BACKGROUND: Angiotensin convertiong enzyme inhibitors have been shown to exert favorable effects on the left ventricular remodeling process associated with ventricular dilation after coronary occlusion. However, the effects of such therapy on global and regional left ventricular remodeling after coronart artery reperfusion have not been characterized, nor have such effects been assessed after exercise training. METHODS AND RESULTS: Female Sprague-Dawley rats(n=80) were randodmized into 4 groups at 5 days after 45 minutes of left coronary artery occlusion followed by reperfusion. Animals completion the experiment included : Untreated Sedentary group(n=20), Untreated with Swimming Exercise group(n=21), Captopril Treated Sedentary group(n=18) and Captoril Treated with Exercise group(n=21). At 3 weeks after randomization, global and regional morphologic changes of the left ventricle(LV) were examined from mid-ventricular transverse slices which were perfusion-fixed at a constant aortic pressure of 60mmHg and a left ventricular cavity pressure of 10mmHG. At rest and during exercise, compared to untreated rats, the captopril treated animals showed significantly decreased LV weight/tibial length ratio(LV/TL)(p<0.01),increased LV cavity area and dimension(both p<0.01), decreased total myocardial area and noninfarcted area(both p<30.001) and reduced wall thicknesses in the noninfarcted and infarcted regions(both p<0.001). Compared to treated and untreated dsedentary rats, exercise significantly increased LV/TL(p<0.05) and epicardial and endocardial areas in the infarcted zone(both p<0.05) and decreased transmurality(p<0.01). Exercise decreased LV cavity area in the captopril treated groups(42.3+/-10.4 vs. 40.4+/-6.0mm2),whereas exercise increased LV cavity area in the untreated groups(33.5+/-8.9 vs. 39.1+/-6.2mm2)(p<0.05). CONCLUSION: These findings provide evidence in rats for evidence in rats for exaggerated left ventricular dilation and supperssion of compensatory myocardial hypertrophy globally and in the infarct zone with 3 weeks of captopril treatment following coronary artery reperfusion with acute nontransmural myocardial infarction. In addition, the effects of captopril on LV dilation and suppression of global and regional hypertrophic response were partially reversible by swimming exercise.
Angiotensins ; Animals ; Arterial Pressure ; Arteries ; Captopril ; Coronary Occlusion ; Coronary Vessels* ; Enzyme Inhibitors ; Female ; Humans ; Hypertrophy ; Myocardial Infarction ; Myocardial Reperfusion ; Random Allocation ; Rats* ; Rats, Sprague-Dawley ; Reperfusion* ; Swimming ; Ventricular Remodeling*

No abstract available.
Decompression* ; Spinal Stenosis*

The tibial plafond fractures result from an axial compression snd rotational forces causing variable degrees of metaphyseal disruption, articular damage, and malleolar displscement. It is relatively uncommon but a most difficult fracture to manage. It has been treated in a number of manners, but the best results have been occurred when stable internal fixation is accomplished using plates and screws. Basic steps in reconstruction are restoration of anatomic length of the fibula with plate fixation, reconstruction of the tibial articular surface, cancellous bone grafting of the metaphyseal defect and buttress plating of the distal tibia. The suthor analysed the 20 cases of the tibial plafond frsctures in 17 patients, which were trested at the Department of Orthopedic Surgery, Paik Hospital, Inje Medical College from Jsnuary 1983 to March 1987. The longest durstion of followup was 2 years and 4 months and shortest one was 6 months, and the aversge was one year. The results were as follows : 1. Among the 17 patients, male were 16 and female was one. 2. The major causes of injury were a fall from a height. 3. The most frequent type of fracture was type C by Ruedi and Allgower classification. 4. Regardless of the method of trestment the type A and B were in good and fair result, but the type C were fair in 4 cases and poor in 8 cases. There were 7 cases of snkle fusion in poor group. 5. It is important to remind the basic steps in reconstruction and applied in sn individual csse especially in type C. If anatomic reconstruction of the joint surface can be restored and stable fixation achieved, esrly motion of the ankle joint is made possible. This early motion reduces stiffness of the ankle and win yeild the most sstisfying result. But the anatomic reduction of ank1 joint is difficult to be obtained in each case especially in type C and may consider an ankle fusion.
Ankle ; Ankle Joint ; Bone Transplantation ; Classification ; Clinical Study ; Female ; Fibula ; Follow-Up Studies ; Humans ; Joints ; Male ; Methods ; Orthopedics ; Tibia

[Background] Over the last thirty years, majority of researches on clinical effectiveness of acupuncture have been explanatory (or experimental) randomized controlled trial. The benefits of acupuncture in clinical trials are stillcontroversial and most studies concluded that further control studies were required. Standardized combinations of acupuncture points for all the experimental subjects in various past studies have been criticized because such treatments do not reflect current routine clinical treatment.
[Objective] This paper aims to review pragmatic clinical trials on the effect of acupuncture treatment and to develop the ideal clinical research methodology of acupuncture study.
[Method] Clinical studies of acupuncture relevant with pragmatic or individualized trials were searched mainly in Pubmed and Science direct databases. All articles were fully reviewed by researchers, and data were evaluated by usage of a standardized form.
[Results & Suggestion] Pragmatic acupuncture researches were tried for various symptoms (eg. low back pain, hypertension, depression during pregnancy, sleep quality in HIV disease, chronic poststroke leg spasticity, headache, etc). Individualized acupuncture treatments based on oriental disease pattern diagnosis reflexes practical treatments which is more effective than unified and fixed acupuncture treatments without any theoretical basis of oriental medical philosophy.
[Conclusion] To overcome the controversies and limitations of past explanatory acupuncture trials, more individualized and tailored acupuncture trials with the theoretical basis of oriental medical diagnosis is highly recommended. Also clear definition and categorization of pattern identification should be established for further active clinical researches and applications of acupuncture.

The antihypertensive effect of nicardipine was studied in 31 cases of essential hypertension and following results were obtained. 1) Daily dose was 30-60mg for 10 weeks. 2) Mean systolic and diastolic pressure were decreased by 39.5mmHg 921%) and 17.2mmHg(15%) respectively(P<0.005) and in 84% of cases, good or fair control of blood pressure was proved. 3) There was no significant change in heart rates before and after treatment. 4) There were no significant side effects except two cases of mild headache and facial flushing which subsided spontaneously.
Blood Pressure ; Flushing ; Headache ; Heart Rate ; Hypertension ; Nicardipine*

The effects of KCI continus tablet(K-Contin(R)) on the serum level of K and uric acid during hydrochlorothizide therapy(25mg/day) were evaluated in 30 patients with essential hypertensien. The results are as follows : 1) During hydrochlorothiazide therapy(25mg/day), 23% of all patients showed hypopotassemia(<3.5mEq/1) while no patient developed hypopotassemia after potassium supplement therapy(8 mEq/day). 2) During the period of K supplement, the level of serum uric acid showed less elevation. 3) The side reaction of KCI continus tablet were mild indigestion which developed in two patients and disappeared soon without any particular treatment. In conclusion, the KCI continus tablet is useful in the prevention of hypopotassemia during chronic diuretic therapy.
Dyspepsia ; Humans ; Hydrochlorothiazide ; Hypokalemia ; Potassium ; Uric Acid*

Acute pyogenic arthritis in renal transplant patient is one of the serious problem resulting in significant morbidity and mortality. The purpose of this paper is to analyze seven patients in whom acute pyogenic arthritis developed following renal transplantation. Pyogenic arthritis developed in seven (0.7%) out of 958 renal transplant patients whose transplanted kidney functioned well for more than two years. The age of the patients ranged from 37 to 65 years with a mean of 48 years. All patients were male. Pyogenic arthritis developed between the period of one and 12 years (mean: 4.5+/-4.2 years) following transplantation. Causative organisms were Staphylococcus aureus (three), E. coli (two), Salmonella (one) and Acinetobacter bananii (one). Involved joints were four knees, one hip, one elbow and one finger. Two patients improved on a conservative regimen of bed rest and antibiotics and five patients required open drainage. However, pyogenic arthritis recurred in three years, four years and seven years after renal transplant in one patient. Looking at the probable risk factors of age, sex, immunosuppresants, diabetics and acute graft rejection, diabetics and older age (over 40 years old) are highly associated with post renal transplant pyogenic arthritis.
Acinetobacter ; Anti-Bacterial Agents ; Arthritis* ; Bed Rest ; Drainage ; Elbow ; Fingers ; Graft Rejection ; Hip ; Humans ; Joints ; Kidney ; Kidney Transplantation ; Knee ; Male ; Mortality ; Risk Factors ; Salmonella ; Staphylococcus aureus ; Transplantation*

PURPOSE: The purpose of this study was to examine the significance of increased bone density according to whether bone grafts were applied using demographic data with Cone Beam Computed Tomography (CBCT) and to compare the bone densities between before and after implant prosthesis using the Hounsfield index. MATERIALS AND METHODS: Thirty-six randomly selected computed tomography (CT) scans were used for the analysis. The same sites were evaluated digitally using the Hounsfield scale with V-Implant 2.0(TM), and the results were compared with maxillary posterior bone graft. Statistical data analysis was carried out to determine the correlation between the recorded Hounsfield unit (HU) of the bone graft and implant prosthesis using a Mann-Whitney U test and Wilcoxon Matched-pairs test. RESULTS: The bone grafted maxillary posterior teeth showed an increase in the mean values from-157 HU to 387 HU, whereas non-grafted maxillary posterior teeth showed an increase from 62 HU to 342 HU. After implantation, the grafted and non-grafted groups showed significantly higher bone density than before implantation. However, the grafted group showed significantly more changes than the non-grafted group. CONCLUSION: Bone density measurements using CBCT might provide an objective assessment of the bone quality as well as the correlation between bone density (Hounsfield scale) and bone grafts in the maxillary molar area.
Bone Density ; Cone-Beam Computed Tomography ; Data Interpretation, Statistical ; Dental Implants ; Molar ; Prostheses and Implants ; Tooth ; Transplants

BACKGROUND: A small but significant proportion of patients with brain tumors continued to have seizures postoperatively. All of them could not be explained simply by the failure to adequately resect the tumor mass. We investigated factors influencing seizure recurrence in primary brain tumors. METHODS: We analyzed 435 patients treated with tumor surgery and examined the differences between epileptic seizure group (ESG) and non-epileptic seizure group (NESG). Among ESG, we selected 99 patients confirmed by pathology. We divided patients into chronic epileptic seizure group (CESG; duration of seizure attack >or=1 year) and acute epileptic seizure group (AESG; < 1 year). We also investigated the differences between two groups. RESULTS: Of 435 patients, 104 were ESG and 331 NESG. Among various factors, male, favorable neurological state, fronto-temporal lobe origin, astrocytoma, oligodendroglioma were statistically significant in ESG compared with NESG (p<0.05). Of 99 patients, 43 were CESG and 56 AESG. Among various factors, seizure recurrence rate without residual tumor or tumor recurrences was significantly higher in CESG than in AESG (p<0.05). On the other hand, the laboratory abnormalities, and the rate of residual tumor or tumor recurrences on follow-up MRI were significantly higher in AESG than in CESG (p<0.05). CONCLUSIONS: Among many factors, sex, neurological state, location and pathology of tumors were significantly related to seizure attacks in brain tumor. There were the differences of epileptogenesis between AESG and CESG. We suggest that patients with brain tumor and chronic epilepsy have to be investigated with extensive work-up including invasive electrophyosiologic studies.
Astrocytoma ; Brain Neoplasms* ; Epilepsy* ; Follow-Up Studies ; Hand ; Humans ; Magnetic Resonance Imaging ; Male ; Neoplasm, Residual ; Oligodendroglioma ; Pathology ; Recurrence* ; Seizures ; Sex Factors

In an attempt to define quantitatively the relation between left atrial size and atrial fibrillation, echocardiography was used to study 58 patients with mitral stenosis and sinus rhythm, 22 patients with mitral stenosis and newly appeared atrial fibrillation, 62 patients with mitral stenosis and atrial fibrillation, 14 patients with sinus rhythm who undergone mitral valve replacement, 18 patients with atrial fibrillation who undergone mitral valve replacement,17 patients with idiopathic atrial fibrillation and 22 control persons. In all groups of mitral stenosis, atrial fibrillation was rare when left atrial dimension was below 40mm but common when this dimension exceeded 40 mm. When left atrial dimension exceeded 50 mm, sinus rhythm was rare even in patients who undergone mitral replacement operation. These data suggest that left atrial size is an important factor in the development of atrial fibrillation. To reduce the risk of systemic embolism complicating atrial fibrillation and to reduce the need of long term anticoagulant therapy postoperatively, the left atrial dimension should be followed closely for the patients with mitral stenosis.
Atrial Fibrillation* ; Echocardiography* ; Embolism ; Heart Atria* ; Humans ; Mitral Valve ; Mitral Valve Stenosis