We studied the natural history of asymptomatic early avascular necrosis of the femoral head in forty-three patients(forty-three hips) who had been treated with arthroplasty due to progressed avascular necrosis of femoral head but had no symptoms in the other side. All initial lesions were classified with Ficat staging and International classification(ARCO). The duration until symptom onset and radiologic evidence of disease progression were evaluated. The average follow up period was over 37 months. Among forty-three hips, twenty-nine cases(67.4%) remained asymptomatic until last follow up but fourteen cases(32.6%) were symptomatic during the follow up, and twenty-six cases(60.5%) did not progress on the radiography but seventeen cases(39.5%) progressed to Ficat stage 3 or 4. Fifteen cases of IA, IIA, IB-cental and II B-central without lateral lesion did not occur symptom and didnt progress to Ficat stage 3 or 4 over a period of average 47 months(24-71 months). But fourteen cases of IB, IC, g B and II C progressed to Ficat stage 3 or 4 and they were all lateral lesion. These results suggest careful observation only can be done in the case of small involvement(less than 15%) and medial or central lesion relatively over a long period of time but for the large involvement(more than 30%) and especially lateral lesion, aggressive surgical treatment may be considered even though the early stage of disease for the prevention of progression. However it will need more period of time to accurately compare the results of various methods of treatment.
Arthroplasty ; Disease Progression ; Follow-Up Studies ; Head* ; Hip ; Natural History* ; Necrosis* ; Radiography

No abstract available.
Fever* ; Microwaves* ; Perfusion*

Human seminal plasrna (HSP) is mixture of secretion derived from various glands associated with male reproductive tract which comprises approximately 80-90% of the volume of normal ejaculate. The present study was undertaken in an effort to explore the effect of HSP pretreatment on the production of IL-1B, TNF-a and IL-12, in mice, and to investigate if HSP may cause to induce active systemic anaphylaxis (ASA) in mice. In addition, effects of HSP pretreatment on contact hypersensitivity to trinitrochlorobenzene (TNCB), antibody response to polyvinylpyrroridone (PVP), a thymus-independent antigen and on ASA induced by egg albumin (OVA) were also studied in this study. For the experiments of contact hypersensitivity, antibody response and cytokine production, mice were pretreated i.p. daily with 0.3ml of HSP or sterile saline alone (control) for 3 consecutive days before antigen sensitization or lipopolysaccharide injection for the cytokine induction. For the experiments of OVA- induced anaphylaxis, mice were pretreated by a single s.c. injection of HSP 0.3ml per mouse before sensitization. For induction of ASA in mice by HSP, a group of mice were sensitized i.p. 2 consecutive days with 0.3ml of HSP and one day with 0.3 ml of HSP plus 2x10(9) B. pertussis and 1.0 mg of alum (schedule A) or another group of mice were sensitized i.p. with a single i.p. injection of 0.3 ml of HSP with 2x10' B. pertussis and 1.0 mg of alum (schedule B). All sensitized and unsensitized control mice were challenged i.v. with 0.2ml of HSP 14 days after HSP sensitization, and mortality were observed. It was found that HSP pretreatment inhibited the production of IL-lB, TNF-a and IL-12, and also inhibited OVA-induced ASA, contact hypersensitivity to TNCB and anti-PVP antibody production. Interestingly, ASA was induced by HSP irrespective of the applied sensitization schedule. Taken together, this study may provide the direct evidences that HSP may inhibit the production of IL-1B, TNF-a and IL-12 and this may be the first to show the induction of ASA by HSP in mice.
Anaphylaxis* ; Animals ; Antibody Formation ; Appointments and Schedules ; Dermatitis, Contact ; Humans* ; Interleukin-12 ; Male ; Mice* ; Mortality ; Ovum ; Picryl Chloride ; Semen* ; Whooping Cough

BACKGROUND: Through the control of tuberculosis at 22 public health centers under the National Tuberculosis Control Program, this study is purposed to examine the situation of the tuberculous patients and the characteristics of the therapeutic regimens. METHODS: The data was obtained from 8091 medical records of pulmonary tuberculous patients who were registered for treatment at public health center in Seoul during the year of 1993. It was comparatively analysed by the general characteristics(gender, age, chest X-ray findings, sputum results, treatment results, side effects, combined diseases and accompanied extra-pulmonary tuberculosis) according to various regimens of the tuberculosis. RESULTS: The male patients were 5144, the female were 2947. 34.1% of patients were between 21 and 30years of age. Short course regimen was 97.1% and long course regimen was 2.9%. According to chest X-ray findings minimal 53.5%, moderately advanced 41.2%, far advanced 5.3%. Sputum AFB negative was 52.2% and positive was 47.8%. Therapeutic efficiency was high in short course regimen. Among the side effects, dermatologic problems was high and at the regimen of EHRZ side effects were developed highly. Combined diseases were liver diseases(5.2%), DM(4.2%). Accompanied extrapulmonary tuberculosis were pleurisy(5.4% ), superficial lymphadenitis(0.4% ). CONCLUSIONS: There was great effects in the treatment of tuberculosis with short course regimen in the National Tuberculosis Control Program. But only 38% among the expected patients were treated in this country. So the greater efforts were needed to find and treat more patients effectively.
Female ; Humans ; Liver ; Male ; Medical Records ; Public Health* ; Seoul* ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary*

No abstract available.
Hand Strength*

The purpose of this study was to elucidate the effects of fentanyl and morphine on the ability of epinephrine to induce arrhythmias in halothane-anesthetized dogs. Epinephrine was infused in progressively increasing doses from 0.5 ug/kg/min. Arrhythmogenic dose of epinephrine(ADE), defined as that induces 4 or more premature ventricular contractions within 15 s during 3 min iafusions of epinephrine, was determined before(control) and after pretreatment of either fentanyl(6 ug/kg i.v. plus 6 pg/kg/hr) or morphine(0.2mg/kg i.v. plus 0.2 mg/kg/hr). Blood pressure and heart rate were also measured immediately before(baseline), immediately after infusion of epinephrine. The results were as follows. l) Fentanyl and morphine increased ADE by 37%(2.19+/-0.49 to 3.00+/-0.44 ug/kg/min, p<0.01) and by 43%(2.50+/-0.60 to 3.58+/-0.93 ug/kg/min, p<0.05), respectively. 2) Percent increases in systolic blood pressure at control were similar to those after pretreatment with fentanyl or morphine in both groups, but systolic blood pressures at the time of arrhythmia after pretreatment were lower than those at control in fentanyl(p<0.05) and morphine group(NS). 3) Fentanyl and morphine decreased heart rate by 27%(127+/-8 to 93+/-6 beats/min, p<0.001) and by 13%(118+/-5 to 103+/-5 beats/min, p<0.05), respectively. These results suggest that fentanyl or morphine inhibits epinephrine induced arrhythmias during halothane-oxygen anesthesia. Thus, pretreatment of surgical patients, who were supposed to receive epinephrine during halothane anesthesia, with either fentanyl or morphine might be safe.
Anesthesia ; Anesthetics ; Animals ; Arrhythmias, Cardiac* ; Blood Pressure ; Dogs* ; Epinephrine* ; Fentanyl* ; Halothane* ; Heart ; Heart Rate ; Humans ; Morphine* ; Pharmacology ; Sympathetic Nervous System ; Ventricular Premature Complexes

Background: The traditional nasolabial V-Y advancement flap is widely used for midface reconstruction, particularly for the lower third of the nose and upper lip, as its color and texture are similar to these areas. However, it provides insufficient tissue to cover large defects and cannot restore the nasal convexity, nasal ala, and adjacent tissues. The purpose of this study is to investigate the modified nasolabial V-Y advancement flap with extension limbs the along alar crease for the reconstruction of complex midface defects. Methods: A retrospective analysis of 18 patients, who underwent reconstruction with the modified nasolabial V-Y advancement flap, was performed between September 2014 and December 2022. An extension limb was added along the alar crease, adjacent to the defect area, and was hinged down as a transposition flap at the end of the advancement flap. Results: The extension limb along the alar crease successfully covered large and complicated defects, including those of the ala, the alar rim, the alar base, the nostrils, and the upper lip, with minor complications. Conclusion The alar crease is a good donor site for the reconstruction of large and complex nasal and upper lip defects.

OBJECTIVES: This study was designed to assess the change of heart rate variability (HRV) at resting, upright, and psychological stress in anxiety disorder patients. METHODS: HRV was measured at resting, upright, and psychological stress states in 60 anxiety disorder patients. We used visual analogue scale (VAS) score to assess tension and stress severity. Beck depression inventory (BDI) and state trait anxiety inventories I and II (STAI-I and II) were used to assess depression and anxiety severity. Differences between HRV indices were evaluated using paired t-tests. Gender difference analysis was accomplished with ANCOVA. RESULTS: SDNN (Standard deviation of normal RR intervals) and low frequency/high frequency (LF/HF) were significantly increased, while NN50, pNN50, and normalized HF (nHF) were significantly decreased in the upright position compared to resting state (p < 0.01). SDNN, root mean square of the differences of successive normal to normal intervals, and LF/HF were significantly increased, while nHF was significantly decreased in the psychological stress state compared to resting state (p < 0.01). SDNN, NN50, pNN50 were significantly lower in upright position compared to psychological stress and nVLF, nLF, nHF, and LF/HF showed no significant differences between them. CONCLUSION: The LF/HF ratio was significantly increased after both physical and psychological stress in anxiety disorder, but did not show a significant difference between these two stresses. Significant differences of SDNN, NN50, and pNN50 without any differences of nVLF, nLF, nHF, and LF/HF between two stresses might suggest that frequency domain analysis is more specific than time domain analysis.
Anxiety ; Anxiety Disorders* ; Autonomic Nervous System ; Depression ; Equipment and Supplies ; Heart Rate* ; Humans ; Stress, Psychological*

No abstract available.
Angioedema*

Dural metastasis associated with chronic subdural hematoma is very rare in patients with malignant neoplasms; it may be difficult to distinguish malignant neoplasms from chronic subdural hematoma. Chronic subdural hematoma is usually a late manifestation of malignant tumors, which contributes to the severity of the prognosis. The scans obtained by using magnetic resonance imaging or computed tomography may be misleading when a subdural hematoma masks the underlying tumor. Herein, we report a case of a subdural hematoma with dural metastasis of unknown origin in a 45-year-old woman; however, the neoplasm was not detected until autopsy.
Adenocarcinoma ; Autopsy* ; Female ; Hematoma, Subdural* ; Hematoma, Subdural, Chronic ; Humans ; Magnetic Resonance Imaging ; Masks ; Middle Aged ; Neoplasm Metastasis ; Prognosis