Neurofibromatosis is a disease which involves both neuroectodermal and mesodermal tissue, and is characterized by cafe-au-lait spot, multiple subcutaneous neurofibromas, elephantiasis neuromatosa, a positive family history, and specific dystrophic osseous changes such as scoliosis, penciling of ribs, vertebral scalloping, a paravertebral soft tissue tumor, and congenital pseudarthrosis. The classic type of scoliosis in neurofibromatosis was known as a sharp localized short curve that is often rapidly progressive and produces severe deformity with dystrophic changes, but another form with long gentle curve is reported. Since conservative treatment is usually unsuccessful, posterior fusion with or without Harrington instrumentation is the treatment of choice even in young age when the curve is progressive. This paper was aimed to review our experience with 11 patients having neurofibromatosis and scoliosis, who were treated with posterior fusion and Harrington instrumentation from Jan. 1971 to Dec. 1980, and the results were as follows: 1. The average age that spinal deformity was observed was 7.7 years old, but the average age at treatment was 14.4. 2. Cafe-au-lait spot was observed in all cases, subcutaneous nodule in 7 cases, local gigantism in 2 cases, and positive family history in 3 cases. 2 cases were combined with congenital spinal anormalies. 3. Specific pattern in spinal deformity was not significant. There were 7 short curves less than 5 vertebrae involved and 6 long curves more than 6 vertebrae involved. 4. There were 5 kyphosis which had more than 50°, and those were usually combined with severe scoliosis. 5. Preoperative average degree of scoliosis was 93.8, and the final correction was 41.2° (43.9%) with loss of correction 5.3°(5.7%) after 3.2 year follow-up in average. 6. It shouid be educated for early detection at home and school, and for the importance of early treatment for the scoliosis, to prevent rapid increase of scoliosis in neurofibromatosis.
Cafe-au-Lait Spots ; Congenital Abnormalities ; Elephantiasis ; Follow-Up Studies ; Gigantism ; Humans ; Kyphosis ; Mesoderm ; Neural Plate ; Neurofibroma ; Neurofibromatoses ; Neurofibromatosis 1 ; Pectinidae ; Pseudarthrosis ; Ribs ; Scoliosis ; Spine

Two major factors, delayed hypoperfusion and membrane failure influence the sequelae of cerebral ischemic injury. Calcium ions play a major role in both pathophysiological mechanisms. Calcium channel blockers are a logical choice for investigation as possible therapeutic agents for the treatment of cerebral ischemia. Nimodipine, a dihydropyridine derivative, is one of the most potent calcium channel blocking agent with a selective action on the intracranial vessels. The present study was designed to test the effects of nimodipine on focal cerebral ischemia in rats. At 1,2 or 6 hours after occlusion of the middle cerebral artery(MCA), rats were treated with either nimodipine or saline. Neurological and pathological evaluation was performed at 24 hours after occlusion. Neurological outcome was better in nimodipine-treated rats and the size of the infarcted area was statistically smaller in rats treated with nimodipine 1,2 or 6 hours after occlusion(P<0.001, P<0.001, P<0.001, respectively) when compared with control rats(MCA occlusion only) or saline-treated rats. The results show that nimodipine improves neurological outcome and decreases the size of infarction after ischemic insult. The mechanism of action of nimodipine is not fully understood but nimodipine could influence cerebral postischemic changes by improving blood flow and/or by a direct action on neurons.
Animals ; Brain Ischemia* ; Calcium ; Calcium Channel Blockers ; Calcium Channels ; Infarction ; Ions ; Logic ; Membranes ; Neurons ; Nimodipine* ; Rats

About 80% of Bladder cancer is non muscle invasive bladder cancer (NMIBC). Despite of appropriate therapy, a lot of NMIBC recur as a superficial tumor or progress to muscle invasive disease. Several studies about prognostic factors of recurrence and progression have reported a single risk factor variously according to each study. These efforts were developed to predict the risk by scoring system and large-scale studies had been conducted. These studies had limitations that their patients did not receive BCG (bacillus Calmette-Guerin) immunotherapy, immediate intravesical chemotherapy, second-look TUR (transurethral resection) in high-risk group. Through studies to date, patients with NMIBC have showed heterogenous prognosis and a more sophisticated scoring system can give personalized treatment and exact prediction.
Drug Therapy ; Humans ; Immunotherapy ; Mycobacterium bovis ; Prognosis ; Recurrence* ; Research Design ; Risk Factors ; Urinary Bladder Neoplasms ; Urinary Bladder*

Induction of general anesthesia with tracheal intubation has several advantages but also causes some cardiovascular side effects. Several approaches have been tried to reduce these side effects. As an attempt to reduce elevated blood pressure and increased heart rate during tracheal intubation, we used thiopental 3 mg/kg with Thalamonal 0.05 mg/kg (experimental group II, 30 cases) as an induction of general anesthesia inatead of the conventional use of thiopental 6 mg/kg(control group I, 30 caaes). The results are as follows:1. Blood pressure and heart rate changes between the 2 gruops at postintubation 30 sec. were statistically significant; 194+/-24 torr, 111+/-15/min. in control gruop and 166+/-29 torr (p<0.01), 102+/-14/min. (p<0.05) in experimental group. 2. There were no significant changes in blood pressure and heart rate at pre-intubation and post-extubation period. 3. The incidence of tachycardia and arrhythmia were more frequent in the control group, while hypotension and severe respiratory depression in experimental group.
Anesthesia, General ; Arrhythmias, Cardiac ; Blood Pressure ; Heart Rate ; Hypotension ; Incidence ; Intubation* ; Respiratory Insufficiency ; Tachycardia ; Thiopental

The maxillary alveolar ridge separates the palate from the lip and clefts of the primary palate have a cleft of the alveolus as well. In the most common clefts of the primary palate, the alveolar portion of the cleft is located between the lateral incisor, if present, and the canine. The cleft may also pass between the central incisor and the lateral incisor, rarer forms of clefts may pass between the central incisor or more distally on the maxillary arch. There are still considerable differences of opinion as to the optimal time for closure of alveolar defects, with or without concomitant bone grafting. But the preferred time for the operation with bone graft is between age 9 and 11 before the canine teeth have fully erupted. As an alternative to primary bone grafting, Skoog developed the periosteoplasty, or "boneless bone graft" technique, in which periosteal continuity was established between maxillary segments by the transfer of local periosteal flaps from the anterior maxillary wall. this procedure, which takes advantage of the propensity of periosteum to form bone in young children, leads to the formation of new bone within the alveolar cleft in spite of the fact that no bone graft is used.This study attempts to defin the effectiveness of early alveolar cleft repair with gingivo-vestibular-mucoperiosteal flap.The results in 6 unilateral alveolar clefts and 1 bilateral alveolar cleft, which is corrected early by gingivo-vestibular-mucoperiosteal flap, have been satisfactory alveolar arch continuity and alveolar bone formation with tooth eruption.
Alveolar Process ; Bone Transplantation ; Child ; Cuspid ; Humans ; Incisor ; Lip ; Osteogenesis ; Palate ; Periosteum ; Tooth Eruption ; Transplants

New bactericidal agent, Cefazolin was administered intramuscularly or intravenously in 1-3 divided doses of 1-3 grams daily in 30 cases of genitourinary tract infection and following results were obtained. 1) Among 12 cases of pyelonephritis, excellent effect was obtained, in 8 cases 2 cases were good and no improvement was noted in 2 cases. 2) Among 6 cases of acute cystitis. excellent in 4 cases and good in 2 cases was noted. 3) Among 4 cases of benign prostatic hypertrophy, excellent result in 1 case, good it 1 case and to improvement in Z cases was noted. 4) Among 3 cases of chronic non-gonococcal urethritis, 2 cases were good and no improvement in l case was noted. 5) Among 2 cases of gonorrhea, no improvement in l case and recurrence in 1 case was noted. 6) No improvement noted in 2 cases of chronic prostatitis and 1 case of prostatic abscess. No serious side effects were observed except slight dizziness in one case.
Abscess ; Cefazolin* ; Cystitis ; Dizziness ; Gonorrhea ; Prostatic Hyperplasia ; Prostatitis ; Pyelonephritis ; Recurrence ; Urethritis ; Urinary Tract Infections* ; Urinary Tract*

The results of alpha-acetyldigoxin(Dioxanin(R)) administration in 21 patients with congestive heart failure were as follows. Alpha-acetyldigoxin is a new oral preparation of cardiac glycoside derived from lanatosid C. 1. For rapid digitalization in 2-3 days, the initial dose was 1.2 to 2.6mg (average 1.96mg). For medium-fast digitalization in 4 days, the loading dose was 2.0 to 3.2mg (average 2.7mg). For slow digitalization 0.1 to 0.4mg was required for 5 to 6 days without loading dose. The maintenance dose was 0.1 to 0.4mg (average 0.33mg) daily. 2. The therapeutic effect of acetyldigoxin was excellent in 15 cases (71%), good in 4 cases (20%) and stationary in 2 cases (9%). 3. Side effects were observed in 2 cases with usual dosage regimen. One accidental case who took single dose of 4mg(20 tablests) developed supraventricular tachycardia with varying degree of atrioventricular block, ventricular bigeminy and premature beat but recovered completely after 6 days.
Acetyldigoxins* ; Atrioventricular Block ; Cardiac Complexes, Premature ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Humans ; Tachycardia, Supraventricular

BACKGROUND: The aim of this study is to evaluate the influence of immunosuppressants on in-hospital mortality from sepsis. METHODS: Using data of the Health Insurance Review & Assessment Service, we collected data from patients who were admitted to the hospital due to sepsis from 2009 to 2013. Based on drugs commonly used for immunosuppression caused by various diseases, patients were divided into three groups; immunosuppressant group, steroid-only group, and control group. Patients with no history of immunosuppressants or steroids were assigned to the control group. To identify risk factors of in-hospital mortality in sepsis, we compared differences in patient characteristics, comorbidities, intensive care unit (ICU) care requirements, and immunodeficiency profiles. Subgroup analysis according to age was also performed. RESULTS: Of the 185,671 included patients, 13,935 (7.5%) were in the steroid-only group and 2,771 patients (1.5%) were in the immunosuppressant group. The overall in-hospital mortality was 38.9% and showed an increasing trend with age. The steroid-only group showed the lowest in-hospital mortality among the three groups except the patients younger than 30 years. The steroid-only group and immunosuppressant group received ICU treatment more frequently (p < 0.001), stayed longer in the hospital (p < 0.001), and showed higher medical expenditure (p < 0.001) compared to the normal group. Univariate and multivariate analyses revealed that age, male gender, comorbidities (especially malignancy), and ICU treatment had a significant effect on in-hospital mortality. CONCLUSIONS: Despite longer hospital length of stay and more frequent need for ICU care, the in-hospital mortality was lower in patients taking immunosuppressive drugs than in patients not taking immunosuppressive drugs.
Comorbidity ; Health Expenditures ; Hospital Mortality ; Humans ; Immunosuppression ; Immunosuppressive Agents ; Insurance* ; Insurance, Health ; Intensive Care Units ; Korea* ; Length of Stay ; Male ; Mortality ; Multivariate Analysis ; Risk Factors ; Sepsis* ; Steroids

Dopamine receptors in the CNS and other several tissues were identified by physiological, biochemical and radioligand binding techniques. But previous morphological and biochemical studies have been unable to charaterize or determine the tissue distribution of dopamine receptor subtypes because no selective ligands are available yet. Furthermore, the cellular distribution of the dopamine receptor subtypes in the rat kidney is not demonstrated well. The present study utilizes specific antibodies to characterize the renal distribution of this dopamine receptor subtype using light microscopic immunohistochemistry in the rat kidney. In the rat kidney, D1 receptor protein was localized to proximal tubule, distal tubule, renal vessels, medullary collecting tubule, juxtaglomerular apparatus(JGA) and glomerulus. And D2 receptor protein was localized to distal tubule, Henle's loop, proximal tubule, medullary collecting tubules, juxtaglomerular apparatus(JGA) and renal vasculature. The D1 and D2 receptors, which present in the central nervous system, are now identified in the rat kidney. There are some differences in receptors expressing sites on the previous radioligand binding and pharmacologic studies, but these results suggest that at least some of the renal dopamine DA1 and DA2 receptors correspond structually to the central dopamine D1 and D2 receptors.
Animals ; Antibodies ; Central Nervous System ; Dopamine* ; Immunohistochemistry* ; Kidney* ; Ligands ; Rats* ; Receptors, Dopamine ; Tissue Distribution

Tibric acid is a new oral hypolipidemic agent with the chemical name of 2-chloro-5(3,5-dimethyl piperidinosulfonyl) benzoic acid. The results of tibric acid administration in 22 patients with primary hyperlipidemia were as follows. 1) Serum triglyceride level was significantly decreased in 84.6% of 22 cases with an average 43.9% decrease in serum triglyceride. 2) Serum cholesterol level was decreased in 59.1% of 22 cases with an average 15.8% decrease in serum cholesterol. The decrease in serum cholesterol level was not significant. 3) It seemed that there were significant falls in the serum triglyceride of the hyperlipoproteinemia type IV and IIb patietns and in the serum cholesterol of type IIa patients 4) The side effects of tibric acid were indigestion, loose stool and anorexia. There was no side effects in 63.6% of cases.
Anorexia ; Benzoic Acid ; Cholesterol ; Dyspepsia ; Humans ; Hyperlipidemias* ; Hyperlipoproteinemia Type IV ; Triglycerides