BACKGROUND: It is well known that neuronal degeneration can occur after a brief deprivation of energy source. To investigate whether glial astrocyte can induce a phenomenon of delayed cell death after transient energy loss and to see how different are the effects of nifedipine, lidocaine, carnosine and hypothermia on delayed toxicity in astrocyte. METHODS: Human astrocytoma cells (U1242MG) were used in this study. To assess the astrocyte survival during post-ischemic period after transient histotoxic hypoxia, 3-[4,5-dimethylthiazol-2yl]-2,5, diphenyl tetrazolium bromide (MTT) test was used. Compared to MTT test, tryphan blue test was also used to demonstrate membrane damage of affected cells. Studies on intracellular calcium dynamics during ischemic and post-ischemic period were carried out with fluo-3 and flow cytometry system. RESULTS: The percentage survival of astrocyte during post-ischemic period was decreasing with time. Calcium channel blocker nifedipine, sodium and calcium channel blocker lidocaine and free radical scavenger carnosine could not prevent post-ischemic cell damage. But, hypothermia was only an effective method in ameliorating post-ischemic cell death. Intracellular calcium increase during ischemia and post-ischemia was dependent on extracellular calcium influx. CONCLUSIONS: Only hypothermia was effective in reducing astrocyte death during post-ischemia after transient energy depletion. Intracellular calcium alterations during post-ischemia was from extracellular space.
Anoxia* ; Astrocytes* ; Astrocytoma ; Calcium ; Calcium Channels ; Carnosine ; Cell Death ; Extracellular Space ; Flow Cytometry ; Humans ; Hypothermia* ; Ischemia ; Lidocaine ; Membranes ; Neurons ; Nifedipine ; Sodium

For the measurement of the bone quantity, various methods have been used. Recently, the methods such as a microdensiometry, single photon absorptiometry, quantitative computed tomography were introduced. However, these methods are expensive modalities to be used in daily clinical practice. For the evaluation of the osteoporosis, author's observed Saville's grades, spine contral score and spine fracture on the simple spine roentgenograms of 346 patients over 40 years of age who were exsmined due to their backache at the Department of Orthopedadic Surgery, Kang Nam St. Mary's Hospital, Seoul, and following results were obtained: 1. The percentile incidence of osteoporosis with regard to age and sex : (1) The percentile incidence of osteoporosis over Saville's Grade I was 59.2%(205 of 346 persons); in males 47.4%(55 of 116 persons) and in females 65.2%(150 of 230 persons). (2) The percentile incidence of osteoporosis over Grade 1 in 5th decade was 27.2%(17.1% in males and 33.9% in females), 55.8% in 6th decade(46.6% in males, and 60.4% in females), 78.1% in 7th decade(64.7% in males, and 82.9% in females), 93.7% in 8th decade(87.5% in males and 97% in females), and 100% in both sexes of 9th decade. (3) The percentile incidence of Grade 1 osteoporosis in 5th decade was 23.9%, and in 6th decade it was 46.7%. Thus, Grade I osteoporosis was most common in these age groups. In 7th and 8th decades, Grade I osteoporosis was more common in males, while in the females ot these age groups Grade II was more common. There was no sex difference in the incidence of osteoporosis after the age of 80. Grade IV osteoporosis was found only in a woman who had hysterectomy 7 years ago, and has suffered from Parkinsonism for 3 years. (4) The overall incidence of Grade I osteoporosis was 34.6%, and Grade II was 21.3 %. The incidence of osteoporosis over Grade III was 1.7% in males, and 6.5% in females. 2. Incidence of osteoporosis assessed by Barnett's central score and its correlation with Saville's assessment: (1) The central score obtained at the 3rd lumbar spine ranged from 71.4 to 106.4. The number of cases were 16 in the score range of 70 to 80, 93 in the score range of 101 to 110, and 5 in the score range of 111 to 120. In consequence the most high incidence was in the score range of 91 to 100. (2) Grade O Oxteoporosis corresponded with the central score of 96.4 on an average (range : 86.8 to 106.4), Grade I corresponded with 91.6 (range : 85.7–103.1), Grade II corrosponded with 86.4 (range : 78.3–96.9), Grade III corresponded with 79.4 (range : 71.4–91), and Grade IV corresponeded with 75.8. (3) Barnett defined the spine is osteoporotic, when the central score is below 80. However, in this study only 16 patients(4.6%) had the score below 80. No bodies having Grade 0 and I osteoporosis had the score below 80; of those 16 patients having the score below 81, 5 were Grade II, 10 Grade III, and one Grade IV. Through this study, it is clesr that there is no correlation in these two assessing methods. The central score below 80 was found in severely porotic patients such as Grade III and IV, but was not found in most cases of Grade I and II osteoporotic patients. (4) The vertebral defromity was found only in 38 cases (10.9%), and it was found only in 18.9% of osteoporosis patients. The percentile incidence of deformity was 5.3% of Grade I, 31% of Grade II and 52.9% of Grade Ill. (5) Of these deformities, wedge-shaped one was found in 6 cases of Grade I porosis, 20 of Grade II, and 3 of Grade III. Cod-fish vertebrae (biconcave) were found in 2 of Grade II and 4 of Grade III. The flattened body was found in 1 of Grade II and 2 of Grade III. Thus, biconcave and flattened vertebrae were found only in the porotics over Grade II severity. (6) In 24 cases, one body was deformed, and in 14 cases multilevel vertebral deformities were found. In these 20 cases had deformity in the Ll, 10 cases each in T12 and L2, 7 cases in L3, 6 cases in L4, and 4 cases in Tll. In summary, the most deformities were in the dorsolumbar region. (7) Fracture was induced by trauma in the 11 cases(29%), among which 10 were wedgeshaped, and the rest was flattened. The biconcave vertebra was found not to be related with injury.
Absorptiometry, Photon ; Back Pain ; Congenital Abnormalities ; Female ; Humans ; Hysterectomy ; Incidence ; Male ; Osteoporosis ; Parkinsonian Disorders ; Seoul ; Sex Characteristics ; Spine

Isolated avulsion fracture of the tibial attachment of the posterior cruciate ligament has been thought very rare. We also had experienced only nine cases of above injury in our center during 5.5 years from January, 1976 to June, 1981. Eight cases of them were followed for an average of the thirteen months, but one of them was eliminated from the study because follow-up study was impossible for the case. The purposes of this paper are to present eight cases of isolated avulsion fracture of the tibial attachment of the posterior cruciate ligament and to discuss the causes and mechanisms of the injury and the method of screw fixation for the avulsed fracture fragment. Seven were injured by traffic accident and one by fall on the knee. All cases seemed to be injured by the force directed against the flexed knee which violently stroke the anterior surface of the proximal end of the tibia or inferior portion of the knee and drove it backwards. We found the tear of posterior capsule only in one patient who was seeming injured by extensive force. All cases were treated operatively by means of screw fixation, and excellent results were obtained in five cases, good in two, and fair in one case.
Accidents, Traffic ; Follow-Up Studies ; Humans ; Knee ; Methods ; Posterior Cruciate Ligament ; Stroke ; Tears ; Tibia

The present study has been undertaken to investigate the values of serum lipids with hypertension and ischemic heart diseases. Serum lipids and lipoproteins were measured from 231 cases of hypertension, 23 cases of angina pectoris, 18 cases of acute myocardial infarction and 67 healthy adults together with normal value as controls. The results obtained were as follows: 1. The mean values of serum lipids in healthy adults were 111.0+/-41.3mg% for triglyceride, 171.2+/-33.5mg% for cholesterol, 175.1+/-36.3mg% for phospholipid, 479.9+/-82.6mg% for total lipid. The values of serum lipoproteins were 219.8+/-46.8mg% for beta-lipoprotein, 93.4+/-53.8mg% for pre beta-lipoprotein and 164.1+/-40.8mg% for alpha-lipoprotein. The values of cholesterol, triglyceride and beta-lipoprotein were gradually increased with aging. 2. The mean values of serum lipids in patients with hypertension were 176.3+/-94.5mg% for triglyceride, 199.7+/-36.9mg% for cholesterol, 207.8+/-38.0mg% for phospholipid, 601.9+/-139.9mg% for total lipid. The values of serum lipoproteins were 266.0+/-73.5mg% for beta-lipoprotein, 147.7+/-89.5mg% for pre-beta-lipoprotein and 187.7+/-56.7mg% for alpha-lipoprotein. The serum lipid values in patients with hypertension were significantly higher than those in healthy controls. 3. The mean values of serum lipids and lipoproteins in patients with angina pectoris were significantly higher than in healthy controls. 4. The serum lipid values in general were higher rather in patients with acute myocardial infarction than healthy controls, but the values of serum phospholipid, pre-beta-lipoprotein and alpha-lipoprotein in them were not significantly higher than those in healthy controls. 5. The values of serum HDL-cholesterol in patients with hypertension, anginal pectoris and acute myocardial infarction were lower than those in healthy controls. The values of serum HDL-cholesterol in all cases were in general higher rather in femal than male.
Adult ; Aging ; Angina Pectoris ; Cholesterol ; Humans ; Hypertension* ; Lipoproteins ; Male ; Myocardial Infarction ; Myocardial Ischemia* ; Reference Values ; Triglycerides

BACKGROUND: The implementation of intraoperative normovolemic hemodilution is a strategy used in an attempt to diminish the need for or obviate allogeneic transfusion and to avert the potential complications. The goal of this study was to evaluate the safety and efficacy of moderate intraoperative normovolemic hemodilution. METHODS: Fifteen patients scheduled for posterolateral spinal fusion underwent intraoperative normovolemic hemodilution with 10% pentastarch to a target hematocrit level of 25% (hemodilution group). All units of blood procured by hemodilution and additional allogeneic blood was transfused in the perioperative period to maintain the hematocrit level of>25%. We investigated the effect of hemodilution on whole blood coagulation as measured by the thromboelastography and, evaluated its efficacy of decreasing the need for allogeneic blood transfusion as compared to the nonhemodilution group, retrospectively. RESULTS: Hemodilution with pentastarch caused a decrease in response and coagulation time (p<0.01) but did not influence on the alpha angle and maximum amplitude on thromboelstogram. Amount of transfusion of allogeneic blood was 4.1 1.7 units for the hemodilution group and 5.0 1.5 units for the nonhemodilution group. Net red blood cell volume ""saved"" from hemodilution was about 120 ml. CONCLUSION: Moderate intraoperative normovolemic hemodilution with pentastarch does not affect the coagulability of whole blood. But its efficacy of decreasing the need for allogeneic blood transfusion is minimal.
Blood Coagulation ; Blood Transfusion ; Erythrocytes ; Hematocrit ; Hemodilution* ; Humans ; Hydroxyethyl Starch Derivatives ; Perioperative Period ; Retrospective Studies ; Spinal Fusion* ; Thrombelastography

Double primary cancer is defined as the case of primary malignant tumors in one person, which must be arisen in different sites and have a different histologic appearances in each other. The number of reported cases of multiple primary malignant tumors has increased in recent years, because of more developed diagnostic procedure and long survival of cancer patients, We have experienced 4 cases of double primary malignant tumors which were stomach cancer with colon, bronchus and esophagus cancer, and report these cases with review of literatures.
Bronchi ; Colon ; Esophageal Neoplasms ; Humans ; Stomach Neoplasms

Double primary cancer is defined as the case of primary malignant tumors in one person, which must be arisen in different sites and have a different histologic appearances in each other. The number of reported cases of multiple primary malignant tumors has increased in recent years, because of more developed diagnostic procedure and long survival of cancer patients, We have experienced 4 cases of double primary malignant tumors which were stomach cancer with colon, bronchus and esophagus cancer, and report these cases with review of literatures.
Bronchi ; Colon ; Esophageal Neoplasms ; Humans ; Stomach Neoplasms

The relative bioavailability amd palsma level fluctuation of controlled release carbamazepine (carbamazepine CR, CBZ CR, Tegretol CR) to the regular product (Carbamazepine RR, CBZ RR, Tegletol RR) were studied in 12 patients who were taking stable dose of carbamazepine for more than six weeks. Fixed dosage regimen (400 mg every 12 hours) of both products was administered in a random cross over manner at least for four days. After reaching steady-state, serial blood samples were drawn after last dose administration. Plasma carbamazepine levels were analysed by fluorescence polarizing immunoassay. The controlled lelease products showed lower area under the concentration time curve (AUC; 89.7)20.0 ug/ml/hr) than that (107.1)13.2 ug/ml/hr) of the regular products (p<0.01), and also showed low peak plasma level (CR;848)l.93ug/ml, RR;10.57+1.55 ug/ml). However. Fluctuation of plasma drug level during dose interval was slightly less in controlled release products compared with carbamazepine regular products in the respect of various indices such as percent fluctuation, fluctuation index and area deviation from mean level. However those parameters did not show no statistical singificance between two products except area diviation (p<0.01). Though the controlled relase product showed slightly less fluctuation during dose interval, this seemed to be the expense of incomplete bioavailability. As a conclusion, the dose correction should be made according to the relative bioavailability of controlled release formulation if switching of the formulation from regular to controlled release form would be needed. However it could not be proved that controlled release fromulation had less fluctiuation during dose interval in this study. More detailed studies should be pursued to show the evidence of significant superiority of currently marketing controlled release formulation to the regular one.
Biological Availability* ; Carbamazepine* ; Fluorescence ; Humans ; Immunoassay ; Marketing ; Plasma

No abstract available.

Tuberculosis of the puboischium is an uncommon entity. The two constant features in tubereulosis of the pubis are limping and abscess formation. This disesse should be differentiated from other diseases such as osteitis pubis, suppurative osteomyelitis, postpartum synphysiolysis, and adolescent osteochondritis. Kirker advocated that wide excision of the lesion for the treatment of this disease is the best method. However, Nicholson(1953) reported that the lesion has a good prognosis snd responds well to simple curettage. Since the first reports by Thilesen(1855) and by Heinnies(1888), there were paucity of reports. Also in Korea, there have been no report about this disease. The five patients who were treated at the Ksng-Nsm St. Marys Hospitsl between 1982 and 1987 were reported. The results were as follows ; 1. Four patients were boys and one was a female. 2. All cases had clinically abscess, tenderness at the lesion, and limp. 3. Lesions in four cases responded well to simple curettage and18 months of chemotherapy. However, in one case fusion of the symphysis using a plate was performed because of tuberculosis-induced instability of the sacroiliac joint. 4. In a child, destroyed symphysis pubis was well restituted after treatment. Through the cases it is concluded that simple curettage and anti-tuberculous chemotherapy are good treatment modality for tuberculosis of the puboischium.
Abscess ; Adolescent ; Child ; Curettage ; Drug Therapy ; Female ; Humans ; Korea ; Methods ; Osteitis ; Osteochondritis ; Osteomyelitis ; Postpartum Period ; Prognosis ; Pubic Bone ; Sacroiliac Joint ; Tuberculosis