There has recently been an increased interest in the use of hypertonic saline for the fluid resuscitation of trauma victims and to control intracranial hypertension. In this study, the cerebral and hemodynamic effects of a 3.2% hypertonic saline solution were compared with those of either a 0.9% saline or 20% mannitol solution in a rabbit model of brain injury. Forty-five minutes following the creation of a left hemispheric cryogenic brain lesion, equal volumes of hypertonic saline, 0.9% saline, or mannitol were infused over a 5 minute period. Monitored variables over the ensuing 120 minutes included mean arterial pressure, central venous pressure, intracranial pressure, hematocrit and serum osmolality. Upon conclusion of the two hour study period, regional cortical water content was determined by the specific gravity method. There were no significant differences in mean arterial pressure between the three groups at any point during the experiment. Plasma osmolality was signifieantly increased by 10-11 mOsm/kg in the mannitol and hypertonic groups. The infusion of either mannitol or hypertonic saline produced a transient decrease in intracranial pressure lasting approximately 60 minutes, whereas animals in the saline group demonstrated a continual increase in intracranial pressure. The lesioned hemisphere demonstrated a significantly greater water content than the non-lesioned hemisphere. There was no difference in regional cortical water content at any sampling site between the various groups.
Animals ; Arterial Pressure ; Brain Edema ; Brain Injuries* ; Brain* ; Central Venous Pressure ; Hematocrit ; Hemodynamics* ; Intracranial Hypertension ; Intracranial Pressure ; Mannitol* ; Osmolar Concentration ; Plasma ; Resuscitation ; Saline Solution, Hypertonic ; Specific Gravity

BACKGROUND: Many investigations were done about pulmonary protection in lung transplantation which is the most effective treatment of end-stage pulmonary disease. The objective of this study is to verify the effect of prostacyclin on the ischemia-reperfusion injury in terms of the change of arterial blood gas (ABGA), pulmonary vascular resistance (PVR) and pulmonary water content. METHODS: In twelve mongrel dogs weighing approximately 20 kg, double-lumen endotracheal tube was intubated and Swan-Ganz catheter was inserted. To obtain control data for water content of left lung right postcaval lobe was resected. Left hilum was snared with umbilical tape after collapse of left lung and tightened to clamp. It was maintained for 90 min. Thereafter, ventilation and perfusion of left lung were restored. To control group (n=6), prostacyclin was not given. To prostacyclin group (n=6), prostacyclin was intravenously administered at 250 ng/kg/min for 20 min, just before ischemia and just after reperfusion. We measured hemodynamic variables and analyzed arterial blood gas before and after ischemia and then at every 1 hour interval. At 4 hours after reperfusion, left lung was resected, and water content was measured with wet-dry method. RESULTS: There was no significant difference between control group and prostacyclin group in ABGA, PVR and water content of lung. However, three subjects of prostacyclin group showed higher PaO2 after reperfusion than that of others. CONCLUSION: This study shows that protective effect of prostacyclin is not uniform in severely injured canine ischemia-reperfusion model. We conclude that prostacyclin does not have pulmonary protective effect in severe ischemia-reperfusion injury.
Animals ; Catheters ; Dogs ; Epoprostenol* ; Hemodynamics ; Ischemia ; Lung ; Lung Diseases ; Lung Transplantation ; Perfusion ; Reperfusion ; Reperfusion Injury* ; SNARE Proteins ; Vascular Resistance* ; Ventilation

PURPOSE: This study was to confirm the effect of acupressure on the emesis control and the weight change among pediatric cancer patients receiving anti-cancer chemotherapy. METHOD: Forty pediatric cancer patients, receiving the induction stage of chemotherapy with MTX and vincristine, were divided into control(n=20) and the intervention group(n=20). Both groups received regular anti-emesis medication, but the intervention group was added acupressure maneuver for 5 minutes on P6 point for 3 times a day for 5days: before chemotherapy, lunch and dinner by investigator during the hospitalization and by mother at home. The instruments for this study were Rhode's(1986) Index of nausea, vomiting and retching(INVR), Cas electric scale and pamphlet developed by researcher. RESULT: Significant differences in the degree of nausea and vomiting were observed between the control and the intervention group as measured by INVR(t=4.73; p=.01). Repeated measures ANOVA also shows that the group effect was significant(F=22.39, P=.01) as was the time effect(F=380.35, P=.01). The group by time interaction was also significant(F=5.27, P=.01). Acupressure maneuver was apparently effective in reducing the degree of chemotherapy-induced nausea and vomiting. There were also statistically significant weight loss noted in the control group than the intervention group(t=5.42, p=.01). CONCLUSION: Acupressure on P6 point shows an effective adjunct maneuver in reducing the degree of nausea and vomiting and conserving the weight in pediatric cancer patients. Therefore, it is proposed that acupressure should be applied as supportive nursing intervention strategies to relieve chemotherapy induced nausea and vomiting and to prevent weight loss in pediatric cancer patients.
Acupressure* ; Drug Therapy* ; Hospitalization ; Humans ; Lunch ; Meals ; Mothers ; Nausea ; Nursing ; Pamphlets ; Research Personnel ; Vincristine ; Vomiting ; Weight Loss ; Child Health

Congenital scoliosis is defined as a lateral curvature of the spine caused by congenital anomalies of the vertebral development. In this study seventeen congenital scoliosis patients seen and treated by either Milwaukee brace or surgical intervention at Department of Orthopedic Surgery, Seoul National University Hospital from December 1972 to April 1978 were evaluated according to frequency of the curve pattern, character of the deformity, method of treatment and its correctability. The following results were obtained in this study. 1. Age distribution was from 2 to 39 years and mean age was 13.4 years. 2. The most common deformity pattern was hemivertebra in 8 cases (47.1%), unilateral unsegmented bar in 4 (23.6%) and mixed type in 3 (17.6%). 3. The most common curve level was thoracic in 6 cases (35.3%), followed by thoracolumbar in 4 (23.5%) and lumbar in 4 (23.5%). 4. The best corrected type by Milwaukee brace was trapezoid vertebra (29.4%) and then mixed type(26.1%), followed by block type (20%) and hemivertebra(2.3%). 5. The operative treatment was performed in the cases of unilateral bar and progressive type with Milwaukee brace. In terms of the correctability of the curvature, the surgical intervention was better than the conservative treatment, with the result of its average correction of 33.5% that is compared with 15.9% of Milwaukee brace. 6. Halofemoral traction was effectively applied in the cases of rigid and severe curve; the initial curve 76.3 degress with 21.3% of flexibility. 7. Loss of correction in operative treatment was 2.3 degrees (6.5%).
Age Distribution ; Braces ; Congenital Abnormalities ; Humans ; Methods ; Orthopedics ; Pliability ; Scoliosis ; Seoul ; Spine ; Traction

The most common fracture about the elbow joint in chilren is a supracondylar fracture. The displaced fracture is difficult to manage due to the potential danger of Volkmann's ischemia, nerve injury, and malunion, During the period of 6 years from June, 1979 to June, 1985, 63 children with supracondylar fractures of the humerus were treated at Pusan Paik Hospital, Inje Medical College, and analyzed. The results are summarized as follows: 1. The average age was 7.1 years, ranged from 1 year to 14 years, and the male and female ratio was 2.5: l. 2. In type of fracture, extension type was 92% and flexion type was 8%. In displacement of fracture, Grade I was only 2 cases, Grade III and IV were 87.3%. Posteromedial displacement was 42.8% (27 cases). 3. At the time of admission, 15cases(23.8%) accompanied nerve injury, of these median nerve injury (9 cases) was most common. All the patient with nerve injury were completely recovered within 14 months after reduction. 4. Severe cubitus varus was 14.2%, and severe limitation of elbow motion was 1.6%. 5. Of 61 displaced fractures, 37 patients were treated with closed reduction and percutaneous pin fixation. By Flynn's criteria, satisfactory results were obtained in 36 of the 37 patients(97.3%) treated with percutaneous pinning. 6. In the displaced fractures, closed reduction and percutaneous pinning is a satisfactory method for obtaining and maintaining reduction while preserving vascular function, if acute flexion is necessary for stable reduction.
Busan ; Child ; Clinical Study ; Elbow ; Elbow Joint ; Female ; Fractures, Closed ; Humans ; Humerus ; Ischemia ; Male ; Median Nerve ; Methods

The final degrees of education for the third and fourth authors were mutually misplaced.

The relationship between infective endocarditis and mycotic aneurysm formation appers clear : In about two to ten percent of patients with infective endocarditis harbor septic intracranial aneurysms. But the pathogenesis, natural course and management of these lesions remains controversial. Aggressive medical treatment of the underlying infected cardiac valve or surgical replacement therapy have significantly reduced the morbidity and mortality rates associated with infective endocarditis. Clinical predictors of mycotic aneurysm, especially neurologic prodromes prior to rupture have been ill-defined since most series contain few patients or include patients with infective aneurysms who have no infective endoarditis. Similarly there has been no consensus regarding the indications and timing of cerebral angiography in patients with infective endocarditis. We have experienced a case of cerebral mycotic aneurysm complicated with subarachnoid hemorrhage due to infective endocarditis in a 29 year-old female patient, who admitted to our hospital because of the pain and paralysis of sudden onset in right forearm, which was diagnosed by echocardiography, brain computed tomography and 4-vessel cerebral angiography. The patient died of sudden rupture of mycotic aneurysm in the 7th hospital day despite intensive medical treatment. We report one case of cerebral mycotic aneurysm with a brief of literature.
Adult ; Aneurysm ; Aneurysm, Infected* ; Brain ; Cerebral Angiography ; Consensus ; Echocardiography ; Endocarditis* ; Female ; Forearm ; Heart Valves ; Humans ; Intracranial Aneurysm ; Mortality ; Paralysis ; Rupture ; Subarachnoid Hemorrhage*

OBJECTIVE: This study aimed to investigate the effect of pre-applied orthodontic force on the regeneration of periodontal ligament (PDL) tissues and the underlying mechanisms in tooth replantation. METHODS: Orthodontic force (50cN) was applied to the left maxillary first molars of 7-week-old male Sprague–Dawley rats (n = 32); the right maxillary first molars were left untreated to serve as the control group. After 7 days, the first molars on both sides were fully luxated and were immediately replanted in their original sockets. To verify the effects of the pre-applied orthodontic force, we assessed gene expression by using microarray analysis and real-time reverse transcription polymerase chain reaction (RT-PCR), cell proliferation by using proliferating cell nuclear antigen (PCNA) immunofluorescence staining, and morphological changes by using histological analysis. RESULTS: Application of orthodontic force for 7 days led to the proliferation of PDL tissues, as verified on microarray analysis and PCNA staining. Histological analysis after replantation revealed less root resorption, a better arrangement of PDL fibers, and earlier regeneration of periodontal tissues in the experimental group than in the control group. For the key genes involved in periodontal tissue remodeling, including CXCL2, CCL4, CCL7, MMP3, PCNA, OPG, and RUNX2, quantitative RT-PCR confirmed that messenger RNA levels were higher at 1 or 2 weeks in the experimental group. CONCLUSIONS These results suggest that the application of orthodontic force prior to tooth replantation enhanced the proliferation and activities of PDL cells and may lead to higher success rates with fewer complications.

Objective: This study aimed to evaluate the association between low tongue position (LTP) and the volume and dimensions of the nasopharyngeal, retropalatal, retroglossal, and hypopharyngeal segments of the upper airway. Methods: A total of 194 subjects, including 91 males and 103 females were divided into a resting tongue position (RTP) group and a LTP group according to their tongue position. Subjects in the LTP group were divided into four subgroups (Q1, Q2, Q3, and Q4) according to the intraoral space volume. The 3D slicer software was used to measure the volume and minimum and average cross-sectional areas of each group. Airway differences between the RTP and LTP groups were analyzed to explore the association between tongue position and the upper airway. Results: No significant differences were found in the airway dimensions between the RTP and LTP groups. For both retropalatal and retroglossal segments, the volume and average cross-sectional area were significantly greater in the patients with extremely low tongue position. Regression analysis showed that the retroglossal airway dimensions were positively correlated with the intraoral space volume and negatively correlated with A point-nasion-B point and palatal plane to mandibular plane. Males generally had larger retroglossal and hypopharyngeal airways than females. Conclusions Tongue position did not significantly influence upper airway volume or dimensions, except in the extremely LTP subgroup.

Idiopathc Central Serous Chorioretinopathy (ICSC)is a self-limited disorder that typically affects healthy middle-aged men. Although extensive information is available pertaining to the clincial features of ICSC in men, little is known about this condition in women. The authors reviewed the medical records and photographic files of 41 CSC cases of women, and comparison was made with 52 cases of men. Thirty eight cases of women were idiopathic, two women were pregnant in the third trimester, and one woman was taking exogenous corticosteroids for asthma. The findings in women with ICSC were similar to those in men, with exception that women tend to have lower initial visual acuity(p<0.05) and smaller size of serous elevation(p<0.01). Our results also reverade a tendency toward increased multiple leaks, higher incidence of smoke stack types, shorter duration of illness and lower recurrence rate in women, but the differences are not statistically significant(p>0.05). The average duration of illness was 3.3 months and the final visual acuity was 0.8 or better in 84.2% and worse than 0.1 in one patient who developed SRNVM. The recurrent elevation was observed in 10.5% of patients. Thus ICSC in women is similar to or more benign than those generally described in men.
Adrenal Cortex Hormones ; Asthma ; Central Serous Chorioretinopathy* ; Female ; Humans ; Incidence ; Male ; Medical Records ; Pregnancy ; Pregnancy Trimester, Third ; Recurrence ; Smoke ; Visual Acuity