No abstract available.

No abstract available.
Humans

The purpose of this study is to investigate the clinical and histologic changes in distraction osteogenesis according to different distraction rates in the rat's tibia. Eighteen adult rats underwent open osteotomy and attachment of an external unilateral distraction device in the middle of left tibia. Latency was allowed for 7 days before distracton began. The distraction device was activated with varying distraction rates of 0.5mm, 1mm, 2mm and same rhythm of twice a day until 5mm length gain was achieved. The animals were sacrificed at post-distraction 4, 8 weeks to observe the bony healing states. At each group, clinical, radiographic and histologic studies were done. The results obtained from this study were as follows: 1. The 0.5mm group showed excellent osteogenesis than other groups. The new bone was formed by intramembranous bone formation mostly and endochondral bone formation partly. 2. The 1mm group showed delayed osteogenesis and incomplete bony healing at 8 weeks. 3. The 2mm group showed weak osteogenesis and fibrous union or nonunion at 8 weeks. From these results, it could be stated that distraction rate of 0.5mm per day was most useful in rat's tibia. The rate of 1mm showed delayed bony healing and needed more consolidation period. Distraction osteogenesis is a excellent clinical method for regenerating local bone deficiencies in limbs and craniofacial area. The more studies needed for the higher animals and human about distraction rates and other biomechanical factors on the basis of this study.
Adult ; Animals ; Extremities ; Humans ; Osteogenesis ; Osteogenesis, Distraction* ; Osteotomy ; Rats ; Tibia*

Diabetic macular edema is a major cause of visual loss and it is difficult to be quantified.We investigated a method of assessment and volumetric quantification of diabetic macular edema with Heidelberg Retina Tomograph[HRT].Ten normal eyes of control group and 20 eyes with diabetic patients were studied.In 20 diabetic patients, 10 patients had macular edema and 10 patients had no macular edema. Macular edema was defined as any visible macular thickening within a circle centered at the fovea with 6mm in diameter. With HRT, the volumes above reference plane[VARP]bound by three consecutive circles centered at the fovea [diameter, 1, 2, and 3mm ]were measured. Measurements were repeated three times, and mean measurements were used for the analysis. Diabetic eyes with macular edema had statistically greater VARP than diabetic eyes without edema[p<0.01]and greater than normal eyes[p<0.01] for all three circles.There was no statistically significant difference between volumes measured in eyes without macular edema and normal control eyes[p>0.05]. The sensitivity of HRT was 90%, and the specificity was 100%. The VARP measured using HRT was found to be linearly correlated with visual acuity expressed on a logMAR scale[p<0.05]. From the above results, we concluded that HRT could identify diabetic macular edema by volumetric analysis and indicated a good relationship of volumetric changes with visual acuity.
Humans ; Macular Edema* ; Retina* ; Sensitivity and Specificity ; Visual Acuity

The intrachoroidal changes in Harada's disease were studied by indocyanine green(ICG)angiography. ICG angiography using confocal laser scanning ophthalmoscope (Heidelberg Retina Angiograph, HRA)and fluorescein angiography were performed in 12 eyes of 6 patients during the acute stage before the initiation of corticosteroid treatment and recovery stage, and the findings were evaluated retrospectively. During the acute stage, early phase HRA images disclosed a dark background fluorescence in all eyes due to the diffuse filling delay and the vague contour of choroidal vessels. In the midphase, Intrachoroidal hyperfluorescence resulting from vascular leakage and scattered hypofluorescent spots were intermingled, and in some eyes patchy hypofluorescence representing focal filling defect was observed. These choroidal changes could be observed before any visible retinal changes appeared. During the recovery stage, choroidal filling was more rapid and choroidal vessels were more clearly visible. However the scattered hypofluorescent spots due to the blockage by the inflammatory precipitates were still observed in small numbers, and in some eyes focal vascular leakage remained. According to these findings, we hypothesize the pathogenesis of Harada`s disease as follows. Severe inflammatory precipitates and vascular leakage can make the choroid edematous with highly viscous fluid. It adds mechanical damage to choroidal vessels already injured by the inflammatory process, leading to reversible circulatory disturbances. The retinal pigment epithelium and the sensory retina may be damaged secondarily.
Angiography ; Choroid ; Fluorescein Angiography ; Fluorescence ; Humans ; Ophthalmoscopes ; Retina ; Retinal Pigment Epithelium ; Retinaldehyde ; Retrospective Studies

No abstract available.
Emergencies* ; Emergency Service, Hospital*

No abstract available.
Cardiopulmonary Resuscitation* ; Emergencies* ; Emergency Service, Hospital*

BACKGROUND: The initial history, physical examination, and ECG assessment should focus on identification of potentially serious noncardiac or cardiac disorders, including coronary artery disease, congestive heart failure, and electrical instability at the emergency room. additionally, it is essential to define disease severity, stability and need for emergency therpy. echocardiography is a useful tool for this purppose. especially Doppler echocardiography may be more sensitive and time-saving diagnostic tool for the evaluation of patients presenting with cardiogenic symptoms. So we evaluate the feasibility of the echocardiographic measurement by emergency physicain after short-term course. METHOD AND RESULTS: Twenty volunteers(10 male, 38.8+/-9.3 years) were included in the study for measurement of myocardial performance index and established parameters of ventricular function using conventional echo-Doppler methods. Myocardial performance index: (ICT+IRT)/ET, was obtained by subtracting ejection time(ET) from the interval between cessation and onset of the mitral inflow velocity to give the sum of isovolumic contraction time(ICT) and isovolumic relaxation time(IRT). The most of mean values of echocardiogrphic parameters were not significantly different between those of cardiologist and those of emergency physicians(p<0.01). The duration for measuring myocardial performance index was shortest among echocardiographic parameters. the validity of echocardiographic parameters measured by emergency physicians was proved relatively good. CONCLUSION: It is proved to be feasible for emergency physician to perform echocardiographic evaluation of ventricular function after short-term course.
Coronary Artery Disease ; Curriculum* ; Echocardiography* ; Echocardiography, Doppler ; Electrocardiography ; Emergencies ; Emergency Service, Hospital ; Heart Failure ; Humans ; Male ; Physical Examination ; Relaxation ; Ventricular Function*

BACKGROUND: To manage the EMS(emergency medical services) system effectively, departments, such as fire stations, emergency information centers, hospitals, and The Ministry of Health and Welfare, should exchange information that they own and/or gather during patient care and/or transportation. Medical records and information are very important for continuing the patient's care and for deciding on a treatment plan, but medical information is not exchanged fully in spite of its importance. METHOD: We analyzed the transfer medical reports that were written by medical doctors who transferred emergency patients to our hospital. The contents and the accuracy of the transfer medical records were analyzed and graded into 4 groups. Group A was fully described and was equipped with diagnosis, laboratory data, X-ray films; group B had a diagnosis and full laboratory data; group C had a diagnosis, but only partial laboratory data; and group D had only a diagnosis. RESULTS: Among 38,214 patients who visited our hospital from Jan. 2001 to Jun. 2001, 7,031 cases were transferred from other hospitals with transfer medical records. According to the accuracy and important contents of the transfer records, Group A occupied 1.9%, group B 5.2%, group C 32.5%, and group D, with only a diagnosis, 60.4%. In the case of our hospital, we delivered all emergency medical information by written paper(transfer note), E-mail, and web-based information system(cyber-AMC) to the doctors concerned with managing the patient. However, 93% of the medical records of patients transferred from other hospital contained insufficient information to adequately care for the emergency patients. In addition, most of the transferred patients had been transorted without prior information about transportation. CONCLUSION: Within the near future, a medical information center equipped with a computerized system should be operated to exchange medical data. As most general hospitals are operating the OCS(order communication system), EMR(electronic medical record), telemedicine, and PACS(picture-archiving communication system), medical information can be exchanged freely in real time if a code standard and HL7(Health Level 7) can be established.
Clinical Laboratory Techniques ; Diagnosis ; Electronic Mail ; Emergencies* ; Fires ; Hospitals, General ; Humans ; Information Centers ; Medical Records ; Patient Care ; Telemedicine ; Transportation ; X-Ray Film

To increase retinal blood flow, we attempted to increase blood flow of ophthalmic artery which in the major vascular supply to the eyeball. The authors evaluated changes in blood flow of ophthalmic artery and retinal capillary after compression of superficial temporal artery. In 5 normal healthy subjects, the superficial temporal artery was compressed for 10seconds and the blood flow was measured with color doppler imaging and Heidelberg Retinal Flowmeter(HRF). After compression, the mean volume of ophthalmic artery was increased by 59.3% and the mean change of diastolic velocity was significantly increased by 29.6%. Systolic velocity did not changing significantly. For evaluation of retinal microcirculation, we measured volume, flow, velocity in retina and optic nerve head. The relative ratio in changes of volume, flow, velocity were 87.9%, 91.5%, 92.6%, in retina respectively and 110.1%, 140.7%, 139.5%, respectively in optic nerve head. These significant changes were not statistically(P>0.05). In 5 diabetic patients with damaged autoregulatory mechanism, the relative ratio in changes of volume, flow, velocity were 114.25%, 118.30%, 117.6%, respectively. These changes were not statistically significant(P>0.05). Our results indicate that the increase of blood flow in ophthalmic artery by compressing superficial temporal artery did not increase retinal blood flow.
Capillaries ; Humans ; Microcirculation* ; Ophthalmic Artery ; Optic Disk ; Retina ; Retinaldehyde ; Temporal Arteries*