No abstract available.
Blood Platelets* ; Hypertension, Pulmonary* ; Lung Diseases, Obstructive* ; Platelet Activation*

No abstract available.
Wegener Granulomatosis*

We built the hypothesis that the hypertrophic callus formation is mediated by beta-endorphin that stimulates secretion of GH and increase circulation growth factor activity in head injury patient. We classified 4 groups such as 5 normal person(control), group I;5 patients with only fracture, group II;5 patients with fracture and head injury, group III; 5 patients with only head injury, group IV. We obtained the samples of serum from each group at 0, 2, 4, 6, 8 weeks after trauma and assessed the serum level of GH, GHRH, somatostatin. The serum level of GH was statisticallyu higher in group III, IV than group I, II. There was not significant difference in serum level of GHRH. The serum level of somatostatin was higher in group II, III, IV than group I, but there was no statistical significance in each group. GH has a important role in hypertrophic callus formation in severe head injury patients, but there was no evidence that the mechanism is mediated by beta-EndorphinGHRH & somatostatin-GH-GF-1, beta-FGF axis. There may be a another mechanism in increasing GH that was stimulated by beta-endorphin in thalamus and lateral ventricle, and it should be necessary for further evaluation of it.
Axis, Cervical Vertebra ; beta-Endorphin ; Bony Callus ; Craniocerebral Trauma* ; Head* ; Humans ; Lateral Ventricles ; Somatostatin ; Thalamus

As the productive activities have vastly increased following industrialization and urbanization in the modem society, the resulting high mobility of people and goods have caused a sharp increase in the accidents in the work places as well as traffic accidents. In particular, deaths caused by injuries are generally concentrated in the economically active young peoples, producing incalculable losses to the society and nation as a whole. Advanced nations with superior medical care systems have succeeded in reducing incidents of such deaths by operating trauma centers. Especially noteworthy is the case of the United States where such specialized trauma centers have greatly contributed to reducing deaths from injuries in the non-urban areas with less access to medical facilities. At present Korea has no medical centers specializing in injuries. In large cities, the injuries are being treated tertiary medical facilities while in the provinces they are referred to small and medium-sized hospitals that constitute secondary medical facilities. Currently in Korea the Trauma patients are treated at general hospitals that consist of 726 secondary medical facilities and 40 tertiary medical centers nationwide. The secondary medical facilities which tend to take most responsibility for the treatment of trauma are generally deficient in medical staff and facilities (including operating and intensive care facilities). Despite such deficiency and limitations, no regulations exist regarding treatment or transportation of trauma patients. This article reports the outcome of a comparative analysis of the results of trauma treatments among different types of medical facilities based on objective data in the hope that such study would facilitate a comparison with the treatment systems of advanced countries and thereby contribute to a precise formulation of problems that must be addressed in this area.
Accidents, Traffic ; Hope ; Hospitals, General ; Humans ; Critical Care ; Korea ; Medical Staff ; Modems ; Social Control, Formal ; Transportation ; Trauma Centers ; United States ; Urbanization ; Workplace ; Industrial Development

BACKGROUND: Domestic violence once considered an infrequently occurring event existing only in deviant relationships, it has been more recently recognized as a widely distributed phenomenon resulting from multiple cultural, social, psycological factors. According to declining world economics, family violence rises with a simultaneous curtailment of agencies available to assist battered persons and there is increasing pressure on emergency departments to serve those who might otherwise have sought help from public agency. In Korea, we don't have any clinical data about domestic violence, and authors analysed clinical pictures of domestic violence victims who came to the emergency department of Korean University medical center. METHOD: We reviewed the victims of the domestic violence retrospectively, who visited in ED, Korean Univ. Hospital from Jan. 1996 to the Dec. 1996. We Analysed data to Age, sex, Injury severity score, location of injury, mechanism, perpetrator. RESULTS: During the study period, total 134 domestic violence victims were identified. The young, females were predominantly victimized. And married women were more commonly violated. (about 70%). ISS was relatively mild (2.491), face and head were mainly injured by punching and objects throwing. The Prevalence of domestic violence victims almost presented at Emergency department between 6:00/P.M. and 8:00 A.M.. CONCLUSION: Emergency physicians suspect domestic violence victims who injured at face and head by punching or hitted would. In these patients, we need more detail history and physical exam. And in case of repeated domestic violence, refer to neuropychatry dept and social workers with perpetratrs, and need mere concerte social programs for domestic violence.
Academic Medical Centers ; Domestic Violence* ; Emergencies* ; Emergency Service, Hospital* ; Female ; Head ; Humans ; Injury Severity Score ; Korea ; Prevalence ; Retrospective Studies ; Social Workers

Background/Aims: Recent reports suggest that the biliary self-expandable metallic stent (SEMS) is highly effective for maintaining hemostasis when endoscopic hemostasis fails in endoscopic retrograde cholangiopancreatography (ERCP)-related bleeding. We compared whether temporary SEMS offers better efficacy than angioembolization for refractory immediate ERCP-related bleeding. Methods: Patients who underwent SEMS placement or underwent angioembolization for bleeding control in refractory immediate ERCP-related bleeding were included in the retrospective analysis. We evaluated the hemostasis success rate, severity of bleeding, change in hemoglobin levels, amount of transfusion, and delay to the start of hemostasis. Results: A total of 27 patients with SEMS and 13 patients who underwent angioembolization were enrolled. More transfusions were needed in the angioembolization group (1.0±1.4 units vs. 2.5±2.0 units; p=0.034). SEMS failure was successfully rescued by angioembolization. The partially covered SEMS (n=23, 85.1%) was generally used, and the median stent-indwelling time was 4 days. The mean delay to the start of angioembolization was 95.2±142.9 (range, 9–491) min. Conclusions Temporary SEMS had similar results to those of angioembolization (96.3% vs. 92.3%; p=0.588). Immediate SEMS insertion is considered a bridge treatment modality for immediate refractory ERCP-related bleeding. Angioembolization still has a role as rescue therapy when SEMS does not work effectively.

BACKGROUND: There is a substantial evidence that anatomical connections and functional interactions exist between vestibular and autonomic systems. The nature of these interactions, however, is complex and has not been fully defined. Heart rate variability (HRV) was used to investigate the physiological role of the vestibular system on control of heart rate. METHODS: HRV including mean, standard deviation, coefficient of variation (CV), power spectrum was analyzed from R-R intervals of ECG during vestibular stimulation in rabbits. RESULTS: Urethane anesthesia increased heart rate and maintained regular R-R intervals, however, low frequency region/high frequency region (LF/HF) was not changed. In anesthetized rabbits, electrical stimulation of the vagus nerve decreased heart rate and decreased LF/HF by increasing HF. On the contrary, electrical stimulation of the cervical sympathetic nerve increased heart rate and increased LF/HF by increasing LF. Atropine, cholinergic blocker, increased heart rate and increased LF/HF by reducing HF, and propranolol, beta-adrenergic blocker, decreased heart rate and decreased LF/HF by reducing LF. In unanesthetized rabbits, stimulation of the vestibular system induced by rotation or caloric increased heart rate and increased LF/HF by increasing LF. Also electrical stimulation of the vestibular nerve produced the same effects as rotation or caloric in anesthetized rabbits. CONCLUSION: These results suggest that stimulation of the vestibular system increased heart rate not by inhibiting the parasympathetic nerve but by activating the sympathetic nerve.
Anesthesia ; Atropine ; Autonomic Nervous System ; Electric Stimulation ; Electrocardiography ; Heart Rate* ; Heart* ; Propranolol ; Rabbits* ; Urethane ; Vagus Nerve ; Vestibular Nerve

BACKGROUND: The possible role of apolipoprotein E (APOE for gene, apoE for protein) allele in atherosclerotic diseases is not clearly understood. For the putative role of APOE genotypes, we examined APOE polymorphism among patients with stroke. METHODS: A total of 202 ischemic stroke patients were involved in this study. The genotype DNA was isolated from whole blood and the APOE alleles were determined by polynicrase chain reaction. RESULTS: The genotype of APOE epsilon3/3 was the most common allele in the stroke group and the control group. The frequencies of APOE epsilon2, epsilon3, epsilon4 allele in stroke group were 0.052, 0.851, and 0.097, respectively. There was no significant difference in APOE genotypes between the stroke group and the control group. No significant associations lions were found for the APOE genotypes and the serum lipid profiles. CONCLUSION: These findings suggest that APOE was not related to the stroke,
Alleles ; Apolipoprotein E2 ; Apolipoproteins E ; Apolipoproteins* ; DNA ; Genotype ; Humans ; Lions ; Stroke

BACKGROUND: The orthostatic hypotension in response to the assumption of an upright posture is regulated by activation of sympathetic nerves. Role of the vestibular system and neural pathway on orthostatic hypotension were investigated. METHODS: Changes of arterial blood pressure produced by head-up tilting, rotatory stimulation of the vestibular system, or electrical stimulation to the vestibular nerve, vestibular nuclei, and rostral ventrolateral medulla (RVLM) were measured in Sprague-Dawley rats. Also, field potentials were recorded in the vestibular nuclei and RVLM and c-Fos expression was evaluated in the brain stem in order to investigate the vestibulosympathetic pathways. RESULTS: The three phasic blood pressure responses were elicited by head-up tilting: initial fall, early recovery, and late sustained pressure at near control levels, the magnitude of the pressure fall was parallel with the degree of head-up tilting in normal rats. Return position from head-up tilting recovered control level of blood pressure after a brief rapid elevation. However, bilateral labyrinthectomy resulted in exaggerated initial falling and devoid of early recovery phase during postural change. Sinusoidal rotation about off-vertical axis of the vestibular system elicited more elevation of blood pressure than rotation about earth vertical axis. Electrical stimulation of the vestibular nerve, vestibular nucleus, and RVLM produced elevation of blood pressure, which was the most prominent by stimulation of RVLM. Field potentials composed of P, N1, N2 waves in the vestibular nuclei were recorded by stimulation of the vestibular nerve, while weak potentials in RVLM were recorded by stimulation of the vestibular nuclei. An electrical stimulation of the vestibular nuclei expressed c-Fos immunoreactive cells in RVLM. CONCLUSION: These results suggest that the otolith organ of the vestibular system plays a major role in control of orthostatic hypotension, and the pathway of vestibulosympathetic reflex in control of blood pressure involves the vestibular nuclei, RVLM, intermed-iolateral nuclei of the thoracic spinal cord.
Animals ; Arterial Pressure ; Axis, Cervical Vertebra ; Blood Pressure ; Brain Stem ; Electric Stimulation ; Hypotension, Orthostatic* ; Neural Pathways ; Otolithic Membrane ; Posture ; Rats* ; Rats, Sprague-Dawley ; Reflex* ; Spinal Cord ; Vestibular Nerve ; Vestibular Nuclei

BACKGROUND: Cerebral white matter lesions(WMLs), such as leukoaraiosis, may be related to damage from cerebral ischemia and may also be associated with the degenerative process. The apolipoprotein E (APOE) 4 allele is a risk factor for degenerative diseases, such as Alzheimer`s disease, and ischemic brain damage through acceleration of atherosclerosis. No study has been performed regarding WMLs and APOE genotype in Korea. We investigated the association between WMLs and APOE among Koreans. METHODS: Brain MRI was performed in 225 subjects(ages 61 to 85 years) without neuropsychiatric disease randomly selected from the Ansan Health Cohort Study. WMLs observed on 225 MRI scans were rated in terms of severity by 2 raters. All study subjects underwent APOE genotyping. RESULTS: WMLs were observed in 109(48.4%) of subjects. In the subjects with WMLs, the distribution of APOE genotypes was 0.9% for epsilon 2/epsilon 2, 11.0% for epsilon2/epsilon3, 1.8% for epsilon2/epsilon4, 61.5% for epsilon3/epsilon3, 22.9% for epsilon3/epsilon4, and 1.8% for epsilon4/epsilon4, respectively. The distribution of APOE genotypes did not differ between subjects with and without WMLs. CONCLUSION: These data suggest that there is no association between WMLs and APOE genotypes in Koreans.
Acceleration ; Alleles ; Apolipoproteins E ; Apolipoproteins* ; Atherosclerosis ; Brain ; Brain Ischemia ; Cohort Studies ; Genotype ; Gyeonggi-do ; Korea ; Leukoaraiosis ; Magnetic Resonance Imaging ; Risk Factors