Early detection of spine deformities by school screening has proven to be valuable for early diagnosis and prevention of severe deformities. Authors screened 1,620 middle and high school male students Seoul who were chosen arbitrarily, to determine the incidence rates of scoliosis. Authors diagnosed scoliosis on a combination of at least one positive physical sign and a lateral curvature more thar 5 degrees on an antero-posterior standing X-ray. According to this criteria 12 students were diagnosed as having scoliosis. They were analyzed for positive physical signs, etiology, degree of curvature. distribution of size of curvature, patterns of curvature, direction of curvation, and following results were obtained. 1. The overall incidence of scoliosis was 0.74%. 2. Idiopathic scoliosis was found in 10 students, congenital scoliosis in 1, and paralytic scoliosis in 1. 3. Rib humps, whose right to left ratio was 5, were found in 6 students, lumbar humps, whose right to left ratio was 0. 2. in 6 students, and shoulder elevation, whose direction were all to right, in 4 students. 4. Close observations were required for all the 12 students and treatment was required in 2 students who had more than 20 degrees, one for Milwaukee brace, and the other for surgical correction. 5. The most common pattern of curvature was thoracic curve. 6. in single curve right to left ratio was 2.7.
Braces ; Congenital Abnormalities ; Early Diagnosis ; Humans ; Incidence ; Korea ; Male ; Mass Screening ; Ribs ; Scoliosis ; Seoul ; Shoulder ; Spine

A clinical observation in 8 cases of multiple laminectomies under the age of 16 years who had been followed for more than 3 years was carried out to analyze deformities and its results of treatment, and the following results were obtained. 1. Spinal deformities were developed in 5 cases-4 kyphosis and 1 lordosis. 2. The kyphosis was developed in 1 case at cervical spine, 1 at thoracic, 1 at thoracolumbar junction and 1 at lumbar, and the lordosis was developed in 1 case at lumbar spine. 3. Anterior interbody fusion was carried out on two cases of kyphosis who had severe pain and neurological symptoms and posterolateral spinal fusion was carried out on one case of lumbar lordosis, with satisfactory results in all cases. 4. Since the incidence of spinal deformities following multiple laminectomies in children is high, laminectomy should be performed only when it is definitely indicated, and when it is done, damage to the posterior complex should be minimized. 5. For the prevention and treatment of the spinal deformities, brace or close observation should be necessary postoperatively, and spinal fusion should be performed in increasing or severe deformities.
Animals ; Braces ; Child ; Congenital Abnormalities ; Humans ; Incidence ; Kyphosis ; Laminectomy ; Lordosis ; Spinal Fusion ; Spine

BACKGROUND: The improved technique for cardiopulmonary resuscitation(CPR) has resulted in the survival of many patient who experienced cardiac arrest. However, mortality in resuscitated patients is high, and the survival rate without brain damage is very low. Various neurological examination models, neuro-imaging techniques, electrophysiological procedures, and biochemical tests have been studied with respect to the detection of cerebral damage and outcome, but an early, reliable prediction of individual outcomes is still uncertain. METHODS: We studied twenty patient who had been in a coma for more than 24 hours after CPR, Somatosensory evoked potentials(SEP) were measured within the first three days after CPR. RESULTS: Of the twenty patients, seven patients(35%) had a good outcome, and thirteen patients(65%) had a bad outcome. Of the eleven patients with loss of the cortical evoked potential's N20 peak, all had a bad outcome. CONCLUSION: SEPs are of great benefit in prognostic evaluation after CPR.
Brain ; Cardiopulmonary Resuscitation* ; Coma* ; Evoked Potentials, Somatosensory* ; Heart Arrest ; Humans ; Mortality ; Neurologic Examination ; Survival Rate

OBJECTIVES: Risperidone is a new antipsychotic drug developed to overcome the therapeutic limitation of conventional antipsychotics. It responses to negative as well as positive symptoms by blocking both dopaminergic and serotonergic receptors, causing no significant side effects such as agranulocytosis and seizure. It is, however, not known whether it induces any serious cardiovascular side effects as evoked by other conventional antipsychotic drugs. The aims of this study were to evaluate the effect of risperidone on cardiovascular function, and to discuss the factors affecting the cardiovascular function. METHODS: For 42 patients(22 males and 20 females) diagnosed as schizophrenia, schizophreniform disorder or schizoaffective disorder according to the DSM-IV classification, the cardiovascular fuctions such as heart rate, systolic and diastolic blood pressure, PR interval, QRS interval and QT inerval were successively checked before and after 2 weeks and 4 weeks risperidone administration. Furthermore, variables such as body weight, Brief Psychiatric Rating Scale(BPRS), Clinical Global Impression(CGE), Extrapyramidal Symptom Rating Scale(ESRS), Anticholinergic Rating Scale(ARS), serum cholesterol level, serum triglyceride level, serum high-density-lipoprotein level, serum WBC, serum Hb, serum platelet level, prothrombin time and partial thromboplastin time were also analyzed before and after 2 weeks and 4 weeks risperidone administration. RESULTS: 1) Risperidone treatment resulted in a significantly decreased heart rate and increased QT interval after 4 weeks administration(p<0.005 respectively). 2) The scores of BPRS and CGI were significantly decreased after 2 weeks and 4 weeks risperidone adminisration as compared with baseline(p<0.001 respectively). The scores of ESRS and ASRS were significantly increased after 2 weeks and 4 weeks risperidone administration as compared with baseline(p<0.001 respectively). 3) There were positive correlations between heart rate after 4 weeks and total dose(p<0.05). Blood pressure was significantly(p<0.05) correlated with sex(higher in male) and significantly(p<0.05) positive correlated with body weight. QT interval was significantly(p<0.05) correlated with sex(longer in female) and smoking history(shorter in smokers). CONCLUSIONS: Risperidone could induce significant change in heart rate and Q-T interval. Therefore, the cardiovascular safety for risperidone should be reconsidered according to the duration and dosage increase.
Agranulocytosis ; Antipsychotic Agents ; Blood Platelets ; Blood Pressure ; Body Weight ; Cholesterol ; Classification ; Diagnostic and Statistical Manual of Mental Disorders ; Heart Rate ; Humans ; Male ; Partial Thromboplastin Time ; Prothrombin Time ; Psychotic Disorders ; Risperidone* ; Schizophrenia ; Seizures ; Smoke ; Smoking ; Triglycerides

BACKGROUND: To describe the fast experience of case-leased advanced cardiac life support(ACLC) course in Korea. METHODS: We have given case-based ACLC course to 13 nurses(6 emergency nurses, 4 coronary care unit muses, 3 professors) and 17 physicians(4 emergency physicians, 12 emergency residents, 1 intem). We performed the case-based ACLS course according to 1992 American Heart Association guidelines and recommendations for advanced cardiac life support by american ACLS instructors(1 pulmonologist, 4 critical care nurses). We performed final theoretical written test and 2 times written survey (immediate and 100th day after the course) about the course. RESULTS: On final written test, all practitioners answered at leasts 70% of the questions correctly. There was no significant difference between nurses and physicians(86.2+/-3.6 of physicians and 82.5+/-6.8 of nurses, p=0.06). 90%of participants considered that case-based advanced cardiac life support was acceptable. 100th day after the course, 93%of participants answered that ACLS course have been helpful on his/her job and also want retraining of ACLS course. 70%of participants considered that ideal ACLS training committee in Korea is the Korean Society of Emergency Medicine. CONCLUSION: Case-based ACLS course is a useful educational method far physicians and nurses in Korea. In the future, we should organize Korean resuscitation committee and then make guidelines for ACLS, and then continuously educate physicians and nurses.
Adult* ; Advanced Cardiac Life Support ; Alprostadil ; American Heart Association ; Coronary Care Units ; Critical Care ; Emergencies ; Emergency Medicine ; Humans ; Korea* ; Resuscitation

BACKGROUND: Doxylamine succinate(DS) is an antihistamine commonly used as an over-the-counter medication to relieve insomnia and frequently involved in overdoses. Its overdoses are dominated by anticholinergic effect. Recently it was revealed that DS had a direct effect on muscle, while its exact mechanism is not clear yet. We evaluated the patients with rhabdomyolysis induced by DS overdose for patients disposition based upon clinical decision, especially by creatinine phosphokinase(CPK). METHODS: We reviewed retrospectively the medical records of patients admitted by DS overdose from Jan. 1998 to Oct. 1999. Seventy and nine cases of DS overdose were evaluated with respect to age and sex distribution, amount ingested, clinical symptomatology, time from ingestion to visit, pattern of CPK, amount of bicarbonate used as therapy, complication and prognosis, especially in patients complicated rhabdomyolysis. RESULTS: Rhabdomyolysis, diagnosed as more than 1,000I. U/L of CPK, has been noted in 25(31.6%) of 79 cases of DS overdose visited to our emergency department(ED). In patients diagnosed rhabdomyolysis, the number of man was 10 cases(40%) and the number aged between 20 and 40 years was 22 cases(88%). The average time from DS ingestion to ED visit was 459 minutes. The amount of DS ingested was 500-5,000mg(mean, 1,980mg). 13(52%) cases ingested less than 2,250mg of DS. The initial levels of CPK(range, 48-14900I. U/L; normal range, 26-200I. U/L) after admitting to our emergency department were normal in 15 cases(60%) of rhabdomyolysis patients. The range of peak CPK levels after ingestion was 607 to 412,500I. U/L(mean, 33,550I. U/L). Its peak time was 6 to 96 hours(mean, 28.96 hours). In 14 cases(67%) of 21 visiting within 24 hours after ingestion, peak time of CPK ranged 12 to 24 hours after ingestion. The amount of bicarbonate used as therapy of rhabdomyolysis ranged 100 to 2,740mEq(mean, 656mEq) and all patients was discharged after improvement without other complication including acute renal failure. CONCLUSIONS : Although patients ingested less than 2,250mg of DS, emergency physicians should observe them more than 24 hours after DS ingestion with CPK follow-up after gastric irrigation and charcoal administration.
Acute Kidney Injury ; Charcoal ; Creatinine ; Doxylamine* ; Eating ; Emergencies ; Emergency Service, Hospital ; Follow-Up Studies ; Gastric Lavage ; Humans ; Medical Records ; Prognosis ; Reference Values ; Retrospective Studies ; Rhabdomyolysis* ; Sex Distribution ; Sleep Initiation and Maintenance Disorders ; Succinic Acid*

Msny clinical and experimental studies trying to elucidate the cause of idiopathic scoliosis have been carried out. There, however, is no established theory to explain it. This paper is aimed at approaching one of various causes of idiopathic scoliosis by producing thoracic scoliosis in growing rabbits with unilateral resection of thoracic spinal nerves. All 43 rabbits were divided into four different groups. The first group(11 rabbits) consisted of rsbbits whose primary anterior and posterior divisions of the unilateral thoracic spinal nerves were resected. The second(11 rabbits) and the third(11 rabbits) were groups of rabbits whose primary anterior and posterior devisions were resected respectively. The fourth(10 rabbits) was the control group. The first group of rsbbits showed the most prominent curvature of the spine. The group of resection of primary posterior division showed less severe scoliosis than the first group but more marked scoliosis than the group of resection of primary anterior division. The biopsy of the denervated muscles included in the scoliosis revealed atrophy. It is concluded from the animal experiments with 43 growing rabbits that unilateral paralysis of the thoracic spinal nerves could be one csuse of iniopathic scoliosis and the primary posterior division of the thoracic spinal nerve contributed to the production of scoliosis more than the primary anterior division.
Animal Experimentation ; Atrophy ; Biopsy ; Muscles ; Paralysis ; Rabbits ; Scoliosis ; Spinal Nerves ; Spine

No abstract available.
Factor VIII* ; Hemophilia A* ; Humans

Psoriasis is an inflammatory skin disease characterized by hyperproliferation and incomplete differentiation of keratinocytes. Mounting scientific evidence suggests that this epidermal alteration occurs as a response to an immunologic injury, giving rise to the concept that psoriasis is a skin-specific autoimmune disease. Indeed, many effective therapeutic agents for psoriasis are immunosuppressive in nature, lending further support to this view. The well known ability of calcipotriene and 1,25(OH)2D3 to inhibit keratinocyte proliferation and to induce its differentiation is certainly compatible with their antipsoriatic actions. In addition, topical calcipotriene has been shown to correct, at least in part, the local cytokine imbalance observed in psoriatic lesions. Interleukin (IL)-8 is a proinflammatory cytokine that is chemotactic for polymorphonuclear cells and T lymphocytes. It also promotes proliferation of keratinocytes and endothelial cells. In lesional psoriatic skin, IL-8 and its receptor levels are markedly elevated. IL-10 is an immunosuppressive cytokine, which as a type2 (T2) cytokine antagonizes cell-mediated immunity. Indeed, IL-10 administration has been shown to improve psoriasis. Topical calcipotriene markedly reduces elevated levels of IL-8 while simultaneously increasing IL-10 levels in lesional skin of psoriasis. These changes occur very early, within the first three days of therapy, prior to significant clinical improvement of psoriasis, indicating that the cytokine alterations are not simply secondary to resolution of psoriatic plaques. Therefore, elaboration of the immunosuppressive cytokine IL-10 and a concomitant reduction in the proinflammatory cytokine IL-8 may mediate the immunopharmacological improvementin psoriasis by calcipotriene.
Autoimmune Diseases ; Cholecalciferol ; Cytokines ; Endothelial Cells ; Immunity, Cellular ; Immunosuppression ; Interleukin-10 ; Interleukin-8 ; Interleukins ; Keratinocytes ; Psoriasis ; Skin Diseases ; Skin* ; T-Lymphocytes ; Vitamin D* ; Vitamins*

Development of supervoltage treatment machine may minimize skin reaction by skin-sparing effect, but skin damage is still one of “the dose limiting factor” in radiation therapy. In spite of these importance, systemic histopathologic studies of skin in similar conditions which used in clinical treatment has not been performed so far. 60 mice were irradiated with conventional fraction (200x5/wk) and whole abdominal field (2x3 cm, from symphysis pubis to xyphoid process). Used machine was 250 KV, 24 mA. orthovoltage x-ray machine. Histopathological changes of acute skin reaction at the level of total irradiation dose were analyzed and possible mechanism of later chronic changes were investigated. Obtained results are as follows 1. In 1,000 rad irradiated group, only mild epidermal edema is noted. 2. In 2,000 rad irradiated group, slightly decreased number and size of hair follicles and appendages, dermal edema and scanty infiltration of inflammatory cells are visible. 3. In 3,000 rad irradiated group, marked increased capillary congestion and prominent infiltration of inflammatory cells are observed. 4. In 4,000 rad irradiated group, vascular wall thickening with proliferation of endothelial cells are prominent. Dermal thinning and hyalinization are newly developed. 5. In 5,000 rad irradiated group, complete desquamation of epidermis is not seen, despite of acceleration of all above mentioned changes.
Acceleration ; Animals ; Capillaries ; Edema ; Endothelial Cells ; Epidermis ; Estrogens, Conjugated (USP) ; Hair Follicle ; Hyalin ; Mice* ; Pubic Bone ; Skin*