No abstract available.

No abstract available.

Sleep disorders such as insomnia, obstructive sleep apnea (OSA), and restless legs syndrome (RLS) are very common disorders and may cause significant burden in terms of individual as well as societal aspects. Sleep insufficiency from such sleep disorders may cause deleterious effects on daily work life and may be associated with other major medical or psychiatric disorders including cardiovascular disease, diabetes mellitus, depression, and anxiety disorder. Various motor or occupational accident may result from the sleep problems. In addition, recent researches provide the method to evaluate the lost productivity time in terms of absenteeism and presenteeism. Moreover, several studies on cost-effectiveness of treatment of sleep disorders show that it is cost-effective.
Absenteeism ; Accidents, Occupational ; Anxiety Disorders ; Cardiovascular Diseases ; Depression ; Diabetes Mellitus ; Efficiency ; Restless Legs Syndrome ; Sleep Apnea, Obstructive ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders

No abstract available.
Area Postrema*

Open fracture characteristically has higher chances of infection and sof tissue damage in comparison with closed fracture. In spite of the development of operation methods and antibiotics, complications such as infection, nonunion, delayed union, and joint stiffness are continuously confronted as problems in the field of orthopedics. Different methods of treatment have been advocated as regards the care of the open wound and the method of stabilization of the fracture fragments. Therefore a comparative analysis of the type of open fracture and the bone union time according to the initial treatment methods was made from 47 cases over the age of 20, who were followed up until bone union developed among the inpatients who were treated for open fracture of tibia in the period of 7 years from January, 1982 to December, 1988, and the results are as follows: 1. The highest incidence of fractures was encountered in 3rd decade(34%) and male to female ratio was 6:l. 2. The most common cause of fractures was traffic accident(76.6%). 3. The most common level of fracture was in mid one-third and the bone union time was longest in mid one-third. 4. The bone union time was longer, and the rate of complication was greater in order of type 1, 2 & 3 according to Gustilo's classification. 5. The good result was obtained in type 1 fractures, by using the closed reduction & cast immobilization and pin & plaster method; in type 2, the bone union time was shortest in the cases of pin & plater method; in type 3, the bone union time was shortest in the cases of closed reduction or open, reduction & external fixation. 6. Bone union was obtained in all cases of delayed union and nonunion and the bone union time was shortest in cases treated with plate & bone graft.
Anti-Bacterial Agents ; Classification ; Clinical Study ; Female ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Incidence ; Inpatients ; Joints ; Male ; Methods ; Orthopedics ; Tibia ; Transplants ; Wounds and Injuries

The treatment of intra-articular fractures of distal radius is difficult and has various problems. Maximum recovery of wrist function is dependent on accurate and stable reduction of the radial articular surface. We analysed one hundred and five cases of intra-articular fracture of distal radius followed for more than 6 months at Yonsei University from January 1980 to September 1988 and studied the result according to the type of treatment. The results of this study were as follows; 1. The incidence was high in female who aged over 6th decade, and in male who is active aged. 2. The main cause of this injury was fall down(34.3%). 3. In a group of closed reduction and cast immobilization, the functional result was satisfactory in 45.4%. 4. In a group of closed reduction and percutaneous pinning, the functional result was satisfactory in 50%. 5. In a group of open reduction and internal fixation, the functional result was satisfactory in 83. 3%. 6. In a group of external fixation, the functional result was satisfactory in 33.3%. 7. Overall result was mainly correlated with initial severity of the injury and anatomical reduction of the intra-articular surface.
Clinical Study ; Female ; Humans ; Immobilization ; Incidence ; Intra-Articular Fractures ; Male ; Radius ; Wrist

Compression ulnar neuropathy was predicted by Guyon in 1961,following his anatomical studies of the ulnar tunnel. Nearly a half century later Ramsey Hunt first reported isolated ulnar motor paralysis in the hand, due to chronic occupational trauma. Many authors has tried to describe the etiology of the ulnar nerve compression syndrome at or around the wrist. That is most frequently caused by ganglion, occupational neuritis, thrombosis of the ulnar artery, thickening of volar ligament or different kinds of trauma (e.g. fractures of the carpal bones). Now we experienced a case of the ulnar nerve compression syndrome at distal forearm by an anomalous branch of the ulnar nerve by piercing the distal tendon of the flexor carpi ulnaris.
Forearm ; Ganglion Cysts ; Hand ; Ligaments ; Neuritis ; Paralysis ; Tendons ; Thrombosis ; Ulnar Artery ; Ulnar Nerve Compression Syndromes ; Ulnar Nerve ; Ulnar Neuropathies ; Wrist

It is generaly accepted that displaced phalangeal neck fractures in hands accelerate the onset of degenerative changes, with increasing pain and stiffness of the affected joint. However, reports on the results of surgical treatment in phalangeal neck fractures are relatively few. We have followed sixteen patients, who had operations for phalangeal neck fractures. The average length of follow up was 13 months. The interval between injury and operation ranged from three days to six years, whith a mean of 18 months. The second finger was the most frcquently injured. The phalangeal neck had been displaced with rotation in 9 cases and slightly displaced without rotation in 7 cases. The most common surgical approach was a mid-dorsal incision. Of 16 cases, thirteen required open reduction and internal fixation with a K-wire, either for dorsal displacement and volar angulation of the head or for a 180 degree proximal rotation of the head. The pull-out wire technique was the second most common fixation method. Excellent and good results were noted in 10 cases(62%). Complications were found in seven cases and loss of motion was the most frequent. Late malrotation with angulation occurred in one case.
Fingers ; Follow-Up Studies ; Hand ; Head ; Humans ; Joints ; Methods ; Neck

BACKGROUND: Although hypoxic pulmonary vasoconstriction (HPC) and hypoxic coronary vasodilatation (HCD) have been recognized by many researchers, the precise mechanism remains unknown. As isolated arteries will constrict or relax in vitro in response to hypoxia, the oxygen sensor/transduction mechanism must reside in the arterial smooth muscle, the endothelium, or both. Unfortunately, much of the current evidence is conflicting, especially concerning to the dependency of HPC and HCD on the endothelium and the role of the K+ channel. Therefore, this experiment was attempted to clarify the dependency of HPC and HCD on the endothelium and the role of the K+ channel on HPC and HCD. METHODS: HPC was investigated in isolated main pulmonary arteries precontracted with norepinephrine (NE). HCD was investigated in isolated left circumflex coronary artery precontracted with prostaglandin F2 alpha. Vascular rings were suspended for isometric tension recording in an organ chamber filled with Krebs-Henseleit solution. Hypoxia was induced by gassing the chamber with 95% N2 +5% CO2, which was maintained for 15 - 25 min. RESULTS: 1)Hypoxia elicited a vasoconstriction in NE-precontracted pulmonary arteries with endothelium, but a vasodilatation in PGF 2 alpha-precontracted coronary arteries with and without endothelium. There was no difference between the amplitude of the HPC and HCD induced by two consecutive hypoxic challenges and the effect of normoxic and hyperoxic control Krebs-Henseleit solution on subsequent response to hypoxia. 2)Inhibition of NO synthesis by the treatment with Nw-nitro-L-arginine reduced HPC in pulmonary arteries, but inhibition of the cyclooxygenase pathway by treatment with indomethacin had no effect on HPC and HCD, respectively. 3)Blockades of the TEA-sensitive K+ channel abolished HPC and HCD. 4)Apamin, a small conductance Ca2+/-activated K+ (KCa) channel blocker, and iberiotoxin, a large conductance KCa channel blocker, had no effect on the HCD. 5)Glibenclamide, an ATP-sensitive K+ (KATP) channel blocker, reduced HCD. 6)Cromakalim, an K(ATP) channel opener, relaxed the coronary artery precontracted with prostaglandin F2 alpha. The degree of relaxation by cromakalim was similar to that by hypoxia and glibenclamide reduced both hypoxia- and cromakalim-induced vasodilations. 7)Verapamil, a Ca2+ entry blocker, caffeine, a Ca2+ emptying drug; and ryanodine, an inhibitor of Ca2+ release from SR, reduced HPC, respectively. CONCLUSION: HPC is dependent on the endothelium and is considered to be induced by inhibition of the mechanisms of NO-dependent vasodilation while HCD is independent of the endothelium and is considered to be induced by activation of the K(ATP) channel.
Anoxia ; Arteries ; Caffeine ; Coronary Vessels ; Cromakalim ; Dinoprost ; Endothelium ; Glyburide ; Indomethacin ; Muscle, Smooth ; Norepinephrine ; Oxygen ; Prostaglandin-Endoperoxide Synthases ; Prostaglandins F ; Pulmonary Artery ; Relaxation ; Ryanodine ; Vasoconstriction* ; Vasodilation*

"Mig is a gamma interferon-inducible T cell chemoattractant that is a member of the chemokine family of cytokines. In order to gain a better understanding of the molecular mechanisms that regulate expression of the Mig gene, we have characterized the Mig gene and compared its structure and regulatory sequences with that of its ciosest IP10 gene. The genomic organization of the Mig gene reveals three introns that interrupt the transcribed sequence into four functional domains with a single ""CAT""- and ""TATA""-like structure. Primer extension analysis was used to identify the transcriptional initiation site that is located 50 bp upstream to the methionine codon that begins the long open reading frame. Comparison of the intron-exon structure of this gene to the gene for IP10 establishes that both genes are interrupted in precisely the same positions within homologous codons. The similarity of the intron-exon structure of the Mig and IP10 genes further support the hypothesis that Mig and IP10 genes have evolved from a common ancestral gene by gene duplication. The 5'-flanking region of Mig gene shows no overall sequence similarity with that from its closest IP10 gene whose production is also affected by gamma interferon. However, there are regions including a sequence with similarity to the NFxB binding site, AP-1 binding site, and ISRE. The r-RF-1 binding site is well conserved from -204 to -194 from the transcription start site in the Mig gene. Given the importance of IFN-r for effective immunity in tuberculosis and induction of Mig and IP10 genes in macrophages by IFN-r, we demonstrated induction of the genes Mig and IP10 with different message levels in the THP-1 human monocytic cell lines stimulated with whole M. tuberculosis. Despite the very similarity in genomic organization and the overlap in biological activities between MIG and IP10, our data described herein further support the suggestion that these chemokines rnay role nonredundantly in vivo. Moreover, our studies done on the Mig gene should provide the structural framework for future studies and begin to dissect cis-acting DNA sequences that are critical for gene regulation mediated by cell surface receptors."
Base Sequence ; Binding Sites ; Cell Line ; Chemokine CXCL9* ; Chemokines ; Codon ; Cytokines ; Gene Duplication ; Genome ; Humans* ; Interferons ; Introns ; Macrophages ; Methionine ; Open Reading Frames ; Transcription Factor AP-1 ; Transcription Initiation Site ; Tuberculosis