therapy and further evidence of carotid artery stenting as an alternative to carotid endarterectomy. The current updated guidelines underwent extensive peer review by experts from the Korean Stroke Society, Korean Society of Intravascular Neurosurgery, Korean Society of Interventional Neuroradiology, Korean Society of Cerebrovascular Surgery, and Korean Neurological Association. New evidences will be continuously reflected in future updated guidelines.
Carotid Arteries ; Carotid Stenosis ; Constriction, Pathologic ; Endarterectomy, Carotid ; Neurosurgery ; Peer Review ; Primary Prevention ; Publications ; Risk Factors ; Stents ; Stroke ; Writing