No abstract available.
Lung Neoplasms* ; Lung* ; Pneumothorax, Artificial*

This treatise summarizes the medical facts about the persistent vegetative state(PVS) and the associated issues. In August 1998, the opinions of the 380 neurologists and the 1007 neurosurgeons are inquired about the diagnostic criteria of PVS, the degree and the withdrawal of treatment on PVS patients. The response rate is 18.8%. The diagnostic criteria of PVS is determined by the items approved above 5007o of responses. (1) no evidence of cerebral function and an inability to interact with visual, auditory stimuli and follow commands. (2) maintaining the respiratory function with spontaneous respiration and normal respiratory pattern. (3) spontaneous eye opening and eye ball movements without sustained tracking. (4) variably preserved brain stem reflexes. (5) presence of sleep-wake cycles. (6) (1)-(5) symptoms should be persist for 6 months after the development of vegetative state. (7) the diagnostic criteria of PVS should be applied more than 3 times during the minimum observation period. (8) this diagnostic criteria of PVS could be applied to adults over 7 ages. As to the degree of treatment, nasogastric tube feeding and air-way keeping through the tracheostomy are approved over 9007b. Also antibiotics can be used in infection. As to the withdrawal of treatment, do not resuscitate order of patient s family is accepted by 46.1% in an emergency condition like cardiac arrest. But discharge against medical advice by the patient s family is accepted by 73.107o in non-emergency condition. In the case of neonates, parents decision is more determinative than any other thing.
Adult ; Anti-Bacterial Agents ; Brain Stem ; Emergencies ; Enteral Nutrition ; Heart Arrest ; Humans ; Infant, Newborn ; Korea* ; Parents ; Persistent Vegetative State* ; Reflex ; Respiration ; Tracheostomy

The cause of osteoporosis are multifactorial; these include aging, immobilization, genetic fsctor, initial bone mass, nulliparity, postmenopause, cigarette, etc. Among them the hormonal factors are very important. It is worthwhile to study the effects of various hormones on bne cells. Authors evaluated the effects of TGB-B, 17-B estradiol, insulin, and human growth hormone as a stimulatory factors, and r-interferon as a inhibitory factor on the MC3T3 osteoblast cells with measurement of cell numbers, osteocalcin and 3[H]-thymidine incorporation. 1. TGF-B was a potent stimulator on ostoblast with increased change in cell morphology (number, size, shape), osteoclacin level and 3[H]-thymidine incorporation in dose depen- dant fashion. 2. 17-B estradiol was also a potent stimulator on osteoblast activity as well as TGF-B except osteoclacin level which w#as not shown in dose dependant fashion. 3. There were little changes on osteoblast with insulin, growth hormone, and r-interferon. Through this study it is confirmed that TGF-B and 17-B estradiol showed marked stimulatory effect on osteoblast cell in vitro.
Aging ; Cell Count ; Estradiol ; Female ; Growth Hormone ; Human Growth Hormone ; Immobilization ; In Vitro Techniques ; Insulin ; Osteoblasts ; Osteocalcin ; Osteoporosis ; Parity ; Postmenopause ; Tobacco Products

No abstract available.
Idiopathic Pulmonary Fibrosis*

Hemorrhagic shock is one of the most common causes of death in patients with multiple trauma and therefore rapid control of bleeding is the main strategy to save these patients. Resuscitative balloon occlusion of the aorta (REBOA) has been applied in several trauma cases and because of the effectiveness of this procedure it has been adopted in the trauma field. Herein, we report the first successful case of REBOA in Korea performed on a 46-year-old man with hemorrhagic shock after a fall from a height of 14-stories. The patient visited our hospital emergency room with hypovolemic shock, we performed Resuscitative Endovascular Balloon Occlusion of the Aorta under bed side blind technique. His vital sign was stabilized after procedure, then we could performed endovascular bleeding control. The patient was discharged on his 33rd in-hospital day without invasive procedure and major scar.
Aorta* ; Balloon Occlusion* ; Cause of Death ; Cicatrix ; Emergency Service, Hospital ; Hemorrhage ; Humans ; Korea ; Middle Aged ; Multiple Trauma ; Shock* ; Shock, Hemorrhagic ; Vital Signs

BACKGROUND: Methicillin-resistant Staphylococcus aureus(MRSA) is an increasingly common cause of nosocomial infections worldwide. Epidemiologic investigation of MRSA outbreaks and identification of pathways of nosocomial MRSA spread require the ability to distinguish individual MRSA strains. We applied molecular tap ing of the methicillin-resistant determinant (mec) and coagulase typing in the investigation of a nosocomial MRSA infections. METHODS: We randomly selected 79 strains of mecA positive MRSA isolated from patients who visited Dong-A university Hospital from Dec. 1995 to Oct. 1996. Molecular typing of MRSA was performed by comparing the size of the mac-associated hypervariable region amplified by the polymerase chain reaction (PCR). Coagulase typing with type I-VIII antisera was also used for classification of MRSA based on its phenotype. Each isolates were classified by the combination of molecular analyses and coagulase type. RESULTS: The 79 MRSA isolates were grouped Into sin hypervariable legion (HVR) genotypes on the basis of the size of the PGR products. In coagulase typing, the most predominant type was II(46.8%) and type V was not found. Nine strains were not typable. The combination of HVR genotypes and coagulase types showed 23 different types in 79 MRSA Isolates. The strains which were repeatedly isolated from the same patients showed the same HYR genotypes and coagulate types. CONCLUSION: The combination of HVR genotypes and coagulase types is thought to be useful in epidemiolgical Investigation of nosocomial infections caused by MRSA ,because of its simplicity and reproducibility.
Classification ; Coagulase* ; Cross Infection* ; Disease Outbreaks ; Genotype ; Humans ; Immune Sera ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Molecular Typing* ; Phenotype ; Polymerase Chain Reaction ; Staphylococcus

In order to evaluate antitumor rnechanisms of interleukin (IL)-12/IL-2 that has been shown significant tumor suppressive activity on established primary and metastatic Renca tumor, we studied chemokine gene expression induced by direct action of IL- 12/IL-2 or cytokine cascade. IL-12/IL-2 induced gene expression of interferon gamma (IFN-r) and granulocyte monocyte-colony stimulating factor (GM-CSF) in splenocytes, and it induced gene expression of monokine induced by IFN-r (Mig), interferon inducible protein 10 (IP- 10), SDF-1, macrophage inflammatory protein (MIP)-1a, MIP-1B, MIP-2, monocyte chemotactic protein (MCP)-1, and Rantes in tumor mass. However IL-12/IL-2 could not induce these chemokines in tumor mass of GKO mice and Renca cell in vitro. IL- 12 also did not increased chemokine gene expression in Renca cell in vitro, but IFN-r induced gene expression of Mig, IP-10, MCP-1 in Renca cell in vitro. In the chemotaxis assay, culture supernatant of Renca cell stimulated with IFN-r increased splenocyte migration in vitro. All these data suggest IL-12/IL-2 can induce IFN-r-chemokine cascade in tumor mass, and Mig, IP-10, MCP-1 produced from tumor cell may play an important role for initial immune cell migration into tumor mass.
Animals ; Cell Movement ; Chemokine CCL5 ; Chemokine CXCL10 ; Chemokines ; Chemotaxis ; Gene Expression* ; Granulocytes ; Interferons ; Interleukins ; Macrophages ; Mice ; Monocytes

Forry-two symptomatic hands of 29 patients with carpal tunnel syndrome operated during the period from Marth 1986 to December 1993 were analized in clinical aspect. Among 29 patients, 3(10.3%) were male and 26(89.7%)were female. The syndrome occured on the right side in 10(34.5%) patients, on the left in 6(20.7%) patients, and on both in 13(44.8%) patients. The causes of the syndrome were idiopathic(90.5%), trauma(7.1%), mass(2.4%). Paresthesia(57.1%) was the most common chief complanit, followed by numbness(35.7%), pain(21.4%), weakness(9.5%). Thenar muscie atrophy occured in 84.8%, positive Tinel sign in 83.3% and positive Phalen sign in 90.0%. Delay of motor conduction velocity of median nerve was noted in all cases and delay of sensory nerve conduction velocity in all cases. Denervation finding such as fibrillation or sharp waves were seen in all cases. The carpal tunnel release was performed in all cases, and 31 cases were treated by carpal tunnel tunnel release with internal neurolysis. 35 cases(83.3%) were excellent or good results. The cases were long duration were poorer results. No significant difference was found between the results in cases treated by carpal tunnel release alone and those in cases treated by carpal tunnel release with internal neurolysis of median nerve.
Atrophy ; Bryophyta ; Carpal Tunnel Syndrome ; Denervation ; Female ; Hand ; Humans ; Male ; Median Nerve ; Neural Conduction

Os subfibulare is a accessory bone arround the lateral maleolus, but it is different from many other accessory bones in foot and ankle in its development related to trauma and frequent symptoms of ankle instability. Accessory bone is a developmental anomaly which fails to unite to main secondary ossification center and usually asymptomatic. But os subfibulare is developed by recurrent ankle sprains in younger age or non-union of avulsion fracture of anterior talofibular ligament and causes instability of ankle. We experienced two cases of symptomatic os subfibulare in adolecents and report them with review of literatures.
Ankle ; Ankle Injuries ; Foot ; Ligaments

Purpose: This study systematically reviewed the effects of physical activity on depression and various menopausal symptoms in middle-aged women. We aimed to identify physical activity as a useful intervention for mitigating the physiological and psychological challenges associated with menopause and promoting healthy aging. Methods: Electronic searches were conducted in the MEDLINE, EMBASE, CINAHL, and the Cochrane Library databases using predefined keywords “menopause” and “physical activities”. Of the 1,391 initial articles, 15 randomized controlled trials involving 1,692 middle-aged women were included. Results: Physical activities led to a reduction in depressive symptoms, with a standardized mean difference (SMD) of -0.60 (95% CI, -0.90 to -0.30). Moreover, all menopausal symptoms, except vasomotor symptoms, were decreased. Specifically, the SMDs for the five subscales of menopausal symptoms were as follows: total scores: -1.53 (95% CI, -2.57 to -0.49); vasomotor: -0.76 (95% CI, -1.53 to 0.00); psychological: -0.93 (95% CI, -1.62 to -0.25); physical: -1.10 (95% CI, -1.77 to -0.43); and urogenital/sexual: -0.67 (95% CI, -1.23 to -0.12). Conclusion Physical activity is beneficial for middle-aged women transitioning from peri- to post-menopause. Engagement in physical activity can contribute to the maintenance of overall health and well-being during aging by reducing depression and menopausal symptoms.