No abstract available.
Ambulatory Care* ; Osteoarthritis*

Background: Bupivacaine was introduced to be a long-acting spinal anesthetic agent. It has been argued about whether the addition of epinephrine prolongs the bupivacaine action or not. The aim of this present investigation was to find out the effect of additional epinephrine on spinal anesthesia with bupivacaine. Methods: 47 patients undergoing an operation on lower extremity were randomly allocated to 2 groups. All patients were anesthetized by subarachnoid block with 0.5% bupivacaine in 8% glucose, which was mixed with 0.2 ml of normal saline in group non-E (n=24) and 0.2 ml of 1:1,000 epinephrine in group E (n=23). We evaluated blood pressure and heart rate, the sensory and motor blockade and voiding time after spinal anesthesia. Results: The systolic blood pressure (SBP) at 8 and 10 min after anesthesia were lower in group non-E than in group E (p<0.05). The trend of decreasing diastolic blood pressure was similar in both groups. The heart rate(HR) at 2 min after anesthesia was lower in group non-E than in group E (p<0.05). The sensory block in T10 was produced faster in group non-E (7 min) than in group E (11 min)(p<0.05). And the maximal sensory block level and its reaching time was T7 and 14 min in group non-E, and T8 and 17 min in group E (p=0.12, p=0.11). Two segment regression time was 124 min in group non-E, and 184 min in group E (p=011). The onset time of motor block to Bromage scale 3 was 12 min in group non-E and 16 min in group E (p=0.06). The recovery time from complete motor block to Bromage scale 1 after maximal motor block was 263 min in group non-E, and 278 min in group E. The time at which patients voided after anesthesia was 469 min in group non-E, and 466 min in group E. Three patients urinated by using a urinary catheter in each group. Conclusions: The addition of epinephrine to bupivacaine for spinal anesthesia can slow the decrease in SBP and increase the HR at early stage of anesthesia, and slow the sensory block.
Anesthesia ; Anesthesia, Spinal* ; Blood Pressure ; Bupivacaine* ; Epinephrine* ; Glucose ; Heart ; Heart Rate ; Humans ; Lower Extremity ; Urinary Catheters

One case of subungual glomus tumor was reported which had characteristic clinical manifestations of paroxysmal pain and tenderness for about 20 years. Histopathologically it was confirmed as subungual glomus tumor. This case was treated completely with simple surgics,l excision of the mass.
Glomus Tumor*

No abstract available.
Audiometry*

In the diagnosis of acute spinal trauma, meticulous physical examination and history taking is the most important tool and auxilliary support support can be given by plain X-ray, CT or myelography, etc. But these cannot show the state of cord injury directly. On the contrary, MRI shows the cord directly as well as the soft and bony tissues. We analysed retrospectively 39 patients who suffered from acute spinal trauma at the level of cervical and thoracic spine and had their spine MRI taken. We verified the meaningful correlation between the signal change in the spinal cord on MRI and the degree of neurologic deficit and prognosis, using Frankel classification and trauma motor index at the time of admission and the final follow-up.
Classification ; Diagnosis ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Myelography ; Neurologic Manifestations ; Physical Examination ; Prognosis ; Retrospective Studies ; Spinal Cord ; Spine

No abstract available.
Neurons*

Since 1957, multiple possible mechanisms have been suggested to explain the production of the osteonecrosis of the femoral head and it is now accepted that steroid medication is one of the etiologic factors producing osteonecrosis of the femoral head. Among the surgical procedures in ischemic osteonercrosis of the femoral head are bone grafting, core decom-pression, rotational osteotomy, angulation osteotomy, hemiarthroplasty and total hip replacement. The choice of surgical procedures in the management of idiopathic osteonecrosis of the femoral head is dependent on several factors. Most important are the etiology and stage of the lesion. Other considerations are the patients age, lifestyle, and demands on his hip, and the surgeons preference and expertise. We reviewed 32 total hip replacements in 22 patients, which had been performed to treat steroid-induced osteonecrosis of the femoral head at Department of Orthopaedic Surgery, National Medical Center from Jan. 1975 to Dec. 1981. The longest follow-up was 7 years and 6 months and the shortest, 1 year, the average being 2 years and 6 months. The results were as follows: 1. There were 13 males and 9 females and more than half were in 5th decade. 2. Principal causes to use oral corticosteroids were rheumatoid arthritis, arthralgia, and low back pain in the order of frequency. 3. Duration of corticosteroid medication was between 2 months and 12 years and 18 patients took more than 12 months. 4. Of 18 patients who had the bilateral involvement, the two also had osteonecrosis of the humeral head. 5. Roentgenographically, 30 hips were in stage IV and 2, in stage III according to the classification of Arlet and Ficat. 6. Types of the implants used were Charnely (28 cases), MQller (2 cases) and Trapezoidal-28 (3 cases). 7. The function of the each hip was evaluated preoperatively and postoperatively by the method of Wilson and Salvati and all improved from average poor to average good.
Adrenal Cortex Hormones ; Arthralgia ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Hip ; Bone Transplantation ; Classification ; Female ; Follow-Up Studies ; Head ; Hemiarthroplasty ; Hip ; Humans ; Humeral Head ; Life Style ; Low Back Pain ; Male ; Methods ; Osteonecrosis ; Osteotomy ; Surgeons

During the reproductive period, human endometrium undergoes a pattern of cyclic change. Human endometrium undergoes a complex pattern of proliferation, secretory activity, and menstruation over an approximately 28 days period. Proliferative activity is highest during late proliferative phase under influence of estrogen, and minimal activity in the late secretory and menstrual phase. To study a possible change of telomerase activity during menstrual cycle, telomerase activities in normal and hormone treated endometrium were tested using telomerase repeat amplification protocol(TRAP) assay. Telomerase activities were detected in 9 of 10 proliferative endometrium(90%), and maximal activity was shown in late proliferative phase. Only 3 of 10 secretory endometrium(30%) revealed weak activity. However telomerase activity was not detected in menstrual phase endometrium(N 2) and senile endometrium(N=3). Four of tamoxifen treated endometrium(N 4) and 1 of provera treated endometrium(N 3) Levels of telomerase activity of treated endometrium(N 4) and late proliferative endometrium(N 6) were as high as them of detected in endometrial cancer and hyperplasia. Above findings reveal that telomerase activity of endometrium is changed according to menstrual cycle, And the level of telomerase activity is related to proliferative activity of endometrium that is dependent on the status of female sex steroid hormone and tamoxifen treatment.
Endometrial Neoplasms* ; Endometrium* ; Estrogens ; Female ; Humans ; Hyperplasia ; Medroxyprogesterone Acetate ; Menstrual Cycle ; Menstruation ; Reproduction ; Tamoxifen ; Telomerase*

We report herein a case of pityriasis lichenoides et variloiformis acuta in a 48- year-old man, who has wide spread erythematous macule, papule, vesicle, hemorrhagic vesicle and reddish-brown crust on the neck, trunk, axillae and both extremities. He was treated successfully with tetracycline 2. 0 gm a day for 4 weeks.
Axilla ; Extremities ; Neck ; Pityriasis Lichenoides* ; Pityriasis* ; Tetracycline

No abstract available.
Osteotomy*