No abstract available.

Three cases of severe spinal kyphotic deformities were treated with Halo-pelvic Apparatus. Among these three cases, two were tuberculous kyphotic deformities involving the thoracolumbar vertebrae with paraplegia. And the other one was cervical kyphotic deformity due to neurofibromatosis with neurologic involvement. The following results and considering problems were obtained. 1. Two cases of tuberculous kyphosis, 130° and 115°, were corrected to 120° and 100° respectively. And one case of neurofibromatic kyphosis, 90° was corrected to 53°. 2. Among two cases of tuberculosis in which the one was revealed full neurologic recovery, and the other resulted in permanent paraplegia. And a case of neurofibromatosis was fully recovered neurologically. 3. Total period of immobilization with Halo-pelvic Apparatus was 16, 18, 18 weeks in three cases respectively, but there was no avascular necrosis of odontoid process. 4. One case of neurofibromatosis with anterior spinal fusion revealed no loss of correction of kyphosis. But two cases of tuberculosis without anterior spinal fusion showed loss of correction of kyphosis, 20° respectively. 5. Removal of internal kyphosis was not easy, because it is likely to injury the blood supply to spinal cord. 6. During distraction, severe pain was noticed in the rib cage, which prevented further distraction. 7. After 9 weeks, ambulation with Halo-pelvic Apparatus was hindered with pain due to pelvic pin loosening. 8. In order to prevent loss of correction of kyphosis, it was considered that anterior spinal fusion should be followed by posterior spinal fusion.
Congenital Abnormalities ; Immobilization ; Kyphosis ; Necrosis ; Neurofibromatoses ; Odontoid Process ; Paraplegia ; Ribs ; Spinal Cord ; Spinal Fusion ; Spine ; Tuberculosis ; Walking

BACKGROUND AND OBJECTIVES: Although a prominent large V wave in left atrial pressure tracing (PVLAP) has been reported to be associated with significant mitral regurgitation (MR) or decreased left atrial compliance (LAC), it is sometimes observed in patients with tight mitral stenosis (MS). The purpose of this study was to determine the prevalence and the hemodynamic significance of PVLAP in tight MS. MATERIALS AND METHODS: Catheterization data before percutaneous mitral balloon valvuloplasty (PMV) were analyzed in 84 consecutive patients and PVLAP was defined as V wave 10 mm Hg higher than mean left atrial pressure (MLAP). RESULTS: PVLAP was observed in 45% (38/84) and factors associated with PVLAP were younger age (p=0.02), higher MLAP (p<0.01), higher mitral gradient (p=0.04), smaller valve area (p=0.01) and low echo score (p=0.02): among them MLAP was the only independent factor in multivariate analysis. The presence of PVLAP had no effect on the result of PMV and successful PMV abolished PVLAP. CONCLUSION: PVLAP was observed not infrequently in these selected patients with MS referred for PMV. The presence of PVLAP was not associated with MR and had good correlation with MLAP, which suggest that PVLAP be determined by decreased LAC.
Atrial Pressure ; Balloon Valvuloplasty ; Catheterization ; Catheters ; Compliance ; Hemodynamics ; Humans ; Mitral Valve Insufficiency ; Mitral Valve Stenosis* ; Multivariate Analysis ; Prevalence

No abstract available.
Cholesterol* ; Female ; Hypertension, Pregnancy-Induced* ; Lipoproteins* ; Metabolism* ; Pregnancy ; Pregnancy*

No abstract available.
Orientia tsutsugamushi* ; Rickettsia* ; Ulsan*

PURPOSE: Coronary artery spasm (CAS) and diabetes mellitus (DM) are implicated in endothelial dysfunction, and insulin resistance (IR) is a major etiological cause of type 2 DM. However, the association between CAS and IR in non-diabetic individuals has not been elucidated. The aim of the present study was to evaluate the impact of IR on CAS in patients without DM. MATERIALS AND METHODS: A total of 330 eligible patients without DM and coronary artery disease who underwent acetylcholine (Ach) provocation test were enrolled in this study. Inclusion criteria included both hemoglobin A1c < 6.0% and fasting glucose level < 110 mg/dL without type 2 DM. Patients were divided into quartile groups according the level of homeostasis model assessment of insulin resistance (HOMA-IR): 1Q (n=82; HOMA-IR < 1.35), 2Q (n=82; 1.35≤HOMA-IR < 1.93), 3Q (n=83; 1.93≤HOMA-IR < 2.73), and 4Q (n=83; HOMA-IR≥2.73). RESULTS: In the present study, the higher HOMA-IR group (3Q and 4Q) was older and had higher body mass index, fasting blood glucose, serum insulin, hemoglobin A1c, total cholesterol, and triglyceride levels than the lower HOMA-IR group (1Q). Also, poor IR (3Q and 4Q) was considerably associated with frequent CAS. Compared with Q1, the hazard ratios for Q3 and Q4 were 3.55 (95% CI: 1.79–7.03, p < 0.001) and 2.12 (95% CI: 1.07–4.21, p=0.031), respectively, after adjustment of baseline risk confounders. Also, diffuse spasm and accompanying chest pain during Ach test were more strongly associated with IR patients with CAS. CONCLUSION: HOMA-IR was significantly negatively correlated with reference diameter measured after nitroglycerin and significantly positively correlated with diffuse spasm and chest pain.
Acetylcholine ; Blood Glucose ; Body Mass Index ; Chest Pain ; Cholesterol ; Coronary Artery Disease ; Coronary Vessels* ; Diabetes Mellitus ; Fasting ; Glucose ; Homeostasis ; Humans ; Insulin Resistance* ; Insulin* ; Nitroglycerin ; Spasm* ; Triglycerides

We studied the ultrastructural alteration of glomerular anionic sites in 6 patients with minimal change nephrotic syndrome, 5 patients with membranous glomerulonephritis, 4 patients with focal segmental glomerulosclerosis, and 4 patients with IgA nephropathy by staining with polyethyleneimine (PEI) as a cationic probe. The control study was examined by using a nephrectomy specimen of non-glomerular disease which had no proteinuria. This method seems to selectively stain heparan sulphate in the basement membranes and has been widely used to evaluate changes in basement membrane charge in various human diseases as well as in experimental studies. The anionic sites in the lamina rara interna and lamina densa of normal glomerular basement membrane were always less numerous and less regularly distributed than those in the lamina rara externa. Characteristic common findings in these glomeruli showed a marked decrease of glomerular anionic sites in the regions with immune-complex deposits and normal distribution in the regions with focally those being absorbed and newly forming glomerular basement membrane. They were not detected in the gap of the basement membrane and on the area of the detached overlying epithelium using the PEI method. But the foot process fusion of epithelial cells seems not to influence the loss of anionic sites on the glomerular basement membrane.
Basement Membrane ; Epithelial Cells ; Epithelium ; Foot ; Glomerular Basement Membrane* ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranous ; Glomerulosclerosis, Focal Segmental ; Humans ; Nephrectomy ; Nephrosis, Lipoid ; Polyethyleneimine ; Proteinuria

No abstract available.
Sterilization, Tubal*

No abstract available.

In order to assess the sensitively and specificity of the pulsed Doppler echocardiography in the aortic regurgitation, 44 patients with valvular heart diseases were examined by pulsed Doppler echocardiography. Every patient was examined in sequence of clinical examination including the physical, M-mode & 2D echocardiographic examination, Doppler technique and then angiocardiography. The obtained results were; 1) Pulsed Doppler echocardiography was very useful in the diagnosis of the aortic regugitation(sensitivity:100%, specificity:90%). 2) Pulsed Doppler echocardiography was especially useful in the detection of the aortic regurgitation in patients who were not detected by physical and conventional echocardiographic examination.
Angiocardiography ; Aortic Valve Insufficiency* ; Diagnosis* ; Echocardiography ; Echocardiography, Doppler, Pulsed* ; Heart Valve Diseases ; Humans ; Sensitivity and Specificity