It is known that the toe-flexors exert some power generation in ankle plantar flexion. However, there has been no paper published in which the power generation was quantified. The purpose of this paper, therefore, is to quantify the amount of contribution of the toe-flexors to the ankle plantar-flexion in normal and rapid walking using the kinetic data of three dimensional gait analysis system. In order to restrict the action of the toe-flexors, we designed special braces which can be applied to the forefeet of the examinee during walking. We performed the gait analysis in ten normal adult volunteers with and without braces, and evaluated the moment and power of toe-flexors during terminal stance and pre-swing phase of gait cycle. Gait analysis was done with the VICON 3-dimensional motion analysis system (VICON, Oxford Metrics, Oxford, England) and 2 force plates (AMTI, Advanced Mechanical Technoiogy, Newton, MA, U.S.A,). The kinetic results are as follows: l. Average speeds of normal and rapid walking were 1.12m/sec and 1.41m/sec respectiveIy. 2. In normal walking, peak ankle plantar-tlexion moment decreased 5.5% with braces, and sum of ankle plantar-flexion moment decreased 12.3% with braces. Both of the results were not significant statistically (p>0.05). Peak ankle power generation decreased 11.0% with braces, and sum of ankle power generation decreased 10.4% with braces. These decreases were also insignificant statistically (p>0.05). 3. In rapid walking, peak ankle plantarflexion moment decreased 26.7% with braces. The decrease was horderline significant statistically (p=0.062). The sum of ankle plantar-tlexion moment decreased 26.6% with braces, but the decrease was not significant statistically (p>0.05). Peak ankle power generation decreased 40.2% with braces, and sum of ankle power generation decreased 37.9% with braces. These decreases showed borderline significance statistically (p=0.062). In conclusion, toe-flexors may contribute about 10% of the total ankle plantar-flexion power generation, and the contribution will be increased with increase of walking velocity. We must be very careful to sacrifice the toe-flexors in cases with weak triceps power.
Adult ; Ankle* ; Braces ; Gait ; Humans ; Toes* ; Volunteers ; Walking*

A 49-year-old woman with anemia who developed headache and seizure after blood transfusion was diagnosed with posterior reversible encephalopathy syndrome (PRES). Magnetic resonance imaging showed typical PRES findings including lesions in bilateral parieto-occipital subcortical white matter and overlying cortex. Only a few cases of PRES after transfusion have been reported and this case is unique in that there was a latent period between infusion and development of PRES. We postulate that rapid change of hemoglobin level may disrupt cerebral autoregulation and result in delayed PRES. We suggest that neurological symptoms after blood transfusion should be appropriately investigated.

OBJECTIVE: Peripartum emergency cesarean hysterectomy of 28 cases at our hospital for 10years were reviewed that the clinical indication, history, and annual incidence change. METHODS: A retrospective descriptive analysis from January, 1988 to December, 1997 was carried out. RESULTS: There were 28 cases of emergency cesarean hysterectomy identified during this period among total 24, 689 deliveries. The annual incidence of emergency cesarean hysterectomy was significantly declined statistically(p<0.005). Cesarean hysterectomy was performed in 20 of 6, 671 cesarean section(0.30%) and in 8 of 18, 018 vaginal deliveries(0.04%), so more frequently after cesarean section than vaginal delivery. The cesarean hysterectomy rate was more frequent in multiparous women(0, 22%) than in nulliparous women(0, 02%). The most common indication of cesarean hysterectomy was 13 cases of uterine atony(46%), followed by 5 cases uterine rupture(18%), 5 cases of placenta previa with placenta accreta(18%), 3 cases of placenta previa(11%), 2 cases of uterine myoma(7%). No significant difference in length of operating time, amount of blood loss and operative complications were found between total abdominal hysterectomy and subtotal hysterectomy. The all patient who had cesarean hysterectomy recieved from 1200ml to 15840ml of blood transfusion with a mean of 3673ml. In aspect of fetal outcome, 3 cases of FDIU(Fetal death in utero) in uterine rupture and 1 case of stillbirth in preterm were found. The maternal complications were wound disruption, DIC, wound hematoma, ureter injury, vaginal stump bleeding, UTI(Urinary tract infection) and retroperitoneal bleeding, CONCLUSION: We conclude that the incidence of emergency cesarean hysterectomy declined with prediction of antenatal risk factor, preparing of sufficient fresh blood, prophylactic antibiotics, vigorous uterotonics and close observation after delivery.
Anti-Bacterial Agents ; Blood Transfusion ; Cesarean Section ; Dacarbazine ; Emergencies* ; Female ; Hematoma ; Hemorrhage ; Humans ; Hysterectomy* ; Incidence ; Peripartum Period* ; Placenta ; Placenta Previa ; Pregnancy ; Retrospective Studies ; Risk Factors ; Stillbirth ; Ureter ; Uterine Rupture ; Wounds and Injuries

A nested polymerase chain reaction (PCR) was applied to detect and identify pathogenic Yersinia enterocolitica and Y. pseudotuberculosis. We used photochemical postamplification procedure with 8-methoxypsoralen to control carryover contamination. Using the ail and inv gene, the sensitivity and specificity of DNA amplification by nested PCR was considerably improved. The amplified fragment sizes were 298 bp for the ail gene and 295 bp for the inv gene. Amplification was successful when the template was derived from three sources: purified DNA, aliquots of boiled bacterial suspension and aliquots of lysed bacterial suspension. The detection limits were 10 fg of DNA and 2 * 10 colony forming units (CFU) for Y. enterocolitica and 10 fg DNA and 2 CFU for Y. pseudotuberculosis.
DNA ; Limit of Detection ; Methoxsalen ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Stem Cells ; Yersinia enterocolitica* ; Yersinia pseudotuberculosis* ; Yersinia*

No abstract available.
Dermoscopy ; Hemangioma* ; Lasers, Dye

No abstract available.
Breast Neoplasms* ; Breast*

Fetal teratomas rarely complicate pregnancy,having an incidance of only 20,000:1 to 40,000:1 of live births. Overthere, cervical teratomas are rare and accounts for only 5.5% of all neonatal teratomas. We have experienced a large cervical immature teratoma and present this case with a brief review of literatures.
Live Birth ; Teratoma*

Although febrile convulsion (FC) is a common clinical entity with a high recurrence rate, no specific factors have been identified to be highly predictive of its recurrence. A total of 114 cases of FC identified during a 28 month period (January, 1989-May, 1991) was analysed. A slight predominance of boys over girls (1.3 to 1.0) was observed. the majority of cases (89.4%) were under 3 years of age and the most common age range for the onset of FC was 1~2 years. The most common form of FC was tonic type (54.0%), followed by tonic-clonic (32.5%), clonic (5.3%), and complex partial type (5.3%). Most FC episodes lasted less than 5 minutes (81.6%), and common clinical diagnosis underlying FC were as follows: pharyngotonsillitis (64.0%), bronchitis and/or pneumonia(16.7%), and gastroenteritis (9.7%). The family history for seizure disorder was present in 27.2% of the cases: FC in 21.1%, epiepsy in 4.4%, and both in 1.8%. Among 78 cases of the first FC, 43 cases were followed for 5 to 29 months without prophylactic anticonvulsant therapy. The overall recurrence rate of FC in this group was 67.4% and the highest incidence was observed in patients less than one year old (86.7%). A higher recurrence rate (80%) was observed in patients whose body temperature was lower than 39degrees C, as opposed to higher than 39degrees C (50%). It is concluded that the recurrence of FC is positively correlated with factors such as younger age (less than one year old), and lower body temperature at the time of onset of FC.
Body Temperature ; Bronchitis ; Diagnosis ; Epilepsy ; Female ; Gastroenteritis ; Humans ; Incidence ; Recurrence ; Seizures, Febrile*

A statistical analysis of the diagnostic value for 244 aspiration biopsy cytology(ABC) among a total 1,043 cases from various sites was performed. ABC, using diagnostic terminology similar to that of a surgical pathology reports, was compared to the final tissue diagnosis. For the entire series, a sensitivity of 91.8%, a specificity of 99.3%, a positive predictive value of 98.9%, a negative predictive value of 94.8%, and an efficacy of the test of 96.3% were shown. There were 8 false negative and 1 false positive diagnosis. The diagnostic accuracy was 89.8%. Those results indicate that the ABC is a considerably highly accurate procedure that should be routinely employed.
Biopsy, Needle ; Child* ; Diagnosis ; Glomerulonephritis, IGA* ; Humans ; Immunoglobulin A* ; Intranuclear Inclusion Bodies ; Meningioma ; Pathology, Surgical ; Sensitivity and Specificity

Disodium cromoglycate(DSCG) has been widely used in the treatment of bronchial asthma and has become the prophylactic drug of choice in patients with mild-to-moderate asthma, because it has anti-allergic, anti-inflammatory and mast cell stabilizing properties. DSCG has been considered one of the safest medications among drugs for asthma treatment. The most common side effects are irritation of throat and dry mouth. Bronchospasm and chest tightness have been reported, but they were usually experienced by patients using spinhaler powdered capsules rather than metered dose inhalers (MDI). In this report, we presented a case of recurrent DSCG-induced bronchoconstriction with brief review of the literature. He had had an aspirin-induced asthma and had been well controlled with steroid inhalers and DSCG-MDI. After aspirin-bronchopro vocation test, he complained of chest discomfort and tightness immediately after inhaling DSCG-MDI. On serial monitoring of peak expiratory flow rate (PEER), there was a significant decline of PEER after two puffs inhalation of DSCG-MDI. Thus we performed DSCG-inhalation broncho provocation test with the nebulizer solution, which was pure DSCG without any addition of ingradients or propellants. This produced an early asthmatic reaction with more than 40% decline of FEV,. He was diagnosed as DSCG-induced bronchoconstriction and his clinical conditions were improved after avoidance of DSCG-MDI.
Asthma* ; Asthma, Aspirin-Induced ; Bronchial Spasm ; Bronchoconstriction* ; Capsules ; Humans ; Inhalation ; Mast Cells ; Metered Dose Inhalers ; Mouth ; Nebulizers and Vaporizers ; Occupations ; Peak Expiratory Flow Rate ; Pharynx ; Thorax