Bone marrow pressure is neither arterial pressure nor venous pressure of extremity, that is thought the precapillary pressure of bone. It is different between long bone and flat bone, and is also different in various site of the bone. Author measured bone marrow pressure of 84 normal femoral heads of Korean adults for basic data of early diagnosis of avascular necrosis of femoral head. The results are followings : 1. The baseline bone marrow pressure of Korean healthy adults is average 22.5 ±7.2mmHg. 2. The most significant change of bone marrow pressure in stress test is observed at 5 min. after injection of 5cc normal saline. 3. The increase of bone marrow pressure at 5 min. after stress test was average 7.4 ±4.4 mmHg. 4. Sex and age factors do not influence bone marrow pressure.
Adult ; Age Factors ; Arterial Pressure ; Bone Marrow ; Early Diagnosis ; Exercise Test ; Extremities ; Head ; Humans ; Necrosis ; Venous Pressure

The methods of treatment of discoid meniscus have been in controversy and there are so many reports which represent different results. We analyzed the results of the 91 knees with discoid menisci of 84 patients who had been treated with arthroscopic partial or total meniscectomy, open partial or total meniscectomy, semi-arthroscopic total menisceetomy form June 1982 to Dec. 1987. The puropse of this paper is to present the indication and prognosis of the each method of treatment. There were 45 cases of male, 46 cases of female, and 10 patients were affected both knee. 2 patients who had served arthroscopic partial meniscectomy were reoperated by arthroscopic total meniscectomy due to recurrence of symptom. We classified the types of tear into 7 classes and observed the clinical characteristics and results. The methods we applied were arthroscopic total meniscectomy 40 cases, semi-arthroscopic total meniscectomy 25 cases, arthroscipic partial meniscectomy 16 cases, open partial meniscectomy 3 cases, open total meniscectomy 2 cases, and conservative treatment after arthroscopic diagnosis 5 cases. The follow up cases were 56, and period of follow up was ranged form 11 months to 5 years and 4 months (av. 2 years and 8 months). The results were followings : l. 71.4% of the patients were placed between 11 years and 30 years old, and there was no sexual difference. 2. 11.9% of the patients were affected bilaterally. 3. The commonest clinical symptom and physical sign was clik (67%) and quadriceps muscle atrophy (48.4%) 4. Diagnostic accuracy of knee arthrogram was 88%, but it could not demonstrate the type of tear. In arthrographic finding, the older the patient, the thinner the meniscus was. 5. The commonest type of tear was type V(34.1%) and it was followed by type II (19.8%). 6. There was no difference between the long term results of arthroscopic and semi-arthroscopic total meniscectomy. 7. The results of total meniscectomy is better than partial meniscectomy.8. The method of treatment should be chosen according to the type of terar, so partial meniscectorny is recommended for type II, IV and total meniscictomy is recommended for type III, IV, V and VI. 9. Less hospitalization, earlier recovery, and better result were obtained by the arthroscopic or semi-arthroscopic total meniscectomy.
Atrophy ; Clinical Study ; Diagnosis ; Female ; Follow-Up Studies ; Hospitalization ; Humans ; Knee ; Male ; Methods ; Prognosis ; Quadriceps Muscle ; Recurrence ; Tears

We report a case of atlantoaxial subluxation with bilateral high-riding vertebral artery with narrow isthmus. Because of the potential risk of bilateral vertebral artery injury, we performed atlantoaxial fixation using rod and screw instead of transarticular screw fixation. Although postoperative computed tomography reconstruction demonstrated slight breach of bilateral vertebral artery groove, postoperative angiography showed no evidence of vertebral artery injury. Though technically demanding, atlantoaxial fixation using rod and screw can be a one of the treatment options for atlantoaxial instability with bilateral high riding vertebral artery.
Angiography ; Vertebral Artery*

Since osseous healing in the fracture of the femoral neck is carried out by endosteal bone formation, the size of contact area of the fracture fragments and impaction are of prime importance. It is not uncommon to be faced with the problem of back out of the internal fixation devices during healing period. It seems unnecessary to emphasize the benefit of sliding to close the gap between the fracture fragments. We report a retrospective study of 25 cases of the femoral neck fractures treated by closed reduction and fixation with multiple Knowles pins, paying particular attention to the amount and duration of sliding back out of the fixation devices and relating these to the final results of fracture union. Our clinical study led us to the following conclusions; 1. The shortoning of the femoral neck over 3mm occurred in 16 cases(64%) out of 25 cases. The average amount of back out of Knowles pin is 6mm. 2. Most of the shortening occurred during the first 8 weeks after surgery and extrusion of the nail is frequent findings in unstable fractures and osteoporoses. 3. Backing out over 12 weeks after surgery was associated frequently with delayed union and non-union. 4. Collapse or shortening is nceessary to promote a bone to bone contact and bone healing.
Clinical Study ; Femoral Neck Fractures ; Femur Neck ; Internal Fixators ; Osteogenesis ; Osteoporosis ; Retrospective Studies

No abstract available.
Humans ; Iron* ; Peritoneal Dialysis, Continuous Ambulatory*

No abstract available.
Child* ; Humans ; Infant*

Two percent dorzolamide, a topical carbonic anhydrase inhibitor (CAI), was developed to reduce the side effects associated with systemic CAI such as fatigue, anorexia, dysesthesia, etc. and to effectively reduce the elevat-ed intraocular pressure(IOP). This study was designed to evaluate the effectiveness and safety of 2%dorzolamide in Korean patients with primary open-angle glaucoma or ocular hypertension. In this randomized, double-blind, placebo-controlled clinical study, 2%dorzolamide or placebo was given three times a day to the patients with primary open-angle glaucoma or ocular hypertension (22mmHg < or =IOP < or =30mmHg)to evaluate the hypotensive effect and safety of dorzolamide during the period of 6 weeks. After 1,3, and 6 weeks treatment, the mean percent decrease of IOP from baseline in the dorzolamide group (16.3 +/-8.9%,17.9 +/- 9.8%,and 18.2 +/-8 .7 %, respectively) was significantly larger (p<0.01)than that in the placebo group (7.5 +/- 6.8%, 8.5 +/-9.5%, 10.4 +/-10.4%, respectively). The decrease of IOP was also significant in each group(p<0.01)compared to the pre-treatment IOP. During the period of treatment, burning sensation was more frequent in the dorzolamide group (p<0.05). In conclusion,this study has shown that the topical application of 2% dorzolamide effectively reduces IOP without serious adverse effects in Korean patients with primary open-angle glaucoma or ocular hypertension.
Anorexia ; Burns ; Carbonic Anhydrases ; Fatigue ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Ocular Hypertension ; Paresthesia ; Sensation

BACKGROUND: The nucleus tractus solitarius (NTS), the region of the brain stem in which primary baroreceptor afferents teminate, is critically important in the normal regulation of arterial pressure (AP). In the NTS, excitatory amino acids such as L-glutamate serve as the main neurotransmitter in the regulation of AP. However, the function of GABA in the NTS has not been established. To test the function of GABA, we applied GABAergic agents to the NTS. METHODS: The experiments were conducted on adult male Sprague-Dawley rats weighing 300-500g. A cannula (PE-50 tubing filled with heparinized saline) was inserted into the femoral artery for recording of AP and heart rate(HR). Another cannula was inserted into the femoral vein for administration of nitroprusside or phenylephrine. After rats were placed on a sterotaxic instrument, the dorsal surface of the medulla was exposed, and with the aid of a surgical microscope, the NTS was visualized. Drug injections were made into the NTS using single- or three-barreled grass micropipettes pulled to an outer diameter of 80-100(micro)m and connected to a 1(micro)l Hamilton syringe. RESULTS: The follwing results were obtained in this experiment. Injection into the NTS of 10 or 20 nmol nipecitic acid, a selective inhibitor of GABA untake, produced an increase in AP. The pressor responses evoked by two doses of nipecotic acid were not significantly different. Injection of GABA(A) agonist, musciml(5 pmol in 80 nl artificial CSF) and GABA(B) agonist, baclofen (20 pmol in 80 nl) into the NTS of urethane-anesthetized rats prodused an increase in AP of 16.6+/-1.3 and 27.6+/-1.5 mmHg, respectively. Thus the pressor response to GABA(B) agonist was greater than to GABA(A) agonist. On the other hand, microinjection of GABA(A) antagonist, bicuculline and GABA(B) antagonist, phaclofen into the NTS decreased AP by approximately 13.4+/-1.0 and 20.9+/- mmHg, respectively. Thus injection of nipecotic acid into the NTS was greater in control group compared with the muscimiol or baclofen groups. The AP changes caused by i.v. injection of nitroprusside or phenylephrine were smallest in control group and greatest in the baclofen group. When calculated as baroreflex sensitivity, the change was greatest in control group and smallest in the baclofen group. CONCLUSION: From these results it was concluded that GABA in the NTS plays an important role in the regulation of AP, especially through GABA(B) receptors, and have an inhibitory effect on baroreceptor reflex.
Adult ; Animals ; Arterial Pressure ; Baclofen ; Baroreflex ; Bicuculline ; Blood Pressure ; Brain Stem ; Catheters ; Excitatory Amino Acids ; Femoral Artery ; Femoral Vein ; GABA Agents ; gamma-Aminobutyric Acid* ; Glutamic Acid ; Hand ; Heart ; Heparin ; Humans ; Male ; Microinjections ; Neurotransmitter Agents ; Nitroprusside ; Phenylephrine ; Poaceae ; Pressoreceptors ; Rats ; Rats, Sprague-Dawley ; Solitary Nucleus* ; Syringes

Brain tissue herniation into the mastoid cavity is an uncommon phenomenon: nevertheless, it has been described since the earliest years of this century. Serious sequelae and central nervous system infection may result from inadequate management, but it has become relatively rare with improved antibiotic treatment and surgical technique. It might be caused by chronic otitis media, previous ear surgery, trauma and neoplasm, or spontaneously. Spontaneous brain herniation is extremely rare. It gives rise to cerebrospinal fluid otorrhea, progressive hearing loss, meningitis and other neurologic symptoms. Treatment depends on site and size of dura defect. We experienced one case of spontaneous brain herniation into the mastoid cavity, which we treated with surgery.
Brain* ; Central Nervous System Infections ; Cerebrospinal Fluid Otorrhea ; Ear ; Hearing Loss ; Hernia* ; Mastoid* ; Meningitis ; Neurologic Manifestations ; Otitis Media

PURPOSE: To prepare the appropriate guideline in choosing the internal fixatives for the intertrochanteric fractures of the femur in the elderly. MATERIALS AND METHODS: We reviewed 95 cases of intertrochanteric fractures of the femur from January, 1999 to December, 2003. We fixed the fracture with Proximal Femoral Nail in 37 cases (PFN group), Dynamic Hip Screw in 56 (DHS group), Dynamic Condylar Screw in 2 cases (DHS group). We reviewed operation time, blood loss during operation, changes in neck-shaft angle and sliding of lag screw. RESULTS: There were no significant differences in the parameters between the 2 groups in stable fracture. In unstable fractures, operation time in PFN group and DHS group revealed 103.9 and 128.2 minutes respectively; mean amount of blood loss during operation revealed 523.2 and 573.1 ml respectively. Mean changes in the neck-shaft angle at final follow-up in PFN group and DHS group revealed 4.6 degrees and 4.1 degrees; sliding of lag screw averaged 3.4 and 6.5 mm respectively. Among the DHS group, cases of additional fixation with trochanteric supporting plate revealed 3.1 degrees of changes in neck-shaft angle and 4.2 mm of lag screw sliding. CONCLUSION: In cases of stable fractures, any fixative might suffice. In cases of unstable fractures, there were no significant differences in results of treatment between these two groups, however, PFN group revealed shoter operation time and less blood loss during operation. It seemed to be necessary to apply additional fixation with trochanteric supporting plate when using DHS in unstable cases.
Aged* ; Femur* ; Fixatives* ; Follow-Up Studies ; Hip ; Hip Fractures* ; Humans