No abstract available.
Adolescent* ; Ecthyma* ; Humans ; Pseudomonas aeruginosa

OBJECTIVE: To compare the change of oxygen consumption and heart rate between walking and running at the same condition of treadmill in healthy male college students. METHOD: Twenty healthy male college students completed steady-state treadmill test at 3 mph and 5 mph, separately, by walking and running. During the each 6 minutes treadmill test, oxygen consumption (VO2), heart rate (H.R), oxygen consumption ratio of maximal oxygen consumption (% VO2max), and heart rate ratio of maximal heart rate (% HR) were measured each minute. RESULTS: The showed that mean heart rate were 123.40+/-4.62 beats/min and oxygen consumption were 12.84+/-1.94 ml/kg/min, in 3 mph walking. The mean heart rate were 139.90+/-6.80 beats/min and oxygen consumption were 16.51+/-1.78 ml/kg/min in 5 mph walking. The running showed that mean heart rate were 187.55+/-6.74 beats/min and oxygen consumption were 26.45+/-3.11 ml/kg/min in 3 mph walking. The mean heart rate were 168.45+/-13.34 beats/min and oxygen consumption were 21.05+/-2.00 ml/kg/min in 5 mph walking. There were significant differences (p<0.05) in mean heart rate, VO2 between the 3 mph walking and running, the 5 mph walking and running. CONCLUSION: We concluded that 3 mph walking and running and 5 mph running were an effective exercise to promote health in healthy college students.
Exercise Test ; Heart Rate* ; Heart* ; Humans ; Male ; Oxygen Consumption* ; Oxygen* ; Running* ; Walking*

OBJECTIVE: Surgically removed herniated lumbar disc specimen are immunostained to evaluate the production of MMPs(Matrix metalloproteinases) -1, 2, 3 for the investigation of the possible correlation of MMPs in lumbar disc herniation depending on the types of disc herniation. METHODS: The study population consists of 30 patients with lumbar disc herniation. There were 18 men and 12 women with patient age averaging 43.4 years(19-68years). The types of disc herniation identified at the time of surgery were classified as follow ; protruded type(Group 1, 10cases), extruded type(Group 2, 10cases), sequestrated type(Group 3, 10cases). Immunohistochemical study for the MMPs of the herniated disc tissue was performed and results of staining were graded to examine differences in histology among three types of disc herniation . RESULTS: The MMPs immunopositive cells were increased in old patients but statistically it was not significant(p=0.074). A significantly increased incidence of positive cells for MMP-1, 2 was found in the herniated lumbar disc tissue than the control group(p=0.02) but there were no significant differences among the three types of disc herniation. The MMP-3 positive cells were predominantly detected in the sequestrated disc tissue group(p=0.037) more than other groups. CONCLUSION: These results suggest that the MMP-1, 2, 3 may play important roles in the process of degeneration, herniation, and resorption of the lumbar intervertebral discs and that the MMP-3 may express the severity of lumbar disc herniation and play a role in resorption of the sequestrated disc tissue.
Female ; Humans ; Immunohistochemistry ; Incidence ; Intervertebral Disc ; Intervertebral Disc Displacement ; Male ; Matrix Metalloproteinases*

Tuberculosis can involve any part of the gastrointestinal tract but 80~90% of patients present the disease in the ileocecal region. The cases of colon cancer coexisting with colonic tuberculosis are relatively rare and ascending colon is the predominant site of the combined disease. A 46-year-old man, without specific past medical or family history, showed multiple colonic polyps and ulcers on colonoscopic examination. After surgery, the surgical specimen disclosed adenocarcinoma in the ascending colon, eleven adenomatous polyps throughout the colon, and multiple tuberculous ulcers in the entire colon. Tuberculosis of terminal ileum was also accompanied. The association of colonic tuberculosis and colon cancer with multiple polyps in this case may have been coincidental. The preoperative colonoscopic examination and pathologic diagnosis by frozen section during operation are necessary for the adequate treatment.
Adenocarcinoma ; Adenomatous Polyps ; Colon* ; Colon, Ascending ; Colonic Neoplasms* ; Colonic Polyps ; Diagnosis ; Frozen Sections ; Gastrointestinal Tract ; Humans ; Ileum ; Middle Aged ; Polyps ; Tuberculosis* ; Ulcer

A 36-year-old man visited Yeungnam University Hospital with a sudden onset of palpitation, headache, and was found to be hypertensive. Chest radiography showed a 6 cm sized mass lesion on the posterior mediastinum. A biochemical study showed elevated levels of catecholamines. An I-123 metaiodobenzylguanidine scan revealed a hot uptake lesion on the posterior mediastinum. The patient was prepared for surgery with alpha and beta blocking agents. Two months later, we removed the tumor successfully. A histological study proved that the resected tumor was mediastinal pheochromocytoma. Functional mediastinal pheochromocytomas are rare. Therefore, we reported the case with a literature review.
Catecholamines ; Headache ; Humans ; Hypertension ; Mediastinum ; Pheochromocytoma ; Thorax

Since the pancreas and the spleen lie in close proximity, splenic complications during the course of pancreatitis are possible, but uncommon. No previously published report in Korean has described splenic subcapsular hematoma due to pancreatitis, and we now report one such case.
Hematoma* ; Pancreas ; Pancreatitis ; Pancreatitis, Chronic* ; Spleen*

BACKGROUND: Currently, the incidence of chronic pancreatitis is increasing due to the change of diet and high alcohol consumption in our country. Regarding more effective treatment of chronic pancreatitis, surgical intervention is favored for the control of intractable pain, various complications from the pancreatitis, suspected malignancy, and amelioration of progressively deterioratory exocrine and endocrine pancreas functions. We attempted to evaluate the various indications for an operation, various surgical treatments, and their results. METHODS: We retrospectively reviewed the clinical records of 50 patients with chronic pancreatitis who were managed surgically between July 1989 and Feb. 1998. RESULTS: The indications for operation were intractable pain in 25 cases, suspected malignancy in 12 cases, biliary obstruction in 4 cases, pancreatic pseudocyst in 7 cases, and treatment of Diabetes Mellitus in 2 cases. We performed 11 drainage procedures, 8 Peustow-Gillesby operations and 3, DuVal operations 2 combined denervations, 28 pancreatic resections 12 pancreaticoduodenectomies, duodenum-preserving resection of the pancreas head 12, distal pancreatectomies, 3 total pancreatectomies and a combined denervation, 9 bypass procedures and 2 pancreas transplantations in 2 cases. The follow-up period were from 1 month to 9 years and 7 months with a mean of 2 years and 11 months. The results were good in 23 cases (51 .1%), fair in 16 cases (35.6%) and poor (no change or aggravation) in 6 cases (13.3%). Postoperative mortality developed in 1 case due to postoperative aspiration pneumonia and sepsis after the bypass procedures. Late mortality occurred in 2 cases, one due to sepsis from uncontrolled DM and the other is rupture of the pseudoaneurysm of the anastomotic vessel after transplantation. CONCLUSIONS: Surgical procedures are the mainstays of definite treatment modality in chronic pancreatitis. Operations should be selected properly for each case. Pancreas or islet transplantation is another treatment option for the control of irreversible exocrine and endocrine pancreatic dysfunction.
Alcohol Drinking ; Aneurysm, False ; Denervation ; Diabetes Mellitus ; Diet ; Drainage ; Follow-Up Studies ; Head ; Humans ; Incidence ; Islets of Langerhans ; Islets of Langerhans Transplantation ; Mortality ; Pain, Intractable ; Pancreas ; Pancreas Transplantation ; Pancreatectomy ; Pancreatic Pseudocyst ; Pancreaticoduodenectomy ; Pancreatitis ; Pancreatitis, Chronic* ; Pneumonia, Aspiration ; Retrospective Studies ; Rupture ; Sepsis

BACKGROUND: An increase in the maximum level of sensory blockade by epidural 'top-up' in combined spinal epidural anesthesia may be explained by two mechanisms; a volume effect, compressing the dural sac, and a local anesthetic effect. This study was undertaken to investigate the relative importance of these factors. METHODS: Eighty patients about to undergo lower limb surgery under combined spinal epidural anesthesia were randomly assigned to four groups. Using the needle-through-needle technique, all patients received a subarachnoid injection of 8 mg of heavy bupivacaine through an epidural catheter. At 30 minutes after subarachnoid injection, an epidural top-up was given according to a randomization code. Experimental groups received 10 ml of saline, 10 ml of bupivacaine 0.25%, or 10 ml of bupivacaine 0.5%. The control group received no epidural top-up. The level of sensory blockade was checked by using the pinprick test at 5, 10, 15, 20, 25 and 30 minutes after subarachnoid injection, and at 5, 10, 15, 20, 25 and 30 minutes after epidural top-up. Blood pressure, heart rate and the incidence of side effects such as hypotension, bradycardia, nausea, and high block were analyzed. RESULTS: There was no significant difference in maximum level of sensory block among the 10 ml saline, 10 ml bupivacaine 0.25% or 10 ml bupivacaine 0.5% treated groups during epidural phase. Although blood pressure and heart rate were decreased, there were no differences among experimental groups during epidural phase. The most common side effect during combined spinal epidural anesthesia was hypotension. The incidence of bradycardia and high sensory block (above T4 dermatome level) was similar among the groups. CONCLUSIONS: After the maximum level of sensory blockade due to subarachnoid injection has been established, an epidural top-up with 10 ml of saline or 10 ml of either 0.25% or 0.5% bupivacaine did not significantly increase the level of subarachnoid block in patients with lower extremity surgery. The author concludes the there were no differences among groups with regard to the volume effect and local anesthetic effect in terms of the sensory blockade level during the epidural phase. However, blood pressure and heart rate in the epidural top-up groups reduced with operation time.
Anesthesia ; Anesthesia, Epidural* ; Anesthetics ; Blood Pressure ; Bradycardia ; Bupivacaine* ; Catheters ; Heart Rate ; Humans ; Hypotension ; Incidence ; Lower Extremity ; Nausea ; Random Allocation

BACKGROUND: The aim of this study was to evaluate causes of unstable total knee arthroplasty and results of revision surgery. METHODS: We retrospectively reviewed 24 knees that underwent a revision arthroplasty for unstable total knee arthroplasty. The average follow-up period was 33.8 months. We classified the instability and analyzed the treatment results according to its cause. Stress radiographs, postoperative component position, and joint level were measured. Clinical outcomes were assessed using the Hospital for Special Surgery (HSS) score and range of motion. RESULTS: Causes of instability included coronal instability with posteromedial polyethylene wear and lateral laxity in 13 knees, coronal instability with posteromedial polyethylene wear in 6 knees and coronal and sagittal instability in 3 knees including post breakage in 1 knee, global instability in 1 knee and flexion instability in 1 knee. Mean preoperative/postoperative varus and valgus angles were 5.8degrees/3.2degrees (p = 0.713) and 22.5degrees/5.6degrees (p = 0.032). Mean postoperative alpha, beta, gamma, delta angle were 5.34degrees, 89.65degrees, 2.74degrees, 6.77degrees. Mean changes of joint levels were from 14.1 mm to 13.6 mm from fibular head (p = 0.82). The mean HSS score improved from 53.4 to 89.2 (p = 0.04). The average range of motion was changed from 123degrees to 122degrees (p = 0.82). CONCLUSIONS: Revision total knee arthroplasty with or without a more constrained prosthesis will be a definite solution for an unstable total knee arthroplasty. The solution according to cause is very important and seems to be helpful to avoid unnecessary over-constrained implant selection in revision surgery for total knee instability.
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee/*adverse effects ; Female ; Humans ; Joint Instability/*etiology ; Knee Joint/*surgery ; Knee Prosthesis ; Male ; Middle Aged ; *Prosthesis Failure ; Reoperation ; Retrospective Studies

PURPOSE: There are a number of conditions that can lead to a hypercoagulable state, however, protein C and S deficiencies are frequently described as causes of the hypercoagulable states. The aim of this study was to evaluate the clinical features and prognosis of vascular diseases associated with protein C and/or S deficiencies and to determine an adequate treatment modality for such cases. METHODS: We prospectively evaluated 7 cases with vascular disease caused by protein C and/or S deficiencies confirmed with serologic tests. RESULTS: Four patients showed venous thrombosis, 1 peripheral arterial insufficiency, 1 cerebral venous thrombosis and peripheral arterial insufficiency, and 1 portal vein thrombosis. Surgical intervention was required in 5 patients. Full anticoagulation with heparin sodium followed by warfarin sodium was done in all patients. CONCLUSION: Protein C and S deficiencies may influence clinical management. Patients presenting with atypical vascular involvement without evidence of other risk factors should be evaluated for a hypercoagulable state. Once the diagnosis is made, patients should be treated with full anticoagulation.
Diagnosis ; Heparin ; Humans ; Prognosis ; Prospective Studies ; Protein C* ; Risk Factors ; Serologic Tests ; Vascular Diseases* ; Venous Thrombosis ; Warfarin