BACKGROUND AND OBJECTIVES: Wall shear stress contributes to atherosclerosis progression and plaque rupture. There are limited studies for statin as a major contributing factor on whole blood viscosity (WBV) in patients with acute coronary syndrome (ACS). This study investigates the effect of statin on WBV in ACS patients. SUBJECTS AND METHODS: We prospectively enrolled 189 consecutive patients (mean age, 61.3±10.9 years; 132 males; ST-segment elevation myocardial infarction, n=52; non-ST-segment elevation myocardial infarction, n=84; unstable angina n=53). Patients were divided into two groups (group I: previous use of statins for at least 3 months, n=51; group II: statin-naïve patients, n=138). Blood viscosities at shear rates of 1 s-1 (diastolic blood viscosity; DBV) and 300 s-1 (systolic blood viscosity; SBV) were measured at baseline and one month after statin treatment. Rosuvastatin was administered to patients after enrollment (mean daily dose, 16.2±4.9 mg). RESULTS: Baseline WBV was significantly higher in group II ([SBV: group I vs group II, 40.8±5.9 mP vs. 44.2±7.4 mP, p=0.003], [DBV: 262.2±67.8 mP vs. 296.9±76.0 mP, p=0.002]). WBV in group II was significantly lower one month after statin treatment ([SBV: 42.0±4.7 mP, p=0.012, DBV: 281.4±52.6 mP, p=0.044]). However, low-density lipoprotein cholesterol level was not associated with WBV in both baseline (SBV: R2=0.074, p=0.326; DBV: R2=0.073, p=0.337) and after one month follow up (SBV: R2=0.104, p=0.265; DBV: R2=0.112, p=0.232). CONCLUSION: Previous statin medication is an important determinant in lowering WBV in patients with ACS. However, one month of rosuvastatin decreased WBV in statin-naïve ACS patients.
Acute Coronary Syndrome* ; Angina, Unstable ; Atherosclerosis ; Blood Viscosity* ; Cholesterol ; Follow-Up Studies ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Lipoproteins ; Male ; Myocardial Infarction ; Prospective Studies ; Rheology ; Rupture ; Rosuvastatin Calcium

BACKGROUND: It has been known that positive end-expiratory pressure (PEEP) increases the vasoconstriction threshold by baroreceptor unloading. We compared the effect on the thermoregulatory responses according to anesthetic techniques between an inhalation anesthesia with desflurane and a total intravenous anesthesia (TIVA) with propofol and reminfentanil when PEEP was applied in patients undergoing tympanoplasty. METHODS: Forty-six patients with a scheduled tympanoplasty were enrolled and the patients were divided in two study groups. Desflurane was used as an inhalation anesthetic in group 1 (n = 22), while TIVA with propofol and remifentanil was used in group 2 (n = 24). PEEP was applied by 5 cmH2O in both groups and an ambient temperature was maintained at 22-24degrees C during surgery. The core temperature and the difference of skin temperature between forearm and fingertip were monitored for about 180 minutes before and after the induction of general anesthesia. RESULTS: The final core temperature was significantly higher in group 2 (35.4 +/- 0.7degrees C) than in group 1 (34.9 +/- 0.5degrees C). Peripheral thermoregulatory vasoconstriction was found in 5 subjects (23%) in group 1 and in 21 subjects (88%) in group 2. The time taken for reaching the thermoregulatory vasoconstriction threshold was 151.4 +/- 19.7 minutes in group 1 and 88.9 +/- 14.4 minutes in group 2. CONCLUSIONS: When PEEP will be applied, anesthesia with TIVA may have more advantages in core temperature preservation than an inhalation anesthesia with desflurane.
Anesthesia ; Anesthesia, General ; Anesthesia, Inhalation* ; Anesthesia, Intravenous ; Body Temperature Regulation ; Forearm ; Humans ; Inhalation ; Positive-Pressure Respiration ; Pressoreceptors ; Propofol ; Skin Temperature ; Tympanoplasty* ; Vasoconstriction

BACKGROUND: Rocuronium has been well known to produce withdrawal response in 50-80% patients when administered intravenously. Several drugs are administered prior injection of rocuronium to prevent the withdrawal response. We compared the preventive effect of lidocaine, ketamine, and remifentanil on the withdrawal response of rocuronium. METHODS: A total of 120 patients undergoing various elective surgeries were enrolled. Patients were allocated into 4 groups according to the pretreatment drugs (Group N, normal saline; Groups L, lidocaine 40 mg; Group K, ketamine 0.5 mg/kg; Group R, remifentanil 1 microg/kg). Patients received drugs prepared by dilution to 3 ml volume before injection of rocuronium. Withdrawal responses after injection of rocuronium were graded on a 4-point scale. Hemodynamic changes were observed before and after administration of pretreatment drugs and after endotracheal intubation. RESULTS: Incidence of withdrawal response was significantly lower in group L (20%), group K (30%), and group R (0%), than group N (87%). Severe withdrawal response was observed in 5 of the 30 patients (17%) in group L, and in 9 of the 30 patients (30%) in group K. There was no severe withdrawal response in group R. Mean blood pressure and heart rate were significantly decreased in group R compared to other groups. CONCLUSIONS: It seems that remifentanil (1 microg/kg intravenously) was the strongest and most effective in prevention of withdrawal response after rocuronium injection among the 3 drugs.
Blood Pressure ; Heart Rate ; Hemodynamics ; Humans ; Incidence ; Intubation, Intratracheal ; Ketamine* ; Lidocaine*

To prepare measures for practical policy utilization and the control of heavy metals, hazard control related institutions by country, present states of control by country, and present states of control by heavy metals were examined. Hazard control cases by heavy metals in various countries were compared and analyzed. In certain countries (e.g., the U.S., the U.K., and Japan), hazardous substances found in foods (e.g., arsenic, lead, cadmium, and mercury) are controlled. In addition, the Joint FAO/WHO Expert Committee on Food Additives (JECFA) recommends calculating the provisional tolerable weekly intake (PTWI) of individual heavy metals instead of the acceptable daily intake (ADI) to compare their pollution levels considering their toxicity accumulated in the human body. In Korea, exposure assessments have been conducted, and in other countries, hazardous substances are controlled by various governing bodies. As such, in Korea and other countries, diverse food heavy metal monitoring and human body exposure assessments are conducted, and reducing measures are prepared accordingly. To reduce the danger of hazardous substances, many countries provide leaflets and guidelines, develop hazardous heavy metal intake recommendations, and take necessary actions. Hazard control case analyses can assist in securing consumer safety by establishing systematic and reliable hazard control methods.
Arsenic ; Cadmium ; Food Additives ; Hazardous Substances ; Human Body ; Joints ; Korea ; Metals, Heavy ; Risk Management ; Safety Management

Endobronchial inflammatory myofibroblastic tumor is a rare primary lung disease. A 39-year-old woman with dyspnea and a productive cough underwent complete surgical resection of a small-sized inflammatory myofibroblastic tumor that invaded the left main bronchus and the carina with lung-saving modified left one-stoma-type carinoplasty. We report this case with a review of literature.
Adult ; Bronchi ; Bronchial Neoplasms ; Cough ; Dyspnea ; Female ; Humans ; Lung Diseases ; Myofibroblasts

The aim of this project was to use 3D scanning data collected at incident scenes and various evidence to 1) develop surveying methods based on 3D data consisting of overall and detailed scene evidence, captured by long-range and micros-canner, which can be shared by personnel working in different fields such as forensic medicine, video analysis, physical analysis, traffic engineering, and fire investigation; 2) create digital storage for human skeletons and set the foundation for virtual anthropology; and 3) improve the credibility of 3D evidence by virtual remodeling and simulation of incident scenes and evidence to provide a basis for advanced and high-tech scientific investigation. Two complete skeletons of male and female were scanned using 3D micro-scanner. Each bone was successfully reproduced and assembled in virtual space. In addition, recreating evidence scheduled for invasive examination by creating RP (rapid prototype) was possible. These outcomes could play an important role in setting up the new field of virtual anthropology. Case-specific surveying methods were developed through analysis of 3D scanning data collected by long-range surface scanners at the scenes of vehicular accidents, falls, shootings, and violent crimes. A technique and recording method was also developed for detecting forged seals by micro-scanning the pressure exerted on the seal. Appraisal methods developed in this project could be utilized to secure 3D data of human skeletal remains and incident scenes, create a standard for application, and increase objectivity, reproducibility, and accuracy of scanning methods. We plan to develop case-specific 3D data analysis techniques to improve the credibility of analysis at the NFS and to establish a 3D data collection and analysis team.
Crime ; Data Collection ; Female ; Fires ; Forensic Medicine ; Forensic Sciences ; Humans ; Male ; Skeleton ; Statistics as Topic

PURPOSE: To examine the feasibility of the treatment planning for minimizing carotid artery dose in the radiotherapy of early glottic cancer. MATERIALS AND METHODS: From 2007 to 2010, computed tomography simulation images of 31 patients treated by radiotherapy for early glottic cancer were analyzed. The virtual planning was used to compare the parallel-opposing fields (POF) with the modified oblique fields (MOF) placed at angles to exclude the ipsilateral carotid arteries. Planning target volume (PTV), irradiated volume, carotid artery, and spinal cord were analyzed at a mean dose, V35, V40, V50 and with a percent dose-volume. RESULTS: The beam angles were arranged 25 degrees anteriorly in 23 patients and 30 degrees anteriorly in 8 patients. The percent dose-volume of PTV shows no statistical difference. Conversely, the cumulative percent dose-volume of carotid artery shows the significant difference (p<0.001). The mean doses of carotid artery were 38.5 Gy for POF and 26.3 Gy for MOF and the difference was statistically significant (p=0.012). Similarly, V35, V40, and V50 also showed significant differences between POF and MOF. CONCLUSION: The modified oblique field was respected to prevent a carotid artery stenosis and reduce the incidence of a stroke based on these results.
Carotid Arteries ; Carotid Stenosis ; Humans ; Incidence ; Spinal Cord ; Stroke

PURPOSE: To assess the degree and clinical impact of location error of the dens on the X-axis during radiotherapy to brain and head and neck tumors. MATERIALS AND METHODS: Twenty-one patients with brain tumors or head and neck tumors who received three-dimensional conformal radiation therapy or intensity-modulated radiation therapy from January 2009 to June 2010 were included in this study. In comparison two-dimensional verification portal images with initial simulation images, location error of the nasal septum and the dens on the X-axis was measured. The effect of set-up errors of the dens was simulated in the planning system and analyzed with physical dose parameters. RESULTS: A total of 402 portal images were reviewed. The mean location error at the nasal septum was 0.16 mm and at the dens was 0.33 mm (absolute value). Location errors of more than 3 mm were recorded in 43 cases (10.7%) at the nasal septum, compared to 133 cases (33.1%) at the dens. There was no case with a location error more than 5 mm at the nasal septum, compared to 11 cases (2.7%) at the dens. In a dosimetric simulation, a location error more than 5 mm at the dens could induce a reduction in the clinical target volume 1 coverage (V95: 100%-->87.2%) and overdosing to a critical normal organ (Spinal cord V45: <0.1%-->12.6%). CONCLUSION: In both brain and head and neck radiotherapy, a relatively larger set-up error was detected at the dens than the nasal septum when using an electronic portal imaging device. Consideration of the location error of the dens is necessary at the time of the precise radiation beam delivery in two-dimensional verification systems.
Brain ; Brain Neoplasms ; Electronics ; Electrons ; Head ; Humans ; Nasal Septum ; Neck

The purpose of this article is to introduce a new virtual orthodontic treatment (VOT) system, which can be used to construct three-dimensional (3D) virtual models, establish a 3D virtual setup, enable the placement of the virtual brackets at the predetermined position, and fabricate the transfer jig with a customized bracket base for indirect bonding (IDB) using the stereolithographic technique. A 26-year-old woman presented with anterior openbite, crowding in the upper and lower arches, and narrow and tapered upper arch, despite having an acceptable profile and balanced facial proportion. The treatment plan was rapid palatal expansion (RPE) without extraction. After 10 days of RPE, sufficient space was obtained for decrowding. After a 10-week retention period, accurate pretreatment plaster models were obtained using silicone rubber impression. IDB was performed according to the protocol of the VOT system. Crowding of the upper and lower arches was effectively resolved, and anterior openbite was corrected to normal overbite. Superimposition of the 3D virtual setup models (3D-VSM) and post-treatment 3D virtual models showed that the latter deviated only slightly from the former. Thus, the use of the VOT system helped obtain an acceptable outcome in this case of mild crowding treated without extraction. More cases should be treated using this system, and the pre- and post-treatment virtual models should be compared to obtain feedback regarding the procedure; this will support doctors and dental laboratory technicians during the learning curve.
Adult ; Crowding ; Female ; Humans ; Laboratories, Dental ; Learning Curve ; Open Bite ; Overbite ; Retention (Psychology) ; Silicone Elastomers

OBJECTIVE: The aim of this study was to analyze the correlation between thromboembolic complications and antiplatelet drugs before and after neurointervention. METHODS: Blood samples and radiographic data of patients who received a neurointervention (coil embolization, stent placement or both) were collected prospectively. Rapid platelet function assay-aspirin (RPFA-ASA) was used to calculate aspirin resistance in aspirin reaction units (ARU). For clopidogrel resistance, a P2Y12 assay was used to analyze the percentage of platelet inhibition. ARU > 550 and platelet inhibition < 40% were defined as aspirin and clopidogrel resistance, respectively. RESULTS: Both aspirin and clopidogrel oral pills were administered in fifty-three patients before and after neurointerventional procedures. The mean resistance values of all patients were 484 ARU and < 39%. Ten (17.0%) of 53 patients showed resistance to aspirin with an average of 597 ARU, and 33 (62.3%) of 53 patients showed resistance to clopidogrel with an average of < 26%. Ten patients demonstrated resistance to both drugs, 5 of which suffered a thromboembolic complication after neurointervention (mean values : 640 ARU and platelet inhibition < 23%). Diabetic patients and patients with hypercholesterolemia displayed mean aspirin resistances of 513.7 and 501.8 ARU, and mean clopidogrel resistances of < 33.8% and < 40.7%, respectively. CONCLUSION: Identifying individuals with poor platelet inhibition using standard regimens is of great clinical importance and may help prevent cerebral ischemic events in the future. Neurointerventional research should focus on ideal doses, timing, choices, safety, and reliable measurements of antiplatelet drug therapy, as well as confirming the clinical relevance of aggregometry in cerebrovascular patients.
Aspirin ; Blood Platelets ; Drug Resistance ; Humans ; Hypercholesterolemia ; Platelet Aggregation Inhibitors ; Prospective Studies ; Stents ; Ticlopidine