Algorithm for pediatric orbital blowout fractures: a 20-year retrospective cohort study

Abstract Objective Pediatric orbital blowout fractures can include pathologies that seem mild but require urgent release; serious sequelae can occur with standby surgery or conservative treatment. We sought to validate an algorithm for the treatment of pediatric orbital blowout fractures. Methods This retrospective cohort study included 61 pediatric patients, aged 18 years or younger, treated for pure orbital blowout fractures according to the algorithm from April 1, 2000, to August 31, 2020, at the Japanese Red Cross Asahikawa Hospital. Results There were 52 males (85%). Median age was 14 years (range, 5-18 years). There were 9 patients categorized as needing urgent release, 16 as needing repair, and 36 as needing conservative treatment. Mean follow-up ocular movement was 98.0 (95% Confidence Interval [95% CI], 96.8-99.2). Postoperative diplopia was not observed in 96% (79.6%-99.9%) of patients, better than in previous studies. A higher proportion of patients aged 0-12 years needed urgent repair than those aged 13-18 years (Odds Ratio [OR] = 14.2; 95% CI 1.6-683.4; p= 0.0046). There were no differences in Hess area ratio by age group. Conclusion Clinical results with the algorithm were satisfactory. The algorithm is suitable for treatment of pediatric orbital blowout fractures. Level of evidence 4.

Evaluation of Astragali Radix quality grade based on appearance characteristics and internal ingredients / 中国中药杂志

This study is to provide the basis of establishing a quality evaluation system, based on the differences in appearance and internal components of Astragali Radix from different sources. The diameter of 18 batches of Astragali Radix, the content of alcohol(water) extract and 7 kinds of flavonoids were determined. The peak area ratio of flavonoid aglycon to aglycone was calculated. PCA and CA were carried out by synthesizing various indexes. The results of PCA and CA showed that Astragali Radix was obviously clustered into three types. Alcohol extract, formononetin/formosan glycosides,(pilose isoflavones+astragalus flavonoid A)/pilose isoflavone glucoside are the most significant differences in the variable importance projection index(VIP) of Astragali Radix. Combining the diameter, alcohol(water) extract, flavonoid aglycon to aglycone peak area ratio can provide an analysis method for the establishment of the grade evaluation system of Astragali Radix.

Semi-quantitative strain elastography may facilitate pre-surgical prediction of mandibular lymph nodes malignancy in dogs

Evaluation of mandibular lymph nodes in a patient with head and neck cancer is important for stage determination and prognosis development, and, in human medicine, the use of sonoelastography for differentiating between non-metastatic and metastatic lymph nodes has been reported. Our prospective, cross-sectional study aimed to evaluate the diagnostic performance of strain elastography and to determine elastographic cut-off values for predicting malignancy. Sixty-six mandibular lymph nodes were included (clinical healthy, n = 45; non-metastatic, n = 8; and metastatic, n = 13). Elastographic images were evaluated qualitatively (elastographic pattern) and semi-quantitatively (mean hue histogram and stiffness area ratios). Elastographic patterns were classified as grades 1 to 4, according to the percentage of high elasticity determined by visualization. The mean hue histogram was defined based on as the mean pixel color values within the lymph node. Stiffness area ratios were determined by computer program analysis of the stiff area. Among the criteria, receiver operating characteristic curve analyses revealed cut-off values for the prediction of malignancy of 92.26 for mean hue histogram (sensitivity: 100%, specificity: 92%), and 0.17 for stiffness area ratios (sensitivity: 86%, specificity of 100%). Reproducibility and repeatability were excellent. In conclusion, semi-quantitative evaluation via strain elastography holds potential for predicting lymph node malignancy.

Tasa relativa de crecimiento en plántulas de dos poblaciones de Magnolia pugana (Magnoliaceae) en distintos niveles de luz y fertilidad del suelo / Relative growth rate in Magnolia pugana (Magnoliaceae) seedlings from two populations at different light levels and soil fertility

Resumen El estudio de la ecofisiología de las especies en peligro de extinción es clave para el éxito de programas de conservación y restauración ecológica. El objetivo de este trabajo fue conocer el efecto de los factores luz, fertilidad de suelo y procedencia de las plántulas en el crecimiento de plántulas de Magnolia pugana. Se estimó la tasa relativa de crecimiento (TRC) y sus componentes (Tasa de Asimilación Neta: TAN y Cociente del Área Foliar: CAF), así como la relación raíz/vástago (C: R/V). Las plántulas fueron obtenidas de semillas recolectadas de dos localidades en Zapopan, Jalisco, México, la primera es una población silvestre en San Nicolás (SN) y la segunda es una plantación ubicada en los jardines del Centro Universitario de Ciencias Biológicas y Agropecuarias (CUCBA). El experimento se llevó a cabo en condiciones de invernadero. En septiembre 2015, 96 plántulas de tres meses de edad fueron sometidas a los siguientes tratamientos con un experimento factorial (2 × 2 × 2): nivel de luz (alta = 1 120 μmol m-2 s-1 y baja = 136.3 μmol m-2 s-1), procedencia de las plántulas (San Nicolás y CUCBA) y fertilidad del suelo (alta = suelo San Nicolás, baja = suelo del CUCBA) con 12 repeticiones por cada combinación de factores y niveles. El crecimiento se estimó con dos cosechas: la primera a los 30 días de establecido el experimento y la segunda a los 60 días. Los niveles de luz, fertilidad del suelo y la procedencia de las plántulas influyeron en el crecimiento a través de ajustes fisiológicos y morfológicos. En general Magnolia pugana mostró mayor TRC y TAN en la luz alta, mientras que el CAF disminuyó. La fertilidad del suelo y la procedencia de las plántulas no afectaron la TRC ni sus componentes. Sin embargo, si fueron afectados por los niveles de luz, las plántulas de SN crecieron más en luz alta. La altura del tallo varió debido a la fertilidad del suelo y a la procedencia de las plántulas, en el suelo con fertilidad baja, en el suelo del CUCBA las plántulas de SN fueron 35 % más altas que las del CUCBA. El suelo de baja fertilidad en la luz alta ocasionó que las plántulas asignaran mayor biomasa a la raíz. El componente fisiológico (TAN) fue el mayor determinante en la variación intraespecífica de la TRC. Las plántulas de SN mostraron mayor plasticidad fenotípica debido a que es una población silvestre, por lo que posiblemente tiene variación genética más alta que la población cultivada del CUCBA. Los resultados sugieren que Magnolia pugana es una especie con capacidad de adaptarse a diversos ambientes debido a su plasticidad fenotípica frente a los distintos niveles de luz y fertilidad del suelo.

Abstract The study of ecophysiology of endangered species is key to the success of conservation and ecological restoration programs. The objective of this work was to know the effect of light, soil fertility and seed origin on the growth of Magnolia pugana seedlings. The relative growth rate (RGR) and its components (Net Assimilation Rate: NAR and Leaf Area Ratio: LAR), as well as the root-shoot ratio (R/S) were estimated. Seedlings were obtained from seeds collected in two localities in Zapopan, Jalisco, Mexico, the first is a wild population in San Nicolás (SN) and the second is a plantation located in the gardens of the Centro Universitario de Ciencias Biológicas y Agropecuarias (CUCBA). The experiment was conducted under greenhouse conditions. In September 2015, 96 seedlings of approximately three months old were subjected to the following treatments in a factorial experiment (2x2x2): light level (high = 1 120 μmol m-2 s-1 and low = 136.3 μmol m-2 s-1), seedling origin (SN and CUCBA) and soil fertility (high fertility = SN soil, low fertility = CUCBA soil) with 12 replicates for each combination of factors and levels. Growth was estimated in two harvests: the first harvest after 30 days of starting the experiment and the second at 60 days. Light and soil fertility levels, as well as seedling origin influenced growth through physiological and morphological adjustments. In general, Magnolia pugana showed higher RGR and NAR in high light, while LAR decreased. Soil fertility and seedling origin did not affect RGR or its components. However, these were affected by the light level, seedlings from SN grew more in high light. Stem height varied due to soil fertility and seedling origin, in low fertility soil (CUCBA) the seedlings of SN were 35 % higher than those of CUCBA. Low fertility soil under high light caused greater investment in seedling root biomass. The physiological component (NAR) was the major determinant of intraspecific variation in RGR. SN seedlings showed greater phenotypic plasticity due to coming from a wild population, which possibly has higher genetic variation than the cultivated population from CUCBA. The results suggest that Magnolia pugana is a species capable of adapting to diverse environments due to its phenotypic plasticity in response to different light and soil fertility levels. Rev. Biol. Trop. 66(2): 622-633. Epub 2018 June 01.

Experimental Study on Estimating the Postmortem Interval in Rabbits Hemorrhagic Shock Death Model Using Liver Computed Tomography Images / 中国医科大学学报

Objective To investigate the relationship between changes in the liver computed tomography (CT) images and the postmortem interval (PMI) of rabbits 129 h after their death due to hemorrhagic shock. Methods CT scanning was used to investigate the hemorrhagic shock death model in 23 rabbits to identify the postmortem cerebral changes from 0 h to 129 h after death. Results The liver or lumbar area in the liver window showed the following characteristic changes: from unchanged, to rapid shrinkage, to slow shrinkage; the mean CT values of the liver initially increased and subsequently decreased. The regression equations for the relationship between the two indices and PMI were established by surgery, and they all had statistical significance (P ＜ 0. 01). Conclusion CT scanning can accurately show changes in the rabbit liver after death. The mean CT value of the liver tissue is more sensitive for inferring early PMI. Furthermore, the liver area/lumbar area ratio parameters are more sensitive for inferring mid-late PMI.

The value of hardness rating and area ratio method of ultrasound elastography in differential diagnosis of benign and malignant lesions / 中国基层医药

Objective To compare the value of hardness rating and area ratio method of ultrasound elastog-raphy in differential diagnosis of benign and malignant lesions.Methods ultrasound imaging data of 120 cases with breast lesions(130 breast)who were pathologically confirmed during the period from January 201 1 to June 2013 were retrospectively analyzed,there were 62 malignant tumors,68 benign tumors,the sensitivity,specificity,accuracy of hardness rating and area ratio method of ultrasound elastography in differential diagnosis of benign and malignant lesions were assessed.Results (1 )The ultrasound elastography of 52 cases with benign tumor were 0 -2point, 16 cases were 3-4point,10 cases with malignant tumors were 0 -2point,52 cases were 3 -4point,the difference between two groups were statistically significant(χ2 =11.55,P<0.05);(2)The average area ratio of benign tumor was (1.09 ±0.37),malignant tumors was (2.28 ±1.68),the difference between two groups were statistically signifi-cant(t =6.22,P=0.01);(3)the sensitivity,specificity,accuracy of elastography hardness rating in diagnosis of malignant breast tumors were 83.87%,6.47%,80.00%,the area ratio method were 80.65%,75.00%,77.68%, joint inspection of two groups were 93.10%,93.55%,93.09%,joint inspection had obvious advantages,the differ-ence was statistically significant(all P<0.05 ).Conclusion Hardness rating and area ratio method of ultrasound elastography in differential diagnosis of benign and malignant lesions had higher value and higher diagnostic accuracy of combined.

Comparison of polysaccharide contents of Dendrobium officinale in collection periods / 中国药学杂志

OBJECTIVE: To compare the polysaccharide contents of Dendrobium officinale in collection periods. METHODS: The contents of polysaccharide and mannose were determined by phenol-sulfuric acid method and HPLC. The ratio of peak area between mannose and glucose was worked out by HPLC. RESULTS: The polysaccharide content of Dendrobium officinale distributed from 26.52% to 46.78%, the mannose content was between 13.36% and 25.25%, and the ratio of peak area between mannose and glucose was 2.48-5.91. CONCLUSION: The polysaccharide contents of Dendrobii officinalis from different sources were diverse, all of which accorded with the standard of Chinese Pharmacopoeia: The content of polysaccharide in Dendrobium officinale from Yunnan province exceeded that from Zhejiang province, and the mannose content in biennial samples were higher than annual samples.

Usefulness of Ultrasonography to Predict Response to Injection Therapy in Carpal Tunnel Syndrome

OBJECTIVE: To verify the feasibility of initial parameters of ultrasonography or electromyography for the prediction of effect after steroid injection therapy in a carpal tunnel syndrome (CTS) patient. METHOD: We recruited individuals with clinical and electrodiagnostic evidence of CTS. Results from the Boston self-assessment questionnaire, median motor and sensory nerve conduction studies, and median nerve ultrasonography were evaluated at baseline, 1 month, and 6 months after injection. Evaluation of median nerve ultrasonography parameters included measurements taken at the maximal swelling point (MS), 2 cm proximal from MS (2MS), and 12 cm proximal from MS (12MS), and its ratio (MS/12MS, 2MS/12MS) was calculated. The correlation between improvement of the symptom score after treatment and baseline parameters was estimated. RESULTS: Fourteen individuals (14 women, mean age 53.8 years) with 22 affected wrists were enrolled. After steroid injection therapy, clinical and electromyographic parameters showed significant improvements at 1 month or 6 months after injection, and ultrasonographic parameters showed significant changes in maximal area and area ratio (MS/12MS) of the median nerve. Symptom score improvement showed a positive correlation in the initial 2MS and ratio of 2MS/12MS after 6 months (p<0.05). CONCLUSION: Most of the improvements occurred during the first month after injection and lasted up to 6 months. The initial median nerve swelling and its ratio may be a useful predictor of response after steroid injection.

Feasibility of Ultrasonographic Area Ratio of Median Nerve in the Diagnosis of Carpal Tunnel Syndrome in Korea

OBJECTIVE: To examine the usefulness of ratio of maximal swelling to normal cross sectional area (CSA) of median nerve with ultrasound in patients with carpal tunnel syndrome (CTS) and healthy controls. METHOD: Patients with electrodiagnostically proven CTS underwent ultrasonography of the median nerve. The median nerve area was measured at three points (maximal swelling site, 2 cm proximal to maximal swelling site, 12 cm proximal to maximal swelling site) and compared to values from asymptomatic volunteers. RESULTS: The ratio of maximal swelling site to 12 cm proximal was 1.34+/-0.14 in asymptomatic volunteers and 2.31+/-0.43 in patients presenting with CTS. The ratio of maximal swelling site to 12 cm proximal gave 73.7% sensitivity and 90.0% specificity. While using only median nerve area at the wrist resulted in 81.6% sensitivity and 70.0% specificity, depending on the cutoff value used. CONCLUSION: The ratio of maximal swelling site to proximal in patients with CTS is elevated as compared to asymptomatic controls. The ratio of maximal swelling site to 12 cm proximal has higher specificity to diagnose CTS, and may be superior to measuring median nerve area at the wrist alone.

Influence of plugger penetration depth on the area of the canal space occupied by gutta-percha / 대한치과보존학회지

To evaluate the ratio of gutta-percha area in the canal after canal obturation with Continuous Wave of Condensation Technique (CWCT) with varying depths of plugger penetration, forty root canals of extracted human teeth were prepared up to size 40 of 0.06 taper with ProFile(R). Canals of three groups were filled with CWCT with System B(TM) (Analytic Tech., USA) and different plugger penetration depths of 3, 5, or 7 mm from the apex. Canals of one group were filled with lateral condensation technique as a control. The filled teeth were cross-sectioned at 1, 2, and 3 mm levels from the apical foramen. The ratio of gutta-percha area in the canal was analyzed using Auto(R)Cad 2000. Data were analyzed with one-way ANOVA and Duncan's multiple range test. At all levels, higher gutta-percha area ratio was found with deeper plugger penetration depth in CWCT, and cold lateral condensation group showed higher ratio than group of plugger penetration to apical 7 mm in CWCT. At apical 1 mm and 2 mm levels, group of plugger penetration to apical 3 mm showed significantly higher gutta-percha area ratio than those of apical 7 mm and lateral condensation (p < 0.05). It is concluded therefore that, under the conditions of the present study, deeper plugger penetration depth results in more favorable and efficient obturation in CWCT.

Obturation efficiency of non-standardized gutta-percha cone in curved root canals prepared with 0.06 taper nickel-titanium instruments / 대한치과보존학회지

The purpose of this study was to evaluate the obturation efficiency of a non-standardized gutta-percha cone in curved root canals prepared with 0.06 taper nickel-titanium instruments. Sixty simulated curved root canals in clear resin blocks were prepared with crown-down technique using 0.06 taper rotary ProTaper(TM) and ProFile (Dentsply-Maillefer) until apical canal was size 30. Root canals were randomly divided into 4 groups of 15 blocks and obturated with cold-laterally compacted gutta-percha technique by using either a non-standardized size medium gutta-percha cone or an ISO-standardized size 30 one as a master cone. Gutta-percha area ratio were calculated at apical levels of 1, 3, and 5 mm using AutoCAD 2000 after cross-sectioning, and the data were analyzed with one-way and two-way ANOVAs and Duncan's multiple range test. Non-standardized size medium cone groups showed significantly higher gutta-percha area ratio than standardized cone groups at all apical levels (p < 0.01). Non-standardized cone groups used significantly less accessory cones than standardized cone groups (p < 0.01).

Significance of Amplitude and Area Ratio of Compound Muscle Action Potential in Diagnosis of Diabetic Neuropathy

OBJECTIVE: The purpose of this study is to find out whether amplitude ratio and area ratio have correlation with nerve conduction velocity in the diabetes mellitus patients. METHOD: Median and deep peroneal motor nerve conduction study was performed in thirty-five normal control group and sixty diabetes mellitus patients group. The motor conduction velocity, amplitude ratio, and area ratio of the compound muscle action potential (CMAP) were measured. The experimental subjects were divided into 6 subgroups (in median nerve: M1, M2, M3, in peroneal nerve: P1, P2, P3) according to the median value of conduction velocity of each nerve; group M1 (n=35) and P1 (n=30): normal control group, group M2 (n=25) and P2 (n=30): below the median value of motor nerve conduction velocity in diabetes mellitus patients, group M3 (n=23) and P3 (n=29): above the median value of motor nerve conduction velocity in diabetes mellitus patients. RESULTS: There was no significant difference of area ratio between the each subgroups in both median and peroneal nerves. There was a significant difference of amplitude ratio between the M1 and M2 subgroups. There was a significant difference of amplitude ratio between the P1 and P2, P3 subgroups. CONCLUSION: According to above results, the decrease of amplitude of compound muscle action potential along with the decrease of conduction velocity seems to be helpful in the electrophysiologic diagnosis of diabetic neuropathy.

Comparison of modifications of intra-abdominal fat between low calorie diet alon and low calorie diet with exercise in Korean women

BACKGROUND: Obesity and its complicatians are increasing as social ecanamic standard of living is improving and life style has been changing in Korea. There is growing evidence that the visceral/subcutaneous adipose tissue area ratio (VSR) on computed tomography (CI) is closely related to the obesity camplications. Therefore, it is important to determine whether the VSR reduction is praduced during weight loss. The purpose of this study was to observe and campare the amount of reduction of intraabdaminal fat between low calorie diet (LCD) alane and LCD with exercise. METHODS: Sixty obese females were randomly prescribed a LCD alone or a LCD with exercise. Thirty obese females were treated with a LCD of 1,000kcal/d for 8 weeks (group A). Another thirty obese females were treated with a LCD of 1,000kcal/d combined with supervised aerobic exercise for 8 weeks (group B). Weight, height, BMI, and body fat distribution were measured in all subjects immediately before and after 8 weeks of this study. The body fat distribution was assessed by CT, by which the total abdaminal adipose tissue area (AT), subcutaneous abdominal adipose tissue (SAT), intra-abdominal adipose tissue (VAT), and visceral/subcutaneous adipose tissue area ratio (VSR) were measured at the level of the umbilicus. A venous blood sample was taken after an overnight fast to determine lipid, glucose, and insulin concentrations in all subjects before and after 8 weeks of this study. RESULTS: Body weight, BMI, CI' measurement of total (AT), visceral (VAT), and subcutaneous (SAT) fat were found to be decreased significantly in the two groups. The VSR of the group A did not change after weight loss. In contrast, the VSR of the group B decreased significantly (P<0.05) during weight loss. Fasting plasma glucose and total cholesterol levels significantly decreased in the both groups (P<0.001). Fasting plasma insulin and triglyceride levels significantly decreased in the group B, but not in group A. CONCLUSIONS: This study shows that the VSR decreased significantly in group B, but not in group A. Fasting plasma insulin and triglyceride levels decreased significantly in group B, but not in group A. These results suggest that the LCD with exercise is more effective in reducing expected complications of obesity than LCD alone.

Visceral Fat Accumulation in Coronary Artery Disease

BACKGROUND: The visceral fat accumulation, an important factor to increase the insulin resistance is known to be associated with coronary artery disease. We investigated the relation between visceral fat accumulation and the coronary artery disease. METHODS: The coronary artery disease (CAD) group included 14 patients (9 men and 5 women) with angina pectoris. All patients had typical chest pain, diagnosed as coronary artery disease with coronary angiogram or treadmill test. The patients with hypertension, hyperlipidemia, non-insulin dependent diabetes mellitus (NIDDM), impaired glucose tolerance (IGT) and taking any medication known to affect the insulin sensitivity were excluded. The control group included 24 healthy volunteers (11 men and 13 women) who were not taking any medication. We measured the visceral fat area, abdominal subcutaneous fat area, thigh muscle area and the thigh fat area with computed tomography (CT) in both groups. We measured the plasma lipid profile, plasma insulin and glucose level during the oral glucose tolerance test in both groups. RESULTS: There were no differences in the age, sex ratio, body mass index (BMI) and the waist to hip ratio (WHR) between both groups. The total cholesterol and LDL cholesterol were significantly higher in CAD group (p<0.001). The HDL cholesterol was significantly lower in CAD group (p<0.05). The fasting insulin, fasting glucose, area under curve (AUC) of the insulin and glucose, and the insulin to glucose (IG) ratio were significant higher in CAD group (p<0.001). There were significant differences between CAD group and the control group in the visceral fat area (94.2+/-19.1 cm2 vs. 76.5+/-34.3 cm2, p<0.05), thigh fat area (60.2+/-24.8 cm2 vs. 92.6+/-41.0 cm2, p<0.01) and the visceral fat to thigh fat area ratio (VSFTF ratio : 1.74+/-0.61 vs. 1.07+/-0.80, p<0.01). The visceral fat area was independently associated with fasting insulin (r=0.661, p<0.01), fasting glucose (r=0.490, p<0.05), the AUC of glucose (r=0.605, p<0.01), HDL cholesterol (r= -0.528, p<0.01) and triglyceride (r=0.483, p<0.05) in control group. After adjustment for visceral fat area, there were still significant differences in the fasting insulin, fasting glucose, AUC of insulin, AUC of glucose and the IG ratio between both groups. CONCLUSION: We observed significant increase in the visceral fat area and VSFTF ratio and decrease in thigh fat area in CAD group compared with age, BMI, WHR matched control group. The insulin resistance was observed in the CAD group. The visceral fat area and VSFTF ratio was associated with cardiovascular risk factors such as low HDL cholesterol and the insulin resistance in control group.

Visceral Fat Accumulation in Coronary Artery Disease

BACKGROUND: The visceral fat accumulation, an important factor to increase the insulin resistance is known to be associated with coronary artery disease. We investigated the relation between visceral fat accumulation and the coronary artery disease. METHODS: The coronary artery disease (CAD) group included 14 patients (9 men and 5 women) with angina pectoris. All patients had typical chest pain, diagnosed as coronary artery disease with coronary angiogram or treadmill test. The patients with hypertension, hyperlipidemia, non-insulin dependent diabetes mellitus (NIDDM), impaired glucose tolerance (IGT) and taking any medication known to affect the insulin sensitivity were excluded. The control group included 24 healthy volunteers (11 men and 13 women) who were not taking any medication. We measured the visceral fat area, abdominal subcutaneous fat area, thigh muscle area and the thigh fat area with computed tomography (CT) in both groups. We measured the plasma lipid profile, plasma insulin and glucose level during the oral glucose tolerance test in both groups. RESULTS: There were no differences in the age, sex ratio, body mass index (BMI) and the waist to hip ratio (WHR) between both groups. The total cholesterol and LDL cholesterol were significantly higher in CAD group (p<0.001). The HDL cholesterol was significantly lower in CAD group (p<0.05). The fasting insulin, fasting glucose, area under curve (AUC) of the insulin and glucose, and the insulin to glucose (IG) ratio were significant higher in CAD group (p<0.001). There were significant differences between CAD group and the control group in the visceral fat area (94.2+/-19.1 cm2 vs. 76.5+/-34.3 cm2, p<0.05), thigh fat area (60.2+/-24.8 cm2 vs. 92.6+/-41.0 cm2, p<0.01) and the visceral fat to thigh fat area ratio (VSFTF ratio : 1.74+/-0.61 vs. 1.07+/-0.80, p<0.01). The visceral fat area was independently associated with fasting insulin (r=0.661, p<0.01), fasting glucose (r=0.490, p<0.05), the AUC of glucose (r=0.605, p<0.01), HDL cholesterol (r= -0.528, p<0.01) and triglyceride (r=0.483, p<0.05) in control group. After adjustment for visceral fat area, there were still significant differences in the fasting insulin, fasting glucose, AUC of insulin, AUC of glucose and the IG ratio between both groups. CONCLUSION: We observed significant increase in the visceral fat area and VSFTF ratio and decrease in thigh fat area in CAD group compared with age, BMI, WHR matched control group. The insulin resistance was observed in the CAD group. The visceral fat area and VSFTF ratio was associated with cardiovascular risk factors such as low HDL cholesterol and the insulin resistance in control group.

Severity of Coronary Artery Disease and Visceral Fat Obesity

BACKGROUND: The visceral fat obesity is known to be associated with coronary artery disease. We investigated the relation between visceral fat obesity and the severity of coronary artery disease by angiography. METHODS: The coronary artery disease (CAD) group included 54 angina patients (43 men and 11 women) with angiographically demonstrated coronary artery disease. The control group included angiographically normal 28 controls (15 men and 13 women). The subjects with hypertension, non-insulin dependent diabetes mellitus (NIDDM) and taking any medication known to affect the insulin sensitivity were excluded. We measured the visceral fat area, abdominal subcutaneous fat area, thigh muscle area and the thigh fat area with computed tomography (CT) in both groups. We measured the plasma lipid profile, fasting plasma insulin and glucose level in both groups. RESULTS: There were no differences in the age, sex ratio and body mass index (BMI) between both groups. Total cholesterol and triglyceride increased in CAD group significantly (p<0.05, p<0.001). The HDL cholesterol decreased in CAD group. But there was no statistical significance (p=0.056). The fasting insulin increased in CAD group significantly (p<0.001). There were significant differences between CAD group and the control group in the visceral fat area (117.8+/-34.4 cm2vs. 85.5+/-17.6 cm2, p<0.001), thigh fat area (50.0+/-22.3 cm2vs. 65.8+/-12.9 cm2, p<0.001), visceral fat to abdominal subcutaneous fat area ratio (VS ratio:0.81+/-0.31 vs. 0.51+/-0.15, p<0.001) and the visceral fat to thigh fat area ratio (VSFTF ratio:2.72+/-1.24 vs. 1.34+/-0.35, p<0.001). In the male subgroup (CAD:43, control:15), triglyceride and fasting insulin increased in CAD group significantly (p<0.001). The visceral fat area, VS ratio, and VSFTF ratio increased in CAD group significantly (P<0.001) The thigh fat area decreased in CAD group significantly (P<0.001). In the female subgroup (CAD:11, control:13), fasting insulin and visceral fat area increased in CAD group significantly (p<0.001, p<0.05). Multiple logistic regression analysis revealed that VSFTF ratio, fasting insulin and the HDL cholesterol were independent associated factors of coronary artery disease. In comparison with normal control, one-vessel disease and multi-vessel disease (two vessel and three vessel), there were significant differences between groups in fasting insulin, triglyceride, visceral fat area, thigh fat area, VS ratio, VSFTF ratio. In Turkey's HSD Post Hoc test, however, there were no significant differences between one-vessel disease and multi-vessel disease. CONCLUSION: We observed significant increases in the visceral fat area, VS ratio and VSFTF ratio and decrease in thigh fat area in angiographically demonstrated CAD group compared with age, BMI matched angiographically normal control. But we did not observed any relation between the visceral fat area and the severity of coronary disease by angiography.

Correlation of the Intrapapillary Parameters to Visual Field Defects in Primary Open-Angle Glaucoma

The relationship between quantitative structual measurements of the optic nerve head and visual field defects was studied in 150 eyes of 150 patients with primary open-angle glaucoma(POAG). The radius and angle of the optic disc and cup were measured every 30 degrees to obtain rim area, rim area to disc area ratio, cup area, and cup to disc ratio with a computer graphic program(Adobe PhotoshopTM) and the photographic magnification was corrected according to Littmann`s method. The visual field indices including mean deviation(MD) and corrected pattern standard deviation(CPSD), using a Humphrey Field Analyzer(C 302) were obtained. Each intrapapillary parameter showed statistically significant linear correlation with MD. And those disc parameters also significantly correlated with CPSD, although this correlation was relatively lower than that of intrapapillary parameter with MD. Rim area to disc area ratio and MD were most highly correlated(r=0.712, p=0.0001), and correlation of rim are with MD followed next(r=0.670, p=0.0001). These findings suggest that intrapapillary parameters in POAG were more correlated with the overall visual field depression(MD) than the localized visual field change(CPSD). The rim area to disc area ratio rather than the rim area itself, was more related to the diffuse visual field defects.

Pattern of Glaucomatous Optic Disc Damage in Primary Open-Angle Glaucoma

To identify the pattern of glaucomatous changes of the optic disc, the rim area to disc area ratio (RA/DA ratio) of 149 eyes (149 cases) with primary open-angle glaucoma (POAG) were measured and compared with that of 88 eyes (88 cases) of normal individuals. At all stages of the disease, glaucomatous rim loss was present in all sectors of the optic disc. The location of the most pronounced rim loss changed depending on the severity of the disease. In the early (RA/DA ratio > 61%; mean deviation(MD): -6.43+/-3.32dB) and medium (RA/DA ratio=41~60%; MD: -7.54+/-5.65dB) glaucoma subgroups, rim loss was found predominantly at the inferior temporal and superior temporal disc region. In the advanced glaucoma subgroup (RA/DA ratio=40~21%; MD: -18.27+/-8.40dB), the temporal horizontal disc region showed relatively marked rim loss. In the far advanced glaucoma subgroup (RA/DA ratio=20~0%; MD: -25.91+/-5.40dB), the rim remnants were located mainly in the nasal disc sector, with a larger rim portion in the upper nasal region than in the lower nasal region. These results indicate that generally in POAG, the loss of neuroretinal rim was found to start predominantly in the inferior temporal and superior temporal disc region, and then the temporal horizontal, the inferior nasal, and the superior nasal disc sectors followed.

Insulin Resistance as an Associated Factor of Essential Hypertension in Korean

BACKGROUND: The insulin resistance is reported as the independent risk factor of the DM and the ischemic heart disease. The association between the insulin resistance and the essential hypertension was reported at the various countries and races. We performed this study to know if the hypertensive patients show the increased insulin resistance than that of the normotensive persons and factors that influence the insulin resistance and the blood pressure. METHODS: The serum lipid profiles, OGTT, body habitus measurement and abdominal CT at umbilical level were performed in 24 hypertensive patients(male : 10, female : 14) and 45 normotensive persons(male : 19, female : 26) who showed the same distributions of age, sex, weight and body mass index(BMI). RESULTS: The average age of the hypertensive group was 49.1+/-7.9 years, and that of the normotensive group was 46.1+/-7.6 years(p>0.05). The average blood pressure of the hypertensive group was 152.2+/-14.2/98.4+/-6.4mmHg and that of the normotensive group was 116.8+/-9.4/78.2+/-49.mmHg(p<0.001). The hypertensive group had significantly higher area under curve(AUC) of glucose(246.8+/-30.4 Vs 219.2+/-32.2mg/dL.hr) and AUC of insulin(88.9+/-38.2 Vs 69.6+/-34.2microU/mL.hr) than the normotensive group(p<0.05), while there were no differences in the age, sex, weight, body mass index(BMI) and waist to hip ratio(WHR) between two groups. They had nodifferences in lipid profile and plasma renin activity. In CT assessment, the hypertensive group had significantly higher visceral fat to thigh muscle area ratio(VSFTM ratio)(0.61+/-0.29 Vs 0.47+/-0.20) and visceral fat to thigh muscle and fat area ratio(VSFTMF ratio)(0.27+/-0.10 Vs 0.22+/-0.13)(p<0.05), while they had same degree of visceral fat to subcutaneous fat area(VS) ratio and visceral fat area. The visceral fat area, VSFTM ratio, VS ratio, visceral fat area to thigh fat area ratio(VSFTF ratio) were positively correlated with AUC of insulin and AUC of glucose ordinary(p<0.05). After adjustment for plasma insulin, AUC of insulin, VS ratio, VSFTM ratio, age and BMI, the AUC of glucose was positively correlated with the diastolic blood pressure(R square=0.19, p <0.05) and the AUC of glucose and WTR were positively correlated with the systolic blood pressure(R square=0.26, p<0.05). THe subgroup over the 75 percentile of AUC of glucose, AUC of insulin and VSFTM ratio in study population had significantly higher odds ratio of the hypertension(OR of AUC of glusose : 5.8, OR of AUC of insulin : 3.2, OR of VSFTM ratio : 4.5, p<0.05). CONCLUSION: These results suggest that the insulin resistance is more prevalent in the hypertensive patients and associated with the hypertension.

Method Evaluation of HPLC Fingerprints for Quality Control of Chinese Herbal Medicine / 中药新药与临床药理

Objective To investigate the effects of different chromatogram fingerprints analysis methods on the quality evaluation of Chinese herbal medicine. Methods With the chromatogram fingerprints of a Chinese patent medicine in different batches as the analytic object, the quality evaluation of three methods such as peak area ratio,peak area quantification and similarity coefficient were investigated. Results The method of peak area ratio has the highest accuracy rate and the precise rate for quality evaluation, and similarity coefficient and peak area quantification came next. The result of peak area quantification was similar to that by current evaluation method. Conclusion Different chromatogram fingerprints analysis methods would result in a great difference in the quality evaluation of Chinese herbal medicine.