No abstract available.
Thymectomy*

The osteoporosis is frequently observed in the patients with the inflammatory arthritis and painful rheumatism. The treatment of the osteoporosis for them is different from that for the patients without the arthritis or rheumatism. The recently developed biologic agents blocking tumor necrosis factor, interleukin(IL)-1, IL-6, or receptor activator of nuclear factor-kappaB ligand (RANKL) which are designed to treat the inflammatory arthritis are also expected to heal the osteoporosis in the inflammatory arthritis. The early use of the bisphosphonate is useful to prevent the glucocorticoid induced bone loss and to treat the spondyloarthropathy including the SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome. The clacitonin is useful for the painful rheumatism and osteoporotic fracture. The estrogen replacement is disputed because the stroke is known to occur more commonly in chronic inflammatory rheumatism than in general population. Moreover the pathogenesis of the most rheumatism may be partly related to the hormone. The parathyroid hormone therapy needs caution in the patients with calcium deposition disease and the hyperuricemia. We are reviewing the recent trend and development in the management of the primary, secondary and inflammatory osteoporosis in the patients with arthritis.
Acne Vulgaris ; Arthritis* ; Biological Factors ; Calcium ; Estrogen Replacement Therapy ; Female ; Humans ; Hyperostosis ; Hyperuricemia ; Interleukin-6 ; Osteoporosis* ; Osteoporotic Fractures ; Parathyroid Hormone ; RANK Ligand ; Rheumatic Diseases ; Rheumatic Fever ; Spondylarthropathies ; Stroke ; Tumor Necrosis Factor-alpha

No abstract available.
Aging* ; Longitudinal Studies*

We measured the bone ingrowth rate on 22 retrieved human cementless porous coated acetabular cups by the help of computer graphics. All the acetabular cups had functioned well, and had had evidence of radiologic bony ingrowth before revising the acetabular cup. The reason for retrieval of the acetabular cups were: one with habitual dislocation, who with stem loosening, and 19 with polyethylene cup wearing. The period from initial surgery to retrieval surgery was 28 months to 108 months(average 56.1 months). All the retrieved porous coated acetabular cups showed macroscophic bony ingrowth, and the ratio of the whole porous surface to bony ingrowth area was showed 1.14% to 92.27% (average 36%).
Acetabulum ; Computer Graphics ; Dislocations ; Humans ; Polyethylene

Since the development of cardiac monitoring, Holter ECG monitoring, His Bundle electrogram and cardiac pacemaker, the cardiac conduction defect has been diagosed more precisely. Also SA block and sick sinus syndrome were well investigated recently. Author reviewed 10,084 cases of electrocardiograms for recent 3 years which were examined at korea University Hospital and analyzed the incidence of conduction defect, type of SA block, conduction defect in myocardial infarction and the relation of SA and AV conduction defect and Q-T(c). There were 5,390 cases of male and 4,694 cases of female with age range of 10 months to more than 80 years. In 60 cases, 24 hour Holter ECG monitoring were also carried out. The data were as follows; 1. There were 568 cases of cardiac conduction defect out of 10,084 cases and the incidence was 5.64% as a whole. Among the conduction defects, there was SA block in 0.36%, AV block in 2.12%(1st degree in 1.86%, Mobitz type I in 0.11%, Mobitz type II in 0.08%, complete block in 0.07%), bundle branck block in 2.52%(RBBB in 2.13%, LBBB in 0.39%), intraventricular conduction defect in 0.20%, left bundle hemiblock in 0.07%, bifascicular block in 0.05%, 1st degree AV block with BBB in 0.18%, W-P-W syndrome in 0.1% and L-G-L syndrome in 0.04%. 2. There were 36 cases of SA block among 10,084 cases(0.36%). In 26 cases, there were one case of Mobitz type I 2nd degree SA block, Mobitz type II in 20 cases, no P wave with nodal escape in 13 cases and 2 cases of transient sinus arrest associated with syncopal attack which were diagnosed by 24 hour Holter ECG monitoring. 3. There were 45 cases of conduction defect in 122 cases of acute or subacute myocardial infarction(36.9%). Among the 45 cases, there were 2 cases of SA block, 15 cases of 1st degree AV block, 2 cases of 2nd degree AV block, 2 cases of complete AV block, 10 cases of RBBB, 3 cases of LBBB, 4 cases of intraventricular conduction defect and 7 cases of left bundle hemiblock. These data showed lower incidence of critical conduction defect such as Mobitz type II and complete AV block in Korea than in United States. 4. The Q-T(c)interval were measured in 207 cases of SA block and AV block without BBB or IVCD. The values of Q-T(c)in cases of conduction defect were within normal limits. In cases of myocardial infarction, there were mild prolongation of Q-T(c)interval, however there was no difference of Q-T(c)interval between infarction with conduction defect and those without conduction defect. There was no correlation between P-R interval prolongation and Q-T(c)interval. These data suggested that the cardiac conduction defect is a specific involvement of conduction system by various causes rather than diffuse myocardial changes.
Atrioventricular Block ; Electrocardiography* ; Electrocardiography, Ambulatory ; Electrophysiologic Techniques, Cardiac ; Female ; Heart* ; Humans ; Incidence ; Infarction ; Korea ; Male ; Myocardial Infarction ; Sick Sinus Syndrome ; United Nations ; United States

A study was made of the respiratory effects of acute carbon monoxide poisoning in mongrel dogs. In this study the dogs were divided into two groups, namely the control and the experimental. In the experimental group, carbon monoxide poisoning was induced by the rebreathing of about 2% carbon monoxide gas mixture for 15 minutes, and the respiratory functions in this group were compared to those in the control group. A significant increase in the minute ventilation was noted in both the control and the experimental groups, and in the latter there was an increase in the respiratory rate and a decrease in the tidal volume compared to those in the control group. In both groups, oxygen consumption showed no significant change and there was a fall in the arterial carbon dioxide tension, but the carbon dioxide elimination was slightly lower in the experimental group.
Animals ; Carbon Dioxide ; Carbon Monoxide Poisoning* ; Carbon Monoxide* ; Carbon* ; Dogs ; Oxygen Consumption ; Respiratory Rate ; Tidal Volume ; Ventilation

No abstract available.
Evidence-Based Practice* ; Humans

BACKGROUND: Propafenone is effective in the treatment of ventricular arrhythmias and paroxysmal supraventricular tachycardia. Propafenone has been shown to be also useful in preventing the recurrence of atrial fibrillation. But to date, date concerning the efficacy of propafenone for patients experiencing paroxysmal and chronic atrial fibrillation have not been examined in Korea. METHODS: In patients with paroxysmal atrial fibrillation propafenone was given at a dose of 450mg daily without dose titration and symptomatic recurrences were evaluated by patient interview during follow-up. In patients with chronic atrial fibrillation, who had no previously attempted cardioversion, propafenone was given at a dose of 450~675mg daily without dose titration, and after a minimum of 3 days pharmacological cardioversion was assessed. Those patients in whom sinus rhythm had been restored pharmacologically or by combined direct current cardioversion were followed with maintaining propafenone therapy also at a dose of 450~675mg daily. RESULTS: Of 7 patients with paroxysmal atrial fibrillation, 4 (57%) patients had marked symptomatic improvement and they were followed for 197 to 460 (mean 286) days Of 13 patients with chronic atrial fibrillation, 7 patients incuding 4 pharmacologically converted patients were initially controlled to sinus rhythm. In 5 (38%) patients maintenance of sinus rhythm was followed for 90 to 415 (mean 224) days. CONCLUSION: Although these observations were made in small number of patients and are so limited, the results are comparable to the previous studies which showed the potential role of propafenone in the management of atrial fibrillation.
Arrhythmias, Cardiac ; Atrial Fibrillation* ; Electric Countershock ; Follow-Up Studies ; Humans ; Korea ; Propafenone* ; Recurrence ; Tachycardia, Supraventricular

For the non-invasive evaluation of cardiac performance in hyperthyroidism, fractional systolic and diastolic time intervals were determined in 96 female patients with hyperthyroidism from the mechanocardiograms which included apexcardiograms together with electrocardiograms, phonocardiograms and carotid arterial pulse tracings. The observed values of the time intervals inversely related to heart rate, i.e., ejection period, mechanical systole, isovolumic relaxation time and active ventricular filling period, were significantly shortened in proportion to the severity of the disease in general, as determined by the rate of the radioactive iodine uptake of the thyroid glands. However, these values were not significantly different from those of the predicted for heart rate, except for one of mechanical systoles which is a time interval from the onset of the systolic upstroke in the apexcardiogram to the second aortic sound. This suggests that the shortening of these observed values is promarily due to tachycardia associated with hyperthyroidism. One the other hand, the observed values of the time intervals unrelated to heart rate, i.e., electromechanical delay, isovolumic contraction time together with one of its components, namely ventricular pressure elevation time, and rapid ventricular filling period, were significantly shorter than those in the controls, although the degree of the shortening was not related to the degree of the radioactive iodine uptake of the thyroid gland. It appears that the shortening of these time intervals is related to the altered cardiac function caused by hyperthyroidism and, in particular, that of the isovolumic contraction time and ventricular pressure elevation time reflects enhancemet by the thyrotoxic myocardial contractility.
Electrocardiography ; Female ; Hand ; Heart Rate ; Humans ; Hyperthyroidism* ; Iodine ; Relaxation ; Systole ; Tachycardia ; Thyroid Gland ; Ventricular Pressure

BACKGROUND: Although hypochlorhydria, hypergastrinemia and antiparietal cell antibody have been well documented in the patients with hyperthyroidism, a cause of hypochlorhydria or hypergastrinemia is unknown at the present time. Therefore, in order to clarify an inhibitory mechansim of gastric acid secretion in the patients with hyperthyroidism, interrelationship among hypochlorhydria, hypergastrinemia and antiparietal cell antibody was investigated in this study. METHODS: The gastric secretory function, fasting and postprandial plasma concentrations of gastrin and titer of antiparietal cell antibody in the plasma were determined in the patients with hyperthyroidism and normal subjects. Immunoblot analysis was performed to identify the gastric membrane protein, a possible gastric antigen to antiparietal cell antibody. Using a immunocytochemical technique with electron microscopy, intracellular structure of the parietal cell reacted with antiparietal cell antibody was observed. RESULTS: The basal and pentagastrin-stimulated maximal acid output were reduced in the patients with hyperthyroidism. The fasting and postprandial plasma concentrations of gastrin were markedly elevated in the patients. The plasma gastrin concentration in the patients with the antiparietal cell antibody was higher than that of the norrnal subjects as well as the patients without the antibody not only in the fasting state but also in the postprandial state. However, the plasma gastrin concentration of the patients without the antiparietal cell antibody was elevated in the fasting state only. There was no difference in the gastrin content of the antral mucosa between the norrnal subjects and the patients. The antiparietal cell antibody was detected in 5 (38.5 %) out of 13 patients by using the indirect immunofluorescence method. Patient IgG dose-dependently inhibited rabbit gastric H (+),K (+)-ATPase activity. Among proteins of the rabbit gastric mucosa membrane, four high molecular weight proteins (91, 140, 170 and 210 K dalton) were reacted to the patient IgG. The patient IgG positive peroxidase-antiperoxidase (PAP) activity was electron microscopically detected on the intracellular cannalicular membrane of the parietal cell CONCLUSION: We conclude that hypochlorhydria and hypergastrinemia in the patients with hyperthyroidism are partially related to the antiparietal cell antibody and that the antigen to the antiparietal cell antibody may be H (+),K (+)-ATPase in the intracellular canalicular membrane of the parietal cell.
Achlorhydria ; Fasting ; Fluorescent Antibody Technique, Indirect ; Gastric Acid* ; Gastric Mucosa ; Gastrins ; Humans ; Hyperthyroidism* ; Immunoglobulin G ; Membrane Proteins ; Membranes ; Microscopy, Electron ; Molecular Weight ; Mucous Membrane ; Plasma ; Rabeprazole