PURPOSE: Exercise is frequently recommended in the management of diabetes mellitus(DM) and can improve blood control by increasing insulin sensitivity and psychological benefits. Exercise can result in good glycemic control in type 2 DM, when combined with diet and drug therapy. However, in type 1 DM, the expected improvement in glycemic control with exercise have not been clearly established. Effects of exercise on glycemic control in patients with type 1 DM were investigated. METHODS: 20 patients with of type 1 DM, who were no retinopathy, neuropathy, nephropathy and cardiac disorders, were enrolled and exercised for 30min. with 50% of individualized maximum VO2. Blood sugar concentration were measured before, immediate and 15min after exercise. The results were evaluated with HbA1c, C-peptide and DM duration. RESULTS: Blood sugar concentration were significantly decreased from pre-exercise 198+/-9.7mg/dL to immediate 145+/-7.1mg/dL and at 15min. Post-exercise 134+/-4.0mg/dL(P<0.05). In case with HbA1c<10%, there was significantly decreased in blood sugar level from pre-exercise 176+/-9.7mg/dL to immediate 123+/-63.2mg/dL and at 15min post-exercise 113+/-1.9mg/dL(P<0.05). In case with HbA1c>10% there was also significantly decreased in blood sugar levels 222+/-64.7mg/dL, 169+/-6.1mg/dL, 157+/-1.2mg/dL respectively(P<0.05). Group with moderate decreased blood sugar(40-99mg/dL) was 8 patients(42.1%), group with mild decreased blood sugar(<40mg/dL) was 7 patients(36.8%) and group with decreased more than 100mg/dL was 4 patients(21.5%). There was no correlation in degree of decreased blood sugar concentration among HbA1c, C-peptide, DM duration. CONCLUSION: Proper exercise in type 1 diabetic children can decrease blood sugar level significantly and make good glycemic control and can decrease DM microvascular complications in addition to motivating physically active lifestyle.
Blood Glucose ; C-Peptide ; Child ; Diabetes Mellitus ; Diabetes Mellitus, Type 1* ; Diet ; Drug Therapy ; Humans ; Insulin Resistance ; Life Style

Spinal anesthesia is a relatively ease and useful technique and provides excellent analge-sia and relaxation for a great number of surgical procedures. It has been used widelr until the introduction of Muscle relaxant to the general anesthesia. However, complications, including hypotension, nausea, postspinal headache, neurologic sequelae, and death have been reported. In addition to those problems, number of failures after administration of spinal anesthetic haute been reported. We collected the 316 cases of spinal anesthesia given between January to May, 1986.the incidence of failure and the int-errelationships between the incidence and technical factors were reuiewed. Variables exam-ined including the patient population, the technical aspects of performing subarachnoid tap and subsequent blockade, and the level 7f training of anesthetist. Total number of patients with administration of anesthesia for 5 monthes was 2075; 316 patients in spinal anesthesia(15.237). We found a 4, l1% incidence of spinal failure, defined as the need to use general anesthesia or frequent administration of anlgesics during the surgical procedures. The technical factors(position of patients, approach method, puncture sites, needle gauge, agents type, and the performer) were insignificantlr contributed to the failure rate, but the amount of local anesthetic was showed statistical significance.
Anesthesia ; Anesthesia, General ; Anesthesia, Spinal* ; Headache ; Humans ; Hypotension ; Incidence* ; Nausea ; Needles ; Punctures ; Relaxation

In recent years the use of epidural opiates has increased and although this method of pain relief has shown good results in clinical practice it is still subject to certain drowba-cks, the most serious of which appears to be delayed respiratory depression. Since ketamine administered systemically is unlikely to produce respiratory depression it seemed worthwhile to investigate the possibility of exploiting the potent analgesic property to ketarnine by its epidural administration. The analgesic effect of ketamine 4 mg, administered epidural space, was evaluated. The duration of pain relief varied from less than 3 hours in 20% to over 24 hours in 30 % of the cases. In 62.5% of the cases pain relief exceeded 6 hours. There was no evidence of respiratery depression, and there no postoperative neurologic sequelae. The present results indicated the need for farther studios to compare the efficacy and safety of epidural ketamine with the response to epidural opioids for the relief of posto- peratiue pain.
Analgesics, Opioid ; Depression ; Epidural Space ; Ketamine* ; Pain, Postoperative* ; Respiratory Insufficiency

The MERA-F breathing circuit is a light in weight, disposable, multi-purpose breathing system corsisting of double coaxial tubes ; inner tube for inspiration and outer corrugate tube for expiration. This circuit is especially effective on head and neck operations that may lead to :Iccidental disconnection or extubation. And the circuit provides effective carbon dioxide elimination with only conventional total fresh gas flow(70 ml/kg/minute) and appropriate maintenance of heat and humidity of the airway mucosa.
Carbon Dioxide ; Head ; Hot Temperature ; Humidity ; Mucous Membrane ; Neck ; Respiration*

PURPOSE: To evaluate MR characteristics of acute disseminated encephalomyelitis (ADEM) in children, which was confirmed by clinical findings. MATERIALS AND METHODS: The subjects were six patients, who were diagnosed by clinical findings. One subject had recurrence one year after clinical improvement leading to one additional care with the total of seven. The modes of viral infections were as follows;four cases of non-specific upper respiratory tract infection, one of E-B virus, one of Japanese-B-encephalitis vaccination, and one of upper respiratory infection in Bruton's disease. The Gd-DTPA enhanced scan was performed in all cases. MR findings were evaluated in anatomic location of the lesions, presence or absence of contrast enhancement, and the temporal changes were also evaluated on follow-up MRI. RESULT: There were multifocal high signal intensity lesions on T2WI in all cases. The location of lesions were basal ganglia in five, thalamus and brain stem in four, and cerebral gray and white matter and cerebellar white matter in three. Bilaterality was 77%. There were contrast enhancement in two of three cerebral cortical lesions and one of three white matter lesions. The size of lesions decreased on the first follow-up MRI which were done after 1 month in 4 cases, but new lesions were developed in two cases. On the second follow-up MRI which were done 2 months after, all lesions were decreased in size and there was no newly developed lesion. However, in one case who had recurrent similar symptom after 1 year, several new lesions developed on follow-up MRI, and it was comidened as a recurrence. CONCLUSION: The characteristic MR findings of ADEM were multifocal bilateral white and gray matter lesions which were high signal intensities on T2WI. The majority of lesions improved on follow-up MRI, but occasionally showed multiphasic pattern.
Basal Ganglia ; Brain Stem ; Child* ; Encephalomyelitis, Acute Disseminated ; Follow-Up Studies ; Gadolinium DTPA ; Herpesvirus 4, Human ; Humans ; Magnetic Resonance Imaging ; Recurrence ; Respiratory Tract Infections ; Thalamus ; Vaccination

Eight cases of chondroblastoma were studied by analyzing the clinical and pathologic findings. The age of eight cases ranged from 17 to 38 years old(median age, 22.7 years old). The tumors developed in the femur (3 cases), patella (2 cases), tibia( 1 case), fibula (1 case), and ulna (1 case). The mean diameter of tumors was 4.0 cm (range, 1.5 to 8.0 cm). Grossly, tumors showed grayish brown solid area with foci of secondary aneurysmal bone cyst. Histologically, the tumor cells were round or polygonal in shape with nuclear groove. And there were chondroid differentiation(7 cases), mitosis(3 cases), calcific deposits(3 cases), secondary aneurysmal bone cyst(4 cases), hemosiderin deposits(4 cases), necrosis(3 cases), vascular invasion(1 caes) and foamy histiocytes and cholesterol cleft(1 cases). All cases showed no metastasis to lymph node and distant organ. Seven cases (87.5 %) were immunoreactive for S-100 protein. None were immunoreactive for cytokeratin.
Aneurysm ; Bone Cysts ; Cholesterol ; Chondroblastoma* ; Femur ; Fibula ; Hemosiderin ; Histiocytes ; Keratins ; Lymph Nodes ; Neoplasm Metastasis ; Patella ; S100 Proteins ; Ulna

Individual identification procedure is one of the most improtant part in medicolegal fields. Recently, radiolegal investigation methods have been widely applicated to the medicolegal field for the purpose of individual identification. So authors attempted to determine sex and calculate stature by using roentgenographic findings of long bones of 248 subjects the living materials. In orthoscanographic study for long bones, we measured total length, midshaft width, epiphyseal width, cortical width, head diameter of each bones The total length, midshaft width, cortical width, condylar breath, horizontal & vertical head diameter of femur show statistically significant differentiation between two sexes, in tibia, total length, midshaft, cortical width, proximal and distal epiphyseal width show statistically significant. In fibula, Humerus, radius and ulna, total length is only statistically significant. And other wresults are statistically insignificant. Using femoral and fibial lengths (mm) with "Regression Analysis method" in SAS program, we derived the following fomulae. Height (cm)=95.62±0.148×Total length of Femur. (mm) Height(cm)=82.07±0.22×Total length of Tibia. (mm). In conclusion, radiologic measurement of long bone might be one of the useful methods in individual identification of unknown subject in Korea.
Femur ; Fibula ; Head ; Humerus ; Korea ; Radius ; Tibia ; Ulna

Primary segmental omental infarction in adults is very rare and occasionally occurs due to impaired perfusion to the greater omentum. Most authors believe that the condition results from an embryologic variant associated with anomalous and fragile blood supply of the right lower portion of the greater omentum, which is consequently susceptible to infarction. Since there are no characteristic clinical findings, the clinical presentation often mimics acute appendicitis or cholecystitis. However, in the proper clinical setting, the correct diagnosis can be established by the radiologist; therefore, unnecessary surgery can be avoided in many cases. Cross-sectional imaging by ultrasound or computed tomography will demonstrate characteristic findings in a location corresponding to the patient's point of maximal tenderness. These findings consist of an ovoid or cake-like mass in the omental fat with surrounding inflammatory changes. We report a case of primary segmental omental infarction in an adults who was treated conservatively after the diagnosis was established with clinical findings.
Abdominal Pain ; Adult ; Appendicitis ; Cholecystitis ; Diagnosis ; Humans ; Infarction* ; Omentum ; Perfusion ; Ultrasonography ; Unnecessary Procedures

BACKGROUND: Smaller guiding catheter had a problem with poor backup support during the transradial coronary intervention which resulted in higher failure rate. This study sought to prove the usefulness of deep seating technique which improves the backup support of the guiding catheter required to deliver interventional materials during the transradial coronary intervention. METHODS: Thirthy-five patients(23 males) were included in this study since March 1998 to August 1999. Clinical presentation of these patients were stable angina(7 patients), unstable angina(17 patients), acute myocardial infarction(11 cases). The mean age was 68+/-8 years. The treated vessel was left anterior descending artery in 22, left circumflex artery in 2 and right coronary artery in 11 of 35 vessels. RESULT: Twenty-six lesions were treated with stents, 3 with PTCA, and 6 with rotablator. Procedural success were achieved in 33 out of 35 cases(94%). Guiding catheters were used mostly with 6 Fr(30/35). In the left coronary system, usual Judkins left type was used in most of the patients(24/26, 92%), and in right coronary Judkins, Amplatz and multipurpose catheters were used similiarly. Hypotension and sinus bradycardia was encountered in one case without clinical significance and there was no dissection in all patients. CONCLUSION: Deep seating technique is a safe and effective technique without major adverse event during the transradial coronary intervention in selected cases.
Arteries ; Bradycardia ; Catheters ; Coronary Vessels ; Humans ; Hypotension ; Stents

BACKGROUND: Smaller guiding catheter had a problem with poor backup support during the transradial coronary intervention which resulted in higher failure rate. This study sought to prove the usefulness of deep seating technique which improves the backup support of the guiding catheter required to deliver interventional materials during the transradial coronary intervention. METHODS: Thirthy-five patients(23 males) were included in this study since March 1998 to August 1999. Clinical presentation of these patients were stable angina(7 patients), unstable angina(17 patients), acute myocardial infarction(11 cases). The mean age was 68+/-8 years. The treated vessel was left anterior descending artery in 22, left circumflex artery in 2 and right coronary artery in 11 of 35 vessels. RESULT: Twenty-six lesions were treated with stents, 3 with PTCA, and 6 with rotablator. Procedural success were achieved in 33 out of 35 cases(94%). Guiding catheters were used mostly with 6 Fr(30/35). In the left coronary system, usual Judkins left type was used in most of the patients(24/26, 92%), and in right coronary Judkins, Amplatz and multipurpose catheters were used similiarly. Hypotension and sinus bradycardia was encountered in one case without clinical significance and there was no dissection in all patients. CONCLUSION: Deep seating technique is a safe and effective technique without major adverse event during the transradial coronary intervention in selected cases.
Arteries ; Bradycardia ; Catheters ; Coronary Vessels ; Humans ; Hypotension ; Stents