Astrocytes are the most numerous cellular elements in the cerebrum, and they normally have a very slow turnover rate. But during regeneration after injury, they proliferate markedly resulting in astrogliosis. The extracellular matrix in the central nervous system is present in the vessel walls and in the external glia limitans as a basal lamina. The presence of an intact extracellular matrix framework is important in regeneration after injury. Understanding the properties of astrocytic proliferation will be helpful to find out new treatment for functional recovery in the central nervous system. In this study, after cryogenic injury was performed on the cerebral cortex in rats, changes in astrocytes and the extracellular matrix were observed using light microscopy, immunohistochemical stain for glial fibrillary acidic protein(GFAP), proliferating cell nuclear antigen(PCNA), fibronectin, laminin, and type IV collagen, autoradiography and electron microscopy. The results were as follows; 1) The coagulative necrosis, which followed cryogenic injury on the cerebral cortex was healed, forming a new pia mater above the lesion. 2) Some of the PCNA positive cells were astrocytes and some of the GFAP positive cells showed a positive reaction to PCNA. 3) Proliferating astrocytes labelled by autoradiography or immunohistochemical stain for PCNA reached maximal numbers 3days after the injury and they were no longer found 2 weeks after injury. 4) In autoradiography with immunohistochemical stain for GFAP, about 1% of GFAP positive astrocytes were labelled by autoradiography and in double immunohistochemical stain for PCNA and GFAP, about 8-16% of GFAP positive astrocytes were also stained by PCNA. 5) In immunohistochemical stain for fibronectin, laminin and type IV collagen, laminin and type IV collagen were present in the newly formed blood vessel walls and fibronectin showed a diffuse positive reaction within the lesion. The new pia mater was formed within 2 weeks after the injury. 6) On electron microscopic examination, basal lamina material was found in the vessel wall 1 week after the injury and at 2 weeks, a nearly complete and continuous basal lamina was formed although the thickness was uneven. According to these findings, astrocytes in the cerebral cortex of adult rats proliferate very early in the regenerative period after cryogenic injury. At 2 weeks after the injury, this regeneration ceases and the damaged basal lamina of pia mater and vessel wall were reconstituted.
Adult ; Male ; Female ; Humans ; Rats ; Animals

No abstract available.
Muscle, Smooth* ; Renin* ; Renin-Angiotensin System*

PURPOSE: To evaluate the surface anatomy of the central sulcus(CS), precentral gyrus(PrCG) and postcentral gyrus(PoCG) on the basis of sulci pattern on MR images. MATERIALS AND METHODS: The MR images were obtained in the plane 10 degree angled to the orbitomeatal line. The MR images of 120 subjects(6 months to 79 years) with normal anatomy were analyzed and another four subjects with known space occupying lesions were also reviewed. RESULTS: The identification of gyri was feasible on the axial T1WI from anterior to posterior and from upper to lower images. The STS demonstrated symmetric pattern on both sides in 84 of 120 cases (70%), including two cases of prominent STS pattern. The asymmetric pattern was seen in 36 of 120 cases (30%):14 of 120 cases (12%) on the right and 22 of 120 cases (18%) on the left at 4.5 cm above the level of the splenium of corpus callosum. The PrCG and PoCG and CS were identified well in all cases with the use 'of the sulci pattern. CONCLUSION: The identification of the gyri on the basis of the cerebral sulci pattern on MR images is useful and important when locating the space occupying lesion of the brain.
Brain ; Corpus Callosum ; Magnetic Resonance Imaging*

Diaphyseal fractures of the long bone associated with massive soft tissue injury or severe comminution is difficult to treat. Fracture healing is often delayed due to the damaged soft tissue, deep seated wound infection, fracture instability and poor local circulation. The delayed fracture healing necessitates prolonged immobilization of the limb which results in joint stiffness. Various type of fracture treatment was suggested for this type of fractures to ease the treatment. The Wagner's apparatus was one of the device to treat it, which was originally introduced as a device for controlled leg lengthening. Its use also has been expanded to serve as a rigid unilateral external fixation frame for fracture. In order to obtain satisfactory fracture union without adjacent joint contracture, the Wagner's apparatus has been employed by us in three cases who were hospitalized in Kangnam St. May's Hospital. The experience of this technique was very encouraging; therefore we recommend its wide application in fracture treatment in cases of the patient who can not receive the bilateral external fixation frame.
Contracture ; Extremities ; Fracture Healing ; Humans ; Immobilization ; Joints ; Leg ; Lower Extremity ; Soft Tissue Injuries ; Wound Infection

No abstract available.
Humans ; Infant, Newborn ; Infant, Premature* ; Nephroma, Mesoblastic* ; Ultrasonography, Prenatal*

The frequency of stab wounds is gradually increasing and patients with stab wounds visit the hospital through the emergency room. Management options for patients with stab wound include mandatory exploration and selective observation, but recently many authors have emphasized the importance of selective conservation with development of diagnostic procedure and controversy still exists concerning the management of patients with stab wounds. We retrospectively analysed the clinical data of 78 patients with stab wounds who visited the emergency room of St. Paul's Hospital over 5 years from January 1 1992 to December 31 1996. The following results were obtained. 1) The most prevalent age group were the twenties & the thirties(58.9% of patient) and then most patients were of young age. The male to female ratio was 2.9: 1. 2) Most injuries occurred at night between 8p.m. and 4a.m.(61.5%) and during September injuries were most frequent. 3) The most common causes of stab wound were fighting(55.1%) followed by suicide (21.8%), then accidents including traffic accidents(16.7%) and robbery(6.4%). 4) The instruments most commonly used were knives(53.8%) and broken glass(28.2%). 5) Half of patients were drunk from alcohol and in 3 cases from an antipsychotic drug. 6) In 11 cases(14.1%), there were multiple wound sites and in 8 cases(10.3%) superficial wounds into subcutaneous fatty tissue. 7) According to stab wound sites, the extremities were wounded in 36 cases(46.2%), chest in 21 cases(26.9%), abdomen in 15 cases(19.2%) and neck in 7 cases(9.0%). 8) Emergency explorations were performed in 43 cases(55.1%) under general or regional anesthesia, which included neck in 4 cases(9.3%), chest in 3 cases(7.0%), abdomen in 11 cases(25.6%) and extremity in 25 cases(58.1%). In exploratory laparotomy, negative exploration rate was 18.2%. 9) Death occurred in 2 cases(2.6%). One died due to sepsis with multiple colon perforation and the other due to hypovolemic shock with Superior Vena Cava injury.
Abdomen ; Adipose Tissue ; Anesthesia, Conduction ; Colon ; Emergencies ; Emergency Service, Hospital ; Extremities ; Female ; Humans ; Laparotomy ; Male ; Multiple Trauma ; Neck ; Retrospective Studies ; Sepsis ; Shock ; Suicide ; Thorax ; Vena Cava, Superior ; Wounds and Injuries ; Wounds, Stab*

No abstract available.
Glomus Tumor*

We performed a retrospective study of 12,307 patients who visited the emergency room of St. Paul's Hospital, secondary medical center, from January 1 to December 31,1996. The results were as follows : 1. Of 12,307 total patients, male to female ratio was 1.16:1 but after 7th decade, there were more female than male. And 3rd decade was the peak age group. 2. The majority o(patients visited our emergency room from noon to midnight (65% of total patients). 3. On average,33.7 patients visited our emergency room per day. Most patients visited on Sundays and other holidays(average 43.3 per day). 4. By monthly distribution, the patients Increased slightly during May, June, July, August and September. 5. Disease to injury ratio was 2.6:1. In disease, male to female ratio was 1 :1 and in injury, the male prominence had a the ratio 1.8:1 In 2nd decade, disease to injury ratio was higher (1.4:1) than that of other decade. And there were mostly disease patients in the group under 1 year old (19.2: 1). 6. Of 12,307 total patients,5,458 patients received only Intern's treatment (44.3%). In 3rd decade, the ratio of Intern's treatment was higher (54.4%). 7, The patients were categorized as follows, Infernal medicine 28.1%, Pediatrics 18.2fo, Orthopedic surgery 13.2%, Plastic surgery 7.4% etc. 8. Averaged admission rate was 25.3% and the rate of general surgery was the highest (49.5%). The rate of admission to intensive care unit (ICU) was 5.5% of total visiting patients and 21.8% of total admission patients. 9. The total patients transferred from other hospitals were 1152 (9.4%), 3.16 per day. The majority used non-emergency vehicles and only 8.5% of patients used the rescue service or ambulances. 10. The average transit time spent in the emergency room was 182 minutes. The longest was 246 minutes in March and the shortest 127 minutes in January.
Ambulances ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Intensive Care Units ; Male ; Orthopedics ; Pediatrics ; Retrospective Studies ; Surgery, Plastic

STUDY DESIGN: We retrospectively reviewed nine patients of lumbar extraforaminal disc herniation which underwent conservative or surgical treatment. OBJECTIVES: We evaluated the clinical characteristics, accuracy of diagnostic methods, and result of conservative or surgical treatment for the lumbar extraforaminal disc herniation. SUMMARY OF BACKGROUND DATA: Lumbar extraforaminal disc herniation represents an important component of lumbar disc herniation because of the difficulty in diagnosis and the difference in clinical characteristics and surgical approaches in contrast to usual intracanalicular disc herniation. MATERIALS AND METHODS: Nine patients which we have experienced from March 1994 to February 1997 were evaluated by physical examination, magnetic resonance imaging, EMG, and disco-enhanced computed tomogram. There were 4 males and 5 females, and average age was 42.4 years. RESULTS: The level of herniation was 4 cases at L4-5 and 5 at L5-S1. Radiating pain was chief complaint but low back pain was absent or mild. Accuracy of disco-enhanced computed tomogram was superior to that of magnetic resonance imaging. The results of conservative treatment were good in 2 cases(40%), fair in 2 cases(40%), and poor in 1 case(20%). And those of surgical treatment including partial laminectomy, medial facetectomy, and discectomy or extraforaminal approach were excellent in 3 cases(75%), good in 1 case(25%) according to the grading of MacNab. CONCLUSIONS: Lumbar extraforaminal disc herniation represents compressive symptoms of upper lumbar root of the involved level characteristically. Location and degree of disc herniation is an important tractor for determining the surgical approach, and disco-enhanced computed tomogram is a definite diagnostic method.
Diagnosis* ; Diskectomy ; Female ; Humans ; Laminectomy ; Low Back Pain ; Magnetic Resonance Imaging ; Male ; Physical Examination ; Retrospective Studies

BACKGROUND: Intravenous catheter-related complication among the hospitalized patients has been increasing recently in Korea, since many hospitals has tried to save expenses by replacing the foreign-made catheter with domestic-made intravenous catheter. We studied the incidence rate of catheter-related complication and compared the incidence of catheter-related complication between domestic-made and foreign-made ones. We also studied to elucidate whether the morphologic characteristics of the intravenous catheter will effect the incidence of catheter-related complication. METHOD: From July 1 to Sept 30, 1998, we surveyed the incidence rate of intravenous catheter-related complication among the hospitalized patients in the wards of Medicine. Surgery, Obstetric, and Neonatal Intensive Care Unit in Guro Hospital, Korea University Medical center. We also compared the incidence of complication between domestic-made catheter (catheter A) and foreign-made catheter (catheter B) of three different gages (24G, 22G and 18G). The morphologic characteristics of intravenous catheters has been studied by electron microscopy. RESULT: Complication associated with use of intravenous catheter had been occurred 263 out of 459 cases (57.3%), among those cases, non-infectious complication and infectious complication were 173 cases (37.7%) and 90 cases (19.6%), respectively. Totally, catheter A group showed higher complication than catheter B group [62.0% (160/258) vs 51.2% (103/201), P=.021]. Analysis on the incidence rate of complication according to the products did not show significant differences in the noninfectious complication in every gage groups. However the infectious complication occurred higher in the domestic-made catheter A group than among the foreign-made catheter B group [(24G: 6% vs 0%, P=.026), (22G: 25.6% vs 9.6%, P=.001), (18G: 36.8% vs 13.4%, P=.002)]. Duration of catheter life did not show the difference between catheter A group and catheter B group [48.5hrs vs 50.3hrs, P=.474]. The analysis on risk factors for complication showed that catheter A group is highly related (odd ratio 1.85). The morphologic analysis of the catheter by using electron microscopy showed that the angles in the tip of the introducing needle of catheter Aand catheter Bare 60degrees and 45degrees , respectively, and the bevel between introducing needle and catheter sheath are 50degrees and 27degrees, respectively. CONCLUSION: There was a higher incidence rate of complication related to domestic-made catheter usage, which might influence increasing the period of the hospitalization and the expenses due to the complication. The study of cost effectiveness analysis needs to be performed regarding intravenous catheter-related complication. Morphologically, catheter A showed more blunt angle in the tip and transition area of the introducing needle than the angle of catheter B, which is considered to influence the higher complication incidence. It needs to improve the quality of domestic-made intravenous catheter.
Academic Medical Centers ; Catheter-Related Infections ; Catheters ; Cost-Benefit Analysis ; Female ; Hospitalization ; Humans ; Incidence* ; Infant, Newborn ; Intensive Care, Neonatal ; Korea ; Microscopy, Electron ; Needles ; Obstetric Surgical Procedures ; Prospective Studies* ; Risk Factors