No abstract available.
Bronchiolitis ; Epidemiology ; Pneumonia ; Respiratory Syncytial Viruses

This treatise summarizes the medical facts about the persistent vegetative state(PVS) and the associated issues. In August 1998, the opinions of the 380 neurologists and the 1007 neurosurgeons are inquired about the diagnostic criteria of PVS, the degree and the withdrawal of treatment on PVS patients. The response rate is 18.8%. The diagnostic criteria of PVS is determined by the items approved above 5007o of responses. (1) no evidence of cerebral function and an inability to interact with visual, auditory stimuli and follow commands. (2) maintaining the respiratory function with spontaneous respiration and normal respiratory pattern. (3) spontaneous eye opening and eye ball movements without sustained tracking. (4) variably preserved brain stem reflexes. (5) presence of sleep-wake cycles. (6) (1)-(5) symptoms should be persist for 6 months after the development of vegetative state. (7) the diagnostic criteria of PVS should be applied more than 3 times during the minimum observation period. (8) this diagnostic criteria of PVS could be applied to adults over 7 ages. As to the degree of treatment, nasogastric tube feeding and air-way keeping through the tracheostomy are approved over 9007b. Also antibiotics can be used in infection. As to the withdrawal of treatment, do not resuscitate order of patient s family is accepted by 46.1% in an emergency condition like cardiac arrest. But discharge against medical advice by the patient s family is accepted by 73.107o in non-emergency condition. In the case of neonates, parents decision is more determinative than any other thing.
Adult ; Anti-Bacterial Agents ; Brain Stem ; Emergencies ; Enteral Nutrition ; Heart Arrest ; Humans ; Infant, Newborn ; Korea* ; Parents ; Persistent Vegetative State* ; Reflex ; Respiration ; Tracheostomy

Sixteen patients who had radial head fractures were treated with open reduction and internal fixation using Herbert screws (10 patients), and with silastic prosthetic replacement (6 patients) from March, 1992 to December, 1994 in Chungnam National University hospital. The average duration of follow up was 19.5 months. The purpose of this study is to examine the role of Herbert screw fixation and silicone replacement arthroplasty and to asscess the clinical results of two groups functionally, radiologically in raidial head fractures. By functional rating index (modified After B.F. Morrey et al), the results were classified as excellent (9 patients), good (6 patients), fair (No patient) and poor (1 patient). Nine of the ten patients treated by open reduction and internal fixation using Herbert screws had resulted in excellent or good. All patients were inserted silastic implants were showed excellent or good results. Especially, in Mason Type III radial head fractures, three of four patients treated by Herbert screws and all 5 patients treated by silastic prosthesis were considered to excellent or good results. We concluded that Herbert screw fixation or silastic prosthetic replacement had satisfactorily appeared to be the alternative treatment option for Mason Type III radial head fractures.
Arthroplasty, Replacement ; Chungcheongnam-do ; Follow-Up Studies ; Head* ; Humans ; Prostheses and Implants ; Silicones

We assessed about growth hormone binding proteins (GHBP) activity which was measured eluted biotin GH fraction with alkaline phosphatase-streptavidine in children with insulin dependent diabetes mellitus (IDDM), short stature due to growth hormone deficiency (GHD), chronic renal failure, short stature due to nutritional deficiency. hypothyroidism and normal control groups using high pressure liquid chromatography protein pak 300 sw column. The following results are observed: 1) There were 3 types of growth hormone (GH) in serum: first GH binded with type I (minor) GHBP suggesting 200K dalton of molecular weight, second GH binded with type II (major) GHBP suggesting 60~70K dalton of molecular weight, and third GH were free form GH suggesting 20~25K dalton of molecular weight. 2) Type II (major) GHBP showed considerable individual variation in all ages. Neonates had the lowest levels of GHBP activity, but by the puberty the levels had increased & remained stable from adolescent to adult periods. 3) GHBP activity of children with IDDM at diagnosis was low value as compared to the same agenormal control group (p<0.05), and difference of GHBP activity among children with IDDM was related with height velocity (r=+0.92). Follow up GHBP activity during insulin therapy was reverse correlation with HbAlc. 4) GHBP activity of children with GHD at diagnosis was a slightly low compared to aged matched control and follow-up GHBP activity after 1 dose GH therapy showed increasing tendency (r=-0.68). 5) Otherwise, children with chronic renal failure, short stature due to nutritional deficiency, and hypothyroidism were assessed lower value than normal control group. Above results, GHBP activity had the lowest levels at neonatal period and then increasing tendency until puberty period and remained steady level until adult period. Regulation of GHBP may be closely related with metabolic control state by insulin, GH, nutritional status, and thyroid hormone..
Adolescent ; Adult ; Biotin ; Carrier Proteins ; Child ; Chromatography, Liquid ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Diagnosis ; Follow-Up Studies ; Growth Hormone ; Humans* ; Hypothyroidism ; Infant, Newborn ; Insulin ; Kidney Failure, Chronic ; Malnutrition ; Molecular Weight ; Nutritional Status ; Puberty ; Thyroid Gland

No abstract available.
Growth Plate*

No abstract available.
Extremities* ; Oximetry* ; Oxygen*

The increased knowledge of the cutaneous circulation of the body and refinements in surgical technique have provided the basis for the successful microvascular transfer of various muscle, skin and myocutaneous free flap. We have found the tensor fascia lata(TFL) inyocutaneous flap to be reliable one and its transfer as a free flap. The TFL myocutaneous free flap was first introduced by Hill et al in 1978 and our two cases report were first introduced in Korea. Two cases of microvascular TFL myocutaneous free flap transfer were performed at the department of Orthopaedic Surgery of Hanyang University Hospital and satisfactory result was obtained from the one of those.
Fascia Lata ; Fascia ; Free Tissue Flaps ; Korea ; Skin

PURPOSE: We measured pulmonary epithelial permeability by Tc-DTPA radioaerosol clearance in patients with diabetes and correlated with the presence of microangiopathy to understand the pathophysiology of pulmonary microangiopathy and evaluate Tc-DTPA radioaerosol clearance as a diagnostic test to assess pulmonary microangiopathy. MATERIALS AND METHODS: We performed ' Tc-DTPA radioaerosol scan in 10 normal subjects, 10 asym-ptomatic smokers, 20 diabetic patients without history of smoking (10 with microangiopathy, 10 without microangiopathy). Tc-DTPA clearance half-time (T1/2) was calculated, then compared with the result of chest radiography and pulmonary function test. RESULTS: Chest radiography and pulmonary function test were normal in all subjects. There were no significant difference of clinical or laboratory characteristics between these groups except age. The diabetic patients with micraangiopathy were significantly older (p<0.05). The T1/2of normal subjects and asyrnptomatic smokers were significantly different (65.2+23.7min vs 39.6+9.8min, p<0.05). For diabetic patients with microangiopathy, the T, was 90 5+46.5min and significantly delayed when compared with those of normals and asymptomatic smokers (p<0.05). However, the T1/2of diabetic patients without microangiopathy, 70.0+12.7 min, was not significantly different from those of normals or asyrnptomatic smokers (p>0.05). No significant correlation was found between the T1/2and spirometric parameters including DLcc>, FVC, FEV>, FEV(/FVC (%) and FEF)5-75g in all subjects, and between the T1/2 and duration of diabetes in diabetic patients. CONCLUSION: Eventhough the influence of age cant be excluded, delayed Tc-DTPA clearance half-time (T1/2)in diabetic patients with microangiopathy indicates decreased pulmonary cspillary permeability as one of the pathophysiologic results of pulmonary microangiopaththy. Further studies are needed in larger number of age matched control and diabetic patients to evaluate the diagnostic efficacy.
Diabetes Mellitus ; Diagnostic Tests, Routine ; Humans ; Permeability ; Radiography ; Respiratory Function Tests ; Smoke ; Smoking ; Technetium Tc 99m Pentetate ; Thorax

No abstract available.
Emergencies* ; Emergency Service, Hospital*

BACKGROUND: Atopic asthma is characterized by activation of Th2-type T cells in the bronchial mucosa. Several reports have suggested an important role for costimulation through the CD28/CTLA4 (cytotoxic T lymphocyte-associated antigen 4)-B7 (CD80/CD86) pathway in allergen activation of T cells in animal models of allergen-induced asthma, because B7-CD28/ CTLA4 interaction can promote the differentiation and development of the Th2 lymphocyte subset. OBJECTIVE: In the present study, we intended to investigate a potential role of humanized CTLA4-Ig on the inhibition of T and B cell activation by blocking B7/CD28 interactions. METHOD: For this purpose we produced humanized CTLA4-Ig fusion protein by transfection to CHO cell and examined its inhibitory effects for activated T and B cell responses. We evaluated the inhibitory effect of MLR (mixed lymphocyte reaction) and con A-stimulated T cell proliferation. And we assayed wheather B cell was inhibited by stimulation of costimulatory signal in LPS-induced B cell response and PFC assay. RESULT: In vitro assay, humanized CTLA4-Ig fusion protein inhibited T cell-specific immune response in dose-dependent manner: CTLA4-Ig inhibited allogeneic stimulation in murine MLR, and the proliferation of T cell by the stimulation of Con A. But CTLA4-Ig did not inhibit directly the proliferative response of B cell by the stimulation of LPS. In addition, in vivo assay, CTLA4-Ig inhibited the production of antibody from B cell, which was presented by plaque-forming cell (PFC) assay. CONCLUSION: These findings suggest that humanized CTLA4-Ig is effective to inhibit the proliferation of activated T cell directly by blocking B7/CD28 costimulation. And humanized CTLA4-Ig influences antibody-producing capacity of B cell indirectly by regulating T cell.
Abatacept ; Animals ; Antibody Formation* ; Asthma ; Cell Proliferation ; CHO Cells ; Cricetinae ; Humans ; Lymphocyte Subsets ; Lymphocytes ; Models, Animal ; Mucous Membrane ; T-Lymphocytes ; Transfection