BACKGROUND: Accurate volume measurement is important in the management of patients with congestive heart failure or renal insufficiency. A bioimpedance analyser can estimate total body water in litres and has been widely used in clinical practice due to its non-invasiveness and ease of results interpretation. To change impedance data to volumetric data, bioimpedance analysers use equations derived from data from healthy subjects, which may not apply to patients with other conditions. Bioelectrical impedance vector analysis (BIVA) was developed to overcome the dependence on those equations by constructing vector plots using raw impedance data. BIVA requires normal reference plots for the proper interpretation of individual vectors. The aim of this study was to construct normal reference vector plots of bioelectrical impedance for Koreans. METHODS: Bioelectrical impedance measurements were collected from apparently healthy subjects screened according to a comprehensive physical examination and medical history performed by trained physicians. Reference vector contours were plotted on the RXc graph using the probability density function of the bivariate normal distribution. We further compared them with those of other ethnic groups. RESULTS: A total of 242 healthy subjects aged 22 to 83 were recruited (137 men and 105 women) between December 2015 and November 2016. The centers of the tolerance ellipses were 306.3 Ω/m and 34.9 Ω/m for men and 425.6 Ω/m and 39.7 Ω/m for women. The ellipses were wider for women than for men. The confidence ellipses for Koreans were located between those for Americans and Spaniards without overlap for both genders. CONCLUSION: This study presented gender-specific normal reference BIVA plots and corresponding tolerance and confidence ellipses on the RXc graph, which is important for the interpretation of BIA-reported volume status in patients with congestive heart failure or renal insufficiency. There were noticeable differences in reference ellipses with regard to gender and ethnic groups.
Adult ; Blood Volume ; Body Fluid Compartments ; Body Water ; Electric Impedance ; Ethnic Groups ; Female ; Healthy Volunteers ; Heart Failure ; Humans ; Male ; Physical Examination ; Renal Insufficiency

The present erratum notice corrects one figure of the article.

OBJECTIVES: We attempted to compartmentalize the periaqueductal gray (PAG) of the rabbit in terms of the different distribution patterns between NADPH-diaphorase (NADPHd)- and calbindin D28K (CB)-positive neurons. METHODS: Immunohistochemistry and immunofluorescent labelling for CB and histochemistry for NADPHd were carried out on coronally-sectioned midbrain slices of the rabbit. RESULTS: NADPHd-positive neurons were selectively localized in the dorsolateral (DL), the middle one-third of the lateral (L), the dorsal half of the ventrolateral (VLd) PAG, and the supraoculomotor cap nucleus (Su3C). Clusters of CB-immunoreactive perikarya marked the dorsal half of DL (DLd), Su3C, the ventral one-third of L, and the ventral half of the ventrolateral (VLv) PAG. Double labelling for NADPHd and CB revealed that two markers labelled different neuronal groups in DLd and Su3C subdivisions. CONCLUSION: The present data suggest that NADPHd and CB can be regarded as reliable neurochemical markers to reveal the longitudinally-columnar organization within the PAG and to subdivide each columnar area.
Calcium-Binding Protein, Vitamin D-Dependent ; Immunohistochemistry ; Mesencephalon ; Neurons ; Periaqueductal Gray

BACKGROUND: Investigating the blood usage and blood wastage in Korea hospitals national wide, and including all types of medical institutes, has not been sufficient with the only study having been carried out by the KCDC thorough an Academic Research Contract in 2007. Yet that study was limited due to lack of participation from hospitals. Our study tried to establish a fundamental database for blood transfusion management by investigating the current status of blood products usage, under the KCDC's supervision, to improve participation from medical institutes. METHODS: From January to December in 2008, the Blood Bank, Red Cross of the Republic of Korea looked into the blood product supply of all the medical institutes and we conducted a national survey using questionnaires distributed via the local public health centers on the blood use, blood waste, the reasons for waste and the inventory of the remaining blood. The supply, as compared to the actual use of blood products in the same period, was analyzed by the Korean Red Cross. RESULTS: The total amount of blood products distributed by the Korean Red Cross to medical institutes in 2008 increased by 13.8% for platelets, 11.5% for RBC products, 8.4% for apheresis products and 2% for FFPs, as compared with that of 2006. A total of 2,500 institutions participated in the questionnaire and 60.7% (1,517 out of 2,500 institutes) of the institutes sent feed-back. The total amount of blood use was 3,483,636 units and 52% of the consumption was focused in metropolitan areas like Seoul, Geong-Ki and Busan. The total wastage rate for blood was 1.2% and it was 4.8% for institutes with admitting capacities of 100 beds or less, with expiration of the storage date being the main reason for wastage, while the wastage rate was 1.1% for general hospitals with admitting capacities of 500 beds or more, with an improving patient status or death being the main reason. CONCLUSION: The results of this study were similar to those of 2007, but the participation rate from medical institutes was much increased. Establishment of an investigational system for the use of blood products in medical institutes on a national level is needed to secure data for dealing with the increased projected demand of blood/blood products in the future.
Academies and Institutes ; Blood Banks ; Blood Component Removal ; Blood Platelets ; Blood Transfusion ; Contracts ; Hospitals, General ; Humans ; Korea ; Organization and Administration ; Public Health ; Red Cross ; Republic of Korea ; Surveys and Questionnaires

OBJECTIVE: The purpose of this study was to investigate the factors affecting the surgical outcome and to compare the surgical results between transsylvian and transcortical approaches in patients with putaminal hematomas. METHODS: Retrospective review of charts and CT scan images was conducted in 45 patients (20 transsylvian and 25 transcortical approaches) who underwent open surgical evacuation of putaminal hematomas. Mean Glasgow coma scale (GCS) score and hematoma volume were 7.5+/-3.2 and 78.1+/-29.3 cc, respectively. The factors affecting the functional mortality were investigated using a multivariate logistic regression analysis. In addition, surgical results between transsylvian and transcortical approaches were compared. RESULTS: None of the patients had a good recovery after the surgery. Overall functional survival rate and mortality were 37.7% and 31%, respectively. The only risk factor for functional mortality was GCS motor score after controlling age, history of hypertension, side of hematoma, hematoma amount, midline shift, presence of intraventricular hemorrhage and surgical approach (p=0.005). Even though a transcortical approach was shorter in operative time (4.4 versus 5.1 hour) and showed a higher mortality rate (40% versus 20%) and lower functional survival (45% versus 35%) compared to the transsylvian approach, the differences were not statistically significant between the two groups. CONCLUSION: In patients who have large amounts of hematoma and require open surgical evacuation, the only significant risk factor for functional survival is the preoperative GCS score. Cortical incision methods such as transsylvian and transcortical approaches have no influence on the surgical outcome. To decompress the swollen brain rapidly, transcortical approach seems to be more suitable than transsylvian approach.
Brain ; Craniotomy ; Glasgow Coma Scale ; Hematoma ; Hemorrhage ; Humans ; Hypertension ; Logistic Models ; Operative Time ; Putaminal Hemorrhage ; Retrospective Studies ; Risk Factors ; Survival Rate

PURPOSE: We wished to compare the ability of ultrasonography and radiography performed on the same day to detect rib fractures in minor chest injuries. MATERIALS AND METHODS: Two hundred and fifteen patients with minor chest injuries were selected. Radiography and ultrasonography were performed on the same day with these patients. Chest wall pain was the only presenting symptom. Two radiologists performed ultrasonography. Fractures were identified by a disruption of the anterior margin of the rib and costal cartilage. The incidence and location of fractures and complications revealed by radiography and ultrasonography were compared. RESULTS: Radiographs revealed the presence of 70 rib fractures in 50 (23%) of 215 patients and ultrasonography revealed the presence of 203 rib fractures in 133 (62%) of 215 patients. Ultrasonography uniquely identified 133 rib fractures in 83 patients. Ultrasonography identified a 2.9 fold increase in the number of fractures in a 2.6 fold number of subjects as compared to radiography. Of the 203 sonographically detected fractures, 201 were located in the rib, one was located at the costochondral junction, and one in the costal cartilage. There were no complications seen by either radiography or ultrasonography. CONCLUSION: Ultrasonography reveals more fractures than those that may be overlooked on radiography for minor chest injuries.
Cartilage ; Humans ; Incidence ; Radiography* ; Rib Fractures* ; Ribs* ; Thoracic Injuries* ; Thoracic Wall ; Thorax* ; Ultrasonography*

PURPOSE: To evaluate the diagnostic capabilities of the low-field (0.2T) magnetic resonance (MR) system in the detection of the superior labrum anterior to posterior (SLAP) lesion. MATERIALS AND METHODS: One hundred fifty patients underwent magnetic resonance imaging of the shoulder over a 7-month period. Forty-six patients underwent arthroscopic surgery, and the surgical results were correlated with the findings of the MR imaging. Arthroscopic procedures were performed within a mean of 8 days after MR imaging. MR imaging of the shoulder was conducted as follows: shoulder coil; T1-weighted spin echo, coronal-oblique images; T2-weighted gradient echo, coronal-oblique and axial images; and T2-weighted spin echo, coronal-oblique and sagittal-oblique images. Prospectively, one radiologist interpreted the MR images. RESULTS: The results of surgery were as follows: SLAP II in 26 shoulders, SLAP III in 1 shoulder, SLAP IV in 1 shoulder, normal labrum in 6 shoulders. For SLAP lesions with a higher grade than type 2, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the low-field MRI were 85.7%, 55.5%, 75%, 71%, and 74%, respectively. CONCLUSION: There was relatively good agreement for the comparison of the MR results obtained using a low-field MR system with the surgical findings for identifying SLAP lesions.
Arthroscopy ; Humans ; Magnetic Resonance Imaging ; Prospective Studies ; Sensitivity and Specificity ; Shoulder

Despite the availability of effective antiviral drugs, human cytomegalovirus (CMV) infection is still a serious life-threatening complication in recipients of allogeneic hematopoietic stem cell transplantation. Ganciclovir (GCV) preemptive therapy is currently the usual treatment for CMV disease and antigenemia. However, prolonged GCV therapy results in the emergence of drug-resistant virus. Most GCV-resistant clinical CMV isolates contain a mutation in the UL97 phosphotransferase gene. We report a case that GCV-resistant CMV antigenemia by UL97 phosphotransferase mutant strain at codon 460 and 605 which was improved by reduction of immunosuppressants for posttransplant lymphoproliferative disease after unrelated cord blood transplantation.
Antiviral Agents ; Codon ; Cytomegalovirus ; Fetal Blood* ; Ganciclovir ; Hematopoietic Stem Cell Transplantation ; Humans ; Immunosuppressive Agents

PURPOSE: The nuclear factor-kappa B (NF-kappa B) has been known to regulate the inflammatory and immune process by transcription of inflammatory intermediates. The purpose of the present study is to show the difference in activity of NF-kappa B and its inhibitory factor-I kappa B alpha in patients with rheumatoid arthritis, osteoarthritis and normal control subjects. MATERIALS AND METHODS: Synovial membrane samples were obtained at the time of orthopedic surgery from the knees of 7 patients with RA and 7 patients with OA. Two control samples were obtained from an amputee with no history of arthritis. We designed the primer of the subunit p65 of NF-kappa B and I kappa B alpha, measured the activity of them by RT-PCR, and analyzed the expression of NF-kappa B by immunohistochemical staining. RESULTS: From the results of RT-PCR, the expression levels of NF-kappa B was found to be higher in synovial tissues obtained from patients with RA than from synovial tissue obtained from patients with OA, and the least from the control group. The expression levels of I kappa B alpha were not different statistically among the three groups. Immunohistochemical staining for the NF-kappa B was dominant in synovial tissue from patients with RA. The result of immunohistochemical staining was similar to the results of RT-PCR for NF-kappa B. The localization of the staining was predominantly nuclear. CONCLUSION: In this study, activity of NF-kappa B of rheumatoid arthritis was higher than the other group, but expressions of I kappa B alpha were no different between the diseases. Further studies about specific inhibitors of NF-kappa B will benefit the development of rheumatoid arthritis regimens with greater efficacy.
Amputees ; Arthritis ; Arthritis, Rheumatoid* ; Humans ; I-kappa B Proteins* ; Knee ; NF-kappa B* ; Orthopedics ; Osteoarthritis* ; Synovial Membrane

No abstract available.
Neoplasm Metastasis*