At first, we review a sample size estimation method for log-rank test in survival analysis. Although it is widely used these days, it has a weakness for practical use. We propose a modification method to avoid the weakness.
Sample Size*

Diaphyseal fractures of the radius and ulna present high incidence of malunion and non-union because of difficulty in reduction and maintenance of two mobile, parallel bones in the presence of the pronating and supinating muscles which exert angulatory as well as rotational forces. Over the years various methods of open reduction and internal fixation or the closed method have been advocated, but open reduction, especially fixation with compression plate and screws resulted in more satisfactory results was proved recently by the major clinical reports. From March. 1977 to December. 1985, 59 cases of diaphysesl fractures of the forearm both bone in adult and children were managed in the Department of Orthopedic Surgery, Chonbuk National University Hospital and comparisions have been made between the conservative treatment group and operative group. The obtained results were as follows; 1. The most common csuse of injury was fallen on the outstretched hand in children and traffic accident in adult. 2. The most frequent site of the fracture was middle one-third(50.8%). 3. The most common pattern of the fracture was stable fracture(50.1%). 4. The applied methods for management of the fractures include cast immobilization after manual reduction or skeletal traction, K-wire fixation, compression plate and screws, intramedullary nailing, and combined. 5. Comparision of conservative treated group with operative treated group was as follows. 1) In roentgenologically, excluding those complicated by nonunion or infection, average bone union time of conservative group in children and adolescence was 10.2 weeks and in adult was 16.7 weeks, and of operative group was 13.9 weeks. 2) According to Grace and Eversmann's evaluation, Satisfactory results were shown in 80.0% of children and adolescence group treated by conservative method and 86.7% of adult group trested by compression plate and screws. 3) Among the various internal fixstion methods, compression plate and screws method was the best measure for rapid bone union and functional recovery in adult. 4) Any marked difference between each group was not seen in nonunion, but angulstory and rotational deformity were more common in conservative group and infection was developed 2 cases in operative group only. 6. There was no noticesble difference between each treatment in children and adolescence, but operative treatment, especially compression plate and screws, in adult was more superior to conservative treatment with. regard to bone union time and functional result.
Accidents, Traffic ; Adolescent ; Adult ; Child ; Clinical Study ; Congenital Abnormalities ; Forearm ; Fracture Fixation, Intramedullary ; Hand ; Humans ; Immobilization ; Incidence ; Jeollabuk-do ; Methods ; Muscles ; Orthopedics ; Radius ; Traction ; Ulna

Succinylcholine-induced prolonged neuromuscular blockade may occur in patients with either a low level of plasma cholinesterase activity or genotypically abnormal form of that enzyme. We experienced a case of succinylcholine-induced prolonged apnea due to a low level of plasma cholinesterase activity. A 31-year-old woman, full term primigravida, underwent cesarean section for breech presentation under general anesthesia. Familial and past medical history were nonspecific and preoperative physical and laboratory findings were within normal range. After operation, delayed apnea was detected and lasted for about one hour. We performed controlled and assisted ventilation for two and half hours. Plasma cholinesterase activity measured 30.00 IU/L (colorimetric method, normal value: 1130~1960 IU/L) at the first postoperative day. She was discharged on 7th postoperative day without any sequelae. From follow-up study after six months, it measured 1.02 U/ml (EIA, normal value: 7~9 U/ml).
Adult ; Anesthesia, General ; Apnea* ; Breech Presentation ; Cesarean Section* ; Cholinesterases* ; Female ; Follow-Up Studies ; Humans ; Neuromuscular Blockade ; Plasma* ; Pregnancy ; Reference Values ; Ventilation

BACKGROUND AND OBJECT: Immunostimulatory CpG-oligodeoxynucleotides (ISS CpG-ODN) up-regulate the TH1-type immune response and down-regulate the TH2-type response. This study was performed to investigate the immune response changes resulting from ISS CpG-ODN on bronchial hyperrestponsiveness, eosinophilic inflammation and mucus hypersecretion in rat asthma. MATERIALS AND METHODS: 10 normal controls(NC) and 26 asthmatic rats, which were generated by ovallbumin(OVA) sensitization and challenge, were studied. The asthmatic rats were randomized into 11 asthma controls(AC) and 15 in the asthma-CpG treatment group(CpG). The CpG group was administered ISS CpG-ODN intramuscularly and the AC group was administered a placebo(0.9% NaCl)on day 15 and 20. After CpG-ODN or placebo administration, we measured the IFN-(TH1-type cytokine) and IL-4(TH2-type cytokine) levels in the bronchoalveolar lavage fluid(BALF), the specific airway resistance(sRaw), eosinophilic fraction in BALF, eosinophilic infiltration, goblet cell dysplasia and MUC5AC gene expression in the lung tissue. RESULTS: In the BALF of the CpG group, the IFN-γ concentration was significantly high and the IL-4 concentration was significantly low when compared with the AC group. Both the sRaw and eosinophilic fraction, and infiltration into the BALF and lung tissue significantly lower in the CpG group when compared with the AC group. However, little difference in goblet cell dysplasia and MUC5Ac gene expression was observed between the CpG group and the Ac group. CONCLUSION: ISS CpG-ODN decreases bronchial hyperresponsiveness and eosinophilic inflammation in the rat asthma model through the up-regulation of the TH1-type immune response with the down-regulation of the TH2-type response. However, the effect of these immune response changes on mucus hypersecretion was is not remarkable in this study.
Animals ; Asthma* ; Bronchoalveolar Lavage ; Down-Regulation ; Eosinophils ; Gene Expression ; Goblet Cells ; Inflammation ; Interleukin-4 ; Lung ; Mucus ; Rats* ; Up-Regulation

PURPOSE: It is presumed that lower urinary tract symptom(LUTS) and hypertension are related to the age-dependent sympathetic activity. Thus, the attempt to elucidate a correlation between these two conditions can be important in their management. We investigated the relationship between LUTS and hypertension. MATERIALS AND METHODS: From 1995 to 1997, 1011 men(422 from routine physical checkup, 288 benign prostatic hyperplasia(BPH) patients, 301 hypertension patients) over 50 years were enrolled. The international prostate symptom score(IPSS) and blood pressure were recorded in all. 422 men from physical checkup were grouped into 4 categories according to the presence of LUTS(IPSS> or =8) or hypertension(systolic> or =140mmHg, diastolic> or =90mmHg). The prevalence of hypertension, and the degree of LUTS were evaluated. Statistical analysis was performed with t-test, chi-square test and Mantel-Haenszel test. RESULTS: The prevalence of hypertension was not significantly different between the LUTS(n=177) and non-LUTS groups(n=245)(38.4% vs 35.9%, p=0.600) in men from physical checkup. There was no difference according to age(p=0.513). The prevalence of hypertension was 39.6% in the BPH group(N=288) and was not different compared to the non-LUTS group(n=245)(p=0.385). No significant difference in the prevalence of LUTS was seen between hypertensives(n=156) and normotensives(n=266)(53.2% vs 48.2%, p=0.447) in the physical checkup group. However, their mean IPSS (8.9+/-6.5 vs 7.6+/-5.6) were significantly different(p=0.030). The mean IPSS between hypertensives(15.21+/-4.5) and normotensives(12.75+/-5.0) from the LUTS group(n=178) were significantly different(p=0.002). The mean IPSS of the patients with hypertension(n=301, 9.6+/-5.9) was significantly higher than normotensive men(n=266, 7.6+/-5.6) from physical checkup(p=0.001). CONCLUSIONS: Hypertension and LUTS including BPH do not correlate prevalence-wise, however, hypertension may affect the degree of IPSS.
Blood Pressure ; Humans ; Hypertension* ; Male ; Prevalence ; Prostate ; Urinary Tract*

PURPOSE: Characteristics of pulsatile flow in 3-dimensional arterial geometry and elastic vessel wall should be investigated in order to understand the physiological blood flow in human body. In this study, the modelling of the physiological blood flow in the elastic blood vessel is proposed. METHODS: The finite volume predictions are used to analyse the pulsatile flow characteristics in the elastic blood vessel. RESULTS AND CONCLUSION: Variations of the pressure and the velocity waveforms are obtained using the proposed modelling. The magnitudes of the pressure waveforms in the elastic blood vessel model are bigger than those of the rigid blood vessel model.
Blood Vessels* ; Human Body ; Pulsatile Flow*

PURPOSE: The objective of the present study is to investigate the steady and pulsatile flow phenomena of the blood substitute fluids in the circular and bifurcated vessels numerically and experimentally. METHODS: The particle image velocimetry (PIV) is adopted to visualize the flow fields in the circular and bifurcated vessels. In order to analyse the complex flow phenomena of the blood substitute fluids in the bifurcated vessel, the constitutive equations which are suitable to describe the rheological properties of the non-Newtonian fluids are determined and the steady and unsteady momentum equations are solved by the finite volume prediction. RESULTS AND CONCLUSION: Velocity vectors of the steady flow in the bifurcated tube obtained by the PIV system are in good agreement with those obtained by the numerical analysis. The experimental and numerical results show the recirculation zone in the outer wall distal to bifurcation.
Blood Substitutes* ; Pulsatile Flow* ; Rheology*

Rhabdomyolysis is an uncommon complication in a vascular surgery. Recently we experienced two cases of rhabdomyolysis after aortic surgery. The first one underwent an elective surgery for AAA but the 2nd case performed an emergency surgery because of ruptured AAA. Both patients recovered from rhabdomyolysis by conservative medical treatment without any major complications such as acute renal failure.
Acute Kidney Injury ; Aneurysm ; Aorta ; Emergencies ; Humans ; Rhabdomyolysis*

The objective of the present study is to obtain information on the hemodynamic characteristics in the anastomotic sites of femoral artery through the vascular implantation. Three dimensional steady and physiological blood flows in the femoral artery are simulated using the finite volume method. The geometrical shape of the anastomotic sites is made based on the vascular anatomy of a white rabbit. Wall shear stress distributions in the anastomotic sites for the physiological flow are compared with those for steady flow. Blood flow phenomena in the anastomotic sites of the femoral artery are discussed extensively.
Arteries ; Femoral Artery* ; Hemodynamics*

The hemodynamic characteristics of the cuff end-to-side anastomosis model are investigated using by the finite volume predictions. The flow rates and the impedance indices through of the cuff anastomosis model are compared with those of the anastomosis model without the cuff. Blood flow increased through the cuff anastomosis model than the standard anastomosis model. The impedance index decreased with the increase of flow rate. The impedance index at a given flow rate is reduced by the increase of anastomosis angle and further reduced by the addition of the cuff. The results suggest that the cuff anastomosis model should be applied for the low Reynolds number flow and/or the small artery anastomosis model.
Arteries ; Electric Impedance ; Hemodynamics*