No Abstract Available.

There are many problems in treatment of intertrochanteric fractures due to osteoporosis and unstable pattern of fractures in old ages and they are different from those in young ages, for example, type of fracture, degree of osteoporosis, and general condition, ect. Anthors studied about the prognostic factors of 42 cases among 88 patients with intertrochanteric fractures, who were treated and followed up from Jan. 1982 to Dec. 1987. 1. The patients under 50 years old were mainly males(94.4%) and its chief cause of injury was traffic accident or fall down(72.2%). The cause of injury over 50 years old was slip down on ground(62.9%). 2. The osteoporosis was increased according to increased age of patients and then the unstable type of fracture was increased. In yaung patients, the unstable intertrochanteric fracture was rare despite of high violent injury. 3. The bone union of the follow-up patients was gained at average 13.8 weeks. 4. The sliding degree of lag screw was increased with unstable fracture and the incidence of metal protrusion into joint cavity was increased in the patients of eccentric fixation of lag screw into femoral head. 5. The all cases of complication were occured in osteoporotic patients over 50 years old and their causes were inadequate fixation of unstable fracture. 6. The most important factors in prognosis of intertrochanteric fractures are initial pattern of fractures, degree of osteoporosis and adequacy of reduction state(postop.).
Accidents, Traffic ; Follow-Up Studies ; Head ; Hip Fractures ; Humans ; Incidence ; Joints ; Osteoporosis ; Prognosis

PURPOSE: Various prognostic indicators have been identified for mammary carcinomas, but the issue of their significance remains unsettled. The prognostic impact of c-erb B2, Ki-67 and topoisomerase II alpha expression was investigated in relation to prognostic factors for carcinomas of the breast and to the tumor cell growth fraction. METHODS: One hundred eighteen cases of invasive mammary carcinoma were investigated by immunohistochemical staining for c-erb B2, topoisomerase II alpha, and Ki-67. Clinicopathologic parameters were compared with the expression pattern and incidence of c-erb B2, topoisomerase II alpha and Ki- 67 in invasive mammary carcinoma. RESULTS: C-erb B2 showed significant correlation with topoisomerase II alpha (P<0.05), but others were not significant. Topoisomerase II alpha and Ki-67 index closely paralleled each other, indicating that both reflect the proliferate activity of tumor cells and were associated with high nuclear and histological grade, ER and PR expression (P<0.05). CONCLUSION: These results indicate that ki-67 and topoisomerase II alpha proteins might play a role in tumor progression of breast carcinoma. The Ki-67 and topoisomerase II alpha index may be proliferate factors of breast cancer. In addition, the increase expression of Ki-67 and topoisomerase II alpha and hormone receptor were closely correlated each other, and could be used as factors suggesting poor prognosis in breast carcinoma.
Breast ; Breast Neoplasms ; DNA Topoisomerases, Type II* ; Incidence ; Prognosis

To attempt a rigorous definition of the structure of the accessory spleen (AS) in the Chinese hamster, we examined twenty-one animals, and found AS in 5 animals (23.8%), which were over 7-month-old. The AS had no connection with the main spleen and was seen as a dark red oval organ (0.7 mm x 1.5 mm), which was embedded in the adipose tissue near the tail of the pancreas. It was demarcated from the adipose tissue and some pancreatic tissue. The organ was encapsulated by thin collagenous connective tissue and smooth muscle fibers, and contained lymphatic nodules, reticular fibers, nodular central arterioles, macrophages and megakaryocytes. Notably the incidence of AS appeared to increase with age in the Chinese hamsters.
Adipose Tissue/anatomy & histology ; Age Factors ; Animals ; Connective Tissue/anatomy & histology ; Cricetinae ; Cricetulus/*anatomy & histology ; Erythrocytes/cytology ; Lymphocytes/cytology ; Muscle, Smooth/anatomy & histology ; Pancreas ; Spleen/*anatomy & histology/cytology

OBJECTIVE: Contrary to some clinical belief, there were quite a few studies regarding animal models of intracerebral hemorrhage (ICH) in vivo suggesting that prior use of statins may improve outcome after ICH. This study reports the effect of 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG CoA) reductase inhibitor, simvastatin given before experimental ICH. METHODS: Fifty-one rats were subjected to collagenase-induced ICH, subdivided in 3 groups according to simvastatin treatment modality, and behavioral tests were done. Hematoma volume, brain water content and hemispheric atrophy were analyzed. Immunohistochemical staining for microglia (OX-42) and endothelial nitric oxide synthase (eNOS) was performed and caspase-3 activity was also measured. RESULTS: Pre-simvastatin therapy decreased inflammatory reaction and perihematomal cell death, but resulted in no significant reduction of brain edema and no eNOS expression in the perihematomal region. Finally, prior use of simvastatin showed less significant improvement of neurological outcome after experimental ICH when compared to post-simvastatin therapy. CONCLUSION: The present study suggests that statins therapy after ICH improves neurological outcome, but prior use of statins before ICH might provide only histological improvement, providing no significant impact on neurological outcome against ICH.
Animals ; Atrophy ; Brain ; Brain Edema ; Caspase 3 ; Cell Death ; Cerebral Hemorrhage ; Hematoma ; Inflammation ; Microglia ; Models, Animal ; Nitric Oxide Synthase Type III ; Oxidoreductases ; Rats ; Simvastatin

PURPOSE: In Korea, there was no specific guidelines for the management of benign prostatic hyperplasia (BPH). We reviewed the practice patterns of Korean urologists in the management of BPH and aimed to describe the need to develop specific guidelines. MATERIALS AND METHODS: A probability sample was taken from the Korean Urological Association Registry of Physicians, and a structured questionnaire, that explored practice patterns in the management of BPH, was mailed to a random sample of 251 Korean urologists. RESULTS: For the initial evaluation of BPH, most urologists routinely performed prostatic specific antigen (PSA) (96.4%), digital rectal exam (94.4%), international prostate symptom score (IPSS) (83.2%) and transrectal ultrasound (79.2%). Symptom assessment (36.4%) followed by transrectal ultrasound of prostate (TRUS) (20.0%) was considered as the most important diagnostic examination affecting the decision about individual treatment options. Almost all urologists (92.2%) chose medical treatment as the first-line treatment option for uncomplicated BPH with moderate symptoms. Of the respondents, 57.2% had prescribed alpha blocker and 41.6% alpha blocker plus 5-alpha reductase inhibitors as the medical treatment option for BPH. The prescription of 5-ARIs was dependent on the size of the prostate and the severity of symptoms. CONCLUSION: The results of our current survey provide useful insight into variations in the clinical practice of Korean urologists. They also indicate the need to develop further practical guidelines based on solid clinical data and to ensure that these guidelines are widely promoted and accepted by the urological community.
Adrenergic alpha-Antagonists/therapeutic use ; Cholestenone 5 alpha-Reductase/antagonists & inhibitors ; Data Collection ; Humans ; Korea ; Male ; Prostatic Hyperplasia/*diagnosis/*drug therapy ; Urology/statistics & numerical data

BACKGROUND: Triage and transportations are important and life-saving medical task performed at the site of mutiple-casualty incidents(MCIs). We pursued three road traffic accidents victims to find out any problem in triaging and transporting them, and to provide an information for equipping an local disaster planning. METHODS: The medical records of 70 consecutive patients who were transported to five emergency facilities in Kangnung, on three MCIs from 1998 to 2000, were analysed, retrospectively. The intervals and types of transport vehicles were analysed. We compared the prehospital time between severity-based groups, which were graded into 3 groups according to the Triage score(0, 1~8, 9). RESULTS: Among the 70 patients, 33 patients(47.1%), 21 patients(30%), and 16 patients(22.9%) were transported to Level I, Level II, and Level III trauma centers, respectively. The time elapsed from scenes to the Level I trauma center was significantly shorter(p=0.003) than to others, but no differences in the mean Triage score between trauma centers were seen(p>0.05). The 119 rescue services transported 58.6%(41 patients) of victims to emergency facilities, and 58.5%(24 patients) of them was concentrated to Level I. There were no significant differences in the prehospital time between three Triage score groups(p>0.05). CONCLUSION: There was no medical control such as triage and transportation in the cases of three MCIs. In the construction of emergency medical service system(EMSS) preparing MCIs or disasters, we suggest the integration and unification of 119 rescue services and emergency medical information centers for effective medical control. We propose to making a new and simple triage guideline. The prehospital personnel should be educated and disaster drills should be performed under the guideline.
Accidents, Traffic ; Disaster Planning ; Disasters ; Emergencies ; Emergency Medical Services ; Humans ; Information Centers ; Medical Records ; Retrospective Studies ; Transportation* ; Trauma Centers ; Triage*

No abstract available.
Lung*

BACKGROUND: Although impaired endothelial function is well known in patients with diabetes mellitus, the precise mechanism and the factors that contribute to this dysfunction remain to be clarified. We examined the effect of acute hyperglycemia on patients with impaired glucose metabolism in vivo by plethysmography. METHODS: Seven patients with diabetes mellitus or impaired glucose metabolism were studied. In each patient, endothelial function was examined in the fasting state and at two levels of hyperglycemia, which were achieved by the infusion of glucose, insulin, and somatostatin. Forearm blood flow was measured while acetylcholine was infused in increasing concentrations(7.5, 15, and 30 microgram/min) through the brachial artery. RESULTS: Glucose concentrations increased accordingly at each stage, from 135.3+/-18.4 mg/dl at stage 1(the fasting state), to 239.0+/-15.2 mg/dl at stage 2(the first level of hyperglycemia), and to 378.3+/-25.3 at stage 3 (the second level of hyperglycemia) [p<0.01]. Maximal acetylcholine-dependent vasodilation achieved by infusion of acetylcholine at 30 microgram/min was significantly aftenuated during stages 2 and 3 compared with stage 1(p<0.05 by AVOVA; forearm blood flow ratio was 2.87+/-0.18 and 2.56+/-0.14 versus 3.58+/-0.21, respectively). This was also evident during the infusion of 15 microgram/min and 7.5 microgram/min of acetylcholine. CONCLUSIONS: Endothelium-dependent vasodilation is significantly aftenuated by acute hyperglycemia in patients with diabetes mellitus or impaired glucose metabolism. Our findings suggest that elevated glucose may contribute to the endothelial dysfunction observed in patients with diabetes mellitus or impaired glucose metabolism.
Acetylcholine ; Brachial Artery ; Diabetes Mellitus* ; Endothelium ; Fasting ; Forearm ; Glucose* ; Humans ; Hyperglycemia* ; Insulin ; Metabolism* ; Plethysmography ; Somatostatin ; Vasodilation*

The purpose of this study is to evaluate an antioxidative effect of estrogen on the bone in oophorectomized rats. Thirty Sprague-Daley rats were equally divided into 3 groups; group 1 as control group with sham operation, group 2 as experimental group with oophorectomy, and group 3 as oophorectomized group treated with estrogen. Estradiol (5mg/kg BW) was administered three times per week from first to sixth week after oophorectomy. Left tibia was obtained to measure the amount of protein carbonyls as an index of oxidative stress and the activity of antioxidant enzymes. The results were as follows: trahecular bone area in proximal tihia decreased after oophorectomy, which increased in response to estrogen administration. The level of protein carbonylation in hone was not significantly different among all groups. Activity of antioxidant enzymes such ais glutathione reductase(GR), glutathione peroxidase(GP) and glutathione transferase(GST) in bone was not significantly different among all groups. However, the activity of catalase in bone markedly increased in group 3 compared with that in group 1 and group 2. In summary, bone trabecular area increased after admin- istration of estrogen. And estrogen induced the activitv of catalase, which might contrihute to prevent the oxidative damage. However, the glutathione utilizing enzymes such as GR, GP and GST were not significantly affected by estrogen status.
Animals ; Catalase ; Estradiol ; Estrogens* ; Female ; Glutathione ; Ovariectomy ; Oxidative Stress ; Protein Carbonylation ; Rats* ; Tibia