BACKGROUND: Experimental data indicate that low-flow reperfusion following prolonged cardiocirculatory arrest may aggravate early cerebral microcirculatory repefusion disorders. We investigated the influence of cerebral repefusion flow change to the ischemic histopathologic damage of brain tissue after incomplete forebrain ischemia in rats. MATERIALS AND METHOD: Anesthetized Sprague-Dawley rats were undergone ligation of both infernal carotid artery by microvascular clamp for 10 minutes. After release of the clamp, reperfusion was started with several different flow levels (0, 10, 20, 30, 50, and 100%) of infernal carotid artery comparing to pre-clamping phase using flowmeter. After 15minutes of reperfusion, rat brains were prepared by perfusion-fixation with 3% formaldehyde. Under light microscopic examination of Hematoxylin-Eosin stained tissue slide, histopathologic damage was examined at cortex, putamen, and hippocampus regions. Categorical hisotopathologic damage scores were derived in each regions by manual counts of ischemic neurons. RESULT: The histopathologic damage scores were 0, 10. 2+/-0.5, 7.6+/-1.5, 5.9+/-1.4, 5.0+/- 2.8, 3.5+/-0.7, and 1.0+/-0.0 in control, 0, 10, 20, 30, 50, and 100% reperfusion groups, respectively(p<0.05). CONCLUSION: Our insults showed significant increment of brain histopathologic damage scores along with decreasing amount of cerebral reperfusion know after incomplete forebrain ischemia. We believe restoration of repefusion flow to pre-ischemic level would be a critical component in attenuation of brain ischemic damage.
Animals ; Brain ; Carotid Arteries ; Flowmeters ; Formaldehyde ; Hippocampus ; Ischemia* ; Ligation ; Models, Animal* ; Neurons ; Prosencephalon* ; Putamen ; Rats* ; Rats, Sprague-Dawley ; Reperfusion*

BACKGROUND: Rapid and accurate identification of methicillin-resistant Staphylococcus (MRSA) is very important for patients because they are one of the most common etiologic agents of hospital infection. Conventional identification methods for MRSA are influenced by various factors such as pH, concentration of salt, conditions of media. METHODS: 53 methicillin resistant staphylococcus strains identified by ATB plus system (Biomerieux, France) were preformed the polymerase chain reaction (PCR), Southern blot hybridization fort the detection of mec A gene, and subcultured in Meuller-Hinton media containing 4 microgram/mL oxacillin for the comparison. RESULTS: The correlation of detection rate of mec A gene PCR and ATB plus systems was 81.6%. The correlation of mec A gene PCR and MRSA on Mueller-Hinton media containing 4 microgram/mL oxacillin was 80%. We confirmed by Southern blot hybridization the amplified mer A gene originated from chromosome of MRSA. As the results of oxacillin sensitivity test, minimal inhibitory concentrations of MRSA were distributed between 40 microgram/mL and 320 microgram/mL. When compared with executing time, ATB plus system took 24 hours, but PCR took 5 hours for identification. CONCLUSION: We concluded that mec A gone PCR techniques were simple and rapid for detection of MRSA comparative to conventional methods.
Blotting, Southern ; Cross Infection ; Genes, vif ; Humans ; Hydrogen-Ion Concentration ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Oxacillin ; Polymerase Chain Reaction* ; Staphylococcus

BACKGROUND: The dose-responses of neuromuscular blocking agents may be influenced by many factors including age and inhalation anesthetics. This study was designed to determine the dose-response relationships of a new, short-acting muscle relaxant, mivacurium during nitrous oxide-halothane or nitrous oxide-enflurane anesthesia in two age groups, infants and 1 to 6 years old preschool children. METHODS: Neuromuscular blockade was monitored by recording the accelerographic activity of the adductor pollicis muscle resulting from supramaximal stimulation at the ulnar nerve at 2 Hz for 2 seconds at 10-second intervals. To estimate dose-response relationships, 24 infants or children of two anesthetic subgroups for each age group received single bolus doses of 45~100 g/kg of mivacurium. The ED50 and ED95 were estimated from linear regression plots of log-dose vs probit of twitch depression. The lag time, onset time and maximal depression of twitch height for the selective medium dose were mesured. RESULTS: The ED50 and ED95 for the infants group were 38.2 and 53.3 g/kg during halothane anesthesia, and 29.8 and 48.6 g/kg during enflurane anesthesia, respectively. And, those for preschool children group were 49.4 and 90.7 g/kg during halothane anesthesia, and 32.3 and 81.4 g/kg during enflurane anesthesia, respectively. There was a parallelism of the dose-response curve between halothane and enflurane anesthesia in either age group. Also, there was statistically significant difference in the maximal twitch depression for the selective medium dose of mivacurium between halothane and enflurane anesthesia in either group. CONCLUSIONS: The potency of mivacurium during enflurane anesthesia is higher than that during halothane anesthesia in infants and preschool children, and during either inhalation anesthesia the dose of mivacurium is less required in infants than preschool children.
Anesthesia* ; Anesthesia, Inhalation ; Anesthetics, Inhalation ; Child ; Child, Preschool* ; Depression ; Enflurane* ; Halothane* ; Humans ; Infant* ; Linear Models ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Ulnar Nerve

We experienced a case of primary hepatic actinomycosis which was initially diagnosed by means of fine needle aspiration. The patient was a 31-year-old emaciated man with a 2-month history of 10 kg weight loss, right upper quadrant pain and flank pain. The liver was palpable and tender on physical examination. Computerized tomography scan of the liver showed two ill-defined hypodense masses in gallbladder fossa and inferior pole of right lobe. Hepatocellular carcinoma was clinically suspected. A CT-guided fine needle aspiration was performed. Microscopically, smears showed numerous radiating clusters of filamentous bacteria with many neutrophils and monocytes in necrotic background. The symptoms were improved by incision and drainage and massive administration of penicillin.
Actinomycosis ; Adult ; Bacteria ; Biopsy, Fine-Needle ; Breast ; Carcinoma, Hepatocellular ; Diverticulum* ; Drainage ; Fibroadenoma ; Flank Pain ; Gallbladder ; Humans ; Infarction ; Liver ; Monocytes ; Neutrophils ; Penicillins ; Physical Examination ; Vesico-Ureteral Reflux* ; Weight Loss

BACKGROUND AND OBJECTIVES: Herpes zoster(HZ) is a well known viral infection of the nervous system. HZ is associated with the neurologic complication. It may have been expected a change in the cerebrospinal fluid(CSF) of patients with HZ. The purpose of this paper is to present the correlation between CSF findings and neurologic complications in HZ. METHOD: The patients(n=75) with HZ were 31 male and 26 females, who were ranged in age from 15 to 79years(mean 53.4 years) admitted to department of Neurology of Chung Ang Gil General Hospital from June 1992 to May 1995. The patients were evaluated for the etiology, lesion distribution, and complications. CSF study was performed in 32 patients(male/female=20/12), whose age ranged from 16 to 79 years(means 51years) during 5 days to 10days after initial symptom onset. CSF findings were analyzed for their etiology, lesion distribution and complication. RESULTS: The CSF of 25 patients(78.1%) showed pleocytosis(5 to 49/mm3 in 10 patients, means, 62.1/mm3). 7 patients(12.3%) had meningitis symptoms, whose cell counts of CSF were more than 50/mm3(means 128.4/mm3) postherapeutic neuralgia was more common in elder patient than younger patients(p=0.005). Complications tended to correlate with the cell counts of CSF. There was no difference in CSF finding between cranial segmental involvements. CONCLUSION: We confirmed the pleocytosis in CSF of patients with HZ and suggest the development of complications in patients in patients with HZ tend to correlate with the cell counts of CSF.
Cell Count ; Female ; Herpes Zoster* ; Hospitals, General ; Humans ; Leukocytosis ; Male ; Meningitis ; Nervous System ; Neuralgia ; Neurology

BACKGROUND AND OBJECTIVES: Herpes zoster(HZ) is a well known viral infection of the nervous system. HZ is associated with the neurologic complication. It may have been expected a change in the cerebrospinal fluid(CSF) of patients with HZ. The purpose of this paper is to present the correlation between CSF findings and neurologic complications in HZ. METHOD: The patients(n=75) with HZ were 31 male and 26 females, who were ranged in age from 15 to 79years(mean 53.4 years) admitted to department of Neurology of Chung Ang Gil General Hospital from June 1992 to May 1995. The patients were evaluated for the etiology, lesion distribution, and complications. CSF study was performed in 32 patients(male/female=20/12), whose age ranged from 16 to 79 years(means 51years) during 5 days to 10days after initial symptom onset. CSF findings were analyzed for their etiology, lesion distribution and complication. RESULTS: The CSF of 25 patients(78.1%) showed pleocytosis(5 to 49/mm3 in 10 patients, means, 62.1/mm3). 7 patients(12.3%) had meningitis symptoms, whose cell counts of CSF were more than 50/mm3(means 128.4/mm3) postherapeutic neuralgia was more common in elder patient than younger patients(p=0.005). Complications tended to correlate with the cell counts of CSF. There was no difference in CSF finding between cranial segmental involvements. CONCLUSION: We confirmed the pleocytosis in CSF of patients with HZ and suggest the development of complications in patients in patients with HZ tend to correlate with the cell counts of CSF.
Cell Count ; Female ; Herpes Zoster* ; Hospitals, General ; Humans ; Leukocytosis ; Male ; Meningitis ; Nervous System ; Neuralgia ; Neurology

161 patients with tibia fracture were treated by closed intramedullary nailing at the department of Orthopedic Surgery, Eul-Ji General hospital, Dae Jeon, during 5 years from January, 1988 to April, 1993. 134 of these patients were performed with Kiintscher IM nailing and 27 patients with Ender nailing. Rigid IM nailing is the method of choice in tibia shaft fracture with rigid fixation, low complication, wide indication and early weight bearing, but the treatment of segmental fracture of the tibia will have many difficulties because of severe displacement, severe comminution, massive soft tissue damage and lack of blood supply at fracture site. Either antegrade or retrograde Ender nailing was of value for the management of segmental fracture which was too proximally or too dixtally located to insert interlocking screws, open fracture and soft tissue injury around Kiintscher insertion site. The result as fllows; 1. 43 fractures were open and 118 were closed. 69 fractures involved the distal portion, 55 fractures the middle portion, 13 fractures the proximal portion of the tibia and 24 fractures were segmental. 2. Among the 161 eases, 114 cases were male and 47 cases were female, the most common ages were ranged from 21 year to 30 year, involving 44 cases. 3. The most common cause was traffic accident. 4. Average intervals from injury to operation were 6.34 days(closed fracture) and 9.84 days(open fracture). 5. The mean durations of the bone union were 18.90 weeks(closed fracture) and 16.46 weeks(open fracture). 6. Complication included 7 cases delayed union, 3 cases nonunion, 8 cases superficial infection, 4 cases joint stiffness, 3 cases nail migration, 2 cases angular deformity, 2 cases rotational deformity, 1 cases osteomyelitis.
Accidents, Traffic ; Congenital Abnormalities ; Daejeon ; Female ; Fracture Fixation, Intramedullary ; Fractures, Open ; Hospitals, General ; Humans ; Joints ; Male ; Methods ; Orthopedics ; Osteomyelitis ; Soft Tissue Injuries ; Tibia ; Weight-Bearing

No abstract available.
Constriction, Pathologic* ; Neurologic Manifestations* ; Spinal Canal*

The loss of penile skin, either traumatic or iatrogenic, is sometimes difficult to treat. Especially, treatment of the penile foreign body granuloma is very difficult. Surgical treatment of penile skin defect are a skin graft, flap-to-graft conversion method, and various scrotal flap. But these have many problems such as wound disruption, skin necrosis, skin contracture, and hypertrophic scar. We present our technique for penile resurfacing using apronlike scrotal flap and groin flap. Apron-like scrotal flap has several advantages: one stage operation, short operation time, avoidance of dorsal scar and flap necrosis, maintenance of erectile capacity. Also we think that groin flap is a proper method for the patients who suffer from a large penile skin defect and whose scrotal skin is not available. We did the research in patients with the penile foreign body granuloma who were used the techniques of groin flap and apron like scrotal flap in the operation from March 2000 to February 2002. All the 15 cases showed excellent outcome. Especially, apron like scrotal flap was very beneficial in patients whose scrotal skin was available.
Cicatrix ; Cicatrix, Hypertrophic ; Contracture ; Foreign Bodies* ; Granuloma, Foreign-Body* ; Groin ; Humans ; Necrosis ; Skin ; Transplants ; Wounds and Injuries

BACKGROUND: Mitral regurgitation is a valvular heart disease that produce complex hemodynamic alternations and myocardial dysfunction occurs subclinically, so result in a high incidence of left ventricular dysfunction that might affect postoperative result. In order to assess preoperative factors affecting the outcome of mitral valve replacement in patients with chronic mitral regurgitaion, we evaluated prognostic factors from preoperative clinical, laboratory, and echocardiographic findings in 71 patients with chronic mitral regurgitation who received mitral valve replacement. METHODS: From 1985 to 1994, 71 patients with chronic mitral regurgitation, who received mitral valve replacement, were included in this study. The patients were defined as group I who had improved symptom and / or decreased left ventricular end-diastolic dimension after operation, and group II who had persistent symptom and / or over 60mm of left ventricular end-diastolic dimension after operation. RESULTS: 1) In clinical findings, preoperative systolic blood pressure was higher in Group I patients(p<0.05). 2) Hemoglobin, serum creatinine, and blood urea nitrogen level were not significantly different in both groups. 3) In echocardigraphic findings, left atrial dimension, left ventricular end-systolic / end-diastolic dimension, and left ventricular volume index of Group II were much higher than those of Group I patients(p<0.05). 4) In the discriminant analysis, left ventricular end-diastolic dimension, age, NYHA functional class, and left ventricular mass index were defined as important prognostic factors. CONCLUSION: According to the above results, preoperative age, NYHA functional class are significant prognostic factors in clinical and laboratory findings. And left atrial dimension, left ventricular end-systolic and end-diastolic dimensions, left ventricular volume index, and left ventricular mass index are significant prognostic factors in echocardiographic findings.
Blood Pressure ; Blood Urea Nitrogen ; Creatinine ; Echocardiography ; Heart Valve Diseases ; Hemodynamics ; Humans ; Incidence ; Mitral Valve Insufficiency* ; Mitral Valve* ; Ventricular Dysfunction, Left