Dendrobium moniliforme (L.) Sw., an herb of the Orchidaceae family, has long been used in traditional medicine to strengthen bones, nourish the stomach, and promote the production of bodily fluid. Recently, polysaccharides isolated from Dendrobium have been used in functional foods and nutraceutical products. A traditional method to process Dendrobium is to soak fresh stems in an ethanol solution, which is the most important factor to ensure high yields of aqueous-extractable polysaccharides. The present study was carried out to investigate the potential acute toxicity of D. moniliforme aqueous extract (DMAE), by a single oral dose in Sprague-Dawley rats. The test article was orally administered once by gavage to male and female rats at doses of 0, 2,500, and 5,000 mg/kg body weight (n=5 male and female rats for each dose). Throughout the study period, no treatment-related deaths were observed and no adverse effects were noted in clinical signs, body weight, food consumption, serum biochemistry, organ weight, or gross findings at any dose tested. The results show that a single oral administration of DMAE did not induce any toxic effects at a dose below 5,000 mg/kg in rats, and the minimal lethal dose was considered to be over 5,000 mg/kg body weight for both sexes. With respect to cytotoxicity, the cell viability of human embryonic kidney (HEK293) cells was less than 50% when the cells were treated with 10 mg/mL aqueous extract for 24 h.
Administration, Oral ; Animals ; Biochemistry ; Body Weight ; Cell Survival ; Dendrobium* ; Dietary Supplements ; Ethanol ; Female ; Functional Food ; Humans ; In Vitro Techniques* ; Kidney ; Male ; Medicine, Traditional ; Methods ; Orchidaceae ; Organ Size ; Polysaccharides ; Rats ; Rats, Sprague-Dawley ; Stomach

PURPOSE: We evaluated the clinical and radiological outcomes of double-bundle anterior cruciate ligament (ACL) reconstruction using an outside-in technique with a follow-up of two- to six-years, especially in terms of the sports activity level and radiological degeneration. MATERIALS AND METHODS: Sixty-seven patients who were available for a minimum two-year follow-up after double-bundle ACL reconstruction using an outside-in technique were retrospectively evaluated. The mean follow-up period was 43.7 months. The knee function and stability were evaluated before the operation, one year after the operation (short-term follow-up), and more than two years after the operation (last follow-up). RESULTS: Regarding the knee function, the Lysholm score, International Knee Documentation Committee (IKDC) evaluation, and hop test showed significant improvement. Regarding the stability, the Lachman test, pivot shift test, KT-2000 arthrometer data, and anterior drawer radiographs using Telos showed significant improvement. Regarding the sports activity level, the patients who returned to pre-injury level activity was 68.7% according to the Tegner activity score and 76.1% according to the Cincinnati sports activity scale score. The incidence of aggravated degeneration or development of greater than IKDC grade A degeneration after surgery was 10.4%. CONCLUSIONS: Double-bundle ACL reconstruction using an outside-in technique showed favorable clinical and radiological outcomes with respect to the knee function and stability, joint degeneraion, and, especially, return to pre-injury sports activity.
Anterior Cruciate Ligament ; Anterior Cruciate Ligament Reconstruction ; Follow-Up Studies ; Humans ; Humulus ; Incidence ; Joints ; Knee ; Retrospective Studies ; Sports

BACKGROUND/AIMS: Symptom-to-door time is associated with the prognosis for ST-segment elevation myocardial infarction. However, this value has not been a concern in patients with non-ST segment elevation myocardial infarction (NSTEMI). The aim of this study was to assess the relationship between symptom-to-door time and clinical outcomes in patients with NSTEMI. METHODS: In total, 1,971 patients with NSTEMI (64.8+/-12.1 years, 23.6% women) were enrolled between Nov. 2005 and Jan. 2008. The patients were divided into two groups according to the time difference between the presentation of symptoms and first medical contact: group I (<12 hours, n=1433) and group II (>12 hours, n=538). One-year mortality rates were compared between the groups. Thrombolysis In Myocardial Infarction (TIMI) and Global Registry of Acute Coronary Events (GRACE) risk scores were calculated in all study patients. RESULTS: The mean age was 64.4+/-12.2 years in group I and 65.6+/-12.0 years in group II (p=0.046). No significant differences existed between the two groups, except for the prevalence of hypertension, diabetes mellitus, initial systolic blood pressure, and initial serum creatinine levels. One-year mortality rates decreased significantly in group I patients [hazard ratio (HR)=1.35, 95% CI (confidential interval): 1.03~1.75, p=0.028] based on a multivariate Cox proportional analysis, which was adjusted by GRACE score, baseline characteristic variables, and predictors of a 1-year mortality in a univariate analysis. In intermediate-to high-risk patients (n=1,184, defined as having a TIMI risk score above 3 points), significant differences were observed in mortality rates between the two groups (HR=1.35, 95% CI: 1.02~1.80, p=0.037); the low-risk patients (n=787, HR=1.57, 95% CI: 0.80~3.05, p=0.188), however, showed no such differences. CONCLUSIONS: Symptom-to-door time was an independent long-term clinical predictor in patients with NSTEMI, especially in intermediate-to high-risk groups.
Blood Pressure ; Creatinine ; Diabetes Mellitus ; Humans ; Hypertension ; Myocardial Infarction ; Prevalence ; Prognosis

PURPOSE: The effectiveness of teaching cardiopulmonary resuscitation (CPR) in schools is known to be higher among older students. However, several easier programs have been successful even for primary school children. The purpose of this study is to determine the optimal target age for teaching CPR in schools. METHODS: Six classes from the fifth to the tenth grade were randomly selected. A video-based self-instructional program was presented by health teachers in each school using the Korean version of CPR Anytime(TM) during normal school hours. Questionnaires were given after training to determine their degree of confidence in performing CPR, their willingness to perform CPR on a family, a friend, and a stranger, and at what age the children wanted to learn CPR. Skill tests were administered for several volunteer students. One week after the training, the students were asked to what extent they had shared their knowledge of CPR technique with other people. RESULTS: Two hundred one students were given the CPR instruction. The confidence in performing CPR was lowest among seventh grade children. The willingness expressed by the students to perform CPR on a family member, a friend, and a stranger were 99.5%, 95.7% and 58.8%, respectively, with boys in the tenth grade most willing to perform CPR on a stranger. The students responded that it is most suitable to learn CPR at grade 6.4+/-2.4. The highest average skill score of 9.5/11 was for sixth grade. The average distribution rate was 1.23, and again this was highest in sixth grade at 3.72. CONCLUSION: This study suggests that the optimal target school age for CPR education using video-based self instruction may be at approximately the sixth grade.
Cardiopulmonary Resuscitation* ; Child ; Education* ; Friends ; Humans ; Programmed Instruction as Topic* ; Surveys and Questionnaires ; Volunteers

OBJECTIVES: Workers from a factory was selected to compare 8 standard threshold shift criteria with the Korean diagnostic criteria of noise-induced hearing loss for this cohort study. METHODS: From 1990 to 1999, 491 workers at a manufacturing company with complete record of the hearing test covering the range of 0.5~6 kHz for 10 consecutive years were finally selected. Eight standard threshold shift criteria (15 dB once, NIOSH (1972), 10 dB average 3~4 kHz, OSHA STS, AAOHNS, 15 dB twice, 15 dB 1~4 kHz, OSHA STS twice) along with the Korean standard for diagnosing the noise-induced hearing loss (the average hearing threshold at 0.5, 1 and 2 kHz) were compared to calculate the degree of the threshold shift and the minimum time required to detect the change. RESULTS: Those workers showing at least one positive shift in the 'once'criteria of NIOSH (1972) were 92.5%; the 'average'criteria of 10 dB average 3~4 kHz were 35.8%; 'twice'criteria of 15 dB twice were 44.4%. The duration from the baseline to the year showing the first positive shift was from 3.2 +/- 3.1 years (NIOSH, 1972) to 6.0 +/- 2.1 years (OSHA STS twice). The percentage of true positive shift ranging from 20.4% (AAO-HNS) to 69.8% (NIOSH, 1972). There were 10 (2%) which met the Korean diagnostic criteria of noise-induced hearing loss. CONCLUSIONS: Currently the concept of hearing threshold shift in diagnosing the hearing loss was adopted in Korea thus in this study we determined the validity and the effect of the various hearing threshold shift criteria and showed that NIOSH (1972) criteria was the best of all. In the future, hearing data from various manufacturing workers should be compared to thoroughly evaluate the threshold shift criteria and to establish adequate standard for Korean workers.
Cohort Studies ; Hearing Loss ; Hearing Loss, Noise-Induced ; Hearing Tests ; Hearing* ; Korea ; National Institute for Occupational Safety and Health (U.S.) ; United States Occupational Safety and Health Administration

BACKGROUND: Has been reported that patients exhibiting prolonged paced QRS duration tend to have more serious heart disease, and the paced QRS duration can be an effective indicator of impaired left ventricular function. However, the acute and chronic hemodynamic effects of paced QRS duration and pacing sites during right ventricular (RV) pacing remain unknown. METHODS: A total of 14 patients who underwent electrophysiologic study for paroxysmal supraventricular tachycardia were examined. RV pacing was performed at 10 different sites with cycle lengths of 600 ms and 500 ms utilizing a 6-7F deflectable quadripolar electrode catheter. Systolic, diastolic, and mean blood pressures during pacing were measured once the blood pressure was stabilized. RESULTS: During RV pacing, blood pressures (systolic/diastolic/mean) decreased. The change of post-pacing QRS duration and pre-pacing the systolic blood pressure (SBP) were greater in the group with paced QRS duration. The differences overall were greater than 140 ms. The SBP decrease during pacing was larger in the group exhibiting paced QRS duration of greater than 140 ms. The SBP decrease during pacing showed relation to QRS duration during pacing (r=0.500, p=0.001), the change of QRS duration post-pacing (r=0.426, p=0.001), and SBP during sinus rhythm (r=0.342, p=0.001) on linear correlation analysis. The pacing site, on the other hand, did not affect acute hemodynamic changes during pacing. CONCLUSION: Ventricular pacing of less than 40 ms at the area of paced QRS duration is recommended.
Blood Pressure/physiology ; *Cardiac Pacing, Artificial ; Electrophysiologic Techniques, Cardiac ; Female ; Heart Ventricles/*physiopathology ; Hemodynamic Processes/*physiology ; Humans ; Male ; Middle Aged ; Tachycardia, Supraventricular/physiopathology/*therapy

Nowadays, the increasing use of antibiotics induces many complications including pseudomembranous colitis. Isolates of toxigenic Clostridium difficile, the most frequent cause of antibiotic-associated pseudomembranous colitis, are almost always highly susceptible to rifampicin. However, resistant isolates exist and have been associated with colitis in humans. We report a case of pseudomem- branous colitis associated with rifampicin administration.
Aged* ; Anti-Bacterial Agents ; Clostridium difficile ; Colitis ; Enterocolitis, Pseudomembranous* ; Humans ; Rifampin*

BACKGROUND: Intraventricular conduction disturbances, as manifested by increased QRS duration, are common in patients with advanced left ventricular (LV) dysfunction and adversely affect LV systolic and diastolic function. It has been reported that the patients with prolonged paced QRS duration have more serious heart disease, and the paced QRS duration can be a useful indicator of impaired LV function. Hemodynamic effects of paced QRS duration and pacing site during right ventricular (RV) pacing are unknown. METHODS: A total of 14 patients who underwent electrophysiologic study for paroxysmal supraventricular tachycardia at Chonnam National University Hospital were examined. All the patients had no structural heart disease. RV pacing was performed at 10 different sites with cycle length of 600 ms and 500 ms using a 6-7F deflectable quadripolar electrode catheter (Livewire, St. Jude Medical, Minneapolis, MN, USA). Systolic, diastolic, and mean blood pressures were measured after stabilization of blood pressure during pacing. RESULTS: Blood pressures (systolic/diastolic/mean) decreased from 146 +/- 31/95 +/- 28/125 +/- 23 mmHg to 128 +/- 33/80 +/- 25/107 +/- 20 mmHg, respectively. The change of QRS duration during pacing and the systolic blood pressure (SBP) before pacing were higher in the group with paced QRS duration greater than 140 msec (59.1 +/- 13.6 msec vs 84.9 +/- 18.7 msec, 141 +/- 30 mmHg vs 152 +/- 38 mmHg, p<0.001, p=0.011, respectively). The decrease of SBP during pacing was higher in the group with paced QRS duration greater than 140 msec (13 +/- 11 mmHg vs 24 +/- 14 mmHg, p=0.009). The decrease of SBP during pacing was related with QRS duration during pacing (r=0.500, p=0.001), the change of QRS duration during pacing (r=0.426, p=0.001), and SBP during sinus rhythm (r=0.342, p=0.001) on linear correlation analysis. Pacing site, however, did not affect acute hemodynamic change during pacing. The independent factors associated with the decrease of SBP during pacing were SBP before pacing and QRS duration during pacing. CONCLUSION: We concluded that acute deleterious hemodynamic effects of RV pacing are related with paced QRS duration but not with pacing site. Ventricuar pacing at the area of paced QRS duration less than 140 msec is recommended particularly in high risk patients.
Blood Pressure ; Catheters ; Electrodes ; Heart Diseases ; Hemodynamics* ; Humans ; Jeollanam-do ; Tachycardia, Supraventricular

BACKGROUND: A proximal Left anterior descending coronary artery (LAD) is one of the most important arterial segment due to its wide area of myocardial blood supply and high incidence of restenosis after percutaneous coronary intervention. This study was aimed to predict the risk factor after stenting in proximal LAD. METHODS: A total of 412 patients with proximal LAD stent implantation, who underwent follow-up coronary angiogram except for the LAD ostial lesion between 1996 and 2001 at Chonnam National University Hospital, were divided into two groups: Restenosis group (n=144 : 57.5 +/- 10.2 years, 78.8% male) and no restenosis group (n=268 : 57.4 +/- 10.0 years, 76.8% male). Restenosis rate, complications and predictive factors after proximal LAD stenting were analyzed. RESULTS: There were no differences in baseline clinical characteristics of sex, age, risk factors of atherosclerosis, lipid profile, clinical diagnosis, type and number of lesion coronary artery, Thrombolysis In Myocardial Infarction flow between the two groups. The restenosis rate after proximal LAD stenting was 35.0%. The complications during the follow up period after stenting were one transient ischemic attack in restesnosis group and one non-hemorrhagic stroke in both groups. There were no differences in major advanced cardiac event until the 12th month clinical follow up. There were no differences in lesion length, reference diameter, minimal luminal diameter, diameter stenosis and stent diameter, but the stent length were longer (20.7 +/- 6.92 mm) in restenosis group compared with no restenosis group (18.8 +/- 6.18 mm, p=0.006). CONCLUSION: The restenosis rate after proximal LAD stenting is relatively high and the only predictive factor for restenosis is stent length.
Atherosclerosis ; Constriction, Pathologic ; Coronary Disease ; Coronary Vessels* ; Diagnosis ; Follow-Up Studies ; Humans ; Incidence ; Ischemic Attack, Transient ; Jeollanam-do ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Phenobarbital ; Risk Factors ; Stents* ; Stroke

OBJECTiVE We investigate the effects of multiple attempts of embryo transfer because of retained embryos in the catheter and of contaminated mucus on the transferred catheter. MATERiALS AND METHODS: We respectively analysed data between November 1998 and August 2002 from 305 patients of 369 cycles who underwent iVF-ET. Of these patients, 47 patients of 50 cycles (Group 2) were required multiple trial of embryo transfer. They were compared with an age-matched control groups (Group 1) with female factor infertility. Pearson's c2 and Fisher's tests were used to compare proportions between discrete variables. Non-categorical data were compared using t-test. Statistical significance was set at p<0.05. RESULTS: Embryos were significantly more likely to be retained when catheter was contaminated with mucus (Group 1: 22.4%; Group 2: 44.0%). The clinical pregnancy rates, however, for the contaminated mucus or not, were 46.8%, 43.5% respectively. There was no significant difference clinical pregnancy rate between those who had all their embryos transferred at the first attempt (45.4%) and those who required more than one attempt (48.0%). CONCLUSiONS: Contaminated mucus in the catheter is associated with failed embryo transferred at the first attempt. Embryo transfers, however, that are repeated attempts do not adversely affect pregnancy rates following iVF-ET.
Catheters ; Embryo Transfer* ; Embryonic Structures* ; Female ; Fertilization* ; Humans ; Infertility ; Mucus* ; Pregnancy Rate* ; Pregnancy*