No abstract available.

No abstract available.
Child* ; Humans ; Visual Acuity*

Increase of AST and ALT is a common biochemical finding in patients with multiple trauma. So it is difficult to make a decision for appropriate operation timing and to predict prognosis with consideration of parenchymal liver disease. We studied patients with multiple trauma who admitted to orthopedic department with increased AST & ALT and patients who had hepatitis from Jan. 1993 to Dec. 1993. The patients were checked AST & ALT on admission day and followed by the 3rd, 5th, 9th day, second and third week. We checked the relation of changed level of these enzymes and severity of injury, combined abdominal trauma, head trauma and the presence of HBs Ag/Ab. We concluded as followed: 1) Traumatized patients had high AST than ALT during first 3 days but hepatitis patients had higher ALT than AST during throughout admission days. High ALT in hepatitis patients had statistically significance compare to traumatized patients. 2) Traumatized patients with high AST were decreased more rapidly than ALT and showed normalized enzymatic level by 3rd week. 3) The AST level was higher in severely injured patients and it was statistically significant within first 3 days. But ALT was not correlated with the severity of injury. 4) In patients with abdominal injury, AST was higher than ALT and AST had significance but ALT had none. 5) There is no specific correlation between these enzyme level in neurosurgical problem and the presence of HBsAg/Ab.
Abdominal Injuries ; Craniocerebral Trauma ; Hepatitis ; Humans ; Liver Diseases ; Multiple Trauma ; Orthopedics ; Prognosis

No abstract available.
Actinomycosis*

BACKGROUND: The relation between treadmill exercise testing and ambulatory ST segment monitoring in detection of ischemia in patients with coronary artery disease has not been well established, with pathophysiologic mechanisms underlying the development of ischemia in the ambulatory setting not being well elucidated. This study was performed to determine the relation between myocardial ischemic indexes on exercise testing and on Holter monitoring. METHODS: We analized 25 patients with stable angina and angiographically documented coronary artery disease, who exhibited ischemia both on a Bruce protocol exercise test and on 24-hr Holter monitoring while receiving routine antianginal medications. RESULTS: Mean heart rate at the onset of 1mm ST segment depression during exercise testing(74.4 VS 114.1 beats/min, p<0.01). Overall the correlations between ischemic indexes on both test were weak. But heart rate at the onset of ischemic episodes during Holter monitoring had a good correlation with heart rate at 1mm ST depression during exercise test. And the number of ischemic episodes on Holter monitoring revealed a weak negative correlation with duration of exercise during treadmill test. CONCLUSION: Ischemic indexes on exercise testing cannot accurately predict ischemic indexes on Holter monitoring in patients with coronary artery disease. In that regard, Holter monitoring may provide other clinical information in addition to that obtained by exercise testing in selected patients.
Angina, Stable ; Coronary Artery Disease ; Depression ; Electrocardiography, Ambulatory* ; Exercise Test* ; Heart Rate ; Humans ; Ischemia* ; Myocardial Ischemia

This paper describes a student-centered case study program concerning the tumor pathology course for first year students in medical school under the traditional curricular structure. A traditional, discipline-oriented, lecture-laboratory approach was partly modified by introducing a tutuorial session using a modified case matrix format during the laboratory hours without altering the general scheme of the existing system. Small group tutorial sessions were set with the development of learning objectives emphasizing clinicopathologic reasoning and early exposure to future practical presentation which was followed by the large class session; each tutorial was supplied with a short clinical history, gross kodachrome slides, and microslides. The session for problem identification was replaced by proving a series of instructor-designed questions for both pathology and interdisciplinary correlation during which pedagogical implication was stressed the most. Student's active participation, development of self learning skill and vigorous teaching-learning process among students, and motivation/relevance for forthcoming pathology study were among the benefits conferred by this modification. We conclude that this approach is an interim step to meet the advantages of problem-based learning even in a traditional curricular structure.

BACKGROUND: The atrial repolarization waves might contribute to ST segment depression during the exercise loading test. As atrial repolarization waves are opposite in direction to P waves, they could shift the ST segment in the absence of myocardial ischemia. METHODS: The exercise test in 20 patients was seemed false positive because of normal coronary angiogram. Twenty-six patients with at least one coronary stenosis > or =50% served as a true positive group. The P waves, PR segments and ST segment were studied in leads II, III, aVF and V4 to V6 in those 46 patients whose exercise ECG suggested ischemia. RESULTS: The finding of steeply downsloping PR segment, particularly in the inferior ECG leads, in patients with longer exercise time and higher exercise heart rate might predict a false positive exercise test in those with a normal rest ECG and no apparent reason for a false positive test. The combination of downsloping PR segments in two of three inferior leads plus either exercise duration > or =5 min or peak heart rate > or =130 bests/min idenified false positive tests with a sesitivity of 75% and a specificity of 81% to 89%. CONCLUSIONS: Atrial repolarization waves might play a role in exercise induced ST segment depression.
Coronary Stenosis ; Depression ; Electrocardiography ; Exercise Test ; Heart Rate ; Humans ; Ischemia ; Myocardial Ischemia ; Sensitivity and Specificity

No abstract available.
Smoke* ; Smoking Cessation* ; Smoking*

The purpose of this article is to review imaging findings and to discuss the optimal imaging methods for craniosynostosis. The discussion of imaging findings are focused on ultrasonography, plain radiography, magnetic resonance imaging and computed tomography with 3-dimensional reconstruction. We suggest a strategy for imaging work-up for the diagnosis, treatment planning and follow-up to minimize or avoid ionized radiation exposure to children by reviewing the current literature.
Child ; Cranial Sutures ; Craniosynostoses* ; Diagnosis* ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Radiography ; Skull ; Ultrasonography

Local cutaneous reactions have been reported at injection sites of interferon therapy, but these are usually erythema or rarely induration. Skin necrosis at the injection site is rare. We describe here a patient with multiple sclerosis who presented with cutaneous necrosis at the injection sites of interferon-β. Biopsy of the necrotic lesion showed dermal vessel thrombosis and complete ischemic coagulative necrosis of epidermis and dermis.
Biopsy ; Dermis ; Epidermis ; Erythema ; Humans ; Interferon-beta* ; Interferons ; Multiple Sclerosis ; Necrosis* ; Skin* ; Thrombosis