No abstract available.
Congenital Abnormalities* ; Neck*

The aim of this stud y was to compare the epidermal thinning properties of four corticosteroid ointments applied under occlusion, using histology and histometry. The results were surnmerized as follows: 1.The stratum corneurn was dramatically thinned, appearing as a wispy layer of horny cells as apposed to the norrnal basket-weave configuration. this effect was prominent at sites treated with clobestasol propionate, fluocinonide, and fluocinolone acetonide. 2. With the histometry, visible epidermal thickness wa.s markedly reduced. This effect w is prominent in the following ascending order: fluocinolone acetonide, fluocienonide, clobestasol-17-propionate. Hydrocortisone was the least atrophogenic. 3. Clohestasol-17-propionate and fluocinonide caused significant flattening of dermo-epidermal junction, Fluocinolone acetonide and hydrocortisone caused less pronounced cbanges. 4. Marked capillary dilation af papilly dermis is caused by clobestasol-17-propionate, fluocinonide and fluocinolone acetonide.
Adrenal Cortex Hormones* ; Atrophy* ; Capillaries ; Dermis ; Diethylpropion ; Epidermis* ; Fluocinolone Acetonide ; Fluocinonide ; Humans* ; Hydrocortisone ; Ointments

A study was made of the differences in clinical features and immunological aspects between herpes zoster patients with malignancies and those without malignant tumors. The results obtained from the retrospective review of medical records are as follows: Herpes zoster occurred more frequently in younger patients(less than twenty) with malignanciee as compared with the control group of the same ages,' Male was dominant among zoster patients with malignancies as is the contrary to contral group; Tihere were no marked differences in primarilly involved dermatomes between the two groups; Generalized varicelliform eruptiona were more common in zoster pa,tients with malignaneies than in control group, It seemed that zoster patients with malignancies complained of milder degree of pain. Zoeter patienta associated with malignancies were more frequently DNCB-negative and had decreased OKT3+ pan T cells, OKT4+ helper/inducer T cells as compared with control group, which suggest impaired cell mediated immunity in the former.
Herpes Zoster* ; Humans ; Immunity, Cellular ; Male ; Medical Records ; Retrospective Studies ; T-Lymphocytes

Infection involving the spinal cord and cauda equina are much less common than intracranial infection. Among the above, bacterial infection in spinal epidural space are relatively uncommon but well recognized entity in adult and children. More than 300 cases with spinal epidural abscess are described in the literatures. Because of its rarity, there is delay in diagnosis and irreversible neurological sequelae in high percentage of cases. Infection of the spinal epidural space are accompanied by fever, tachycardia, headache, pain and tenderness in the back, weakness of the lower extremities and finally a complete paraplegia. The modes of infection are 1) direct extension from inflammatory process in adjacent tissues 2) perforating wounds or lumbar puncture 3) hematogenous route from the remote origin. The most frequent causative organism is staphylococcus aureus always, but pneumococcus, streptococcus, pseudomonas, typhoid bacillus, pyocyanus, oidium coccidioides and fungus are causative organisms occasionally. In spinal epidural abscess with complete paraplegia, the neurologic sequelae are permanent and unhappy. So the spinal epidural abscess is neurosurgical emergency in which early diagnosis and prompt surgery are necessary to avert permanent cord damage. Recently, the spinal epidural abscess has increasing tendency. We have treated 5 cases with spinal epidural abscesses from Nov. 1974 to Apr. 1976. The followings are results ; 1) Sex incidence showed male 2, female 3 and age incidence ranged from 21 years to 38 years, but 4th decade was most common. 2) Most common mode of infection was unknown though all cases have been applied the acupunture for the back pain several times. 3) Most avaliable procedures of diagnosis were the usual infectious symptoms, leukocytosis, increased erythrocyte sedimentation rate, obstructive responce by Queckenstedt test and findings of myelography, including increased protein and pleocytosis in cerebrospinal fluid. 4) All 5 cases had been performed total laminectomy from T3-L3, according to the lesions commonly in thoracic spine with spinal epidural abscess and had been treated with penicillin G, Methicillin and Geopen. 5) The prognosis was poor in 4 cases with complete paraplegia but 1 case with incomplete paralysis recovered completely.
Adult ; Bacillus ; Back Pain ; Bacterial Infections ; Blood Sedimentation ; Carbenicillin ; Cauda Equina ; Cerebrospinal Fluid ; Child ; Coccidioides ; Diagnosis ; Early Diagnosis ; Emergencies ; Epidural Abscess* ; Epidural Space ; Female ; Fever ; Fungi ; Headache ; Humans ; Incidence ; Laminectomy ; Leukocytosis ; Lower Extremity ; Male ; Methicillin ; Myelography ; Paralysis ; Paraplegia ; Penicillin G ; Prognosis ; Pseudomonas ; Spinal Cord ; Spinal Puncture ; Spine ; Staphylococcus aureus ; Streptococcus ; Streptococcus pneumoniae ; Tachycardia ; Typhoid Fever ; Wounds and Injuries

BACKGROUND: Recently, measurement of heart rate variability and the nonlinear complexity of heart rate dynamics have been used as indicators of cardiovascular health. Hypertensive patients showed alternation of cardiovascular homeostasis. We designed this study to evaluate the effect of anesthesia in hypertensive patients with approximate entropy (ApEn), representing the nonlinear complexity. METHODS: With informed consent, none premedicated normotensive (n=18) and hypertensive patients (n=18) were included in this study. ECG data were collected from 10 minutes before induction to 15 minutes after induction. Collected ECG data were stored into computer binary files. We calculated ApEn from the collected ECG data. RESULTS: Before induction, ApEn of hypertensive patients was significantly lower than that of normotensive patients (p<0.05). During induction and maintenance of anesthesia, there was no difference of ApEn between the two groups. ApEn of normotensive patients during induction and maintenance of anesthesia was significantly lower than that of pre-induction (p<0.05). ApEn during maintenance of anesthesia was lower than that of induction of anesthesia (p<0.05). ApEn of hypertensive group during maintenace of anesthesia was significantly lower than that of pre-induction of anesthesia (p<0.05). CONCLUSIONS: As the ApEn of hypertensive patients is lower than that of normotensive patients during pre-inducton period, the heart rate dynamics of hypertensive patients is more regular normotensive patients. The anesthesia is deepened, the heart rate dynamics of the both group is more regular. During the maintenance of anesthesia, the regularity of the heart rate dynamics that not different in both group from the results.
Anesthesia* ; Electrocardiography ; Entropy* ; Heart Rate ; Homeostasis ; Humans ; Hypertension* ; Informed Consent

PURPOSE: To compare the Hong's grading method, utilized for slit-lamp grading of the mid-peripheral angle, with other conventional grading methods. Actual angle was measured by ultrasound biomicroscopy (UBM) for comparison. METHODS: Fifteen eyes with narrow angles and eighteen eyes with wide angles were studied. The average age of thirty-three subjects was 46.8+/-19.2, and the male to female ratio was 1:3.7. The mid-peripheral angle was graded by Hong's, van Herick's and Spaeth's grading system. The actual anterior chamber angle was evaluated by UBM and the correlation between each grading system and actual angle was investigated. RESULTS: The results from the Hong's grading (r=0.802, R2=0.643, p<0.01), Spaeth's grading (r=0.728, R2=0.530, p<0.01) and van Herick's grading (r=0.618, R2=0.382, p<0.01) methods correlated significantly with the actual angles. CONCLUSIONS: The Hong's grading method was an easy and effective tool to evaluate anterior chamber angle. In addition, the results of the Hong's grading method were closer to the actual angle than the other methods.
Anterior Chamber ; Female ; Glaucoma ; Humans ; Male ; Microscopy, Acoustic

BACKGROUND: To evaluate the role of emergency debridement performed in conjunction with an empirical antibiotic therapy in clinically diagnosed, full-blown Vibrio vulnificus sepsis. METHODS: Immediate surgical debridement was performed on 13 out of 15 patients who were clinically diagnosed as having Vibrio vulnificus sepsis. RESULTS: Among 15 patients Vibrio vulnificus was isolated in 8 patients. Underlying diseases were liver cirrhosis (2), chronic alcohol ingestion or chronic liver disease (10), diabetes mellitus (3), gastrectomy (1) and in 4 cases no underlying condition was identified. All patients had skin lesions such as erythema, bulla, vesicle and gangrene. All but one initially showed variable degree of hypotension, thrombocytopenia, hepatic dysfunction, renal failure and mental confusion. Their mean APACHE III score was 84. Immediate survival (within 48hrs) in clinically diagnosed Vibrio sepsis was 80% (12/15) and long term survival rate among them was 66.6%. Forty-eight hour survival rate in bacteriologically confirmed cases of Vibrio vulnificus sepsis was 75%, where their long-term survival was 62.5%. CONCLUSION: In treating full-blown Vibrio vulnificus sepsis, immediate emergency surgical debridement performed in conjunction with the empirical antibiotics gives a possibility to improve both immediate and long term prognosis of the disease.
Anti-Bacterial Agents* ; APACHE ; Debridement* ; Diabetes Mellitus ; Eating ; Emergencies* ; Erythema ; Gangrene ; Gastrectomy ; Humans ; Hypotension ; Liver Cirrhosis ; Liver Diseases ; Prognosis ; Renal Insufficiency ; Sepsis* ; Skin ; Survival Rate ; Thrombocytopenia ; Vibrio vulnificus ; Vibrio*

BACKGROUND: In the acute phase of myocardial infarction, the hemostatic mechanism is known to be activated. However, it remains unclear whether increased activity of the hemostatic mechanism is only a marker of the acute thrombotic episode or precedes its appearance. It is also inapparent whether a hypercoagulable state persist for a prolonged period after the apparent resolution of these disorders. METHODS: In a group of 23 patients with acute myocardial infarction who received fibrinolytic therapy with urokinase(group A) or tPA(group B), the plasma level of fibrinogen, antithrombin compared to those of the 10 normal controls. RESULTS: The plasme level of fibrinogen was significantly decreased in both group A and B before and 4 to 24 hours after thrombolytic therapy compared to that of normal controls. But it was increased 7 to 14 days after thrombolytic therapy. In a few of the patients, the plasma level of FDP and D-dimer were positive before thrombolytic therapy and in the most patients they were positive 4 hours after thrombolytic therapy. The plasma level of AT-III was significantly increased in both group A and B before thrombolytic therapy compared with that of normal controls, but, after thrombolytic therapy, there was no significant change in its level. CONCLUSIONS: In the patients with acute myocardial infarction, the thrombolysis occurred before thrombolytic therapy and it lasted for 24 hours after thrombolytic therapy.
Antithrombin III* ; Fibrinogen ; Humans ; Myocardial Infarction* ; Plasma ; Thrombolytic Therapy*

To increase the survival area of the venous flap, we studied the arterialized venous flap in a rabbit ear model. The ears of 12 New Zealand white rabbits(n=24) were randomized into three groups, group A receiving arterio-venous anastomosis 14 days before the arterialized venous flap elevation; group B receiving bipedicled flap elevation 14 days before arterialized venous flap elevation; group C receiving no pretreatment before the arterialized venous flap elevation. Tc -pertechnetate scan was performed on all groups immediately after the arterialized venous flap elevation to evaluate the blood flow of the flap. The survival area of the flap was measured 14 days after the arterialized venous flap elevation. Average ratio of survival area was 92% in Group A, 88% in group B, which were comparatively higher than the 12% in group C. The entire flap was visualized in groups A and B on scan images, however, only the proximal area of the anterior and posterior marginal vein was visualized in group C. Flap survival pattern was similar to that of the scan image and the slope of time-activity curve of groups A and B was much steeper than that of group C. High survival rate of group A, which received the arterio-venous anastomosis as a pretreatment, may be due to the decrease of resistance of outflow during the 14 days. Anticipated mechanisms involved are, valve insufficiency due to high pressure arterial inflow, development of vascular collaterals in the flap, and opening of arteriovenous(A-V) shunt. Bipedicled flap elevation as a pretreatment may not effect on valves, however, may impair the sympathetic nerve and cause ischmic stimuli which in turn may develop vascular collaterals and make an opening of the A-V shunt.
Ear ; New Zealand ; Survival Rate ; Veins

Rapamycin, a macrocyclic lactone, is effective in reducing the incidence of acute rejection after renal transplantation. The inhibitory effects of rapamycin on lymphocyte proliferation and the molecular mechanisms that were involved have been described. However, its effects on glomerular mesangial cells have not been clearly understood, and here, we examined the effect of rapamycin on platelet-derived growth factor (PDGF) - induced extracellular matrix synthesis as well as cell proliferation in mesangial cells. Rat mesangial cells were isolated from the glomeruli of Sprague-Dawley rats and cultured with Dulbecco's modified Eagles medium containing 20% fetal bovine serum. Different concentrations of rapamycin were administered 1 hour before the addition of 10 ng/ml of PDGF into growth arrested and synchronized cells. Cell proliferation was assessed by [3H]thymidine incorporation, total collagen synthesis by [3H]proline incorporation, and fibronectin secretion into the medium by Western blot analysis. In the mesangial cells, PDGF increased cell proliferation by 4.6-fold, total collagen synthesis by 1.8-fold, and fibronectin secretion by 3.2-fold. Rapamycin above 10 nM significantly inhibited PDGF-induced proliferation and collagen synthesis, but the treatment of rapamycin up to 1micrometer did not show any significant effects on PDGF-induced fibronectin secretion. These inhibitory effects of rapamycin on PDGF-induced mesangial cell proliferation and collagen synthesis reflect the potential value of rapamycin in the prevention and treatment of glomerulosclerosis in patients with chronic allograft nephropathy.
Animals ; Cells, Cultured ; Collagen/*antagonists & inhibitors/biosynthesis ; Fibronectins/*biosynthesis ; Glomerular Mesangium/cytology/drug effects/*metabolism ; Immunosuppressive Agents/*pharmacology ; Male ; Platelet-Derived Growth Factor/*pharmacology ; Rats ; Rats, Sprague-Dawley ; Research Support, Non-U.S. Gov't ; Sirolimus/*pharmacology