In open wounds of the hand that have exposed bone or tendons, management may be difficult. Compared with conventional cutaneous pedicle flaps, the fascial radial flap transfer has several advantages : (1) one operation is required by one operating team reliably and easy to perform, (2) the appearance is not bulky, (3) the donor area is closed primarily, and (4) the hand is free for early motion of the shoulder and the elbow. One potential disadvantage is the permanent loss of the contribution of the radial artery to the circulation of the hand. One case of the fascial radial flap transfer was performed at the Department of Orthopaedic Surgery of Hanyang University Hospital, and satisfactory result was obtained.
Elbow ; Hand ; Humans ; Radial Artery ; Shoulder ; Tendons ; Tissue Donors ; Wounds and Injuries

No abstract available.
Pregnancy*

No abstract available.
Broad Ligament* ; Female ; Hemorrhage* ; Pregnancy*

Takayasu's arteritis is briefly as an inflammatory process of unknown etiology occuring dominantly in young female most commonly involving the great vessels arising from the aortic arch. The disease process results in stenosis and obliteration of involved vessels. Syncope in Takayasu's arteritis is known to result from decreased blood flow to brain because of stenosing blood vessels. We herein describe a case of paroxysmal atrioventricular block in a 40-year old man with Takayasu's arteritis. The patient presented with spontaneous recurrent syncope associated with paroxysmal AV block. Carotid sinus pressure repeatedly induced paroxysmal AV block and syncope. Carotid sinus pressure after pretreatment of atropine failed to induce AV block or syncope. Coronary angiogram was normal. We concluded that syncope in this patients was attributed to carotid hypersensitivity rather than decreased blood flow to the brain due to vessel stenosis.
Adult ; Aorta, Thoracic ; Atrioventricular Block* ; Atropine ; Blood Vessels ; Brain ; Carotid Sinus ; Constriction, Pathologic ; Female ; Humans ; Hypersensitivity ; Syncope ; Takayasu Arteritis*

We investigated the effect of alpha-adrenergic and cholinergic receptor agonists on Ca2+ current in adult rat trigeminal ganglion neurons using whole-cell patch clamp methods. The application of acetylcholine, carbachol, and oxotremorine (50 muM each) produced a rapid and reversible reduction of the Ca2+ current by 17+/-6%, 19+/-3% and 18+/-4%, respectively. Atropine, a muscarinic antagonist, blocked carbachol-induced Ca2+ current inhibition to 3 +/- 1%. Norepinephrine (50 muM) reduced Ca2+ current by 18 +/- 2%, while clonidine (50 muM), an alpha2-adrenergic receptor agonist, inhibited Ca2+ current by only 4 +/- 1%. Yohimbine, an alpha2-adrenergic receptor antagonist, did not block the inhibitory effect of norepinephrine on Ca2+ current, whereas prazosin, an alpha1-adrenergic receptor antagonist, attenuated the inhibitory effect of norepinephrine on Ca2+ current to 6 +/- 1%. This pharmacology contrasts with alpha2-adrenergic receptor modulation of Ca2+ channels in rat sympathetic neurons, which is sensitive to clonidine and blocked by yohimbine. Our data suggest that the modulation of voltage dependent Ca2+ channel by norepinephrine is mediated via an alpha1-adrenergic receptor. Pretreatment with pertussis toxin (250 ng/ml) for 16 h greatly reduced norepinephrine- and carbachol-induced Ca2+ current inhibition from 17 +/- 3% and 18 +/- 3% to 2 +/- 1% and 2 +/- 1%, respectively. These results demonstrate that norepinephrine, through an alpha1-adrenergic receptor, and carbachol, through a muscarinic receptor, inhibit Ca2+ currents in adult rat trigeminal ganglion neurons via pertussis toxin sensitive GTP-binding proteins.
Acetylcholine ; Adult ; Animals ; Atropine ; Carbachol ; Clonidine ; GTP-Binding Proteins ; Humans ; Neurons ; Norepinephrine ; Oxotremorine ; Pertussis Toxin ; Pharmacology ; Prazosin ; Rats ; Receptors, Muscarinic ; Trigeminal Ganglion ; Yohimbine

No abstract available.
Renal Insufficiency*

BACKGROUND: Handgrip and cold pressor test may increase the afterload of the heart. And in left ventricular hypertrophy, it is known that mitral flow pattern is affected by decreased left ventricular compliance. We investigated the effects of handgrip and cold pressor test on mitral flow pattern in patients with left ventricular hypertrophy. METHODS: Handgrip and cold pressor test were performed in 12 subjects with left ventricular hypertrophy and in 14 healthy normal subjects. In supine position, blood pressure, heart rate and Doppler echocardiographic parameters(early peak flow velocity : E, atrial peak flow velocity : A) were obtained at rest, 1 and 3 minutes after the onset of tests respectively. RESULTS: In both groups, handgrip and cold pressor test increased blood pressure slightly without a statistical significance. In left ventricular hypertrophy group, there were significant increments in heart rates at 1 minute of handgrip (78+/-12min-1, p<0.001) and cold pressor test(77+/-7min-1, p<0.05) as compared to that at rest (73+/-12min-1). Mitral flow velocities did not show significant change after the tests in control group. A waves after 1 minute of handgrip(85.2+/-18.4cm/sec, p<0.05) and cold pressor test (87.3+/-17.8cm/sec, p<0.001) showed significant increases as compared to that at rest (79.1+/-14.9cm/sec) in left ventricular hypertrophy group whereas E waves did not. CONCLUSION: Although handgrip and cold pressor tests did not affect the mitral flow significantly in control group, each test raised A waves in left ventricular hypertrophy group. These results suggest that increased A waves may be due to a rise in afterload and decreased left ventricular compliance caused by handgrip and cold pressor test in left ventricular hypertrophy group.
Blood Pressure ; Compliance ; Echocardiography ; Heart ; Heart Rate ; Humans ; Hypertrophy, Left Ventricular* ; Supine Position

OBJECTIVE: To evaluate the effects of estrogen replacement therapy and pamidronate on the bone metabolism in the postmenopausal women. METHODS: This prospective randomized clinical trial examined the effects of oral pamidronate and conjugated equine estrogen, in combination and seperately, on biochemical markers of bone turnover in 140 women with low bone mass. Treatment included pamidronate (group I, n=50), or conjugated equine estrogen (group II, n=50), conjugated equine estrogen plus alendronate (group III, n=40) for 12 months. Biochemical markers of bone turnover were also measured at months 6 and 12 months. RESULTS: Serum osteocalcin and urinary deoxypyridinoline in Group I, Group II and Group III decreased signifiantly at 12 months of treatment (p<0.05). But total alkaline phosphatase decreased significantly during the treatment in Group III, but not in Group I and Group II. CONCLUSION: The combined treatment with pamidronate and conjugated equine estrogen is more effective in postmenopausal women with osteoporosis by decreasing bone biochemical markers.
Alendronate ; Alkaline Phosphatase ; Biomarkers ; Estrogen Replacement Therapy* ; Estrogens* ; Female ; Humans ; Metabolism* ; Osteocalcin ; Osteoporosis ; Postmenopause ; Prospective Studies

Thallium-201 brain SPECT is utilized in the diagnosis of brain tumor especially in cases where CT or MRI findings alone cannot differentiate malignant lesion from benign. Recently we came across two cases of positive T1-201 brain SPECT in clinically suspected brain tumor patients that turned out to be hemorrhagic cerebral infarction instead on biopsy. The findings in these cases demonstrate that thallium-201 accumulation may occur by the breakdown of the blood-brain barrier and phagocytic cell infiltration in the liquefaction stage of infarction.
Biopsy ; Blood-Brain Barrier ; Brain ; Brain Neoplasms ; Cerebral Infarction* ; Diagnosis ; Humans ; Infarction ; Magnetic Resonance Imaging ; Phagocytes ; Tomography, Emission-Computed, Single-Photon

No abstract available.
Humans ; Pregnancy, Twin* ; Twins*