Respiratory syncytial virus is the most common cause of lower respiratory infection (bronchiolitis and pneumonia) of infancy and early childhood. We analyzed clinical and radiological features of 76 patients with lower respiratory infections by respiratory syncytial virus, which were diagnosed by indirect immunofluorescent test or culture of nasal aspirate in Hep-2 cell monolayer, during the period of January-December, 1991. There were peaks of incidences in March-May and November-December, accounting for 87% of eases. Sixty-two cases (82%) were under 1 year of age. Fifty cases(66%) had underlying diseases. Major radiographical findings were overaeration (83%), parahilar peribronchial infiltrates(67%), segmental or subsegmental atelectasis(32%), and segmental or lobar consolidation(16%). In 15 cases(20%), overaeration was the only radiological findings. There was no evidence of pleural effusion or hilar lymph node enlargement in all cases. By considerig clinical features(symptoms, age. Underlying diseases, epidemic seasons) in addition to the radiological findings, radiologists would be familiar with lower respiratory infection by respiratory syncytial virus. Air space consolidation, which is generally though to represent bacterial pneumonia, is also observed not infrequently in respiratory syncytial virus infections.
Child* ; Humans ; Incidence ; Infant* ; Lymph Nodes ; Pleural Effusion ; Pneumonia, Bacterial ; Respiratory Syncytial Virus Infections ; Respiratory Syncytial Viruses* ; Respiratory Tract Infections

Purpose: This study systematically reviewed the effects of physical activity on depression and various menopausal symptoms in middle-aged women. We aimed to identify physical activity as a useful intervention for mitigating the physiological and psychological challenges associated with menopause and promoting healthy aging. Methods: Electronic searches were conducted in the MEDLINE, EMBASE, CINAHL, and the Cochrane Library databases using predefined keywords “menopause” and “physical activities”. Of the 1,391 initial articles, 15 randomized controlled trials involving 1,692 middle-aged women were included. Results: Physical activities led to a reduction in depressive symptoms, with a standardized mean difference (SMD) of -0.60 (95% CI, -0.90 to -0.30). Moreover, all menopausal symptoms, except vasomotor symptoms, were decreased. Specifically, the SMDs for the five subscales of menopausal symptoms were as follows: total scores: -1.53 (95% CI, -2.57 to -0.49); vasomotor: -0.76 (95% CI, -1.53 to 0.00); psychological: -0.93 (95% CI, -1.62 to -0.25); physical: -1.10 (95% CI, -1.77 to -0.43); and urogenital/sexual: -0.67 (95% CI, -1.23 to -0.12). Conclusion Physical activity is beneficial for middle-aged women transitioning from peri- to post-menopause. Engagement in physical activity can contribute to the maintenance of overall health and well-being during aging by reducing depression and menopausal symptoms.

PURPOSE: Non-cement total hip arthroplasty for unstable intertrochanteric fracture in elderly patients is regarded as another surgical technique preventing complications such as non-union, long term limitation of weight bearing, pressure sore, pulmonary thromboembolism after open reduction or closed reduction with intramedullary nailing, or plate fixation. We would like to announce the short-term results of primary non-cement total hip arthroplasty with double strands and double loops figure of 8 wiring for unstable intertrochanteric fracture in elderly patients. MATERIALS AND METHODS: All of the 20 patients admitted to the hospital between April 2010 and February 2012 who underwent non-cement total hip arthroplasty with double strands and double loops figure of 8 wiring for unstable intertrochanteric fractures were evaluated. The mean age was 71.1(57-86), there were nine males, and 11 females, with an average follow up period of six months. The post-operative state was evaluated by Harris hip score. RESULTS: The mean operation time was 95 min, and the average blood loss was 800 cc. Mean Harris hip score at the last available follow-up was 92.7, and, among the patients, 15 had all functions of daily life without limitation of walking distance, one had hip dislocation, one had breakage of strands. Pressure sore, deep vein thrombosis, and pulmonary thromboembolism were absent. Radiography at the last available follow-up showed no loosening of the femoral stem in any of the patients, and 13 patients had osteogenesis around the fracture site, and there was no osteolysis. CONCLUSION: Primary non-cement total hip arthroplasty with double strands and double loops figure of 8 wiring in elderly patients with unstable intertrochanteric fractures showed satisfactory results. These results are expected to be useful for further studies with a long-term follow-up and in development of a reduction method.
Aged ; Arthroplasty ; Female ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Hip ; Hip Dislocation ; Hip Fractures ; Humans ; Male ; Osteogenesis ; Pressure Ulcer ; Pulmonary Embolism ; Venous Thrombosis ; Walking ; Weight-Bearing

PURPOSE: To determine (1) the relationship between the cortical defects seen on 99 mTc-DMSA renal scans and age, and (2) the presence and degree of vesicoureteral reflux, and then to depict the risk factors for cortical defects in children with acute urinary tract infection (UTI). Furthermore, to assess the diagnostic value of VCUG in predicting a defect on 99 mTc-DMSA renal scans. MATERIALS AND METHODS: We studied 134 kidneys in 67 children aged 15 days-10 years (M:F=39:28) in whom symptomatic UTI was present. In all these children, both DMSA renal scans and voiding cystourethrography (VCUG) were performed. Scanning took place within 7 days of diagnosis and VCUG was performed after one month of diagnosis. Scintigraphic findings were graded according to the extent and number of cortical defects. We evaluated the relationships between the cortical defects seen on DMSA scans and age, and the grade of vesicoureteral reflux. The diagnostic value of VCUG in predicting cortical defects was analysed. Results: The prevalence of cortical defects was greater in patients older than two years (38/54, 70%) than in those aged less than two (38/80, 48%). The frequency of cortical defects was related to vesicoureteral reflux (p<0.05) and grade of reflux (p<0.05). As this latter increased, the extent of cortical defects also increased (p<0.05), and DMSA scans revealed the presence of these in 76 of the 134 kidneys (57%) with acute UTI. In 30 of these 76 (39.5%), VCUG demonstrated the presence of vesicoureteral reflex. On the other hand, vesi-coureteral reflex was found in 36 of the 134 kidneys (27%), and in 30 of these 36 (83%), cortical defects were noted. The sensitivity of VCUG in predicting cortical defect was 39.5%, while specificity was 89.7%. The positive predictive value for defects was 83.3%, and the negative predictive value was 53.1%. The relative risk of cortical defect in the presence of vesicoureteral reflux was 1.78. CONCLUSION: Renal cortical defects are significantly related to age and grade of vesicoureteral reflux. Risk factors for developing cortical defects were older age (> or =2yrs) at the time of acute UTI, and high grade of vesicoureteral reflux. The specificity of VCUG in predicting cortical defects is relatively high but the sensitivitiy is low, and a significant proportion of cortical defects therefore occurred in the absence of vesicoureteral reflux.
Child* ; Diagnosis ; Hand ; Humans ; Kidney ; Prevalence ; Radionuclide Imaging* ; Reflex ; Risk Factors* ; Sensitivity and Specificity ; Succimer* ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux

PURPOSE: Radiotherapy has been the mainstay of the treatment of brain metastases. We evaluated the response rate, survival and prognostic factors of patients with brain metastases treated with radiotherapy for palliative purpose. MATERIALS AND METHODS: From January 1994 through April 1997, in all 42 patients, a retrospective analysis was undertaken. Of these, 33 patients received whole brain irradiation with 30Gy in 10 daily fractions with or without a boost of 10Gy in 5 daily fractions to the site of solitary lesion. Nine patients failed to complete the planned treatment. RESULTS: Of 33 patients who finished radiotherapy, complete and partial response were observed in 4 (12%) patients and 22 (67%) ones, respectively. Overall response rate was 79% and median survival was 4 months. In univariate analysis, prognostic factors affecting survival were initial neurologic function class (p=0.0136), extracranial tumor activity (p=0.042), and response after radiotherapy (p=0.001). CONCLUSION: We confirmed that whole brain irradiation is the effective means for treating the patient with brain metastases. Initial neurologic function class, extracranial tumor activity, and response after radiotherapy were identified as prognostic factors affecting survival.
Brain* ; Humans ; Neoplasm Metastasis* ; Radiotherapy* ; Retrospective Studies ; Survival Rate

Systolic time interval measurements were made sequentially during second, third trimesters and postpartum period. Recordings were made in the supine position after bed rest for at least five minutes in order to obtain a steady state. In second trimester, pre-ejection period index (PEPI) was significantly shortened and left ventricular ejection period index(LVETI) remained normal while PEP/LVET decreased. Four possible mechanisms may be involved to account for the alterations in hemodynamic changes during this period(late stage of second trimester) : (1) increased metabolic demands of pregnancy: (2) hemodynamic effects of hypervolemia: (3) circulatory adjustments secondary to an arteriovenous shunt-like effect of the placental circulation: (4) cardiovascular effect of steroid hormone. The third trimester was characterized-by a markedly shortened LVETI, a prolonged PEPI and PEP/LVET. This findings are consistent with impaired left ventricular performance and are probably due to decreased left ventricular preload resulting from diminished venous return secondary to inferior vena caval obstruction by the large gravid uterus. In the postpartum period, the PEPI and PEP/LVET remained elevated and the LVETI shortened in the supine position. It is concluded that alterations in systolic time intervals occur normally during the course of uncomplicated pregnancy and persist into the postpartum period.
Bed Rest ; Female ; Hemodynamics ; Humans ; Placental Circulation ; Postpartum Period* ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third* ; Supine Position ; Systole* ; Uterus

This study was conducted to evaluate the effect of a teaching program on patients with myocardial infarction. Forty-five patients were randomly selected 22 were assigned to a teaching group and 23 to a control group. An individualized teaching program was delivered to the teaching group during the hospitalization period. It covered aspects such as: the characteristics of heart disease, the anatomy and physiology of the heart, risk factors of atherosclerosis, medication and diet and exercise therapy. When these subjects were discharged to their homes, they received regular supportive care via telephone or mail for 12 weeks. Atherosclerotic risk factors, including, smoking, exercise, blood lipid profile and BMI were measured before and after the teaching program. Post-testing revealed that the numbers of those who exercised and the number of non-smokers were significantly higher in the teaching group than in the control group. Increased HDL cholesterol (High-Density Lipoprotein cholesterol) was significantly greater in the teaching group than in the control group. The above findings suggest that this individualized teaching program might be helpful at reducing the risk factors of atherosclerosis in myocardial infarction patients.
Adult ; Aged ; Arteriosclerosis/etiology/*prevention & control ; Comparative Study ; Exercise ; Female ; Human ; Lipids/blood ; Male ; Middle Age ; Myocardial Infarction/*prevention & control ; *Patient Education ; Risk Factors ; Smoking

No abstract available.
Emergencies* ; Emergency Service, Hospital*

PURPOSE: To evaulate the effects of chlorhexidine and H2O2 on matrix metalloproteinase-1 (MMP-1), tissue inhibitor of metalloproteinase(TIMP-1, TIMP-2), Type 1 collagen, fibronectin and UNCL expressions in human periodontal ligament fibroblasts (hPDLF). MATERIALS AND METHODS: 1.2x10(-1)%, 1.2x10(-2)% and 1.2x10(-3)% CHX and 3x10(-3)%, 3x10(-4)% and 3x10(-5)% H2O2 and mixture of CHX and H2O2 were applied to hPDLF for 1 min and 30 min. The mRNA expressions of MMP-1, TIMP-1 and 2, Type 1 collagen, fibronectin and UNCL in hPDLF were analysed by RT-PCR. RESULTS: The result were as follows: 1. The expression of UNCL mRNA was higher than that of other mRNAs. 2. 1.2x10(-3) % CHX increased mRNA expressions of hPDLF as application time increased. 3. H2O2 lower than 3x10(-3) % increased expression of UNCL mRNA, and did not decrease mRNA expression of hPDLF. 4. hPDLF treatment with 1.2x10(-1) % CHX (with or without H2O2) resulted in no gene expression. 5. hPDLF treatment with 1.2x10(-2) % CHX (with or without H2O2) for 30 minutes resulted in no gene expression. CONCLUSION: Because low concentration of CHX and H2O2 increased UNCL mRNA expression of hPDLF, low concentraction of CHX and H2O2 may have an antioxidative effect.
Chlorhexidine ; Collagen Type I ; Fibroblasts ; Fibronectins ; Humans ; Matrix Metalloproteinase 1 ; Periodontal Ligament ; RNA, Messenger ; Tissue Inhibitor of Metalloproteinase-1

This study was executed to measure the shear bond strength of Panavia EX and Panavia 21 when the Ni-Cr-Be alloy castings were cemented to the enamel surfaces with these cements. The cast metsl plates of Ni-Cr-Be alloy were sandblasted and cemented to acid etched enamel surface with Panavia EX or Panavia 21. Their shear bond strength were measured with Instron Universal Testing machine. Within the limits of this study, following conclusions were withgdrawn. 1. The mean shear bond strength were 26.85.7Mpa, in Panavia EX and 28.35.2Mpa, in Panavia 21. 2. t-Test revealed no statistical significance between two groups(.05 level) 3. Macroscopically, bond failures were revealed compound fracture at metal and enamel interfaces, in cases of both cements, as the cement attached partly on both metal and enamel surface.
Adhesives* ; Alloys* ; Dental Enamel* ; Fractures, Open