BACKGROUND: Single or multiple episodes of brief period of ischemia and reperfusion(ischemic preconditioning, IP) have been shown to limit infarct size after a subsequent longer period of ischemia. A considerable number of possible mechanisms has been proposed, however, controversies still remain. Accordingly, we evaluated the effect of four cycles of 5 minutes ischemia and 5 minutes reperfusion(IP) followed by subsequent 30 minutes ischemia(ISCH) and 60 minutes reperfusion using isolated Langendorff-Perfused rabbit hearts. Methods and RESULTS: After a 50-minute recovery phase, parameters of the left ventricular function(LVF) including left ventricular developed pressure(LVDP), contractility and the heart rate were recorded, and ultrastructure was examined. Myosin ATPase activity was determined by measurement of inorganic phosphorus and isozymes of the myosin heavy chain were examined by polyacrylamide gel electrophoresis containing pyrophosphate buffer. The ISCH hearts showed severe to irreversible change of the cardiac myocytes homogenously in contrast to the IP hearts in which changes were not homogenous and irreversible injury was only focal. However, parameters of the LVF were not significantly different between the IP and the ISHC hearts during reperfusion. Myosin ATPase activities were also not significantly different(0.67+/-0.123 micromol/mg protein/h in the IP hearts, 0.56+/-0.172 micromol/mg protein/h in the ISCH hearts, and 0.76+/-0.239 micromol/mg protein/h in the control hearts). Band patterns of the myofibrillar proteins, separated by sodium ddodecyl sulfate-polyacrylamide gel electrophoresis, revealed no differences between the IP, ISCH and the control hearts. Myosin heavy chains in the IP and the ISCH hearts were separated into 3 isozymes, V1,V2and V3in pyrophosphate gel electrophoresis in contrast that the control hearts revealed two isozymes, V1and V2. However, there were no differences in the protein composition and electrophoretic motility between the IP and the ISCH hearts. CONCLUSION: These results indicate that IP could not attenuate the changes in LVF, myosin ATPase activity and myosin isozymes on reperfusion, however, it could attenuate the ultrastructural changes of the cardiac myocytes.
Adenosine Triphosphatases* ; Electrophoresis ; Electrophoresis, Polyacrylamide Gel ; Heart Rate ; Heart* ; Ischemia ; Ischemic Preconditioning* ; Isoenzymes ; Myocytes, Cardiac ; Myosin Heavy Chains ; Myosins* ; Phosphorus ; Reperfusion ; Sodium ; Ventricular Function, Left*

The authors reviewed 73 cases of ligament injuries in 70 patients from October, 1972 to June, 1978 who were admitted and treated in the Orthopedic Department at Kyung Hee University Hospital. Of 70 patients, the sex distribution was 59 patients (84%) in male and 11 patients (16%) in female. The high incidence was in age group from 21 to 40 years, that was 46 patients (55%). Traffic accident was most common cause of ligament injuries that was 61 patients (87%). Methods of treatment were direct repair, reconstruction and conservative treatment. Degree of angle and distance were measured with stress radiogram. Degree of angle and distance were also compared with normal and abnormal knee joints. Eleven cases were treated conservatively, and 62 cases, operatively, of whlch direct repair performed in 56 cases and reconstructive surgery, in 6 casea, The summary were as follows: 1. The result was better in the group with conservative treatment, as compared with operative treatment. And conservative treatment was applied only in single ligament injuries. 2. In normal knee joint, degree of angle was distributed evenly in the range of 0° to 10°, and distance was in the range of 0 to 10 mm. 3. In stress radiograrn, the significance of ligament injuries was present in more than 10° and 10 mm. 4. The measurement of distance seemed to be more meaningful than degree of angle. 5. It is helpful to measure the degree of angle and distance in diagnosis of ligament injuries, though not absolute.
Accidents, Traffic ; Clinical Study ; Diagnosis ; Female ; Humans ; Incidence ; Knee Joint ; Knee ; Ligaments ; Male ; Orthopedics ; Sex Distribution

No abstract available.

No abstract available.
Talus*

VATER association of vertebral defects, imperforate anus, tracheoesophageal (T-E) fistula with esiphageal atresia, and radial and renal dysplasia are utilized to identify this complex. Other anomalies are vascular anomalies (cardiac defects and single umbilical artery), and prenatal and postnatal growth deficiency, defects of external genital and urinary tract as well as bone defects (preaxial lower extremity anomalies, supernumerary digits, rib anomaly). This pattern of malformation generally occurs sporadically in an otherwise normal family, and may occur as a part of a broader pattern, such as the trisomy 18, del (4p, 6q, and 13q) syndromes, and sirenomelia. As inversion of chromosome does not lose of genetic materials, phenotypic abnormalities does not occur. But rare cases have been reported. We report a neonate who had multiple congenital anomalies, including the VATER association defects associated with an unusual chromosomal abnormality, a paracentric inversion of chromosome 6 : 46, XY, .inv (6)(q11q16).
Anus, Imperforate ; Chromosome Aberrations ; Chromosomes, Human, Pair 6 ; Ectromelia ; Fistula ; Humans ; Infant, Newborn ; Lower Extremity ; Ribs ; Trisomy ; Urinary Tract

Drowning is the second most common cause of accidental death of children in Korea. But the study of near-drowning is very rare in Korea. The purpose of our study is to determine the factors that may influence survival on the basis of submersion time, consciousness state upon admission to hospital, the kinds of water, laboratory findings and neurological outcomes. The survey was performed by a retrospective cohort study on 28 near drowning victims of less than 15 years of age who were admitted to the emergency room in the Chosun University Hospital between May 1988 & May 1997. The results were as follows 1) Sex distribution was 22 males and 6 females. 2) Submersion time was (5 minutes in 9 cases, 5-9 minutes in 6 cases,10-14 minutes in 5 cases,15-19 minutes in 3 cases, > or =20 minutes in 5 cases. 3) Comatose patients upon arrival were 6/7 cases in the death group(86%) and 2/21 cases in the improved group(10%). they had unfavorable outcomes(P<0.05). 4) The first pH value was mean 7.02)0.12 in the death group and mean 7.31 +/-0.13 in the improved group. there was a statistically significant difference between the death and the improved group(P<0.05). 5) The patients who had increased blood glucose concentration were all 7 cases in the death group and 12/22 cases in the improved group(54%). The mean blood glucose concentration was mean 424.7235.6mg/dl in the death group and mean 140.182.7mg/dl in the improved group. There was a statistically significant difference between the death and the improved group(P<0.05). 6) The patients who had pulmonary edema upon arrival were all 7 cases in the death group and 1/21 cases in the improved group(18%). They had unfavorable outcomes(P<0.05). 7) The patients who had been submerged more than 15 minutes were all 7 cases in the death group and 6/21 cases in the improved group(5%). They had unfavorable outcomes(P<0.05). We conclude that pediatric victims of near-drowning can be assigned to high or low likelihoods of unfavorable outcomes with the use of five variables, comatose mentation upon arrival, decreased initial blood pH, increased initial blood glucose concentration, pulmonary edema, and maximum submersion time estimated longer than fifteen minutes. This prediction rule may be useful if it can be validated in another cohort.
Blood Glucose ; Child* ; Cohort Studies ; Coma ; Consciousness ; Drowning ; Emergency Service, Hospital ; Female ; Humans ; Hydrogen-Ion Concentration ; Immersion ; Korea ; Male ; Near Drowning ; Pulmonary Edema ; Retrospective Studies ; Sex Distribution

No abstract available.
Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating*

No abstract available.
Peripheral Nerves*

Background: The effects of anesthetic techniques on postdural puncture backache (PDPB) have not been specifically evaluated. The purpose of this study was to compare the incidence and severity of PDPB between median and paramedian techniques. Methods: Patients were randomized to receive spinal anesthesia by either a median (Group M, n = 50) or paramedian (Group P, n = 50) approach.We recorded each patient’s personal number of puncture attempts, surgical position, and operation duration. We investigated the incidence and intensity of back pain 1 day, 1 week, and 1, 2, and 3 months postoperatively. Results: The overall incidence of PDPB was higher in the Group M (18/50, 36%) than in the Group P (8/50, 16%) (P =0.023). Twenty-four hours after surgery, 8 patients in Group M and 6 patients in Group P complained of back pain, and the average numeric rating scale (NRS) pain scores showed no evidence of differences. Seven days after the surgery, 16 patients in the Group M and 5 patients in the Group P complained of pain (P = 0.007); their NRS scores did not significantly differ. After 1 month, 5 patients in the Group M and 1 patient in the Group P complained of pain. Only one patient in each group complained of pain after 3 months. Conclusions The results of this study suggest that spinal anesthesia using the paramedian approach reduces the incidence of PDPB during the early postoperative period.

Background: The effects of anesthetic techniques on postdural puncture backache (PDPB) have not been specifically evaluated. The purpose of this study was to compare the incidence and severity of PDPB between median and paramedian techniques. Methods: Patients were randomized to receive spinal anesthesia by either a median (Group M, n = 50) or paramedian (Group P, n = 50) approach.We recorded each patient’s personal number of puncture attempts, surgical position, and operation duration. We investigated the incidence and intensity of back pain 1 day, 1 week, and 1, 2, and 3 months postoperatively. Results: The overall incidence of PDPB was higher in the Group M (18/50, 36%) than in the Group P (8/50, 16%) (P =0.023). Twenty-four hours after surgery, 8 patients in Group M and 6 patients in Group P complained of back pain, and the average numeric rating scale (NRS) pain scores showed no evidence of differences. Seven days after the surgery, 16 patients in the Group M and 5 patients in the Group P complained of pain (P = 0.007); their NRS scores did not significantly differ. After 1 month, 5 patients in the Group M and 1 patient in the Group P complained of pain. Only one patient in each group complained of pain after 3 months. Conclusions The results of this study suggest that spinal anesthesia using the paramedian approach reduces the incidence of PDPB during the early postoperative period.