BACKGROUND: Left ventricular hypertrophy(LVH) is the independent poor prognostic factor in hypertensives. But, it is uncertain that the reduction of LVH by antihypertensives therapy will improve the prognosis of hypertensive patioents. THe effect of reduction of LVH on LV function(espacially diastolic function) and the mechanism of reduction of LVH are not clarified also. The aim of this study was to ascertain whether reduction in LV mass with enalapril has a beneficial effect ofn LV diastolic filling in hypertensive patients with diastolic dysfunction. METHODS: Mild to moderate hypertensive patients were treated with enalapril(10-20mg once daily) for 4 months. Their blood pressure and pulse rate were regularly measured devery 2 weeks. Using M mode echocardiograms, LV dimensions at end-diastole and end-systole, thicknesses of ventricular septum and LV free wall were measured. LV ejection fraction(EF), LV mass index(LVMI) and total peripheral resistance(TPR) were calculated. Pulsed ddoppler examination of transmitranl flow for assessment of LV diastolic function was performend from apical four chamber viw. The peak flow velocities of the early and late waves and their ratio(PFVE, PFVA, PFVE/PFVA) were measured from consecutive 3 cardiac cycles. In addition, the time velocity integral of the early and late waves and their ratio(EA, AA, EA/AA) were measured. Echocardiographic evaluations were performed at baseline and at the end of treatment. RESULTS: Average systolic and diastolic blood pressure decreased after treatment with enalapril. But there was no significant difference of pulse rate between basal and after treatment. The LV dimensions at end-diastole and end-systole and the thickness of LV free wall didn't change significantly. The thickness of interventricular septum, LVMI and TPR reduced significantly after treatment. The ejection fraction of LV didn't change significantly after treatment. There was no significant change in PFVE, EA, AA and EA/AA. But PFVA was significantly decreased after treatment with enalapril for 4 months. PFVE/PFVA was significantly increased also. CONCLUSION: In conclusion, antihypertensive treatment with enalapril led to a significant reduction of LVH partially associated with improvement in LV diastolic performance and no deterioration of LV systolic function.
Antihypertensive Agents ; Blood Pressure ; Echocardiography ; Enalapril ; Heart Rate ; Humans ; Hypertension* ; Prognosis ; Ventricular Septum

PURPOSE: The aim of this study is to analyse the clinical characteristics and results of treatment of knee dislocation. MATERIALS AND METHODS: The 18 cases of the traumatic dislocation of knee were treated at Yeung-nam university hospital from 1991 Jan. to 1997 Apr. and those were followed more than one year after injury. Result: Anterior and posterior cruciate ligament were ruptured in all cases and the two thirds of the ruptured site of cruciate ligament was femoral attachment, Medial collateral ligament injury(13 cases) were more than lateral collateral injury(8 cases) and more than half cases of collateral ligament injury were rup- tured at tibial and fibular attachment. The functional result by Lysholm knee scoring revealed fair(81 score) in average and excellent in 3 cases, good in 5 cases, fair in 10 cases. Complications were limitation of motion in 6 cases, pain in 2 cases and nerve paraiysis in 1 case. CONCLUSION: Applying classification system according to direction of displacement is sometimes difficult because the dislocation of knee could be transferred after reduction. It was thought that another subclassifica- tion system in terms of ligaments involved should be used. Functional results by Lysholm knee scoring revealed fair(81 score) in average. Early range of motion should be started after surgical repair and minimal immobilization to avoid limitation of knee motion.
Classification ; Collateral Ligaments ; Dislocations* ; Immobilization ; Knee Dislocation ; Knee* ; Ligaments ; Posterior Cruciate Ligament ; Range of Motion, Articular

Serum C-reactive protein (CRP) levels and erythrocyte sedimentation rates (ESR) were measured in 46 patients treated with uncomplicated primary hip replacements, 39 total tip replacements and 7 bipolar hip replacements. In uncomplicated primary hip replacements, ESR levels were slightly elevated preoperatively and were variable postoperatively. But CRP was normal before surgery and elevated in postoperative course, but back to normal within three weeks in most cases. Early success of hip arthroplasty is in indicated by normalization of CRP within three weeks, regardless of ESR. Since ESR seems to react somewhat differently from the CRP, both methods are useful in the monitoring of complications after hip arthroplasty.
Arthroplasty* ; Blood Sedimentation* ; C-Reactive Protein* ; Erythrocytes* ; Hip* ; Humans

Segmental fractures of the femoral shaft result from high energy trauma such as a traffic accident or falls, and it is frequently accompanied by multiple fractures and severe injuries to other organs. Thus it is very difficult to treat these fractures satisfactorily and several complications can be caused. Early operative intervention and rigid fixation is important to mobilize the patient and to ensure early rehabilitation. Nineteen cases of segmental fractures of the femoral shaft were treated with operative intervention(intramedullary nailing) and followed up between May 1989 and Nov. 1993.; minimal follow-up period was more than one year. Results were obtained as follows: 1. The methods of treatment were interlocking intramedullary nailing in 16 cases(colsed nailing in 7 cases, open nailing in 9 cases) and Kiintscher nailing in 3 cases. Bone grafts were done in 11 cases among 19 cases(8 cases in the interlocking nail group). 2. The closed interlocking intramedullary nailing could be obtained in more shortened operation time than in the open method. 3. There was earlier bone union time in the closed intramedullary nailing than in the open method with bone graft, but there was no statistical significance(SPSS/pc+progam). 4. There was a tendency of earlier bone union time in the proximal fracture site than in the distal fracture site.
Accidental Falls ; Accidents, Traffic ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Fractures, Multiple ; Humans ; Methods ; Rehabilitation ; Transplants

Possible seasonal differences in serum Insulin-Like Growth Factor-I (IGF-I) concentrations have not been studied in newborn infants. Recently we demonstrated sea- sonal differences in bone mineral content (BMC) in newborn infants: lower BMC was present in summer vs. winter-born infants (J Pediatr Gastroenterol Nutr 1992; 15: 285). In a second stduy, higher serum osteocalcin, an index of bone formation, and lower BMC were found in summer vs. winter (J Pediatr Gastroenterol Nutr 1994; 19: 2207). We speculated that increased serum osteocalcin in summer could be an adaptive response to decreased bone mass. Since growth factors such as IGFs are local regulators of bone formation, we hypothesized that in summer-born infants, serum IGF-I will be higher than in winter, associated with high bone formation activity. Fifty-nine healthy, term appropriate for gestational age (AGA) infants were studied prospectively in winter (Jan-Mar, 29) and in summer (July-Sept., 30). Thirty infants were male, and 29 infants were female. Gestational ages and birth weights were not different by season(in summer, mean+SD, 39.61.1 wk, 3,471360 g,' in winter, 39.31.4 wk, 3,402 392 g). Cord serum IGF-I was measured by radioimmunoassay, modified from Furlanetto et al (1977), after acidification and sep-pack extraction of serum, and osteocalcin concentrations were determined by a kit radio-immunoassay. Cord serum IGF-I concentrations were not different by season of birth(summer vs. winter, 20.11.83 vs. 16.5 1.75 ng/mL, p=0.2). No gender differences were found: 18.21.8 vs. 18.2+1.8 ng/ mL in males vs. females. Serum osteocalcin was higher in summer vs. winter-born infants (8.22.3 vs. 4.951.58 ng/mL, p=0.009). BMC was different by season (87.2+ 14.5 vs. 94.1+16.4 mg/cm, p=0.02). Cord serum IGF-I was not related to serum osteocalcin and BMC. We conclude that serum IGF-I concentrations are not different by season or gender, and are not related to bone formation activity and BMC. Thus, IGF -I concentrations in serum are not seasonally regulated, nor associated with an index of bone formation activity.
Birth Weight ; Bone Density ; Female ; Gestational Age ; Humans ; Infant ; Infant, Newborn* ; Insulin-Like Growth Factor I ; Intercellular Signaling Peptides and Proteins ; Male ; Osteocalcin ; Osteogenesis ; Prospective Studies ; Radioimmunoassay ; Seasons*

To investigate the inflammatory cytokine production of human epithelial cell lines stimulated with uropathogenic E. coli strains showing 3 different adherence patterns, differential expression of inflammatory cytokine (IL-1a, IL-lB, IL-8, TNFa, and TGFB) mRNA were detected by RT-PCR. IL-1a, IL-1B, IL-8, and TGFB mRNAs constitutively expressed in epithelial cell lines, but not TNFa. The expression of IL-1a and IL-1B mRNA was increased in J-82 cells stimulated with E. coli strains showing DA, LA, or AggA pattern. The expression of IL-8 mRNA was increased, whereas TGFj3 mRNA was decreased in J-82 cells stimulated with E. coli strain showing AggA.pattern. Treatment with crude bacterial adhesins (CBA) isolated from E. coli strains showing DA or LA pattern increased IL-la, IL-lB, IL-S, and TGFj3 mRNA expressions in J-82 cells and HeLa cells. IL-la, IL-lB, and TGFB mRNA expressions were decreased in epitheUal cells stimulated with CBA from E. coli strain showing AggA pattern, whereas IL-8 mRNA expression was significantly increased. The expressions of cytokine mRNAs showed little differences between epithelial ceRs used, but great differences between CBA from DA or LA and AggA strain. LPS stimulation was little changed cytokine mRNA expressions in epithelial cells. This study suggests that cytokine gene expression of epithelial cells by the bacterial stimulation mainly depends on the bacterial adhesins recognized by the respective receptors of epithelial cells.
Adhesins, Bacterial ; Epithelial Cells* ; Gene Expression ; HeLa Cells ; Humans ; Interleukin-8 ; RNA, Messenger ; Uropathogenic Escherichia coli*

We have studied male patients with cosmetic allergy in patch test during 5 years from September, 1982 to August, 1986 (Group A) and during 7 1/2 years from March, 1988 to August, 1995 (Group B). The results are as follows. 1. In Group A, 7 patients were diagnosed as contact allergy due to cosmetics. In Group 13, 30 patients were diagnosed as contact allergy to cosmetics. 2. Sixteen patients were positive to only cosmetic related allergens. Two patients were positive to only their own cosmetic products. Nineteen patients were positive to both cosmetic related allergens and their own cosmetic products. 3. The age of patients with cosmetic allergy ranged from 10 to 70 years with a peak in the fifties. The patients more than 50 years were about 40% of all patients. 4. The most frequently, affected area was face(n=31) followed by neck(n=6) and scalp (n = 6 ). 5. Twenty four patients with cosmetic allergy had eczematous skin lesions. Thirteen patients had pigmented skin lesions and pigmented contact dermatitis was suspected. Two out of 13 patients with pig men ted skin lesions were positive in photopatch test. 6. Cosmetic related allergens showing frequent positive reactions were paraphenylene-aliamine, fragnance mix, balsam of Peru, benzyl salicylate, amerchol L101, oakmoss absolute, musk muskene. 7. Cosmetic products showing frequent positive reactions were skin care products, hair dye, soap, after shave lotion, shampoo and toothpaste. In conclusion, cosmetic allergy in men seems to increase in our society.
Allergens ; Dermatitis, Contact ; Hair ; Humans ; Hypersensitivity* ; Male* ; Patch Tests ; Peru ; Scalp ; Skin ; Skin Care ; Soaps ; Toothpastes

No abstract available.
Molecular Biology* ; Shigella*

Recently, the Supracondyle fracture of the femur is so severe and comminuted that it is difficult to treat open reduction and rigid fixation sufficiently due to violent traffic accident and external forces. The associated injuries are accompanied variously. So compliactions of the supracondyle fractures 'including joint.. stiffness, delayed union, infection are serious. However development of internal implant and operation skill result in relatively satisfactory function than conservative management. The authors reviewed. 20 cases of the supracondyle fracture of the femur treated at Yeungnam University Hospital from 1989. Dec. To 1992. Jan. The results were as follows 1. The male was common(70%). The 2nd-4th decade was most(87%). 2. The most common cause of injuries was traffic accident. The rate of open fracture was 35%, most of it was traffic accident. 3. According to the ASIF group classification, 4 cases were type A, 4 in type B, 12 in type C (10 in type C2&C3). 4. Accompanied injuries included multiple fractures in 9 cases and femoral artery injury in 1 case. 5. Among the 20 cases, conservative treatment was done in 5 cases and operative treatment was done in 15 cases. 6. Functional results (by Schatzker criteria) were as follows. The satisfactory results were achieved in 40% of cases in consevative treatment and 67 in operative treatment. 7. The average time of partial weight bearing was 15 weeks. 8. Complications were knee stiffness in 6 cases and 4 in delayed union.
Accidents, Traffic ; Classification ; Femoral Artery ; Femur* ; Fractures, Open ; Humans ; Joints ; Knee ; Male ; Weight-Bearing

Transmitral left ventricular diastolic inflow velocities determined by pulsed Doppler in 47 normotensives, 80 hypertensives and 44 age-matched hypertensives were measured to evaluate the effects of age and left ventricular hypertrophy on left ventricular diastolic fuction in normotensives and hypertensives. The results were as follows: 1) The peak E velocity in normotensives(77.82+/-13.53cm/sec) was significantly different from those of hyeprtensives(58.13+/-11.80cm, p<0.01) and age-matched hypertensives(59.31+/-10.94cm/sec, p<0.01). The peak E/A in normotensives(1.31+/-0.45) was significantly different from those of hypertensives(0.83+/-0.21,p<0.01) and age-matched hypertensives(0.83+/-0.20, p<0.01). 2)In normotensives, simple linear regression analysis revealed strong inverse correlations of peak E with age(r=-0.758, p<0.01), peak E/A with age(r=-0.748, p<0.01), but no significant correlation of peak E and peak E/A with LVMI(p>0.05). Stepwise regression analysis revealed that age was the most important correlate of peak E and peak E/A in normotensives(peak E: R
Heart Diseases ; Hypertrophy, Left Ventricular* ; Linear Models