Rotator cuff tear is a common reason for shoulder pain. Although the surgical technique of rotator cuff repair is developing, high retear rate requires additional supplementary methods. Among these supplementary methods, as a kind of biologic augmentation, platelet-rich plasma (PRP) has been spotlighted and has recently been studied by many researchers. PRP, a concentrate of platelet extract obtained from whole blood, contains numerous growth factors. As this is known to play an important role in the tissue recovery process, it had been used for research in a variety of fields including orthopedics. Use of PRP has been attempted in surgical treatments of rotator cuff tear for better results; however, only a few large-scale research studies on the effect of PRP have been reported. Clinical results of each study are also variable. Therefore research using large-scale randomized, double-blind trials should be conducted in order to prove the application range, safety, and clinical effects of PRP.
Blood Platelets ; Intercellular Signaling Peptides and Proteins ; Orthopedics ; Platelet-Rich Plasma* ; Rotator Cuff* ; Shoulder ; Shoulder Pain

Considerable controversy exists as to whether rhythm or rate control is the more appropriate management for the patients with persistent atrial fibrillation (AF). Until recently, it was our belief that the initial approach to rhythm management should give primary consideration to the restoration and maintenance of the sinus rhythm (SR), which provides the potential benefits of reducing the risk of thromboembolism and the need for anticoagulants, and improved the hemodynamics and quality of life. However, there are negative aspects of rhythm control, including the poor efficacy of the antiarrhythmic drugs and the potential of adverse effects. Five recent clinical trials; AFFIRM (The Atrial Fibrillation Follow-Up Investigation of Rhythm Management), RACE (Rate Control versus Electrical Cardioversion), PIAF (Pharmacological Intervention in Atrial Fibrillation), HOT CAFE (How to Treat patients with Chronic Atrial Fibrillation) and STAF (The Strategies of Treatment of Atrial Fibrillation), have looked specifically at the issue of the balance between the benefits and risks of restoration and maintenance of the SR, primarily with drug therapy. The conclusions of these trials were consistent, although the study subjects were heterogeneous;1) Rhythm control, with anti-arrhythmics, does not lead to an improvement in the symptom control, quality of life or a reduction in the short to median term clinical events, in fact, in the longer term the mortality may increase. 2) Maintenance of the SR remains poor, even with an aggressive strategy. Hence, long term anticoagulation is needed for most patients treated with rhythm control, even if the SR is restored in the short term. A number of non-pharmacological therapies have emerged, such as catheter ablation and pacing, for patients remaining highly symptomatic, despite the use of several anti-arrhythmics and serial electrical cardioversion. In conclusions, rate control should be considered as the initial strategy in the majority of the patients with persistent AF. For the minority that remain highly symptomatic, aggressive rhythm control, with invasive treatments, such as pulmonary vein isolation or rate control, with atrioventricular nodal ablation and ventricular pacing, should be considered.
Anti-Arrhythmia Agents ; Anticoagulants ; Atrial Fibrillation* ; Catheter Ablation ; Continental Population Groups ; Drug Therapy ; Electric Countershock ; Follow-Up Studies ; Hemodynamics ; Humans ; Mortality ; Pulmonary Veins ; Quality Control ; Quality of Life ; Risk Assessment ; Thromboembolism

Statisticsl observation was made on 404 patients who had been referred for consultation to the Department of Dermatology during their admission in Seoul National University Children's Hospital from October 1985 to March 1987. The results were as follows : 1. The consulted pstients were 404 among 126,622 inpatients(0.32%). 2. The most frequent age group was below 1 year(25.0%). 3. Pediatrics was the most importnat department in the number, as well as in the rate of consulted patients to inpatients. 4. The most common 10 dermatoses were contact dermatitis, atopic dermatitis, drug eruption, fungal infection, viral infection, infantile eczema, benign tumor, miliaria, urticaria, and skin manifestation of systemic diseases in order of frequency. 5. The frequent causes of consultation were as follows ; the dermatologic diseases or conditions 67.6%, the diseases related to the trestment 13.4%, the skin lesions of systemic diseases 10.8%, the dermatologic tests 3.6%, and admitted to other departments with dermatologic diseases 1.2% respectively.
Dermatitis, Atopic ; Dermatitis, Contact ; Dermatology* ; Drug Eruptions ; Humans ; Inpatients* ; Miliaria ; Pediatrics ; Seoul ; Skin ; Skin Diseases ; Skin Manifestations ; Urticaria

No abstract available.
Cryopreservation* ; Fetal Blood*

No abstract available.

BACKGROUND: Reperfusion after brief periods within 20 minutes of myocardial ischemia can result in prolonged depression of contractile function without causing myocardial necrosis-myocardial stunning. It has been also demonstrated that low reflow phenomenon and the impairment of coronary flow reserve(CFR) can occur as the consequences of brief ischemia-reperfusion on the coronary vasculature. Although these vascular functional derangements may occur after various periods of ischemia, a 15-min episode of ischemia is known to be long enough to induce microvascular dysfunction and a briefer 10-min occlusion is not. Whether reperfusion after ischemia for 15-min or 20-min results in structural damage to the large and microvessels, as well as vascular function, and their relationship with contractile dysfunction, remains uncertain. PURPOSE: This study was performed to determine whether 1) c5-min and 20-min coronary occlusion followed by 60 minutes of reperfusion in vivo would result in injury of coronary vasculature, evident as functional and ultrastructural derangements, 2) there are any differences in the severity of vascular alterations by the duration of ischemic period, and 3) these vascular alterations relate to the regional myocardial dysfunction. METHODS: Open chest dogs underwent a 15-min(n=8) and 20-min(n=10) left circumflex coronary artery occlusion followed by reperfusion for 60 minutes. Coronary blood flow(CBF) was measured with electromagnetic flow probes. At 30 minutes and 60 minutes of reperfusion, CFR was determined after intracoronary acetylcholine(ACH, 0.01microg/kg), adenosine(ADE, 1.5microg/kg) and reactive hyperemia(RH) after 20 seconds coronary occlusion. Segmental LV function was assessed with % myocardial thickening and % endocardial wall motion by 2D echocardiography. The ultrastructure of epicardial artery and the microvessels in the endocardium was examined. RESULTS: Following reperfusion, increase in CBF and decrease in coronary vascular resistance in reponse to ACH, endothelium dependent vasodilator, was significantly impaired in both 15-min and 20-min occlusion groups. The CBF response to ADE, endothelium independent vasodilator, was intract in 15-min occlusion group, whereas significantly impaired in 20-min occlusion group. The CBF response to RH was significantly depressed in both groups. On ultrastructural examination, there was no evidence of injury in the microvessels of the subendocardium in all subjects. In the large epicardial arteries, the endothelium was damaged in all subjects and its severity was milder in 15-min occlusion group than those with 20-min occlusion. Furthermore, in 50% cases of 20-min occlusion group, the injury of superficial layer of medial smooth muscle was accompanied. There was no difference in the severity of segmental LV dysfunction between two groups, and there was no appreciable correlation between myocardial dysfunction and the depressed CBF responses to ACH, ADE and RH. CONCLUSION: 1) Reperfusion after occulsion for 15 minutes produced selective dysfunction and damage to the endothelium of epicardial artery, whereas those after 20 minutes significantly decreased coronary flow reserve and induced more pronounced damage to the epicardial artery, indicated that the severity of vascular alterations is determined by the duration of ischemic period even within 20 minutes. 2) These vascular derangements are not related to the severity of contractile dysfunction, suggesting that brief ischemia-reperfusion precipitates vascular stunning as an independent phenomenon of myocardial stunning.
Animals ; Arteries ; Coronary Occlusion ; Coronary Vessels ; Depression ; Dogs ; Echocardiography ; Endocardium ; Endothelium ; Ischemia ; Magnets ; Microvessels ; Muscle, Smooth ; Myocardial Ischemia* ; Myocardial Stunning ; Reperfusion* ; Thorax ; Vascular Resistance

Nevus flammeus is benign but cosmetically devastating congenital vascular malformation whose past treaments have been marred by unacceptable complication or by unacceptable ineffectiveness. Argon laser is a therapeutic device which has been newly applied to this condition with fairly good result. However, all lesions do not show good response and it depends on the clinical and histopathological types. Therefore, it is very important to select patients who will show good response to argon laser therapy. Histological pattern was indicated as the most important prognostic factor. However, it is not always possible to get the histological data. This study was undertaken to evaluate whether it is possible to anticipate histologic patterns of nevus flammeus from color and clinical morphology of the lesions when biopsy is difficult to be taken. Color and clinical morphology of the lesions were recorded, and 4-mm punch biopsies were performed in 74 patients who visited the Laser Clinic in our dermatologic department during past 2 years, The study results were as follows. Eleven pink cases were all patch form morphologically but 8 cases(72, 7%) were constricted type and 8 cases(27 Q%) were intermediate type histopathologically. In 28 red cases, 27 cases(96 4gp) were patch form and only 1 case was smooth elevated form morphologically. And 2p cases(74, l%) were dilated or intermediate type and 7 cases(25 9%) were constricted or deep located type histologically.
Argon ; Biopsy ; Humans ; Laser Therapy ; Nevus* ; Port-Wine Stain* ; Vascular Malformations

No abstract available.
Epilepsy*

No abstract available.
Epilepsy*

For selected subsets of colon cancer (T4 lesions or those with cancers in areas of the colon where anatomic factors preclude surgery with adequate resection margins), local failure rates are similar with those of rectal cancers. The role of adjuvant external beam radiation therapy in this subset of patients has been evaluated in both retrospective and prospective studies. Postoperative radiation with or without 5-FU improved local control and disease-free survival when compared with historical controls in many single-institution studies such as MGH series, however, there is no phase-III prospective randomized study to elucidate the role of postoperative radiation therapy. One must treat each patient on the basis of through evaluation of stage, operative findings, and results of pathologic and imaging studies.
Colon* ; Colonic Neoplasms* ; Disease-Free Survival ; Fluorouracil ; Humans ; Prospective Studies ; Radiotherapy* ; Rectal Neoplasms ; Retrospective Studies