A retrospective clinical study was done on 78 cases of acute myocardial infarction admitted to Jeonje Presbyterian Medical Center from Jenuary 1972 to June 1982. The following results had been obtained. 1) The ratio of male to female patients with acute myocardial infarction was 3.9:1. Most patients were in the age group between the 6th and 7th decade(64%). 2) The number of patients admitted annually was about 8, and was increased 2.5 folds in the latter 5 years as compared with the first 5 years. 3) The most common past illnesses of patients with acute myocardial infarction were coronary insufficiency with angina pectoris, hypertension, previous myocardial infarction, diabetes mellitus, valvular heart disease and hyperthyroidism in order named. The patients without significant past illness amount to 41.0%. 4) Among the patients with acute myocardial infarction smokers were 1.9 times as many as non-smokers. 5) The chief complaints of the patients with acute myocardial infarction on admission were chest pain(60.3%), dyspnea(26.9%) and mental change(6.4%). 6) The distribution of the patients withacute myocardial infarction by Killip classification was as follows: Class I, 47.4%, class II, 16.7%, class III, 16.7% and class IV, 19.2%. 7) The most common location of acute myocardial infarction by EKG was anterior wall of the myocardium at 79.5%. 8) The patients with arrhythmia by EKG amount to 53.8% and conduction disturbance 20.5%. 9) The patients with acute myocardial infarction who expired during admission were 23%. The ratio of male to female was 2.6:1. Among the expired patients Killip class IV was 80.8% and anterior wall infarction was 77.8%.
Angina Pectoris ; Arrhythmias, Cardiac ; Classification ; Diabetes Mellitus ; Electrocardiography ; Female ; Heart Valve Diseases ; Humans ; Hypertension ; Hyperthyroidism ; Infarction ; Male ; Myocardial Infarction* ; Myocardium ; Protestantism ; Retrospective Studies ; Thorax

PURPOSE: To evaluate the results of TKRA (Total knee replacement arthroplasty)for the treatment of stiff knee. METHODS & MATERIALS: TKRA has been performed for 18 cases of stiff knee ( ROM < 50 degrees ) between January 1994 and December 2000. 16 cases which have been followed up for more than 2 years were analysed. Average follow-up was 3.3 years(2-6 years). 3 were male and 13 were female. The average age was 55.8 years(34-75years). Sequales of infection were most with 6 cases and followed by osteoarthritis (4 cases, 2 cases had been performed arthroscopic debridement) and rheumatoid arthritis (3 cases) and traumatic arthritis (3 cases) in order. TKRA was performed on average 12.2 years (1-40 years) after knee stiffness has been developed. We evaluate the results with ROM, HSS score and complications. RESULTS: Average ROM was increased from 31.6 degrees(0 degrees-50 degrees) preoperatively to 95.4 degrees(80 degrees-120 degrees) postoperatively. 5 degrees of flexion contracture was present in only 1 case. Average HSS score was improved from 59.6 points preoperatively to 84.6 points postoperatively. The patella tendon was partially ruptured in 1 case during surgery, but by brace application and rehabilitative exercise, ROM was improved to 90 degrees, 1 year post operatively. There were 1 superficial skin infection which was resolved by revision of wound and skin graft, and deep infection in 3 cases, which needed knee fusion finally. CONCLUSION: TKRA is a good method for improving function in knee stiffness although infection risk is high.
Arthritis ; Arthritis, Rheumatoid ; Arthroplasty* ; Braces ; Contracture ; Female ; Follow-Up Studies ; Humans ; Knee* ; Male ; Osteoarthritis ; Patellar Ligament ; Skin ; Transplants ; Wounds and Injuries

Dexmedetomidine, which is a selective alpha2-adrenoceptor agonist, was recently introduced into clinical practice for its analgesic properties. The purpose of this study was to evaluate the effects of dexmedetomidine in a vincristine-evoked neuropathic rat models. Sprague-Dawley rats were injected intraperitoneally with vincristine or saline (0.1 mg/kg/day) using a 5-day-on, 2-day-off schedule for 2 weeks. Saline and dexmedetomidine (12.5, 25, 50, and 100 microg/kg) were injected to rats developed allodynia 14 days after vincristine injection, respectively. We evaluated allodynia at before, 15, 30, 60, 90, 120, 180, and 240 min, and 24 hr after intraperitoneal drug (normal saline or dexmedetomidine) injection. Saline treatment did not show any differences for all the allodynia. Maximal paw withdrawal thresholds to mechanical stimuli were 3.0 +/- 0.4, 9.1 +/- 1.9, 13.0 +/- 3.6, 16.6 +/- 2.4, and 24.4 +/- 1.6 g at saline, 12.5, 25, 50, and 100 microg/kg dexmedetomidine injection, respectively. Minimal withdrawal frequency to cold stimuli were 73.3 +/- 4.2, 57.1 +/- 6.8, 34.3 +/- 5.7, 20.0 +/- 6.2, and 14.3 +/- 9.5 g at saline, 12.5, 25, 50, and 100 microg/kg dexmedetomidine injection, respectively. Dexmedetomidine shows a dose-dependent antiallodynic effect on mechanical and cold stimuli in vincristine-evoked neuropathic rat models (P < 0.05).
Analgesics/*therapeutic use ; Animals ; Behavior, Animal/drug effects ; Dexmedetomidine/*therapeutic use ; Disease Models, Animal ; Hyperalgesia/chemically induced/*drug therapy ; Injections, Intraperitoneal ; Male ; Pain Threshold ; Rats ; Rats, Sprague-Dawley ; Vincristine/toxicity

Dexmedetomidine, which is a selective alpha2-adrenoceptor agonist, was recently introduced into clinical practice for its analgesic properties. The purpose of this study was to evaluate the effects of dexmedetomidine in a vincristine-evoked neuropathic rat models. Sprague-Dawley rats were injected intraperitoneally with vincristine or saline (0.1 mg/kg/day) using a 5-day-on, 2-day-off schedule for 2 weeks. Saline and dexmedetomidine (12.5, 25, 50, and 100 microg/kg) were injected to rats developed allodynia 14 days after vincristine injection, respectively. We evaluated allodynia at before, 15, 30, 60, 90, 120, 180, and 240 min, and 24 hr after intraperitoneal drug (normal saline or dexmedetomidine) injection. Saline treatment did not show any differences for all the allodynia. Maximal paw withdrawal thresholds to mechanical stimuli were 3.0 +/- 0.4, 9.1 +/- 1.9, 13.0 +/- 3.6, 16.6 +/- 2.4, and 24.4 +/- 1.6 g at saline, 12.5, 25, 50, and 100 microg/kg dexmedetomidine injection, respectively. Minimal withdrawal frequency to cold stimuli were 73.3 +/- 4.2, 57.1 +/- 6.8, 34.3 +/- 5.7, 20.0 +/- 6.2, and 14.3 +/- 9.5 g at saline, 12.5, 25, 50, and 100 microg/kg dexmedetomidine injection, respectively. Dexmedetomidine shows a dose-dependent antiallodynic effect on mechanical and cold stimuli in vincristine-evoked neuropathic rat models (P < 0.05).
Analgesics/*therapeutic use ; Animals ; Behavior, Animal/drug effects ; Dexmedetomidine/*therapeutic use ; Disease Models, Animal ; Hyperalgesia/chemically induced/*drug therapy ; Injections, Intraperitoneal ; Male ; Pain Threshold ; Rats ; Rats, Sprague-Dawley ; Vincristine/toxicity

BACKGROUND AND OBJECTIVES: Recently, methicillin resistent Staphylococcus aureus (MRSA) infecton in persistent otorrhea is on the increase. Beside the systemic side effects of vancomycin, systemic vancomycin injection needs admission and higher medical cost. We used vancomycin topically in the treatment of otorrhea by MRSA infection to minimize the disadvantages of systemic vancomycin injection. The objective of this study was to compare the therapeutic effects between topical and systemic use of vancomycin. MATERIALS AND METHODS: Twenty-five patients with persistent otorrhea were performed ordinary culture and sensitivity test. Among them, 18 patients were proved to have MRSA and they were divided into two groups. One group was treated with topical vancomycin packing, the other with systemic injection. RESULTS: MRSA was cultured in 18 cases (72%) among the 25 patients with persistent otorrhea. Therapeutic effects of topical vancomycin on MRSA infection was 77% and the average therapeutic period was 13.5 days. On the other hand, therapeutic effect was 100% and the average period was 5.6 days in systemic vancomycin injection group. CONCLUSION: Topical vancomycin packing in the treament of chronic otitis media with MRSA infection has advantages in view of time and economy, though the average therapeutic period is longer than that of systemic vancomycin injection.
Hand ; Humans ; Methicillin ; Methicillin-Resistant Staphylococcus aureus ; Otitis Media ; Staphylococcus aureus* ; Staphylococcus* ; Vancomycin*

BACKGROUND: Postoperative pulmonary complications are amongst the greatest causes of morbidity and mortality during liver transplantation. Postoperative mechanical ventilation and tracheal extubation are important parts of postoperative critical care. However, there are no comparative studies on postoperative mechanical ventilation, duration of intensive care units admission between cadaveric whole liver transplantation and living related liver transplantation groups, which are different from anesthetic and surgical procedures. In our present study, we have compared mechanical ventilation, duration of ICU admission and its influencing factors between the two groups. METHODS: We have retrospectively studied 67 cases and depending on the surgical procedures, we divided them into two groups; control group undergoing cadaveric whole liver transplantation and experimental group undergoing living related liver transplantation. Each group was evaluated based on operation time, time of mechanical ventilation, duration of ICU admission, amounts of infused fluid and transfusion during operation, preoperative and extubation O2 index, serum creatinine levels, and preoperative and intraoperative risk score. RESULTS: The mechanical ventilation time in experimental group was observed to be shorter than in control group, and serum creatinine level during the 3rd postoperative day in experimental group was lower than in control group (P<0.05). However, there was no difference in duration of ICU admission, O2 index, fluid amount and transfusion, and risk score between the two groups. CONCLUSIONS: We conclude that living related liver transplantation reduces mechanical ventilation time with no effect on ICU admission periods. Higher risk score is correlated with prolongation of postoperative mechanical ventilation.
Airway Extubation ; Cadaver* ; Creatinine ; Critical Care ; Intensive Care Units ; Liver Transplantation* ; Liver* ; Mortality ; Respiration, Artificial* ; Retrospective Studies

As prediction of rapidly aging society, bone health is considered increasingly important and received more attention than ever. Bone health is regulated by balancing between bone resorptive osteoclasts and bone formative osteoblasts. Disruption of balance between bone-resorbing osteoclasts and bone-forming osteoblasts results in bone disease. Natural products have recently received much attention as an alternative tool for the development of novel therapeutic strategy. Baicalein is reported it has anti-cancer, anti-inflammatory and antioxidant effects. Baicalein also has been known that it has both promotive effect on MC3T3-E1 cell line and inhibitory effect on RAW 264.7 cell line. However, the inhibitory mechanism of baicalein using bone marrow derived macrophages (BMMs) on osteoclast differentiation remains not clear. In this study, the suppressive mechanism by baicalein on osteoblast differentiation was evaluated. Bicalein inhibited receptor activator of nuclear factor-kappaB ligand (RANKL)-induced osteoclast differentiation in BMMs in a dose dependent manner without any toxicity. Baicalein suppressed phosphorylation of protein kinaseB (Akt), c-Jun N-terminal kinases (JNK) and phosphoinositide-specific phospholipaseCgamma2 (PLCgamma2). Furthermore, Baicalein suppressed the induction of RANKL-induced c-Fos and Nuclear factor of activated T cell c1 (NFATc1), essential genes on osteoclastogenesis. In BMMs, Bicalein inhibited the mRNA expression of tartrate-resistant acid phosphatase (TRAP), osteoclast-associated receptor (OSCAR), cathepsinK, dendritic cell-specific transmembrane protein (DC-STAMP). Moreover, baicalein promoted differentiation of osteoblast on bone marrow stromal cells (BMSCs). Taken together, these results suggest that baicalein has a potential for treating bone lytic diseases, such as osteoporosis, periodontitis, and rheumatoid arthritis.
Acid Phosphatase ; Aging ; Antioxidants ; Arthritis, Rheumatoid ; Biological Products ; Bone Diseases ; Bone Marrow* ; Cell Line ; Genes, Essential ; Macrophages* ; Mesenchymal Stromal Cells ; Osteoblasts ; Osteoclasts* ; Osteoporosis ; Periodontitis ; Phospholipase C gamma ; Phosphorylation ; Phosphotransferases ; RANK Ligand ; RNA, Messenger

We present an unusual case of a penile cavernosal abscess. This patient did not improve clinically despite repeat percutaneous aspiration of the abscess and administration of oral fluoroquinolone. Surgical drainage was required. Culture of pus and infected tissues were negative. Three months postoperatively, penile deviation to the left side and erectile dysfunction occurred but the patient was able to have sexual intercourse by using the medication of oral vardenafil. Colchicine was administered orally to the patient for 9 months and the penile curvature was improved.
Abscess* ; Coitus ; Colchicine ; Drainage ; Erectile Dysfunction ; Humans ; Male ; Penis ; Suppuration ; Vardenafil Dihydrochloride

BACKGROUND: Bronchial hyperresponsiveness and abnormal response such as a loss of distensi- bility are pathophysiologic characteristics if bronchial asthma. The only means of direct in vivo measurement of airway size had been a tantalium bronchography, until high-resolution computed tomography(HRCT) enabled to measure noninvasively two dimensional airway area more accurately and reliably. METHOD: To investigate airway area responses to bronchial provocation with methacholine and evaluate the major sites of bronchial constriction in patients with bronchial asthma. We examined HRCT scans in five patients with bronchial asthma who had significant bronchoconstriction(20% or more decrease in FEV1) using CT scanner(5,000T CT, Shimadzu Co, Japan) before and in 3~5 min. after methacholine inhalation. Airways which were matched by parenchymal anatomic landmarks in each patient before and after methacholine inhalation were measured using film scanner(TZ-3X scanner; Truvel Co. Chatsworth CA, USA) and a semiautomated region growing method. RESULTS: 1) We identified 9 to 12 airways in each patient which were matched by parenchymal anatomic landmarks before and after methacholine inhalation. 2) Airway responses to methacholine are quite different even in a patient. 3) The constriction of small airways(average diameter <2 mm; area <3.14mm2) was 48.7% (8.3; SEM, n=43), being more prominant than that of large airways(average diameter >2 mm; area >3.14 mm2), 53.8% (4.4;SEM, n=10), but not significantly different(p>0.05). 4) There was no significant difference in the degree of constriction between upper(44.3% +5.8; mean + SEM, n=30) and lower lung regions(56.7% +4.5, n=23). CONCLUSIONS: Thus airway responses to methacholine bronchoprovocation is quite variable in a patient with bronchial asthma and has no typical pattern in patients with bronchial asthma.
Anatomic Landmarks ; Asthma* ; Bronchoconstriction ; Bronchography ; Constriction ; Humans ; Inhalation ; Lung ; Methacholine Chloride

BACKGROUND: Endobronchial tuberculosis is one of the serious complications of pulmonary tuberculosis. Without early diagnosis and proper treatment of endobronchial tuberculosis, bronchostenosis can leave and lead to the collapse of distal lung parenchyme, bronchiectasis, and secondary pneumonia accompanied with moderate to severe dyspnea, cough, hemoptysis, and localized wheezing. Therefore steroid therapy has been tried to prevent bronchostenosis. But the effect of steroid therapy on the endobronchial tuberculosis is not definite at present. We tried to elucidate the effect of steroid on the treatment of endobronchial tuberculosis for prevention of bronchoste- nosis. METHODS: We observed the initial and sequential bronchoscopic findings, pulmonary function tests and simple chest roentgenograms in 58 patients diagnosed as endobronchial tuberculosis and admitted to Chung-Ang university hospital from 1988 to 1992. The patients in nonsteroid group (n=39) were treated with anti-tuberculosis chemotherapy only and steroid group(n=17) with combined steroid therapy. Sequential bronchoscopic findings, pulmonary function tests, and chest roentgenograms were comparatively analyzed between the two groups. RESULTS: 1) The endobronchial tuberculosis was highly prevalent in young females especially in third decade. 2) Both actively caseating type and the stenotic type without fibrosis was the most common in the bronchoscopic classification. 3) The sequential bronchoscopic findings in steroid group 2 months after treatment showed no significant improvements compared with nonsteroid group. 4) There was no significant difference between the two groups in the sequential bronchoscopic improvements according to bronchoscopic types. 5) We did not find any significant difference in improvements on follow-up pulmonary function tests and simple chest roentgenograms between the two groups 2 month after treatment. 6) There was no significant adverse effect of steroid during the treatment. CONCLUSION: Combined steroid therapy provably would not influence outcome of the treatment of endobronchial tuberculosis.
Bronchiectasis ; Classification ; Cough ; Drug Therapy ; Dyspnea ; Early Diagnosis ; Female ; Fibrosis ; Follow-Up Studies ; Hemoptysis ; Humans ; Lung ; Pneumonia ; Respiratory Function Tests ; Respiratory Sounds ; Thorax ; Tuberculosis* ; Tuberculosis, Pulmonary