BACKGROUND: It is generally accepted that propofol does not inhibit hypoxic pulmonary vasoconstriction (HPV). However, because the previous studies for the effects of propofol on HPV were established in vivo, the effects of physiologic variables could not be ruled out. Therefore, we investigated the effects of various concentrations of propofol on HPV at isolated rat lungs and the relationship of these effects of propofol on HPV and endothelium-derived relaxing factor (EDRF) and an ATP-dependent K+ channel which were candidates as the mechanism of HPV. METHODS: In 30 isolated rat lungs, after three hypoxic challenges for 5 minutes, we administered saline in the control group, N(G)-nitro-L-arginine methyl ester (L-NAME) in the L group and glibenclamide in the G group followed by three hypoxic challenges for 5 minutes. In addition, we studied the effects of various concentrations of propofol on HPV in the three groups. RESULTS: L-NAME and glibenclamide did not alter baseline pulmonary arterial pressure but L-NAME significantly enhanced HPV. Clinical concentrations of propofol did not affect HPV and high concentrations of propofol inhibited HPV. The pretreatment of L-NAME and glibenclamide did not alter the inhibition of HPV even at high concentrations of propofol. CONCLUSIONS: The EDRF and ATP-dependent K+ channel did not largely contribute to baseline pulmonary arterial tone but EDRF might be released and downregulate HPV. Clinical concentrations of propofol did not inhibit HPV but high concentrations of propofol inhibited HPV. In addition, the mechanism of inhibition of HPV at high concentrations of propofol did not relate to the EDRF pathway and ATP-dependent K+ channel.
Animals ; Arterial Pressure ; Endothelium-Dependent Relaxing Factors ; Glyburide* ; Lung* ; NG-Nitroarginine Methyl Ester* ; Propofol* ; Rats* ; Vasoconstriction*

No abstract available.
Neurofibromatoses* ; Scoliosis*

No abstract available.
Kyphosis*

Acute disseminated encephalomyelitis(ADEM) and acute relapsing disseminated encephalomyelitis(ARDEM) are representative demyelination diseases that occur among young children with a fulminant onset similar to encephalitis or meningitis. The diseases often occur after some viral infection of immunization and the etiology of these diseases is considered to be an autoimmune response because of the similarity in pathologic findings to experimental allergic encephalomyelitis. Cerebral computed tomography(CT) findings of demyelination in ADEM or ARDEM show normal to low density areas in the white matter. In cerebral MRI findings, a scattered distinct high intensity lesion considered to be demyelination is observed in 72-weighted imaging even in the early stages. ADEM is usually monophasic, but recurrent episodes may occure. When ADEM is reccurent, the distinction from multiple sclerosis becomes difficult. We report here a case of acute relapsing disseminated encephalomyelitis(ARDEM) in a 9 years old male child who experence ADEM, 3 times.
Autoimmunity ; Child ; Demyelinating Diseases ; Encephalitis ; Encephalomyelitis, Acute Disseminated* ; Encephalomyelitis, Autoimmune, Experimental ; Humans ; Immunization ; Magnetic Resonance Imaging ; Male ; Meningitis ; Multiple Sclerosis

OBJECTIVES: To determine changes in the incidence and pattern of eclampsia in Il Sin Christian Hospital over a 46-year period. METHODS: Information was collected from medical records of the 1910 eclamptic patients among 233,613 deliveries in Il Sin Christian Hospital from Jan. 1 1953 to Dec. 31 1998. Incidence, presentation, and management of eclampsia were reviewed retrospectively, and maternal mortality rate and perinatal mortality rate were calculated. Statistical analysis was done by Chi-squared and Fisher's exact test through two by two tables looking at relative changes between each study period. RESULTS: The overall incidence of eclampsia was 81.8 per 10,000 deliveries. The incidence of eclampsia had increased from 137.3/10,000 in 1953-1962 to 278.4/10,000 in 1963-1972, but the rate had reduced to 6.5/10,000 in 1993-1998. There was a statistically significant fall in the rate of eclampsia every decade between 1973 and 1992, but there has been steady decrease in the last study period. Convulsion occurred antepartum in 54% of patients, intrapartum in 29% and postpartum in 17%. With the reduction in the proportion of antepartum eclampsia, there has been a relative increase in that of intrapartum and postpartum eclampsia. Maternal death occurred in 59 cases among eclampsia, and maternal mortality rate was 3.1%. Maternal mortality rate had significantly decresed from 11.1% in 1953-1962 to 3.8% in 1963-1972, and there has been no maternal death from eclampsia since 1986. Postpartum eclampsia had increased death risk compared with antepartum or intrapartum eclampsia. There were 280 cases of perinatal death and overall perinatal mortality rate was 144.1 per 1000 deliveries. There was a significant decrease in the rate from 243.2/1000 in 1953-1962 to 141.5/1000 in 1963-1972, but the rate has risen steadily since 1983. CONCLUSIONS: With the improvement in antenatal care and management of eclampsia, the incidence of eclampsia and its associated maternal mortality has decreased over the last 46 years. But eclampsia still remains a significant complication of pregnancy with high maternal and perinatal mortality.
Eclampsia* ; Female ; Humans ; Incidence ; Maternal Death ; Maternal Mortality ; Medical Records ; Perinatal Mortality ; Postpartum Period ; Pregnancy ; Retrospective Studies ; Seizures

PURPOSE: In this study a recreational combination gymnastics program was provided for women 75 years of age or older and the effects on physical fitness (grip strength, static balance, ability to do complex movement), depression, cognitive function and quality of life were examined. METHODS: A quasi-experimental study employing a nonequivalent control group, pre-post design was conducted. Participants included 53 women elders whose cognitive function was within the normal range. The women were assigned to an experimental group (27) or a control group (26). The intervention was conducted twice a week for a period of 12 weeks. Chi-square test, t-test, paired t-test, Wilcoxon rank sum test and Wilcoxon signed rank test were used for data analysis. RESULTS: Following completion of the program, left grip strength (t=2.17, p=.035), right grip strength (t=2.04, p=.046), static balance (t=-2.18, p=.030), depression (z=-2.88, p=.004), cognitive function (t=3.96, p<.001), and quality of life (t=-3.19, p=.002) were significantly better in the experimental group. CONCLUSION: Findings from this study indicate that recreational combination gymnastics programs are effective in enhancing physical fitness, cognitive function, and quality of life and in decreasing depression for female elders and could therefore be regarded as positive programs for promotion of physical and mental health for older women.
Aged ; Cognition ; Depression ; Female ; Hand Strength ; Humans ; Mental Health ; *Physical Fitness ; *Program Evaluation ; Quality of Life ; Women

BACKGROUND AND OBJECTIVES: Qualitative oculomotor abnormalities have been reported in parkinsonian patients for many years, but conflicting results have been obtained. This study was performed to evaluate the correlation between the severity of the disease and the abnormalities of the ocular movements in idiopathic parkinson's disease. METHODS: We gave the vestibular function tests in patients with idiopathic parkinson's disease and normal controls. Eye movement recordings were made with automated electronystagmography and rotation test was performed. A total of 46 patients (mean age : 61.2+/-6.7) and 24 controls (mean age : 60.5+/-4.3) were studied. The severity of the disease was divided into two groups by modified Hoehn & Yahr staging ; H-Y stage 1 and 2 as a mild group and stage 3 and 4 as a severe group. RESULTS: Saccadic latency and accuracy, pursuitic gain and velocity, vestibulo-ocular reflex (VOR) suppression by vision were significantly altered in patients, whereas mean velocity of optokinetic nystagmus (OKN) and VOR gain in darkness were normal. Alteration of saccadic latency and accuracy, pursuitic gain and velocity, VOR suppression by vision were profound in the severe group compared with a mild group and controls, but the above parameters did not differ between a mild group and controls. In a hemiparkinson's group, saccadic latency and accuracy, pursuitic gain, OKN mean velocity and gain was not different between the both sides. CONCLUSION: The results indicate that severe Parkinson's disease damages nigrostriatal or other specific pathways which were involved in the regulation of the saccadic, pursuitic and pursuitic-mediated visual fixation system. In a hemiparkinson's group asymmetric damage of dopaminergic innervation which was involved in the regulation of ocular movements was not found.
Darkness ; Electronystagmography ; Eye Movements ; Humans ; Nystagmus, Optokinetic ; Parkinson Disease* ; Reflex, Vestibulo-Ocular ; Vestibular Function Tests

STUDY DESIGN: This is a retrospective study analyzing the clinical results of various surgical methods for the treatment of delayed posttraumatic kyphosis. OBJECTIVES: The purposes of this study are to define the risk factors of delayed postraumatic kyphosis and to establish a rational therapeutic guideline for the treatment of established kyphosis. METHODS: Sixteen cases of surgically treated delayed posttraumatic kyphosis were analyzed. Their initial injuries were burst type in 10, flexion-distraction in 5 and uncertain in l. Initial treatments were conservative in 10 and surgical in 6. Treatments for established kyphosis were posterior fusion in 2, anterior fusion in 5, combined anterior-posterior fusion in 9. Anterior decompression was carried out in 5 treated with anterior fusion and in 4 treated with combined anterior-posterior fusion. RESULTS: Mean follow-up was 2.7 years. The mean preoperative kyphosis of 28.6。 was reduced to 18.5。 (35.3% correction) with most pronounced correction in the group with combined anterior and posterior stabilization(44.8% correction). Early loss of correction averaged 2.7。 (18.5%) with least loss in the combined anterior-posterior group. Neurological improvement was related to the duration of the symptoms(P < 0.05). Back pain was improved in all patients. CONCLUSIONS: Thoracolumbar fractures with initial three column injuries or those rendered unstable by laminectomy are highly susceptible to development of delayed posttraumatic kyphosis; Combined anterior and posterior fusion offered the most satisfactory result in correction and stabilization of the deformity; Neurologic improvement was more pronounced with shorter duration of the symptoms.
Back Pain ; Congenital Abnormalities ; Decompression ; Follow-Up Studies ; Humans ; Kyphosis ; Laminectomy ; Retrospective Studies ; Risk Factors

Surgical treatment of congenital scoliosis is often frustrating due to its severity and rigidity. Many surgical methods were provided for these complex deformities and some instruments were used to achieve better correction. However, no surgical treatment was satisfactory to correct the deformities. Recently, pedicle screw fixation, enabling a powerful grip of individual vertebral segment, is becoming a promising method to enhance correction of these tenacious deformities. This study was to compare the correction, loss of correction and complications of the various surgical methods employed for congenital scoliosis in Seoul National University Hospital and to verify the advantages of pedicle screw fixation. Ninety-two congenital scoliosis subjected to surgery and followed up for more than 2 years(range 2-9 years) were analysed. Surgical methods were; anterior uninstrumented fusion, 5; posterior fusion, 50(14 without instrument, 15 with hooks, 21 with screws); combined anterior and posterior fusion, 37(7 without instrument, 11 with posterior hooks, 10 with posterior screws, 9 with anterior VDS and posterior screws). Mean preoperative magnitude of index curve was 58° with no significant difference between the groups except for the anterior VDS and posterior screw group which had a mean magnitude of 93°. Mean flexibility of index curve was 18.7% with no significant difference between groups. The correction of index curves were; anterior uninstrumented fusion, 23%; posterior uninstrumented fusion, 28%; posterior hook, 31%; posterior screw, 46%; combined anterior and posterior uninstrumented, 37%; anterior fusion and posterior hook, 30%; anterior fusion and posterior screw, 47%; anterior VDS and posterior screw, 48%. The correction of pedicle screws were significantly better(p < 0.01) with significantly smaller loss of correction(p < 0.01). Nonunion occurred in 4, 1 in posterior uninstrumented fusion, 2 in posterior hooks and 1 in posterior pedicle screws with concomitant instrument failures. However, there were no neurologic or visceral complications related to screw placement. Pedicle screw fixation offers an enhances correction of congenital scoliosis with low complication rate, and when combined with an anterior procedure, enables control of the most severe and rigid curves.
Congenital Abnormalities ; Hand Strength ; Methods ; Pedicle Screws ; Pliability ; Scoliosis ; Seoul

Diabetic foot is one of the most serious complications of diabetes, and is associated with significant portions of admission, medical cost, disability and mortality in diabetic patients. According to a recent report from the Korean Diabetes Association Basic Statistics Research Task Force Team, 1.2% of Korean diabetic patients had diabetic foot, representing a decrease since 1980. The age at amputation increased since 1980, from 60 to 70 years of age, while the mortality rate decreased due to advances of therapeutic technology. Further epidemiologic studies are required to obtain current data regarding incidence, amputation rates, and mortality, and to identify risk factors and new therapeutic modalities in diabetic foot.
Advisory Committees ; Amputation ; Diabetic Foot ; Humans ; Incidence ; Risk Factors ; Ulcer