PURPOSE: To assess the signal enhancement by gadolinium-DTPA-polylysine (Gd-polylysine) as compared to gadopentetate (Gd-DTPA) in MR imaging of heart that have undergone ischemia-reperfusion, and to estimate the extent of myocardial damage covered bythe MR signal enhancement. MATERIALS AND METHODS: A series of contrast enhanced cardiac MR images were obtained from 17 cats subjected to a 90 minutes of occlusion of the left anterior descending coronary artery (LAD) followed by a 90 minutes of raperfusion. Time courses of changes in the signal intensity (Sl) of the ischemic area were measu red in Gd-polylysine group (8 cats) and Gd- DTPA group (9 cats). The size of U R signal enhanced area was then compared to the sizes of infarction and the area at risk revealed byTTC histochemical staining. RESULTS: Maximum Sis were obtained at 60 minutes and 30 minutes after injection of the contrast material, respectively for Gd-polylysine group and Gd-DTPA group. Signal enhancement was stronger and persistent for a longer period in Gd-polylysine group than in GD-DTPA group. Sizes of the enhanced area, the infarction, and the area at risk were about 30%, 15%, and 50% of the total left ventricle (LV) area; the difference between the groups was statistically insignificant. CONCLUSION: Gd-polylysine can be used better for a blood pool marker than Gd-DTPA in MR imaging of myocardial ischemia, due to its strong and persistent signal enhancement. The MR signal enhanced area includes both the infarcted area and a portion of the area at risk.
Animals ; Cats* ; Coronary Vessels ; Gadolinium DTPA ; Gadolinium* ; Heart ; Heart Ventricles ; Infarction ; Magnetic Resonance Imaging* ; Myocardial Ischemia ; Pentetic Acid ; Polylysine*

Many unsolved probIems still remain in these in management of trochanteric fracture of hip, especially unstable type of trochanteric fracture. Among many cases of the trochanteric fracture treated during period from Jan. 1963 to July, 1973 at Busan National University Hospital, six patient has severe sequelae such as coxa vara deformity, shortening of the affected limb and ankylosis of the hip joint, which were analyzed clinically and results obtained were as follow. 1. It is the most important factor that the medial and the posterior cortex is good alignment in reduction with internal fixation and maintainance of unstable trochanteric fracture. 2. It is dangerous for the unstable type of trochanteric fracture to be reducted and maintained with only screws or plates. Jewett nail is more effective than the S-P nail and Thornton plate in internal fixation of unstable type of trochanteric franture. 3. The posterior fragments can hardly be found in A-P view but easily in lateral view 4. In cases that had not good alignments between posterior fragments the distaI fragment displaced medially and migration of the naiI, distraction of the pIate, malunion have developed in spite of prolonged immobilization in cast. 5. In one case that the severe coxa vara deformity have been developed. we performed the transverse osteotomy & fixed with Blount-V-blade plate like device. The result was good but the shortening of the limb could not prevent.
Ankylosis ; Busan ; Congenital Abnormalities ; Coxa Vara ; Extremities ; Femur ; Hip Joint ; Hip ; Humans ; Immobilization ; Osteotomy

We have studied the angiograms before and after arteriorrhaphy, which were performed on 20 cases at Busan National University Hospital. Among the cases, 15 were on upper extremity and 5 on lower extremity. The results obtained were as follows; 1. 8 cases among 19 on which angiogram were checked after arteriorrhaphy revealed the obstructive findings distal to injured vessels. 2. Necrosis did not occur following arteriorrhaphy for brachial artery, radial artery and ulnar artery and ulnar artery ruptures. On a cases of anterior tibial artery rupture, an A-K amputation was done due to progressive tissue necrosis. 3. Collateral circulations were very important pathway after brachial artery rupture and increased collateral circulations were showed on angiograms. 4. Localized thrombosis and hypertrophic vascular changes were found in 3 cases of re-exploration because of the obstruction after initial surgery.
Amputation ; Brachial Artery ; Busan ; Clinical Study ; Collateral Circulation ; Extremities ; Lower Extremity ; Necrosis ; Radial Artery ; Rupture ; Thrombosis ; Tibial Arteries ; Ulnar Artery ; Upper Extremity ; Vascular System Injuries

Schizencephaly, first described by Yakovlev and Wadsworth in 1946, is a rare congenital anomaly characterized by gray matter-lined clefts that extend through the entire cerebral hemisphere, from the ependymal lining of the lateral ventricle to the subarachnoid space. Clinically, patients with schizencephaly present motor dysfunction such as hemiparesis, seizures, and variable developmental delay. Absence of septum pellucidum, gray matter heterotopia, polymicrogyria, and hypoplasia of optic nerves were also frequently found to be associated with schizencephaly. We experienced a case of open-lip schizencephaly in a one-day-old male infant with wide, tense fontanel, which was confirmed by MRI.
Cerebrum ; Humans ; Infant ; Lateral Ventricles ; Lip* ; Magnetic Resonance Imaging ; Male ; Malformations of Cortical Development* ; Optic Nerve ; Paresis ; Seizures ; Septum Pellucidum ; Subarachnoid Space ; Transcutaneous Electric Nerve Stimulation

In vivo 31P NMR spectroscopic study of forearm wrist flexor muscles was performed in two groups of volunteers composed respectively of 6 sedentaries and 6 canoe athletes. A continuous isometric contraction of endurance exercises was adopted in oder to assess the endurance capacity and recovery potential of skeletal muscles. Differences in high energy phosphorus metabolism between the sedentaries and athletes were evaluated with and emphasis on the intracellular pH and Pi/PCr ratio as indicators of high energy phosphorus metabolism. There were no differences of baseline pH and Pi/PCr ratio between the two groups. The athletes sustained the exercise at more acidic intracellular pH and at a higher Pi/PCr ratio of intracellular conditions for an all-out than did the sedentaries. The recovery rate of pH showed no difference between the two groups. There was a tendency of faster recovery of Pi/PCr in athletes showing half recovery time(T1/2) of 39.0±3.0 seconds as compared to that of sedentaries (55.7±7.5 seconds). The recovery rate of Pi/PCr as a function of Pi/PCr ratio at a given period of time was significantly faster in athletes than in sedentaries (P<0.001). The correlation coefficient of the recovery rate of Pi/PCr against the Pi/PCr ratio was 0.985 and 0.914 respectively for the athletes and sedentaries. The pH and the Pi/PCR ratio at an all-out state can be used as indicators of endurance capacity and the recovery rate of Pi/PCr, as a reovery potential of skeletal muscles.
Athletes* ; Exercise ; Forearm ; Humans ; Hydrogen-Ion Concentration ; In Vitro Techniques* ; Isometric Contraction ; Metabolism ; Muscle, Skeletal* ; Muscles ; Phosphorus ; Volunteers ; Wrist

PURPOSE: To investigate the changes in postural balance before and after total hip arthroplasty (THA) using computerized dynamic posturography MATERIALS AND METHODS: This was a prospective study of 18 patients undergoing total hip arthroplasty. We evaluated each patient's postural balance prior to, and at least 12 months after, total hip arthroplasty by using computerized dynamic posturography. We compared the preoperative equilibrium scores with the postoperative equilibrium scores. Clinical results were assessed for all patients preoperatively and postoperatively using the Harris hip scoring system. We investigated whether postural balance improves, and what factors were related to this parameter. RESULTS: Patients showed significant improvement in postural balance by means of proprioception after total hip arthroplasty (p<0.05). We found, during intercepting visual compensation, that an increase in the Harris hip score was correlated with an improvement in balance (p<0.01, r = 0.649). CONCLUSION: Patients with Total hip arthroplasty showed improvement in dynamic postural balance through proprioceptive recovery, and balance improved as the Harris hip score increased. This resulted in decreased pain, recovery of articular function, enhancement of physical activity, and ultimately improvement in postural balance by means of total hip arthroplasty.
Arthroplasty ; Compensation and Redress ; Hip ; Humans ; Motor Activity ; Postural Balance ; Proprioception ; Prospective Studies

BACKGROUND/AIMS: The principle of the rapid urease test is the assessment of the color change of the pH indicator, phenol red, by ammonium and bicarbonate ions which were produced by the urease. We modified a conventional rapid urease test, and quantified H. pylori infection by measuring the change of spectrophotometric absorbance. METHODS: 202 patients with upper gastrointestinal symptoms were endoscopically examined and three biopsies were performed in each antrum and fundus. Two biopsy specimens were stained with Giemsa and scored from 0 to 4 according to the distribution of bacteria by the Wyatt method. Another specimen was used for the quantitative rapid urease test. The tissue was incubated in a cuvette containing 10% of urea solution and phenol red at 37C. We measured optical densities in 550 nm at 5 min, 10 min, 15 min, 30 min, 1 hrs, 2 hrs, 4 hrs and 24 hrs time points.
Ammonium Compounds ; Bacteria ; Bicarbonates ; Biopsy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Hydrogen-Ion Concentration ; Phenolsulfonphthalein ; Urea ; Urease*

Paraganglioma is a tumor from the extra adrenal paraganglion system and is rarely observed in the mediastinum. The authors experienced a case of nonfunctioning paraganglioma of the posterior mediastinum. The patient was 34-years-old male in whom abnormal mass lesion was nites in chest radiograph with hemoptysis. His blood pressure and serologic examination were within normal range upon admission to our hospital. Chest CT revealed a tumor in the left lower lobe. Diagnostic thoracoscopy was performed and diagnosed a posterior mediastinal mass. Surgical resection was them performed. Posterior mediastinal mass was removed successfully and histological examination of the surgical specimen diagnosed paraganglioma. He received radiotherapy after surgery and was followed up. Related literature are reviewed.
Blood Pressure ; Hemoptysis ; Humans ; Male ; Mediastinum* ; Paraganglioma* ; Radiography, Thoracic ; Radiotherapy ; Reference Values ; Thoracoscopy ; Tomography, X-Ray Computed

BACKGROUND: Reestabilshment of blood flow is a standard therapeutic modality to salvage the myocardium at risk in an acute phase of myocardial infarction. However, there are significant evidences that reperfusion per se may injure the potentially viable myocardium, and a number of pharmacological agents were tried to reduce this reperfusion injury. Adenosine, an endogenous vasodilator, is suggested to reduce repergusion inury. To evaluate the myocardial protective effect of adenosine, magnetic resonance spectroscopy with superscript P was applied to feline model of acute myocardial ischemia-reperfusion, as well as pathological examination. METHODS: Effects of adenosine on the recovery of high energy phosphorous metabolites during 90 minutes of reperfusion period following 90 minutes of left anterior descending coronary artery ligation were assessed by31P spectroscopy in 27 cats(10: control group, 8: adenosine I group, 9: adenosine II group). In adenosine groups 0.2 mg/kg/min of adenosine was infused intravenously for 90 minutes from 30 miniutes before reperfusion in group I, and from just before reperfusion in group II. The experiments were performed on a 4.7 T/30 cm Biospec MRS/MRI system and the MR signals were obtained by using inner-diameter 1.5 cm-sized doubly tuned surface coil. The size of the spectral peaks was measured by area integration method. RESULTS: 1) Phosphocreatine(PCr) decreased rapidly with progression of ischemia, and recovered in reperfusion period in each group. PCr values in the reperfusion period were significantly higher in adenosine group than those in control group, although there was no difference between adenosine group I and II. 2) ATP decreased with progression of ischemia, and recovered in reperfusion period in each group. ATP values in the reperfusion period were significantly higher in adenosine groups than those in control group, byt there was no difference between adenosine group I and II. 3) pH decreased uniformly with progression of ischemia and recovered in reperfusion period, showing no difference between control and adenosine groups. 4) PCr/ATP ratio, representing the potential of oxidative phosphorylation, dereased with progression of ischemia and increased in reperfusion period. PCr/ATP ratio showed no difference between control, adenosine I and II groups. 5) Risk area/left ventricle ratio was not different in control and adenosine groups. Infarct size/risk area and infarct size/left ventricle ratios were smaller in adenosine II than those in control group. Howerver no significant diffence was noticed between adenosine I and control, and between adenosine I and II group. CONCLUSION: Intravenous infusion of adenosine showed the tendency of reducing the infarct size in the feline model of acute myocardial ischemia-reperfusion, and adenosine could improve significantly the recovery of high energy phosphate metabolites. This myocardial pretective effect of adenosine is considered to be present mainly in the reperfusion period.
Adenosine Triphosphate ; Adenosine* ; Coronary Vessels ; Hydrogen-Ion Concentration ; Infusions, Intravenous ; Ischemia ; Ligation ; Magnetic Resonance Spectroscopy ; Myocardial Infarction ; Myocardial Ischemia ; Myocardium ; Oxidative Phosphorylation ; Polymerase Chain Reaction ; Reperfusion ; Reperfusion Injury ; Spectrum Analysis

OBJECTIVE: Although there are a few studies reporting the efficacy of moclobemide in the treatment of social phobia, it has been poorly studied in Korea. The purpose of this study was to investigate the short term efficacy of moclobemide in Korean patients with social phobia. METHOD: Sixty six patients with social phobia based on DSM-IV criteria were enrolled to 4-week trial with a flexible-dose regime of moclobemide. Treatment responses were assessed at baseline and week 4 with Liebowits Social Anxiety Scale (LSAS), Brief Fear of Negative Evaluation (BFNE), Mattick's Social Phobia Scale, Beck Depression Inventory (BDI), and Sheehan's Disability Scale (SDS). RESULT: Thirty eight of 66 patients completed the 4-week trial. Scores of LSAS, BFNE, and Mattick's Social Phobia Scale at baseline were not significantly reduced after 4-week trial (p=0.084, p=0.537, p=0.283, p=0.111, respectively). But scores of BDI and 3 of 4 Sheehan's Disability Subscale at baseline were significantly reduced (p=0.026, p=0.000, p=0.005, p=0.002, respectively). CONCLUSION: Overall results of preliminary study showed that moclobemide could be used for the treatment of depression and functional impairment, but that it was not effective for treatment of anxiety and phobic avoidance of social phobic patients. More controlled, long-term studies are needed to evaluate the efficacy of moclobemide for treatment of social phobia.
Anxiety ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Korea ; Moclobemide* ; Phobic Disorders*