Purpose: This study investigated the effects of open kinetic chain (OKC) exercise for the gastrocnemius (GCM) and tibialis anterior (TA) muscles on static and dynamic balance and muscle strength. Methods: We recruited 21 healthy participants, dividing them into 3 groups (GCM, TA, and non-exercise). Each group contains 7 participants. Two exercise groups (GCM and TA) performed OKC exercise with elastic bands twice per week for 4 weeks, while non-exercise group did nothing. We obtained the data for static and dynamic balance and muscle strength before and after the intervention. We used the Kruskal–Wallis test to compare and analyze the pre–post-intervention differences among the groups. Results: For static balance, the stability index of the TA group was the lowest for the dynamic platform (p < 0.05). The dynamic balance of the TA group increased for the anterior and posteromedial directions (p < 0.05). The peak torque increased in the TA group for dorsiflexion (D/F) movement and in the GCM group for plantar flexion movement compared with the other groups, except for the left direction during D/F (p < 0.05). Conclusion OKC exercises with elastic bands were effective for selectively increasing muscle strength. It is clinically thought that strength training for TA muscles will be effective among the muscles of the ankle.

BACKGROUND: 5-Hydroxytryptamine3 (5-HT3) receptor antagonists have been reported to attenuate spinal anesthesia-induced hemodynamic changes. This study was conducted to determine whether the second generation 5-HT3, antagonist palonosetron attenuates hypotension and bradycardia during spinal anesthesia. METHODS: Sixty adult patients scheduled for lower limb surgery were enrolled in this study. Patients were randomly assigned to receive either normal saline (Control group, N = 30) or palonosetron (0.075 mg, i.v.) (Palonosetron group, N = 30) prior to spinal anesthesia. Hemodynamic variables were recorded during anesthesia. RESULTS: The mean blood pressure (MBP) were 89.2 ± 11.4 mmHg in the control group and 87.6 ± 12.1 mmHg in the palonosetron group at 10 min after intrathecal injection (P = 0.609). The median blocked levels of the control group and the palonosetron group were T10 (interquartile range, 9-10) and T10 (8-10) at 20 min after intrathecal injection (P = 0.939). Requirements for ephedrine, phenylephrine, and atropine were similar (P = 0.652, 0.533 and 0.417, respectively). The incidences of hypotension (40% vs. 41%) and bradycardia (7% vs. 17%) were comparable (P = 0.562, P = 0.198, respectively) between the control and the palonosetron group. There were no significances in the changes of systolic blood pressure, diastolic blood pressure, MBP and heart rate by the group (P = 0.632, 0.287, 0.556, 0.733, respectively). CONCLUSIONS: Intravenous palonosetron (0.075 mg) prior to spinal anesthesia might not attenuate spinal anesthesia-induced hypotension during low level of neuroaxial block for lower limb surgery.
Adult ; Anesthesia ; Anesthesia, Spinal ; Atropine ; Blood Pressure ; Bradycardia ; Ephedrine ; Heart Rate ; Hemodynamics ; Humans ; Hypotension* ; Incidence ; Injections, Spinal ; Lower Extremity ; Orthopedics* ; Phenylephrine

BACKGROUND/AIMS: The ballooning time in endoscopic papillary large balloon dilation (EPLBD) remains controversial. The aim of this study was to evaluate the significance of the ballooning time comparing an immediate balloon deflation method with a conventional ballooning time of > 45 seconds. METHODS: Between January 2010 and December 2010, 126 patients with bile duct stones treated with EPLBD and endoscopic sphincterotomy were divided according to the ballooning time: the immediate deflation group (n=56) and the conventional inflation group (ballooning time 45s to < 60s) (n=70). RESULTS: The overall success rate and the success rate of the first attempt of ERCP (endoscopic retrograde cholangio-pancreatography) were 96.4% (54/56) and 80.4% (45/56) in the immediate group and 97.1% (68/70) and 77.1% (54/70) in the conventional inflation group. There were no statistically significant differences in the overall success and the first attempt of ERCP success rate (p=0.99, p=0.66). The frequency of mechanical lithotripsy was 0% in the immediate deflation group and 7.1% in the conventional inflation group (p=0.065). Complications occurred in 3.6% (2/56) patients in the immediate deflation group and 8.6% (4/70) patients in the conventional inflation group (p=0.298). CONCLUSIONS: The ballooning time in EPLBD does not affect the outcomes of the treatment for bile duct stones. And the feasibility of the immediate deflation method in EPLBD is acceptable.
Bile Ducts* ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Humans ; Inflation, Economic ; Lithotripsy ; Sphincterotomy, Endoscopic

The gradual loss of telomeric DNA can contribute to replicative senescence and thus, having longer telomeric DNA is generally considered to provide a longer lifespan. Maintenance and stabilization of telomeric DNA is assisted by binding of multiple DNA-binding proteins, including those involved in double strand break (DSB) repair. We reasoned that declining DSB repair capacity and increased telomere shortening in aged individuals may be associated with decreased expression of DSB repair proteins capable of telomere binding. Our data presented here show that among the DSB repair proteins tested, only the expression of Ku70 and Mre11 showed statistically significant age-dependent changes in human lymphocytes. Furthermore, we found that expressions of Ku70 and Mre11 are statistically correlated, which indicate that the function of Ku70 and Mre11 may be related. All the other DSB repair proteins tested, Sir2, TRF1 and Ku80, did not show any significant differences upon aging. In line with these data, people who live in the regional community (longevity group), which was found to have statistically longer average life span than the rest area, shows higher level of Ku70 expression than those living in the neighboring control community. Taken together, our data show, for the first time, that Ku70 and Mre11 may represent new biomarkers for aging and further suggest that maintenance of higher expression of Ku70 and Mre11 may be responsible for keeping longer life span observed in the longevity group.
Telomere/genetics ; Middle Aged ; Longevity ; Humans ; DNA-Binding Proteins/*metabolism ; DNA Repair/*genetics ; DNA/genetics ; Cell Aging/*physiology ; CD4-Positive T-Lymphocytes/metabolism ; Antigens, Nuclear/*metabolism ; Aging/*physiology ; Aged, 80 and over ; Aged ; Adult

BACKGROUND: Since most of epidemiologic studies of cancer disease in Korea are on the basis of data from large hospitals in metropolitan area, they neither represent the separate district, nor reflect the characters of rural area. We aimed to help prevent cancer and present control strategies in good accordance with regional features by evaluating the epidemiologic characters of cancers and performing a comparative study between urban and rural area. METHODS: We retrospectively reviewed the medical records of newly diagnosed cancer patients from January 1997 to December 2000 in Gangneung Asan Hospital, who resided in Gangneung city on diagnosis and investigated their pathologic results, radiologic findings, risk factors, stages, treatment modalities, etc. On the basis of them, we estimated incidence rates including crude rates and age standardized rates and compaed the differences between urban and rural area. RESULTS: The numbers of newly diagnosed cancer patients during this period were 367 in gastric cancer, 186 in hepatoma and 177 in lung cancer. The age standardized annual incidence rates of gastric cancer were estimated to be 49.7/17.8 (M/F) in urban area and 52.7/25.9 (M/F) in rural area per 100,000 persons. In hepatoma, the rates were 28.4/6.3 in urban and 36.3/6.5 in rural area and in the case of lung cancer, 23.5/6. 1 in urban and 32.0/7.4 in rural area. As a consequence, the age standardized annual incidence rates of rural area were higher than those of urban area in all the three cancers and the diffences were statistically significant except female hepatoma and lung cancer. However, risk factor survey among cancer patients revealed only difference in the amount of alcohol consumption associated with hepatoma, between urban and rural area. CONCLUSION: In rural area, the age standardized incidence rates were significantly higher than those of urban area in Gangneung city except female hepatoma and lung cancer. Moreover, in rural area, cancers were detected as more advanced state. Hence, preventive measures fit for these features were required urgently. In addition, more investigations about risk factors were needed to discover the cause of difference, including environmental and host factors which were not covered in this study.
Alcohol Drinking ; Carcinoma, Hepatocellular* ; Chungcheongnam-do ; Diagnosis ; Epidemiologic Studies ; Female ; Gangwon-do* ; Humans ; Incidence* ; Korea ; Lung Neoplasms* ; Lung* ; Medical Records ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms*

We report 3 cases of unusual cutis marmorata telangiectatica congenita (CMTC). The ages of the first two cases of CMTC were premature babies, born at intrauterine pregnancy of 31 weeks and 34 weeks. the other patient was a 45-year old female. Compared to the age of other cases reported in the literature our patients ages are unusual. It is not surprising that the first two cases of premature babies had typical signs because CMTC is a congenital disorder, usually seen at birth, but the fact that the skin lesion of CMTC appeared already in the early third trimester may provide some clues to the pathogenesis of CMTC. The third case seems to be very rare because most reported cases show that the skin lesion usually disappear gradually over a period of months to years. The site and size of the lesion in the last case was told to have been fixed for 45 years without any change.
Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Female ; Humans ; Parturition ; Pregnancy ; Pregnancy Trimester, Third ; Skin

We report a case of infantile acropustulosis in a 7 month-old female infant who had a family history of scabies in her parents and brother. She had pruritic papulovesicles and pustules, predominantly on the hands and feet. Histopathologically, there was a well-circumscribed unilocular, subcorneal pustule filled with neutrophils, mostly. Under the diagnosis of an infantile acropustulosis associated with scabies, she was treated with a potent topical corticosteroid and oral antihistamines without recurrence.
Diagnosis ; Female ; Foot ; Hand ; Histamine Antagonists ; Humans ; Infant ; Neutrophils ; Parents ; Recurrence ; Scabies* ; Siblings

Glutaraldehyde is commonly used as a biocide to disinfect delicate instruments such as dental instruments, to treat warts, hyperhidrosis and bullous diseases and as a preservative in various materials. Contact sensitivity to glutaraldehyde may not be detected, because it is not included in the standard screening chemicals recommended in the screening tests. We report a case of allergic contact dermatitis caused by Wydex(2% glutaraldehyde). A 54-year-old female made a visit to our departrnent with eczematous dermatitis of both hands, neck and face. She worked as a cleaner in delivery room and newborn nursery, and had developed the dermatitis 1 month after Wydex' containing 2% glutaraldehyde had been to clean the rooms. She had no family or personal history of atopy or contact dermatitis. Patch tests with Korean Standard(KS-1000) and Wydex were performed, and patch tests with 2% glutaraldehyde, 0.2% gluteraldehyde and rubber mix followed. The positive results were, Wydex 2% ++, 0.2% +, 0.02% + and. glutaraldehyde 2% aq. +, 0.2% aq. + on day 2 and day 4. We confirmed that the skin lesions had been caused by Wydex . The symptoms were eradicated after she changed her work environment and there has been no evidence of recurrence.
Delivery Rooms ; Dental Instruments ; Dermatitis ; Dermatitis, Allergic Contact* ; Dermatitis, Contact ; Eczema ; Female ; Glutaral* ; Hand ; Humans ; Hyperhidrosis ; Infant, Newborn ; Mass Screening ; Middle Aged ; Neck ; Nurseries ; Patch Tests ; Recurrence ; Rubber ; Skin ; Warts

A 16-year old girl was admitted for chronic diarrhea, generalized edema, severe pain of lower extremities, and general weakness. She could not walk because of burning pain of knee and ankle. 99mTc-MDP bone scan demonstrated increased periarticular uptake in both lower extremity with focal increased activity in proximal portion of both tibias.. Abnormal abdominal activity in ascending, transverse, and descending colon is also seen. Bone densitometry showed severe osteoporosis in lower extremity. 99mTc-HSA scan showed abnormal radioactivity in small bowel, and descending colon indicating protein losing enteropathy. Endoscopic biopsy of terminal ileum showed a few dilated lymphatics in the submucosa. After steroid and supplemental therapy, the symptoms and signs of both protein losing enteropathy and RSDS much improved simultaneously. Reflex sympathetic dystrophy syndrome is a complex of symptoms characterized by severe pain, swelling, autonomic vasomotor dysfunction, and impaired mobility of affected extremities. The important causes are trauma, fracture, and inflammation. We assumed that the reflex sympathetic dystrophy syndrome of this girl was due to protein losing enteropathy. And as far as we know there has not been reported case that protein losing enteropathy assumed as a cause of reflex sympathetic dystrophy syndrome.
Adolescent ; Ankle ; Biopsy ; Burns ; Colon, Descending ; Densitometry ; Diarrhea ; Edema ; Extremities ; Female ; Humans ; Ileum ; Inflammation ; Knee ; Lower Extremity ; Osteoporosis ; Protein-Losing Enteropathies* ; Radioactivity ; Reflex Sympathetic Dystrophy* ; Reflex* ; Technetium Tc 99m Aggregated Albumin ; Technetium Tc 99m Medronate ; Tibia

BACKGROUND: Pityriasis versicolor is often found following pathologic transformation of Malassezia fungi from yeast to mycelial forms by a poorly understood mechanism and is characterized by squamous skin lesions manifesting hyper- or hypo-pigmentation. Itraconazole is a synthetic oral antifungal agent of triazole family, which acts as a selective inhibitor of the cytochrome P-450-dependent synthesis of ergosterol and is reported to demonstrate a potent antifungal efficacy against Malassezia yeasts. OBJECT: The present clinical study was designed to evaluate the therapeutic efficacy of one- week regimen of itraconazole by studying 20 patients with pityriasis versicolor, who were diagnosed both clinically and mycologically. In addition, we wished to identify Malassezia species from skin lesions of pityriasis versicolor and examine the possible correlation of a certain Malassezia(M.) species and pityriasis versicolor. METHODS: Twenty patients (ages, 18 to 49) were included in the study, following the diagnosis of pityriasis versicolor, which was based on clinical examinations and mycological studies (microscopy and culture). Patients received a single 200 mg dose of itraconazole (Sporanox? capsules daily with a full meal for one week. For all patients, clinical examinations and culture and microscopic studies were done before treatment, at the end of treatment, and 4 weeks later. Scales obtained from skin lesions were studied by Parker-KOH smear examination and culture studies to identify Malassezia yeasts. Cultures were done using agar media of Leeming & Notman. RESULTS: By comparing skin lesions before and immediately after treatment, marked improvement was observed in 7 patients (35%) and moderate improvement in 12 patients (60%) among a total of 20 patients, and 1 patient (5%) showed no response. On the other hand, by comparing skin lesions examined before treatment and 4 weeks after completing medication, complete cure was observed in 13 cases (65%), marked improvement in 5 (25%), and moderate improvement in 2 (10%). With culture studies before treatment, M. globosa, M. furfur, and M. restricta were isolated as a major fungal species in 18, 1, and 1 patients, respectively. CONCLUSION: The result suggested that administration of a single dose of 200 mg itraconazole (Sporanox? capsules daily for a week is a very effective treatment for pityriasis versicolor and also indicated that pityriasis versicolor is very closely related with the infection of M. globosa.
Agar ; Capsules ; Cytochromes ; Diagnosis ; Ergosterol ; Fungi ; Hand ; Humans ; Itraconazole* ; Malassezia ; Meals ; Pityriasis* ; Skin ; Tinea Versicolor* ; Weights and Measures ; Yeasts