BACKGROUND: Fibrostenosis of large airway due to tuberculosis is one of the most perplexing clinical problems not only because it can lead to respiratory failure but also because of difficulty in the management. No one technique, such as balloon dilatation or insertion of self expandable metallic steno, has proved totally satisfactory in the management of fibrostenosis. We evaluated the effect of laser therapy in patient with severe fibrostenosis due to tuberculosis. METHOD: We classified the fibrostenosis to three types by bronchoscopic finding - the diaphragm type: stenosed by fibrous diaphragm, sparing the tracheobronchial wall, the collapse type: stenosed by collapse of the wall due. to destruction of the cartilage, and the combined type: stenosed by nonspecific inflammatory scar tissue within internal lumen with collapse of the wall. We have treated 10 patients complaining dyspnea due to with severe fibrostenosis of the diaphargm or the combined type using a neodymiumyttrium aluminum garnet(Nd-YAG) laser through a flexible bronchoscopy. RESULTS: Eight of the 10 cases improved after laser therapy and maintained during a follow up period of average 31.9 months. All of the cases undergoing laser therapy showed no serious complication to need the therapy. CONCLUSION: The results of our present study indicate that the Nd-YAG laser therapy is an effective and safe method for the management of selective tuberculous fibrostenosis.
Aluminum ; Bronchoscopy ; Cartilage ; Cicatrix ; Diaphragm ; Dilatation ; Dyspnea ; Follow-Up Studies ; Humans ; Laser Therapy ; Lasers, Solid-State* ; Respiratory Insufficiency ; Tuberculosis

No abstract available.
Bronchiectasis*

Glutathione (GSH) is a well-known antioxidative cellular component which is ubiquitous in nature. Several enzymes involved in GSH metabolism and recycling have been found to play important roles in detoxification of xenobiotics and free radicals. In this study, total GSH content, activity of GSH peroxidase and GSH reductase were measured in liver and kidney of cisplatin treated rats. Total GSH content (mM/g protein) of liver was higher in cisplatin treated rats (1.51±0.28) than of nontreated control (0.95±0.28), and in kidney, it was also higher in cisplatin treated rats (0.87±0.20) than that of control (0.68±0.14). The activity of GSH peroxidase (µM/mg protein/min) was lower in liver of cisplatin treated rats (348.0±18.54) than that of control (415.5±53.15), in kidney it was increase din cisplatin treated rats (380.5±51.86) compared to control (327.3±20.36). The activity of GSH reductase (µM/mg protein/min) was higher in liver of cisplatin treated rats (3.09±0.88) than that of control (2.28±0.61), in kidney it was also higher in cisplatin treated rats (8.50±2.62) than that of control (3.30±1.10). In summary, detoxification of ciplatin was revealed lesser effect in kidney as show increasion of GSH peroxidase and reductase and detoxification of cisplatin was expressed effectively in liver by increasing of GSH content and decreasing GSH peroxidase.
Animals ; Cisplatin* ; Free Radicals ; Glutathione* ; Kidney* ; Liver* ; Metabolism* ; Oxidoreductases ; Peroxidase ; Rats* ; Recycling ; Xenobiotics

Glutathione(GSH) has a very important role in detoxification of cells and is closely related to antitumor drug-resistance of cancer cells. In order to evaluate the importance of glutathione metabolism in the drug-resistant cancer cells, the concentration of celluar GSH and activities of y-glutamylcysteine synthetase(GCS), y-glutamyl transpeptidase (GGT) and glutathione S-transferases(GST) in the adriamycin, vincristine, or cisplatin resistant L1210 (L1210AdR; L1210VcR, or L12100s) sublines were measured. Expression and amplification of GCS, GGT, and GST-i7 genes were also observed in the parent L1210 and the drug-resistant L1210 sublines. The concentration of GSH was increased 5.34 fold in L12100s, 2.83 fold in L1210VcR, and 1.78 fo-d in L1210AdR, compared to L1210. The activities of GCS and GGT were -increased in drug-resistant L1210 sublines. The GST activity was increased in L1210VcR and L1210Cis but decreased in L1210AdR compared to L1210. Expression of GCS, GGT, and GST-rr genes were increased in the resistant L1210 sublines compare to the parent L1210 in northern blot analyses. Overexpression of GCS, GGT, and GST-77 were observed in the resistant sublines, and the increases of the concentration of glutathione and the activities of GCS and GGT in the resistant sublines may be involved in a part of the drug-resistance in the resistant sublines.
Blotting, Northern ; Cisplatin ; Doxorubicin ; Drug Resistance ; Glutathione* ; Humans ; Metabolism* ; Parents ; Vincristine

No abstract available.
Anterior Cruciate Ligament* ; Patellar Ligament*

Painful stiff shoulder after trauma may be one of the difficult situation. Incomplete brachial plexus palsy may cause painful stiff shoulder. Symptoms and signs of this entity are vague. It is not rare to miss detecting subtle damage of the brachial plexus. We analysed these cases to identify specific clues on history and physical examination that help making the diagnosis of this entity. We have experienced 14 cases of incomplete brachial plexus palsy that showed painful stiff shoulder in Asan Medical Center from March 1995 to February 1996. All the charts and letters from primary care hospitals were reviewed. Initial diagnosis of the primary hospital, duration of delay of diagnosis after initial trauma, clues for the diagnosis in history and physical findings, patterns of the nerve injuries were analyzed. Average age was 48 years (from 25 to 84). Nine cases were male, and five cases were female. The most common primary diagnosis was proximal humerus fracture. Delayed diagnosis was the most remarkable feature. Average duration of delayed diagnosis was about three months (from one to thirteen months). Tentative diagnosis was made on the base of history and physical examination. The most frequent clue on the history was long standing painful stiff shoulder inappropriate to the initial diagnosis. The most common physical finding was tenderness at the brachial plexus area. Definite diagnosis was confirmed with electromyography. Careful history taking and thorough physical examination are essential for every shoulder injury. Incomplete brachial plexus palsy is one of the cause of painful stiff shoulder. It is important to keep in mind this entity to arrive correct diagnosis. Eletromyography should be done for the suspected cases.
Brachial Plexus ; Chungcheongnam-do ; Delayed Diagnosis ; Diagnosis ; Electromyography ; Female ; Humans ; Humerus ; Male ; Paralysis* ; Physical Examination ; Primary Health Care ; Shoulder*

Injuries and pains of musculoskeletal joint in human body is common onset in industrialized world. However, muscle fatigue plays a very significant role in contributing causes of many pains associated with musculoskeletal joints. Based on this hypothesis, degree of muscle fatigue was investigated using electromyography measurement technique during isometric and concentric/eccentric muscle contractions. Different response of the muscle fatigue between two different muscle contractions (isometric and concentric/eccentric contractions) was examined by comparison of parameters which were median frequency, median power and RMS value. Healthy 16 young persons without previous musculoskeletal diesease history were tested with Noraxon Myosystem 2000 EMG measurement system. In this study, two different exercises were performed. First exercise was concentric/eccentric exercise. Second exercise was isometric muscle contraction. In the case of the isometric exercise, median frequency was decreased, but median power and RMS were increased. However, during the concentric/eccentric exercse, median frequency was increased, but median power and RMS were decreased. Both of those revealed that the pattern of the median frequency was W type, but median power and RMS were M type as time passed. In this study, the patterns of the muscle fatigue during concentric/eccentric exercise as well as isometric exercise were identified. It will be helpful to prevent musculoskeletal injury from over-working andexercising.
Electromyography* ; Exercise ; Human Body ; Humans ; Joints ; Muscle Contraction ; Muscle Fatigue*

Three cases of fatigue fracture were experienced, whose tibia, fibula and femoral neck had been involved. The mechanism of fracture was explained as the result of repeatation of uncustomed stress mainly in lower extremities. Several authors suggested many types of predisposing factors, such as spastic flat foot, short first metatarsal bone and osteoporosis after steroid administration. Two of the cases were treated conservatively and one case with femoral neck fracture treated by open reduction and Sith-Peterson nailing.
Causality ; Femoral Neck Fractures ; Femur Neck ; Fibula ; Flatfoot ; Fractures, Stress ; Lower Extremity ; Metatarsal Bones ; Muscle Spasticity ; Osteoporosis ; Tibia

Although several kinds of instrumentation systems are available for the transpedicular screw fixation in the treatment of spondylolisthesis, the clinical results and the difference between them remdins unclear. In order to study the feasibility of Zielke instrumentation system for that purpose, the author analysed the clinical results of 73 patients with mild or moderate degree of spondylolisthesis who were instrumented with the systems and followed up 25 months in average(Min. 12Ms). The results between the groups with different rod thickness in the system, 3.2mm(20 patients), 4mm(33 patients) and 5mm(20 patients), were compared to study the most appropriate thickness. Reduction of the deformity were done by aid of temporarilly applied Harrington system in 3.2mm group. Inlayed reduction potential coming from the jointing mechanism was utilized in the cases with less than 30% of slippage in 4 and 5mm group. Percentage of slippage was changed from 20% preoperatively, to 4% postoperatively and 6% at the end of follow up. The methods of fusion after reduction and fixation were anterior in 25 and posterolateral in 48. Bony fusion was achieved in all but one with pathological spondylolisthesis. Rod failures were observed in two of 3.2mm and one of 4mm group, and loosening of the joint were developed in three of 5mm group. Clinically, 93% of the patient showed excellent and good results at the end of follow up. From the results, we concluded that the instrumentation is a efficient method of treatment with several advantages in the reduction capacity and the stability of fixation. However, this system has several points in its mechanics that needs to be improved.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Joints ; Mechanics ; Methods ; Spondylolisthesis

To study the relationship between the bone mineral density measured by DEXA and QCT methods and to study the factors influencing on the value, bone mineral density in 208 patients with low back pain were measured by the two methods and compared statistically. Ages were varied between 17 to 79(Av. 46.7) years and male and female were 86 and 122. The results of this are as follows; 1. The values of DEXA and QCT showed statistically significant relationship(γ=0.58) as a whole. And bone mineral density in L2, L3 and L4 showed no difference in both groups. 2. Bone loss by aging(per year) in male and female was 0.99% and 1.06% by DEXA, 0,99% and 1.41% by QCT. 3. Body height and weight showed no significant influence of the value in two methods. 4. In body mass index over 27.5, the value measured by QCT was influenced to be diminished while that of DEXA was not influenced. 5. The value by QCT was influenced to be diminished by the increase of age especially over 50 years old in both sex. While the value by DEXA was influenced to be lowered than expected in female over 50 years old. It is concluded that the methods of measurement of bone mineral density have their limitation depend on the age, sex and mass index.
Body Height ; Body Mass Index ; Bone Density ; Female ; Humans ; Low Back Pain ; Male ; Spine