BACKGROUND: An entry of needle into the epidural space has been identified by the development of negative pressure to the advancing needle; hanging drop, loss of resistance, or use of Macintosh balloon. But it is suspicious that epidural space is a true negative pressure space. METHODS: We measured the epidural pressures of pregnant patients in right lateral decubitus (RLD) and sitting position and compared with the values of non-pregnant patients of respective position. 17G Tuohy needle with closed system was used, the pressure of which was zeroed to the puncture level at third lumbar intervertebral space. RESULTS: Epidural pressures were positive in all subjects. Values of measurement were 13+/-4mmHg, 15+/-7mmHg, 16+/-6mmHg and 25+/-7mmHg for pregnant-RLD, pregnant-sitting, non-pregnant-RLD, and non-pregnant-sitting group, respectively. CONCLUSIONS: There was a significant difference between RLD and sitting position in non-pregnant patient only (p<0.05). It is suggested that the hydrostatic pressure of CSF above puncture level and the hydrostatic pressure of valveless epidural venous plexus blood influenced the epidural pressure of non-pregnant group in sitting position. But in pregnant group, abdominal mass may have elicited a draining effect on epidural venous plexus during lumbar flexion in sitting position and partially nullified the hydrostatic pressure of CSF and blood.
Epidural Space ; Humans ; Hydrostatic Pressure ; Needles ; Pregnancy ; Punctures

PURPOSE: To assess the relationship between the retinal thickness analyzer (RTA) parameters, and those of the GDx VCC scanning laser polarimeter (GDx VCC), Stratus OCT optical coherence tomography (Stratus OCT), and Heidelberg retinal tomograph II confocal scanning laser ophthalmoscopy (HRT II). METHODS: Twenty-nine primary open-angle glaucoma patients were retrospectively included in this study. Measurements were obtained using the RTA, GDx VCC, Stratus OCT, and HRT II. We calculated the correlation coefficients between the parameters of RTA and those of the other studies. RESULTS: Among the optic disc parameters of RTA, the cup volume was best correlated with Stratus OCT (R=0.780, p<0.001) and HRT II (R=0.896, p<0.001). Among the posterior pole retinal thickness parameters, the posterior pole abnormally thin area (PPAT) of the RTA and the inferior average of the GDx VCC were best correlated (R=-0.596, p=0.001). The PPAT of the RTA and the inferior maximum of the Stratus OCT were best correlated (R=-0.489, p=0.006). The perifoveal minimum thickness (PFMT) of the RTA and the cup shape measurement of the HRT II were best correlated (R=-0.565, p=0.004). CONCLUSIONS: Many RTA optic disc parameters were significantly correlated with those of the Stratus OCT and HRT II. The RTA posterior pole retinal thickness parameters were significantly correlated with those of the GDx VCC, Stratus OCT and HRT II. The RTA optic disc and posterior pole retinal thickness parameters may be valuable in the diagnosis of glaucoma.
Adolescent ; Adult ; Aged ; *Diagnostic Techniques, Ophthalmological ; Female ; Glaucoma, Open-Angle/*diagnosis ; Humans ; Lasers/diagnostic use ; Male ; Middle Aged ; Ophthalmoscopy ; Optic Disk/*pathology ; Optic Nerve Diseases/*diagnosis ; Retina/*pathology ; Retrospective Studies ; Tomography, Optical Coherence

PURPOSE: Assessment of the diameters of the aortic arches in the human fetus may be helpful in the prenatal diagnosis of aortic arch anomalies. The purpose of this study is to construct valuable reference ranges of fetal aortic arch for various fetal growth parameters in an unselected Korean population. METHODS: A prospective, cross-sectional study was performed in 98 normal singleton fetuses between 20 and 38 weeks of gestation. The transverse aortic arch diameter (TAD) and distal aorta isthmus diameter (AID) were measured in the longitudinal view during systole. The bi-parietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL) were obtained at the same time. Ultrasound examinations were performed with a 2.0-6.0 MHz convex probe by abdominal ultrasound. RESULTS: TAD and AID as a function of gestational age (GA) was expressed by the regression equation TAD= -1.246+0.168 X GA, and AID = -1.341+0.180 X GA; TAD and AID are expressed in millimeters and GA in weeks. TAD and AID as a function of BPD was expressed by the regression equation TAD= -1.147+0.664 X BPD, and AID = -1.152+0.696 X BPD. TAD and AID as a function of HC was expressed by the regression equation TAD = -1.187+0.182 X HC, and AID = -1.350+0.198 X HC. TAD and AID as a function of AC was expressed by the regression equation TAD = -0.528+0.173 X AC, and AID = -0.533+0.183 X AC. TAD and AID as a function of FL was expressed by the regression equation TAD = -0.519+0.799 X FL, and AID = -0.601+0.860 X FL; BPD, HC, AC and FL are expressed in centimeters. Correlations were found to be highly statistically significant in relation to GA, BPD, HC, AC, and FL respectively (P<0.0001 in all). Normal mean of TAD and AID per GA, BPD, HC, AC and FL and 95% prediction limits were also defined, respectively. CONCLUSION: New reference ranges of fetal aortic arch related to other fetal bio-parameters representing fetal growth were obtained successfully. The normative date will be helpful in the prenatal accurate diagnosis of aortic anomalies and abnormal growth of fetal aortic arches in Korea.
Aorta ; Aorta, Thoracic ; Cross-Sectional Studies ; Echocardiography ; Femur ; Fetal Development ; Fetus ; Gestational Age ; Head ; Humans ; Korea ; Pregnancy ; Prenatal Diagnosis ; Prospective Studies ; Reference Values ; Systole

The effect of betaxolol and dipivefrin on microcirculation of peripapil lary reina and optic disc in normal tension glaucoma was assessed. Betaxolol, selective beta-1 blocker, was known to improve the blood flow of retrobulbar arteries, and dipivefrin was known to decrease the flow of ciliary body. Total subjects were 29 normal tension glaucoma patients; 18 subjects with no previous IOP reducing eye drops during 4 weeks were assigned for betaxolol group, and 11 subjects with using timolol for dipivefrin group. The intraocular pressure was significantly reduced after instillation in betaxolol group(p<0.01), and in dipivefrin group(p<0.05). But systemic blood pressure and pulse rate were not changed after instillations in both groups. Blood flow, volume, velocity of optic disc and peripapillary retina of betaxolol group and dipivafrin group were not significantly changed. From the above results, we concluded that betaxolol and dipiverin with timolol did not influenced the microcirculation of peripapillary retina and opit disc.
Arteries ; Betaxolol* ; Blood Pressure ; Ciliary Body ; Heart Rate ; Humans ; Intraocular Pressure ; Low Tension Glaucoma* ; Microcirculation ; Ophthalmic Solutions ; Optic Disk* ; Optic Nerve* ; Retina ; Retinaldehyde* ; Timolol

Early recognition of coalescence in pneumoconiotic lesions is important because such coalescence is associated with the respiratory symptoms and deterioration of lung function. This complicated form of pneumoconiosis also has worse prognosis than does simple pneumoconiosis. High resolution computerized tomography(HRCT) provides significant additional information on the stage of the pneumoconiosis because it easily detects coalescence of nodules and emphysema that may not be apparent on the simple radiograph. The Purpose of this study is to clarify the role of HRCT in detection of large opacity and the relationship of change between the coalescence of nodules or emphysema and lung function in dust exposed workers. 1. There was good correlation between the HRCT grade of pneumoconiosis and ILO category of profusion. 5(9.09%) in 55 study population had confluent nodule extending over two or more cuts on HRCT. HRCT could identify the pneumoconiotic nodules which was not found by simple radiography in 6 workers with category 0/0. 2. No significant difference was observed coalescence of nodules and emphysema by dust type. 3. There was no significant difference in pulmonary function according to ILO and HRCT classification. 4. HRCT could detect the significant reduction in FEV1, FEV1/FVC, PEER, FEF25, FEF50, and FEF75 and remarkable increase in RV and TLC in study persons with emphysema compared with non-emphysema group. 5. Emphysema was found more often in nodules-coalescence group than small opacity group by HRCT. We found that HRCT could easily detect areas of coalescence and complicated emphysema compared to plain chest X-ray. Also our data suggest that it is primarily the degree of emphysema rather than the degree of pneumoconiosis that determines the level of pulmonary function.
Classification ; Dust ; Emphysema ; Humans ; Lung ; Pneumoconiosis* ; Prognosis ; Radiography ; Thorax

No abstract available.
Erythrocyte Membrane* ; Erythrocytes* ; Hydroxyl Radical* ; Lipid Peroxidation* ; Macrophages, Alveolar* ; Mineral Fibers*

It is widely accepted that a relatively small proportion of chronic disease can be explained by genetic factors alone. Although information about environmental exposure is important to comprehensively evaluate chronic diseases, this information is not sufficiently or accurately assessed by comparison with genomic factors. To emphasize the importance of more complete evaluation of environmental exposure, the concept of the exposome, which indicates the entirety of environmental exposure from conception onwards, was introduced in 2005. Since the 2010s several epidemiological studies, such as the Human Early-Life Exposome project, have applied the exposome concept. The exposome consists of three overlapping domains: the general external, the specific external, and the internal environments. General external factors include the broader socioeconomic environment, and specific external factors include lifestyles, occupations, and pollutant exposures. Internal factors include biological effects and responses. Because the exposome covers exposures from conception to death, the birth cohort is an important part of the exposome study. Although there is not yet an established consensus in selecting what, when, and where to measure concerning the exposome, the use of omics analyses, especially analysis of the metabolome, should be considered in order to implement the exposome concept in the birth cohort. The exposome needs to be measured repeatedly in certain important phases of life, such as during pregnancy and infancy. To perform exposome-informed epidemiological studies, untargeted data-driven approaches in conjunction with dimension reduction techniques need to be developed and refined. The exposome concept has the potential to make a breakthrough in overcoming some of the limitations of conventional epidemiology. Concerted national and international efforts are required for future exposome studies.
Chronic Disease ; Cohort Studies ; Consensus ; Environmental Exposure ; Epidemiologic Studies ; Epidemiology ; Fertilization ; Humans ; Life Style ; Metabolome ; Occupations ; Parturition ; Pregnancy

OBJECTIVE: To evaluate the clinical course of the patient who had the gynecologic operation using minolaparotomy. METHODS: We reviewed the chart of the patient who had the gynecologic operation using minilaparotomy in department of obstetrics and gynecology of St. Mary's hospital during Jan. 2000 Sept. 2002. RESULTS: Postopertive diagnosis is myoma (154 cases), adenomyosis (41 cases), ovary cyst (89 cases) and so on. We had performed hysterectomy (225 cases), myomectomy (86 cases), cystectomy or adenexectomy (85 cases) for these patient. There is no significant difference in clinical course between two total hysterecomized groups, one who had the operation history and the other who had not the operation history. CONCLUSION: In gynecological operations, minilaparotomy is the useful methods in any kind of the indication of operation, and show good clinical course.
Adenomyosis ; Cystectomy ; Diagnosis ; Female ; Gynecology ; Humans ; Hysterectomy ; Laparotomy* ; Myoma ; Obstetrics ; Ovary

PURPOSE: The purpose of study is to develop a home nursing care project model suitable for Korea's heath care system and policy directions for expansion and establishment of home nursing care. METHOD: The first, status of home nursing care program in medical institution and public health center was evaluated respectively in view of structure, process and performance. And then, issues of the program were analyzed in view of accessibility, safety, and sufficient supply. The second, demand projection of home nursing care according to income level and technical level of service that is needed to the subject was tried. In addition, the level of supply for home nursing care at present was estimated. The third, home nursing care program in advanced countries (Japan and U.S.A.) was examined. RESULT AND CONCLUSION: Community-based home nursing care program is developed into public-operation model and private-operation model from above the sub-subject result. Functional network for referral system among related institutions is built up to meet various needs, regardless of accessibility to distance and economy. And prior settlements and policy directions for expansion and establishment of home nursing care are suggested.
Home Nursing* ; Public Health ; Referral and Consultation

Genome-wide association studies (GWASs) have greatly contributed to the identification of common variants responsible for numerous complex traits. There are, however, unavoidable limitations in detecting causal and/or rare variants for traits in this approach, which depends on an LD-based tagging SNP microarray chip. In an effort to detect potential casual and/or rare variants for complex traits, such as type 2 diabetes (T2D) and triglycerides (TGs), we conducted a targeted resequencing of loci identified by the Korea Association REsource (KARE) GWAS. The target regions for resequencing comprised whole exons, exon-intron boundaries, and regulatory regions of genes that appeared within 1 Mb of the GWA signal boundary. From 124 individuals selected in population-based cohorts, a total of 0.7 Mb target regions were captured by the NimbleGen sequence capture 385K array. Subsequent sequencing, carried out by the Roche 454 Genome Sequencer FLX, generated about 110,000 sequence reads per individual. Mapping of sequence reads to the human reference genome was performed using the SSAHA2 program. An average of 62.2% of total reads was mapped to targets with an average 22X-fold coverage. A total of 5,983 SNPs (average 846 SNPs per individual) were called and annotated by GATK software, with 96.5% accuracy that was estimated by comparison with Affymetrix 5.0 genotyped data in identical individuals. About 51% of total SNPs were singletons that can be considered possible rare variants in the population. Among SNPs that appeared in exons, which occupies about 20% of total SNPs, 304 nonsynonymous singletons were tested with Polyphen to predict the protein damage caused by mutation. In total, we were able to detect 9 and 6 potentially functional rare SNPs for T2D and triglycerides, respectively, evoking a further step of replication genotyping in independent populations to prove their bona fide relevance to traits.
Cohort Studies ; Exons ; Genome ; Genome-Wide Association Study ; Humans ; Korea ; Polymorphism, Single Nucleotide ; Regulatory Sequences, Nucleic Acid ; Triglycerides