In order to investigate a hemodynamic complication associated with the resection of a large arteriovenous malformation, we planed the following experiment. We divided the left common caroted artery and the internal jugular vein for microsurgical anastomsis between the rostral carotid and caudal jugular vessel ends : the 2 remaining wessel stumps were ligated. This created an arteriovenous shunt with afferent flow from the contralateral caroted and the basilar artery and retrograde down to the carotid-jugular anastomosis. And then, we occluded the shunt vessels at the each stage of the first and fourth week after anteriovenous shunt. Forty adult cats weighing from 2.2 to 2.4kg were used in this study The animals were devided into 4 groups : group 1(acute occlusion-1 week after shunt, n=10), group 2(staged occlusion-1 week after shunt, n=10), group 3(acute occlusion-4 week after shunt, n=10), group 4(staged occlusion-4 week after shunt, n=10) respectively. The regional cerebral blood flow(rCBF), cardiopulmonary function were measured in each animal group and also observed the response of the cerebral blood flow on induced changes of the blood pressure and the arterial bicarbonate. The arteriovenous shunt patency was evaluated by serial angiography. The results were as follows ; 1) Considerable increases in the mean arterial blood pressure(mABP) as well as bradycardia were observed in acute occlusion groups(group 1, 3). After induced hyercarbia, the increments of mABP in acute occlusion groups were less than staged occlusion groups, considerbly. 2) Significant decreases in the mean pulse rate were observed in acute occlusion groups. the mean pulse rate were the highest decrease in group 3. 3) The values of rCBF of left frontal cortex in acute occlusion groups were more greater increase than those of staged occlusion groups considerably. 4) After induced hypercarbia, considerable increases of the rCBF were demonstrated in all groups and increases of the rCBF were lowest in group 3 compared with the other groups. After induced hypercarbia, considerable increases of the rCBF were demonstrated in all groups and reductions of the rCBF were lowest in group 3 compared with the other groups. 5) After induced hypercarbia, considerable increases of the rCBF were demonstrated in all groups. The rCBFs were the highest increase in group3 and lowest increase in group 2 compared with the other groups. After induced hypotension, considerable reductions of the rCBF were demonstrated in all groups. The rCBFs were the highest reduction in group 3 and lowest reduction in group 2 compared with the other groups. It might be infered from these results that patients with large arteriovenous malformations, particulary those with cerebral steal symptoms, are at risk to develp neurologic defictis related to perfusion breakthrough if their malformed vessels are abruptly removed, and staged or gradual occlusion of feeding arteries may prevent this potentially devastating complication.
Adult ; Angiography ; Animals ; Arteries ; Arteriovenous Malformations ; Basilar Artery ; Blood Pressure ; Bradycardia ; Cats ; Heart Rate ; Hemodynamics ; Homeostasis* ; Humans ; Hypotension ; Jugular Veins ; Perfusion

No abstract available.
Dermabrasion* ; Eyebrows* ; Foreign Bodies* ; Foreign-Body Reaction*

The Author reports here the statistical observation of poliomyelitis from the 46 cases during a 3 month period (June, August, 1971) at the department of Orthopaedic Surgery, Korea General Hospital under the support of Shrine Club in Korea. The statistical results were as follows: 1. Among 46 cases, 30 were male, age of infection of poliomyelitis ranged from 2 month to age of five. The majority of cases were under the age of one and 95% of total patients were under the age of three. 2. Among 46 cases, 78.2% was not vaccinated fer poliomyelitis. The sequela of paralysis were more prevalent in this group. 3. tibialis anterior muscle and quadriceps femoris muscle were paralized predominently, 78.2% and 60.8% respectively. 4. Seventy eight and two tenth percent (78.2%) of patient seeked Chinese medicine practitionar with herb and acupunture, following paralysis, only 39.1% reported to the hospital and 4.4% did not see any treatment at all.
Asian Continental Ancestry Group ; Hospitals, General ; Humans ; Korea ; Male ; Paralysis ; Poliomyelitis ; Quadriceps Muscle

After the success of total hip replacement arthroplasty by John Charnley in 1962, it was well known fact that total hip replacement arthroplasty can be applied to degenerative arthritis, rheumatoid arthritis, post-traumatic arthritis, ankylosing spondylitis, even on the fused hip. However the old dislocated hip gives arise a few problem for its total hip replacement with the follwing causes:, 1. floor of the falad acetabulum is very thin and inadequate to receive a socket. 2. distorted anatomy of the acetabulum and proximal femur. 3. short and atrophic abductor mechanism. Total hip replacement arthroplasty could be successful for the old dislocated hip, if the adequate size of cup ard prosthesis are available and there is adequate length of the hip abductor. Preoperatively we can measure the size of the acetabulum and the distorted femur with roentgenogram. But it is not known how to measure or predict whether or not there is enough length of the abductor muscle mechanism preoperatively. Therefore the question arises how to measure or predict the length of the hip abductor in the old dislocated hip. Although this is a preliminary report, it is our feeling that the more the range of motion the hip has, the better the length of the hip abductor muscle. In our series acetabular socket can be positioned at the original site and the osteomized greater trochanter reduced to the femur easily in the cases more than 190 of total range of motion of the affected hips, The range of motion of the affected hip can be measured preoperatively.
Acetabulum ; Arthritis ; Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Femur ; Hip ; Osteoarthritis ; Prostheses and Implants ; Range of Motion, Articular ; Spondylitis, Ankylosing

PURPOSE: To evaluate the changes of brachial arterial Doppler waveform during immersion of the hand of young men in ice-cold water. MATERIALS AND METHODS: Doppler waveforms of brachial arteries in 11 young male patients were recorded before and during immersion of ipsilateral hand in ice-cold water(4--5 degree C). The procedure was repeated on separate days. Patterns of waveform during immersion were compared with the changes of pulsatility index. RESULTS: Four men showed high impedance waveforms, and 5 men showed low impedance waveforms during immersion both at the first and at the second study. Two men, however, showed high impedance waveforms at the first study and low impedance waveforms at the second study. The pulsatility index rose and fell in high and low impedance waveforms, respectively. CONCLUSION: The changes of brachial arterial Doppler waveforms could be classified into high and low impedance patterns, probably reflecting the acute changes in downstream impedance during immersion of hand in ice-cold water.
Brachial Artery ; Electric Impedance ; Hand* ; Humans ; Immersion* ; Male ; Water*

No abstract available.

No abstract available.

No abstract available.
Urinary Bladder*

Pain is the most persistent and incapacitating symptom of recurrent or metastatic cancer. About 60~90% of patients with metastatic cancer have pain long before the terminal stage of their illness. According to a recent report, in Korea, the proportion of cancer patients who have pain is 52.1% and 62.6% of them are not given adequate analgesia. Despite widespread knowledge about many aspects of pain relief and the availability of appropriate opioid analgesics, inadequate pain management in cancer patients remains pervasive. The reasons can be classified into three categories ; societal barriers, knowledge deficits, and influenced of governmental regulations. Cancer pain can be effectively treated in 85 to 95% of patients with an integrated program of systemic, pharmacologic, and anticancer therapy. However, pain relief in cancer patients remains inadequate because it is not given priority and there is a lack of education and inappropriate understanding of the nature of cancer pain. To overcome these barriers, professional education needs to be focused on the proper assessment of pain, the management of side effects, and the use of adjuvant medications. A better understanding of the pharmacology of opioid analgesics is also needed. In addition, physicians should educate patients to report pain and to take the medications prescribed for pain management effectively.
Analgesia ; Analgesics, Opioid ; Education ; Education, Professional ; Humans ; Korea ; Pain Management ; Pharmacology ; Social Control, Formal

No abstract available.