BACKGROUND: Calcium status is more accurately determined by measuring free calcium, the tightly regulated biologically active form. The concentration of ionized calcium is strongly dependent on different preanalytic factors. In this study the influence of several methodological factors on the concentration of ionized calcium in blood is investigated. METHODS: Authors selected 127 persons of health care management center & comparatively healthy-look, out-patients of our hospital. When serum was needed, blood was anaerobically withdrawn in vacutainers, the serum was separated after standing at room temperature. For the plasma sample blood was anaerobically drawn into the tube with dry sodium heparin 143 IU/10ml blood in the same patient. And then, to avoid CO2 loss, the samples were left unopened and centrifuged anaerobically at 900g for 15 min; the serum and plasma were then pipetted as quickly as possible into 2ml plastic eppendorf-tube, which were completely filled and sealed off immediately and keeping it in refrigeration before testing. For the studies of calcium binding effect by different volume of sodium heparin. blood was collected into two type of tube, each containing 30IU heparin/whole blood ml or 125 IU/ml. Ioniged calcium were measured by ion-selective electrodes. RESULTS: 1. The reference value of ionized calcium in serum and plasma was 4.9+/- 0.19, 4.9+/-0.17 mg/ml(serum versus plasma, p>0.05) respectively. 2. The concentration change of ionized calcium according to heparin volume shows no significant difference until heparin 14.3 IU/blood 1 ml compared with serum. 3. The concentration of ionized calcium of serum and plasma was stable until 4 hours and 4 days after serum and plasma separation. CONCLUSIONS: Above shows that the concentration of ionized calcium have the same reference range on both serum and plasma. But each laboratory should have their own reference range according to heparin volume, ionized calcium in serum and plasma samples kept at -4degrees C remains stable within few days, provided the proposed conditions for storage.
Calcium* ; Delivery of Health Care ; Heparin ; Humans ; Ion-Selective Electrodes ; Outpatients ; Plasma ; Plastics ; Reference Values ; Refrigeration

PURPOSE: The study of the causative factors, surgical approachs and the clinical course of symptoms related to sciatic nerve injury after THR. MATERIAL AND METHODS: A retrospective review of 6 patients with sciatic nerve injury in 669 hips total hip arthroplasty during the period from Jan., 1986 to Dec., 1994. Each patient's record was reviewed with respect to age, sex, possible etiology, clinical course, surgical approach, treatment, and clinical condition at follow-up examination. RESULTS: ➀ The increased prevalence of nerve palsy was seen in revision surgeries(4 cases, 3.2%) compared to primary arthroplasty(2 cases, 0.4%) ➁ There was 2 cases(0.8%) of sciatic nerve injury in direct lateral approach and posterior approach, 4 cases(1%) ➂ Possible mechanisms of nerve injury included excessive soft tissue traction(3 cases), electrical thermal injury(1 case), Trochanteric fracture during femoral stem removal(1 case), and overlengthening of femur(1 case). ➃ The isolated peroneal division of the sciatic nerve was injured in 5 cases, and the both peroneal and tibial divisions were injured in one case. ➄ At a following period of 5 month, recovery of neurologic function was complete in con case, and two years follow up, 4 cases had a enough recovery of neurologic function(modified Sunderland scale 1,2). However, remained one case had a persistent severe weakness & dysesthesia at even 3 years follow-up. The prognosis for neurological recovery was related the degrees to which the nerve was damaged.
Arthroplasty, Replacement, Hip ; Femur ; Follow-Up Studies ; Hip ; Humans ; Paralysis ; Paresthesia ; Prevalence ; Prognosis ; Retrospective Studies ; Sciatic Nerve

To ease the convinience of indentification of common dermatophytes in Korea and to check the possibility of diseovering new species not yet reported in Korea, several species of dermatophytes were cultured on potato dextrose agar(PDA) at the room temperature. They were 46 strains isolated from Korea and 6 domestic strains from a foreign country. Gross and microscopic findings of their colonies were examined. The colonial morphology and microscopic appearance were compared with those of the same strains on Sabouraud dextrose agar(SDA) and corn meal agar(CMA). The results were as follows Typical T. rubrum and its varisnts showed characteristic wine red pigmentation which was rapid, diffuse and uniform, typically arrsnged microconidia were better on PDA. T. mentagrophytes showed yellow-brown pigmentation which were more rapid and darker in the center with gradual fading to the periphery. The mscroconidia, grape-like clusters of microconidia and spiral hyphae were seen better on SDA. T. tonsurans showed characteristic mahogsny colored pigmentation, ballooned microconidia and macroconidia which were seen better on PDA, but diffusible pigmentation of agar were present on SDA only. The gross morphology of T. verracosum were similar on PDA and SDA, but macroconidia were seen better on PDA and CMA, and tortuous hyphae with antler-like branching were seen better on SDA. T. rnegninii showed green-brown pigmentation which appeared rapidty and prominently on PDA. T. rubrum-like microconidia were seen better on PDA and CMA, but in SDA only hyphae were seen. The gross morpholgy of M. canis was similar on PDA and SDA, but spindle shaped macroconidia were seen more typically on PDA. The gross morphology and microscopic appearance of M. gypseum were very similar in all three media. M. ferruginenm showed characteristic rust colored pigmentation and bamboo hyphae which were seen more typically on PDA. The gross morphalogy of E floceosum were similar on PDA and SDA, but cluster formation of club shaped macroconidia were seen more prominently on PDA and CMA. These findings suggest that PDA is a mare convincing media t6Cifferentiate among dermatophytes belonging to genus Trichopkyton.
Agar* ; Arthrodermataceae* ; Glucose ; Hyphae ; Korea ; Meals ; Pigmentation ; Solanum tuberosum* ; Wine ; Zea mays

BACKGROUND: There are many reports showing the efficacy of polymerase chain reaction(PCR) for the diagnosis of Mycobacterium tuberculosis in sputum. but only few reports in extrapulmonary specimens. Because of the difficulty in establishing a diagnosis of tuberculosis in the extrapulmonary specimens there have been considerable interest in the development of a rapid sensitive diagnostic test that might be useful. Therefore we used PCR for detection of M. tuberculosis DNA in extrapulmonary specimens and compared the results of conventional acid-fast stain, culture methods and PCR assay. METHODS: Total of 63 clinical samples(10 cerebrospinal fluids, 12 pleural fluids, 1 pericardial fluid, 3 bone marrow aspirates, 1 ascitic fluid, 25 fine needle aspirates of lymph nodes, 7 urine, 1 stool and 3 tissue biopsies) in Ewha Womans University Tongdaemun hospital were analysed by the PCR. We performed the PCR using a species-specific M. tuberculosis DNA fragment(mtp 40 gene) as primers that was cloned and sequenced at recent and a 396-bp fragment was specifically amplified. We analyzed sensitivity and specificity of AFB culture and PCR for the diagnosis of extrapulomonary tuberculosis. RESULTS: The positivity of AFB smear, culture and PCR were 2(10%), 4(20%), 13(65%) out of total 20 cases diagnosed as clinically active extrapulmonary tuberculosis. respectively. All of 2 smear-positive samples and 2 of 4 culture-positive and smear-negative samples were PCR-positive. And 9 of 14 smear and culture negative specimens also gave detectable DNA products in PCR The specificity of PCR(95.4%) is compared with those of smear and culture(100.0%). CONCLUSIONS: This results suggest that the PCR assay is a sensitive and rapid diagnostic alternative to classical procedures for the diagnosis of extrapulmonary tuberculosis.
Ascitic Fluid ; Bone Marrow ; Cerebrospinal Fluid ; Clone Cells ; Diagnosis* ; Diagnostic Tests, Routine ; DNA ; Female ; Humans ; Lymph Nodes ; Mycobacterium tuberculosis ; Needles ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Sputum ; Tuberculosis*

Classic pulmonary blastoma is a variant of carcinosarcoma which is seen almost exclusively in adults. By contrast, most cases of pulmonary blastoma in children have been described as having an exclusive mesenchymal composition, which was proposed as pleuropulmonary blastoma. Recently we experienced a case of pleuropulmonary blastoma, type 1. This 27-month-old male baby was transferred to our hospital due to the left tension pneumothorax. Chest CT revealed a subpleural pulmonary cystic lesion on the left upper lung and an open cystectomy was performed. Histologically the lesion was composed of variable-sized cystic structures lined with a single layer of respiratory-type epithelium. the underlying stroma was composed of sheets of small, round to oval, primitive tumor cells. Some of them had eccentric, eosinophilic cytoplasm, suggestive of rhabdomyoblastic differentiation. These rhabdomyoblastic cells were fuchsinophilic and positive with desmin and vimentin on immunohistochemistry.
Child ; Adult ; Male ; Female ; Humans

No abstract available.
Animals ; Arteries* ; Rats*

Primary tumors of the heart are rare, and one-third of them are malignant. The most common malignant intracardiac tumor is angiosarcoma, which usually involves right atrium. MR features in one patients with right atrial angiosarcoma is presented and the literature briefly reviewed. Angiosarcoma demonstrated slightly heterogeneous intermediate signal intensity on T1-weighted images, high signal intensity on T2-weighted images and higher signal intensity on Gd-DTPA enhanced images. MRI provided more information regarding the extent of the tumor than 2D echocardiography or CT.
Echocardiography ; Gadolinium DTPA ; Heart ; Heart Atria ; Hemangiosarcoma* ; Humans ; Magnetic Resonance Imaging*

Two cases of old unreduced dislocation of shoulder are reported. One was the posterior dislocation for six months with malunited fracture of humeral shaft in thirty degree lateral angulation. Her shoulder and arm aches with limitation of motion remaining only ten degrees in every direction but abduction in thirty degrees, The malunion of humeral shaft and shoulder were reduced surgically in result of eighty degrees abduction, seventy degrees flexion, sixty degrees extension and twenty degrees of external rotation with free of pain. Another case was an anterior dislocation for one year. Her range of shoulder motions are almost normal degree but brachial plaxus compression symptoms. Open reduction in practically Putti-Platt procedure was performed. She became completely free of brachial plexus symptom and ranges of shoulder motion are normal except about fifteen degrees less external rotation than preoperative condition. The surgical indication and the result of treatment were discussed for the the neglected cases of old unreduced dislocation of the shoulder.
Arm ; Brachial Plexus ; Dislocations ; Fractures, Malunited ; Shoulder

A case of osteochondritis dissecans of both knee joints is developed in 15 year old boy. Since the original articles of Paget, Koning and others were reported, many theories as to etiology and pathogenesis have been proposed but exact cause has been unknown. Many Joint may show evidence of osteochondritis dissecans but lateral aspect of medial femoral condyle of knee is by far the most frequent site. Under the diagnosis of osteochondritis dissecans of both knees with clinical symptoms and X-ray finding, the one was treated with excision of framents and curettage, and the other treated with drilling of fragments. In follow up study for one year, the result was good without any complaints.
Curettage ; Diagnosis ; Follow-Up Studies ; Humans ; Joints ; Knee Joint ; Knee ; Male ; Osteochondritis Dissecans ; Osteochondritis

Two cases report on osteogenesis imperfecta tarda and review of literature has been made. The rare genetic disorder, osteogenesis imperfecta tarda is familiar to most orthopedic surgeons because of management of fracture and skeletal deformities, espicially bowing of long bone. Its clinical manifestations are known as bony fragility, blue sclera and deafness less frequently ligamentous laxity but its etiological factor is obscure; The basic defect is thought to involvement some abnormality of collagen. Recently the bony weakness caused by increased bony turnover rate. One case of osteogenesis imberrfecta tarda in 8 year old male was belonged to tarda type 1. (Falvo-classification), who could not walk due to marked anterolateral bowing of right tibia and the another to tarda type II. in 13 year old male with fresh fracture of right femoral shaft. The former was performed corrective multible osteotomy, realignment and intramedullary rod fixation for correction of bowing deformity of right tibia, and the later was managed the fracture of right femoral shaft with Russels traction and hip spica cast. The result of reported therapeutic mesure was good.
Collagen ; Congenital Abnormalities ; Deafness ; Fibrinogen ; Hip ; Humans ; Ligaments ; Male ; Orthopedics ; Osteogenesis Imperfecta ; Osteogenesis ; Osteotomy ; Sclera ; Surgeons ; Tibia ; Traction