The indication of the total hip prosthesis seems to be far less incidence in this country than western part of the world. Accordingly the report of this surgery is few in Korea. In this report a case of total hip prosthesis operation performed in December 1971 is described. The patient was a 41-year-old female who had marked limited motion of the left hip as well as walking disturbance in such a grade to manage only for toilet by help of bilateral axillary crutches. The hip had 40° of flexion contracture and total range of motion of the hip was 70. Diagnosis was an aseptic necrosis of the femoral head. McKee-Farrar type of total hip prosthetic operation was performed. Walking exercise started from seven weeks after the operation. She has been obtained markedly improved range of motion of the hip with total of 220° actively. 350° passively and normal walking ability. No complication occurred.
Adult ; Contracture ; Crutches ; Diagnosis ; Female ; Head ; Hip Prosthesis ; Hip ; Humans ; Incidence ; Korea ; Necrosis ; Range of Motion, Articular ; Walking

Segmentary mobility of the mobile lumbar spines upon a total of 90 cases was studied by means of the functional radiographic examination. Segmentary mobility was determined by Falconer method. The cases were divided into four groups as Group I, 20 cases, who had no symptoms on low back, Group II, 20 cases, who had herniated disc in L4-5 confirmed either by surgery or by myelography, Group III, 30 cases, who had low back pain and neurological signs of L5 root irritation, and Group IV, 20 cases, who had low back pain as well as neurological signs of S1 root irritation. The result of the analysis was concluded as follows: 1. Total mobility of the lumbar spine in group I was significantly higher than other groups. Large normal variation in segmentary mobility of the lumbar spine was found, however, the mean angle of the segmentary mobility was highest in L4-5 and higher in the order of L5-S1, L4-3, L3-2 and L2-1. 2. Total mobility of the lumbar spine in group II was markedly reduced compared with group I, however, proportion of the segmentary mobility of L4-5 versus total mobility of the lumbar spine was somewhat higher than that of group 3. Total mobility of the lumbar spine in group III was significantly reduced than group I and significantly higher than group II. Proportion of the segmentary mobility of L4-5 versus total mobility of the lumbar spine in group III was somewhat higher than group I and the same as group II. 4. Total mobility of the lumbar spine in group IV was reduced than group I and group III, and higher than group II. Proportion of the segmentary mobility of L5-S1 was significantly higher than any other group. 5. In the groups with low back pain and herniated disc, in other words, there was found relatively increased segmentary mobility in the affected lumbar segments in contrast to reduced mobility of the total lumbar segments.
Diagnosis ; Intervertebral Disc Displacement ; Low Back Pain ; Methods ; Myelography ; Spine

The central venous catheter(Quinton) was replaced in the right atrium for chemotherapy and blood sampling to a eight-year old girl with acute lymphoblastic leukemia. The catheter was flushed with heparin two times daily and the chemotherapeutic drug regimens by CCSG-105 protocol were vincristine, prednisone, L-asparaginase, daunomycin, methotrexate, cyclophosphamide, cytosine arabinoside, 6-mercaptopurine and adriamycin. On day 31 of catheterization, the lumen for blood sampling was blocked. From day 60 of catheterization, anorexia, nausea, vomiting, abdominal distension and tachypnea were developed. Echocardiogram, lung scan, pulmonary function test(PFT), arterial blood gas analysis (ABGA) were done. Two cemtimeters in diameter of thrombosis was found in the right atrium on echocardiogram. The lung scan showed slight decrease in uptake of Tc-99m on the whole lung fields. Restrictive ventratory impairment on PFT and decreased PaO2(48 mmHg) on ABGA were found. To lysis of thromboembolism, urokinase(4,400 IU/kg for initial 10 minutes and the 4,400 IU/kg for 12 hours) was injected intravenously and aspirin(30 mg/kg/d, po) was given. The thrombosis was disappeared from the atrium on echocardiogram and PaO2 was increased up to 97 mmHg temporary. The catheter was removed but total haziness on the right middle and lower lobes were developed after 5 days. The same dose of urokinase was injected just infront of the embolism through Pitfall catheter for 8 days intermittently as results of pulmonary angiography. Symptoms and PaO2 were alleviated and the lung was expanded with mild atelectasis on day 55 of the first fibrinolytic enzyme therapy. Although the frequent complications of central venous catheter are catheter occlusion and infection, we have to check the development of thromboembolism with echocardiogram periodically or in case of unexplained respiratory symptoms.
6-Mercaptopurine ; Angiography ; Anorexia ; Blood Gas Analysis ; Catheterization ; Catheters ; Central Venous Catheters* ; Cyclophosphamide ; Cytarabine ; Daunorubicin ; Doxorubicin ; Drug Therapy ; Embolism ; Enzyme Therapy ; Female ; Heart Atria ; Heparin ; Humans ; Lung ; Methotrexate ; Nausea ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prednisone ; Pulmonary Atelectasis ; Tachypnea ; Thromboembolism* ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Vincristine ; Vomiting

A 70-year-old woman with Parkinson disease was admitted to the emergency department with altered consciousness, fever and convulsive movements without experiencing withdrawal from antiparkinsonian medication. Six hours after the emergency department visit, the patient had a hyperpyrexia (>40℃) and a systolic blood pressure of 40 mmHg. There was no evidence of bacterial infection based on extensive workups. The patient was discharged without aggravation of Parkinson disease symptoms after treatment that included administration of dantrolene sodium, enforcement of continuous renal replacement therapy and cooling blankets. Malignant syndrome should be suspected if high fever occurs in Parkinson disease patients without evidence of a definitive infection.
Aged ; Bacterial Infections ; Blood Pressure ; Consciousness ; Dantrolene ; Dehydration ; Emergency Service, Hospital ; Female ; Fever ; Humans ; Parkinson Disease* ; Renal Replacement Therapy

No abstract available.
Animal Experimentation* ; Animals* ; Botulism* ; Humans

The problem of carbon monoxide intoxication has been increasing since 1950s and it is still regarded as one of the most serious public health problem in Korea. If the patients survives the acute episode, elimination of carbon monoxide occurs in the rate of a halt-time of 3 to 4 hours. Nevertheless, there may remain after effect. Therefore, the present study was desinged to elucidate the change of myocardial tissue caused by acute carbon monoxide poisoning were evaluated by electrton microscopic observation of the severity of the mitochondrial swelling and cytochrome oxidase activity, which was demonstrated by histochemical staining with diaminobenzidine(DAB). Male Sprague-Dawley rats were exposed to the carbon monoxide of 1500 ppm for 150 minutes. They were divided into two groups ; one group were treated with hyperbaric oxygenation 15 minutes after carbon monoxide exposure, the other were not treated. Rats were sacrified 6 hours, 12 hours, 1 day, 3 days, 7days, 14 days, and 21 days after carbon monoxide exposure. The specimens were collected from the apex of the heart. In the group without hyperbaric oxygenation, mitochondrial swelling subsided 21 days after carbon monoxide exposure accompained by restoration of cytochrome oxidase activity. On the other hand, with hyperbaric oxygenation, healing process was shortened. Cytochrome oxidase activity was restored 7 days after carbon monoxide exposure.
Animals ; Carbon Monoxide Poisoning ; Carbon Monoxide* ; Carbon* ; Cytochromes* ; Electron Transport Complex IV* ; Hand ; Heart ; Humans ; Hyperbaric Oxygenation ; Korea ; Male ; Mitochondria* ; Mitochondrial Swelling ; Myocardium* ; Public Health ; Rats* ; Rats, Sprague-Dawley

BACKGROUND: This study aimed to present our 5-year experience of extracorporeal cardiopulmonary resuscitation (ECPR) performed by emergency physicians. METHODS: We retrospectively analyzed 58 patients who underwent ECPR between January 2010 and December 2014. The primary parameter analyzed was survival to hospital discharge. The secondary parameters analyzed were neurologic outcome at hospital discharge, cannulation time, and ECPR-related complications. RESULTS: Thirty-one patients (53.4%) were successfully weaned from extracorporeal membrane oxygenation, and 18 (31.0%) survived to hospital discharge. Twelve patients (20.7%) were discharged with good neurologic outcomes. The median cannulation time was 25.0 min (interquartile range 20.0-31.0 min). Nineteen patients (32.8%) had ECPR-related complications, the most frequent being distal limb ischemia. Regarding the initial presentation, 52 patients (83.9%) collapsed due to a cardiac etiology, and acute myocardial infarction (33/62, 53.2%) was the most common cause of cardiac arrest. CONCLUSIONS: The survival to hospital discharge rate for cardiac arrest patients who underwent ECPR conducted by an emergency physician was within the acceptable limits. The cannulation time and complications following ECPR were comparable to those found in previous studies.
Cardiopulmonary Resuscitation ; Catheterization ; Emergencies* ; Extracorporeal Membrane Oxygenation ; Extremities ; Heart Arrest ; Humans ; Ischemia ; Myocardial Infarction ; Retrospective Studies ; Treatment Outcome

BACKGROUND: Unilateral lung hyperinflation develops in lungs with asymmetric compliance, which can lead to vital instability. The aim of this study was to investigate the respiratory dynamics and the effect of airway diameter on the distribution of tidal volume during mechanical ventilation in a lung model with asymmetric compliance. METHODS: Three groups of lung models were designed to simulate lungs with a symmetric and asymmetric compliance. The lung model was composed of two test lungs, lung1 and lung2. The static compliance of lung1 in C15, C60, and C120 groups was manipulated to be 15, 60, and 120 ml/cmH₂O, respectively. Meanwhile, the static compliance of lung2 was fixed at 60 ml/cmH₂O. Respiratory variables were measured above (proximal measurement) and below (distal measurement) the model trachea. The lung model was mechanically ventilated, and the airway internal diameter (ID) was changed from 3 to 8 mm in 1-mm increments. RESULTS: The mean ± standard deviation ratio of volumes distributed to each lung (VL1/VL2) in airway ID 3, 4, 5, 6, 7, and 8 were in order, 0.10 ± 0.05, 0.11 ± 0.03, 0.12 ± 0.02, 0.12 ± 0.02, 0.12 ± 0.02, and 0.12 ± 0.02 in the C15 group; 1.05 ± 0.16, 1.01 ± 0.09, 1.00 ± 0.07, 0.97 ± 0.09, 0.96 ± 0.06, and 0.97 ± 0.08 in the C60 group; and 1.46 ± 0.18, 3.06 ± 0.41, 3.72 ± 0.37, 3.78 ± 0.47, 3.77 ± 0.45, and 3.78 ± 0.60 in the C120 group. The positive end-expiratory pressure (PEEP) of lung1 was significantly increased at airway ID 3 mm (1.65 cmH₂O) in the C15 group; at ID 3, 4, and 5 mm (2.21, 1.06, and 0.95 cmH₂O) in the C60 group; and ID 3, 4, and 5 mm (2.92, 1.84, and 1.41 cmH₂O) in the C120 group, compared to ID 8 mm (P < 0.05). CONCLUSIONS: In the C15 and C120 groups, the tidal volume was unevenly distributed to both lungs in a positive relationship with lung compliance. In the C120 group, the uneven distribution of tidal volume was improved when the airway ID was equal to or less than 4 mm, but a significant increase of PEEP was observed.
Airway Obstruction ; Compliance ; Lung Compliance* ; Lung* ; Positive-Pressure Respiration ; Positive-Pressure Respiration, Intrinsic ; Respiration, Artificial ; Tidal Volume ; Trachea ; Ventilation

No abstract available.
Erythema* ; Hydroxychloroquine* ; Sjogren's Syndrome*

The muscle glycogen is an important energy source for muscle contraction especially in prolonged exercise. One of the important factors for improvement of physical performance in athletes is the storage of extra-amount of glycogen (supercompensation) in liver and muscles. During 120 minutes treadmill exercise (intensity of exercise was approximatly 80% VO2max), the glycogen concentration was significantly decreased to 36% in liver and 46% in muscles after 60 minutes exercise. At 90 and 120 minutes of exercise, the level of glycogen concentration of liver and muscles statistically were not different from the levels of the 60 minutes exercise. The repletions of glycogen in the liver and muscles in overnight fasted control(C) and 120 minutes treadmill exercise(E) groups during l80minutes after glucose ingestion were investigatect. ln the liver, the concentration of glycogen in C and E groups were markdly increased till 120 minutes after zlucose ingestion, hut the levels of concentration at 180 minutes were decreased comparing to the levels of 120 minutes in both groups. In the muscles, the repletion of glycogen at 60, 120 and 180 minutes of C and E groups were significantly increased comparing to 0 minute of respective groups in the soleus and plantaris muscles. In soleus(SOL), the repletion of glycogen in all of the E groups was significantly higher than that of the respective C groups. However, the repletion of glycogen in all of the E groups of plantaris was revealed higher tendency comparing to respective C groups. Mean repletion rates of glycogen in liver and muscles after glucose ingestion were highest during the first 60 minutes in all groups and the rates of E groups were 2-3 times than those of respective C groups. These results suggest that the glycogen supercompensation in the muscle be provided with decrement of glycogen concentration by exercise, increment of glucose uptake by muscuiar contraction itself and increased insuJin level, and the activation of glycogen synthetase by insulin.
Animals ; Athletes ; Eating* ; Glucose* ; Glycogen Synthase ; Glycogen* ; Humans ; Insulin ; Liver* ; Muscle Contraction ; Muscles ; Rats*