The halogenated anesthetics, halothane, enflurane and isoflurane undergo biotransformation in man. They produce inorganic fluoride ion as a metabolite, which is well known as the cause of methoxyflurane induced nephrotoxicity. This study was done to investigate the rapidity and extent of biotransformation of volatile anesthetics for 2 hours of operation. Thirty patients were randomly divided into halothane, enflurane and isoflurane group according to anesthetics. Blood and urine sampling was done before operation, post-induction 10 min, 20 min, 30 min, 1 hour, 1 hour 30 min and 2 hours for the measurement of inorganic fluoride ion. Aspartate aminotransferase, alanine aminotransferase, blood urea nitrogen and creatinine levels were measured before and 24 hours after operation. The results were as follows ; 1) The values of blood fluoride ion in halothane and isoflurane group were decreased with time during operation and there was no change in enflurane group. 2) The values of urine fluoride ion in three groups were increased with time during operation. The rate of increase was the greatest in enflurane group. 3) There were no changes in the value of AST, ALT, BUN and creatinine. The above results suggest that the biotransformation of volatile anesthetics to inorganic fluoride ion was the greatest in enflurane, but the level was insufficent to cause renal dysfunction during 3.18 hour operation.
Alanine Transaminase ; Anesthetics* ; Aspartate Aminotransferases ; Biotransformation* ; Blood Urea Nitrogen ; Creatinine ; Enflurane ; Fluorides ; Halothane ; Humans ; Isoflurane ; Metabolism ; Methoxyflurane

Changes of bone turnover with aging are responsible for bone loss and play a major role in osteoporosis. Among the early postmenopausal women, as are known by previous study, there are about 35% ""fast bone losers and bone turnover is more uncoupled in osteoporotic group than in normal control. So, early detection of such fast losers"" and women who have high turnover rate is important to prevent postmenopausal osteoporosis and spontaneous fracture. Dual-energy X-Ray absorptiometry (DEXA), however, cannot reflect current bone loss because changes in bone mineral density (BMD) are only seen after 1 or more years of bone densities declining. In this study, we have measured a battery of new sensitive and specific markers of bone turnover which reflect current bone loss. To investigate the changing pattern of those markers, 674 healthy women including 451 postmenopausal women were classified, according to their menopausal period (less than 5 years, 5-10 years, more than 10 years). Bone formation was assessed by serum osteocalcin (OC), bone-specific alkaline phosphatase (BSAP) and bone resorption by the urinary excretion of deoxypyridinoline (DPD), cross-linked N-telopeptide of type I collagen (NTX). All Biochemical markers, except OC, significantly increased after menopause (p < 0.05). NTX and BSAP remained elevated after 10 years of menopause. These data indicated that the overall rates of both bone formation and bone tesorption increased after menopause and remained high in elderly women.
Absorptiometry, Photon ; Aged ; Aging ; Alkaline Phosphatase ; Biomarkers ; Bone Density ; Bone Resorption ; Collagen Type I ; Female ; Fractures, Spontaneous ; Humans ; Menopause ; Osteocalcin ; Osteogenesis ; Osteoporosis ; Osteoporosis, Postmenopausal

The aim of this study was to verify the epidemiology of spectator injury and illness in the baseball stadium during the games and the role of the on-site physician in hospital referral of spectators. We retrospectively reviewed the 'Documents of the medical aids' from 2011 to 2012 at Jamsil stadium. We have provided medical consultation to spectators as on-site physicians since 2012. The incidence of spectator injury and illness was 0.009% (1.68 spectators/game). During the study period, a total 448 spectators visited the first aid station, of which 324 cases (72%) were injuries and 124 cases (28%) were illness. The most common cause of injury was direct foul ball attacks (58.6%). According to the location of injuries, upper extremity injuries were most common, however, severe injury cases that were immediately referred to the hospital by ambulance were more commonly facial and oral injuries (p=0.000). Severe injuries occurred more frequently in games on weekends than weekdays (p=0.000).Headache was the most common illness followed by gastrointestinal problems. Hospital referrals were more frequent in the 2012 season when we were designated on-site physicians, as compared to the 2011 season (p=0.035).
Ambulances ; Baseball* ; Epidemiology* ; First Aid ; Incidence ; Referral and Consultation ; Retrospective Studies ; Seasons* ; Upper Extremity

No abstract available.
Adenosine* ; Diagnosis* ; Radionuclide Imaging*

Post-thoracotomy pain is so severe that may lead to postoperative complications, such as sputum retention, atelectasis, pneumonia and respiratory failure. These complications are associated with shallow breathing and inability to cough due to pain. To reduce postoperative pulmonary complications and improve respiratory mechanics, effective pain relief is essential. Among the many methods, epidural administrations of narcotics or local anesthetics have been shown to provide profound relief of postoperative pain. Forty-five patients undergoing thoracotomy were randomized into three groups based on a postoperative pain regimen as indi-cated: Group I; intermittent intramusculal injections of nalbuphine 0.2mg/kg for pain control(n= 15) Group II; intermittent epidural injections of mixtures of 0.2% bupivacaine and fentanyl 3 ug/ ml (n=15) Group III: continuous epidural infusion of mixtures of 0.2% bupivacaine and fentanyl 3 ug/ml at a rate of 4-5 ml/hr with supplementation on pain complaint. We evaluated postoperative pain score at 30 minutes, 8 hours, 16 hours, 24 hours, 32 hours, 40 hours, and 48 hours after thoracotomy. And we observed the duration of analgesia and the incidence of systemic side effects of three methods. The results were as follows; 1) The pain score was significantly decreased in group III compared to group I and II<0. 05). 2) The mean duration of analgesia was significantly longer in group III compared to group I and II(p<0.05). 3) the number of case of systemie side effects in group I was one case of nausea and vomiting, in group II, two cases of mild hypotension, and one case of nausea and vomiting, pruritus, headache, and urinary retention each respectively and in group III, one case of ruinary retention.
Analgesia* ; Anesthetics, Local ; Bupivacaine* ; Cough ; Fentanyl* ; Headache ; Humans ; Hypotension ; Incidence ; Injections, Epidural ; Nalbuphine ; Narcotics ; Nausea ; Pain, Postoperative ; Pneumonia ; Postoperative Complications ; Pruritus ; Pulmonary Atelectasis ; Respiration ; Respiratory Insufficiency ; Respiratory Mechanics ; Sputum ; Thoracotomy* ; Urinary Retention ; Vomiting

It is essential to keep sirway during, general anesthesia. Tracheal intubation is the most useful and safe method to keep airway. But there are hemodynar. ic changes in using laryngoscope and tracheal intubation. And also sore throat may by developed in postoperative period. In 1983, Brain introduced laryngeal mask as a new airway and thereafter its use is increasing. Laryngeal mask have many advantages of easy intubation, insertion without muscle relaxant, and decreasing damage of larynx and pharynx, and also useful in difficult intubation. We studied hemodynamic changes during tracheal intubation and laryngeal mask insertion, and examined postoperative sore throat in postoperative 24 hours. The results are as follows: 1) There were significant increase in systolic, diastolic, mean arterial pressure and heart rate in both groups, but degree and duration of increase was more in endotracheal intubation group. 2) There were more cases of sorethroat in control group than mask group, but no significance was noted between them.
Anesthesia, General ; Arterial Pressure ; Brain ; Heart Rate ; Hemodynamics ; Intubation* ; Intubation, Intratracheal ; Laryngeal Masks* ; Laryngoscopes ; Larynx ; Masks ; Pharyngitis ; Pharynx ; Postoperative Period

BACKGROUND: The diagnosis of malaria has been usually made using microscopic examination of Wright stained thin blood films in Korean army. This method is labor-intensive, time consuming and requires the microscopic expertise. Therefore, the alternative techniques, rapid diagnostic test, have been sought for use in Korean army. We performed a comparison of the OptiMAL test with GENEDIA Malaria (P. vivax) Ab Rapid I, II to assess its sensitivity and specificity of Plasmodium vivax malaria. METHODS: Blood specimen were collected from 51 patients who were presented and initially diagnosed for P. vivax by the microscopy of blood smears and from 30 control patients without malaria infection at the Capital Armed Forces General Hospital (CAFGH) between October 2000 and February 2001. Among the 51 patients, we also collected 24 samples from 24 patients at 2 or 3 days after therapy. The OptiMAL test and GENEDIA Malaria (P. vivax) Ab Rapid I, II were performed according to the manufacturer's instructions on all samples respectively. RESULTS: Compared with the blood film, sensitivities and specificities of the OptiMAL test, GENEDIA Malaria (P. vivax) Ab Rapid I and GENEDIA Malaria (P. vivax) Ab Rapid II were 94.1~100% (29/29), 80.4~83.3%, 96.1~96.7% respectively. One case was interpreted as 'undetermined' by OptiMAL test. In 24 patients during therapy, the sensitivities of the OptiMAL test, GENEDIA Malaria (P. vivax) Ab Rapid I and GENEDIA Malaria (P. vivax) Ab Rapid II on 8 specimens with mean 120/microliter parasitemia and 16 specimens with negative parasitemia were 75~43.8%, 87.5~81.3%, 100~100% respectively. CONCLUSION: Our data demonstrated that the sensitivity and specificity of the GENEDIA Malaria (P. vivax) Ab Rapid I were not satisfactory, but the sensitivity and specificity of the OptiMAL test and GENEDIA Malaria (P. vivax) Ab Rapid II were relatively high and useful diagnostic tests for diagnosis of P. vivax in areas like the militaries where laboratory facilities are poor or non-existent.
Arm ; Diagnosis* ; Diagnostic Tests, Routine ; Hospitals, General ; Humans ; Malaria* ; Malaria, Vivax ; Microscopy ; Military Personnel* ; Parasitemia ; Plasmodium vivax* ; Plasmodium* ; Sensitivity and Specificity

PURPOSE: Third generation shoulder arthroplasty is widely performed nowadays; however, few studies on the anatomy of the proximal humerus in the Korean population have been reported. The authors have attempted to review the anatomy of the proximal humerus. MATERIALS AND METHODS: The study sample consisted of 100 humeri of patients with a mean age of 48 years (range of 17 to 83 years) who underwent computed tomography imaging between January 2009 and October 2011 at Myongji Hospital. Diameter of the articular surface, head thickness, radius of curvature, head inclination, head to tuberosity height, bicipital groove-shaft angle, lateral angle, medial offset and posterior offset were analyzed. Results were compared depending on age and gender. RESULTS: Mean values of diameter of the articular surface was 42.70+/-3.57 mm, head thickness was 14.3+/-2.0 mm, and radius of curvature was 22.50+/-1.97 mm; these three variables showed significant sex differences. Head inclination was measured as 130.00+/-4.28 degrees, head to tuberosity height was 7.50+/-0.99 mm, bicipital groove-shaft angle was 6.60+/-0.92 degrees, and lateral angle was 163.40+/-4.05 degrees. Mean medial and posterior offset were 5.2+/-2.1 mm and 3.1+/-1.8 mm, respectively. CONCLUSION: Based on the results of this study, the measurement values of Korean humeri can be used in design of the arthroplasty prosthesis, and this will lead to more accurate anatomical reconstruction of the shoulder joint.
Arthroplasty ; Head ; Humans ; Humerus* ; Prostheses and Implants ; Radius ; Sex Characteristics ; Shoulder ; Shoulder Joint

Rosai-Dorfman disease (RDD) is a benign proliferative histiocytic disorder of unknown etiology, which typically manifests as lymphadenopathy and systemic symptoms. Lymph node involvement is typical, but soft tissue RDD without nodal or systemic involvement is extremely rare. We report on a case of soft tissue RDD in a 16-year-old girl with a palpable mass on her buttock. It was firm, mobile, and discrete without tenderness. Excisional biopsy was performed, then RDD was confirmed histologically. RDD is a non-neoplastic disease that should be considered in the differential diagnosis of other soft tissue tumors. While the optimal treatment for extranodal RDD remains controversial, surgical excision is typically curative.
Adolescent ; Biopsy ; Buttocks ; Diagnosis, Differential ; Emperipolesis ; Female ; Histiocytosis, Sinus* ; Humans ; Lymph Nodes ; Lymphatic Diseases

Bone is a complex tissue in which resorption and formation continue throughout life. The bone tissue contains various types of cells, of which the bone forming osteoblasts and bone resorbing osteoclasts are mainly responsible for bone remodeling. Periodontal disease represents example of abnormal bone remodeling. Osteoclasts are multinucleated cells present only in bone. It is believed that osteoclast progenitors are hematopoietic origin, and they are recruited from hematopoietic tissues such as bone marrow and circulating blood to bone. Cells present in the osteoclast microenvironment include marrow stromal cells, osteoblasts, macrophages, T-lymphocytes, and marrow cells. These cells produce cytokines that can affect osteoclast formation. In vitro model systems using bone marrow cultures have demonstrated that IL-1 beta, IL-3, TNF-alpha, bFGF can stimulate the formation of osteoclasts. In contrast, IL-4 inhibits osteoclast formation. Knowledge of cytokines and bFGF that affect osteoclast formation and their capacity to modulate the bone-resorbing process should provide critical insights into normal calcium homeostasis and disorders of bone turnover such as periodontal disease, osteoporosis and Paget's disease.
Bone and Bones ; Bone Marrow* ; Bone Remodeling ; Calcium ; Cytokines* ; Fibroblast Growth Factor 2 ; Homeostasis ; Interleukin-1beta ; Interleukin-3 ; Interleukin-4 ; Macrophages ; Osteoblasts ; Osteoclasts* ; Osteoporosis ; Periodontal Diseases ; Stromal Cells ; T-Lymphocytes ; Tumor Necrosis Factor-alpha