BACKGROUND: Intracellular ionized calcium plays a central role in the transduction of external stimuli as a critical second messenger. The spectral properties of fluo-3 allows the analysis of intracellular ionized calcium level by flow cytometers. The aim of this study is to assess the performance of flow cytometer for measuring intracellular ionized calcium level using fluo-3 and to define the reference interval of intracellular ionized calcium level of lymphocytes from healthy people, and to find out the clinical implications according to various disorders. METHODS: For the analytical performance of flow cytometer on determining the concentration of intracellular ionized calcium, precision study, lowest limit of detection, analytical range, and the loading stability of fluo-3 were per foamed. Fifty-four cases of healthy people, 52 cases of renal transplant patients, and 20 cases of diabetes mellitus patients were included in this study. RESULTS: Loading effect of fluo-3 at room temperature was stable upto 5 hours. Lowest limit of detection of ionized calcium concentration was 4.34 nM at in-situ calibration procedure. Within-run and among-day intraindividual CVs of in-situ calibration procedure were 6.67% and 13.99% respectively, and of optical calibration procedure were 13.86% and 16.12% respectively. The reference interval of cytosolic free calcium level for healthy people ranged 73.54 - 155.09 nM without sexual differences. The level of intracellular ionized calcium was lowered by 36.9% on renal transplant group in comparison with healthy control group. But, level of cytosolic free calcium was Increased upto 276.0% on acute rejection group and 159.1% on diabetes mellitus group compared to control group. CONCLUSIONS: These results reveal that in-situ calibration method for intra cellular ionized calcium using flow cytometry with flue-3 can be regarded as an accurate and standardized method. Quantitation of intracellular ionized calcium level might be used as the monitoring test for early detection of acute rejection after renal transplantation.
Calcium* ; Calibration ; Cytosol ; Diabetes Mellitus ; Flow Cytometry* ; Humans* ; Kidney Transplantation ; Limit of Detection ; Lymphocytes* ; Second Messenger Systems

In the practice of modern craniomaxillofacial surgery, there is a general agreement in favor of obtaining solid bony union through the use of titanium and vitallium rigid fixation. These metallic osteosynthesis are not free from inherent drawbacks and limitation. They are liable to have an adverse effect on the growth of the craniofacial skeleton, be a cause of secondary bony resorption, increase risk of infection, result in palpability or exposure and cause artifact in radiologic imaging. These can lead to undue secondary operations necessitating their removal. To overcome there shortcomings, there had been a continuous research on the development of a bioabsorbable skeletal fixation system using polymer of polylactic and polyglycolic acid. Recently, with introduction and commercial availability of a product(Lactosorb, Walter Lorenz) with a minimized resorption period and foreign body reaction, there is an increasing acceptance of its use as an alternative fixation device in craniomaxillofacial surgery. In effort to extend its use in facial bone fractures, Tatum and Eppley were the first report in its successful application in a clinical setting. We report on the clinical experience of such bioabsorbable rigid fixation in patients with maxillofacial trauma. In included one adult and three children in their growth period, underwent open reduction of facial bone fractures. They were followed up in terms of clinical and radiologic outcome for six months. Stalbe and adequate longterm fixation was obtained and no recurrences were noted.
Adult ; Artifacts ; Child ; Facial Bones* ; Foreign-Body Reaction ; Fracture Fixation* ; Humans ; Polyglycolic Acid ; Polymers ; Recurrence ; Skeleton ; Titanium ; Vitallium

There was a report that midazolam-thiopental coinduction reduced ED99 of thiopental for hypnosis from 5.75 mg to 2.37 mg. This study was designed to test whether the former study can be used clinically and to compare midazolam-thiopental coinduction with thiopental or midazolam induction. After 120 patients of ASA calss I, II classified into 3 groups randomly, 5.75 mg/kg of thiopental was injected intravenously to each patient for Group I while 0.23 mg/kg of midazolam was injected intravenously to each patient for Group II. For Group III, 2.37 mg/kg of thiopental was injected intravenously to each patient one minute after 0.02 mg/kg of midazolam was injected. Induction rate, induction time, and the changes of cardiovascular response for each group have been compared and the results are as follows: 1) Induction rate was 100%, 75%, 75% for each group. 2) Time for the spontaneous eye closure and loss of the eyelid reflex for Group I were 12.2+/-8.0 seconds, 20.36.9 seconds respectively, while for Group II 51.5+/-26.5 seconds, 69.3+/-29.5 seconds, and for Group III, 25.3+/-7.4 seconds, 37.0+/-10.8 seconds (G. I< G. III < G. II). 3) However, heart rate was relatively higher in Group I at the point of induction but there were no significant differences between groups statistically. 4) It was also impossible to prove that the changes of blood pressure were more stable in one group than others statistically. By judging from the results above, midazolam-pentothal coinduction can be a useful means of induction but coinduction is not superior to thiopental or midazolam induction.
Blood Pressure ; Eyelids ; Heart Rate ; Humans ; Hypnosis ; Midazolam* ; Reflex ; Thiopental*

BACKGROUD: A lot of "Folk Remedies" on rheumatoid arthritis treatment prevail in Korea, but they have never been evaluated or investigated systemically. Therefore we studied folk remedies used in rheumatoid arthritis patients. METHODS: We delivered 12 questionnaires to 106 rheumatoid arthritis out -patients of family medicine, internal medicine, and orthopedics, located in Seoul and Kyungki area. These questionnaires addressed to demographic characteristics, duration of rheumatoid arthritis, current treatments, kind of folk remedies experienced, decision to choose folk remedies and its subjective effects, and volition to try new folk remedies. RESULTS: There were up to 27 kinds of folk remedies used by 77 people (72.8% of total). Lower education level was proved to be correlated with folk remedies experience. Most patients began their remedies introduced by relatives or close friends (83.1%) . Many Patients on folk remedies were skeptical about its effect, but they were still willing to try new folk medicine (80.6%). Many rheumatoid arthritis patients experienced folk remedies and were skeptical about its effects, but they were still willing to try new folk medicine. Therefore, education on folk remedies is needed.
Arthritis, Rheumatoid* ; Education ; Friends ; Humans ; Internal Medicine ; Korea ; Medicine, Traditional* ; Orthopedics ; Seoul ; Volition ; Surveys and Questionnaires

The reconstruction of defects after the resection of oropharyngeal tumors must not only cover the defect area but also be able to recover its functional structure enabling speech and mastication. To achieve a functional reconstruction, the volume and the length of the pedicle must be suitably designed and a donor site fit for the location and size of the defect must be chosen. However, in reality, the structures in oropharyngeal tumor patients who underwent resection to classify the different defect shapes according to the resection site. Bases on the classification of oropharyngeal defects, we tried to standardize a flap design method for the different defects. We investigated 44 patients who underwent tumor resection and reconstruction surgery for oropharyngeal tumor during the past 3 years at Severance hospital. The defects were divided into 6 zones and 4 types of design methods of radial forearm free flap were standardized. Surgery was performed on 25 patients during September of 1998 to September of 1999 with modified design methods based on the standardized ones. A faster and more efficient flap design was possible due to the standardized method. It was also possible to enable a functional reconstruction in cases where the soft palate was involved without any nasal escape.
Classification ; Forearm* ; Free Tissue Flaps* ; Humans ; Mastication ; Palate, Soft ; Tissue Donors ; Tongue Neoplasms ; United Nations

PURPOSE: This study investigated the surgical results and nasal findings of an endoscopic dacryocystorhinostomy according to differences in nasal mucosal and lacrimal bone opening size. METHODS: This investigation included 40 eyes of 35 patients who had undergone endoscopic dacryocystorhinostomy by nasolacrimal duct obstruction between February 2003 and December 2004. Comparisons of nasal mucosal opening with lacrimal bone opening were performed using of digital images recorded during the operations. Opening size was defined as the definite to average length of the long and short axes of each opening. Success rates were evaluated by postoperative subjective symptoms and syringing findings. Postoperative nasal cavity findings were obtained by endonasal evaluation. The results were verified by the Pearson chi-square test. RESULTS: The success rate was higher in the group with a nasal mucosal opening size at least twice as wide as their lacrimal bone opening size (84.62%) compared to the group with a nasal mucosal opening sizes less than twice as wide as their lacrimal bone opening size (78.57%), but the difference was not significant (p=0.78). Granulation tissues were observed at a significantly lower rate in the group with nasal mucosal opening sizes at least twice as wide as their lacrimal bone opening size. CONCLUSIONS: Large resection of nasal mucosa in endoscopic dacryocystorhinostomy can improve the result by decreasing the granulation formation.
Dacryocystorhinostomy* ; Granulation Tissue ; Humans ; Nasal Cavity ; Nasal Mucosa* ; Nasolacrimal Duct

OBJECTIVES: The purpose of this study was to investigate the effects of methysergide(serotonin receptor antagonist) on serum growth hormone response after electroconvulsive therapy(ECT). METHODS: We studied the changes of the serum growth hormone levels of the day before ECT(No ECT), ECT without methysergide pretreatment(ECT alone), and ECT with methysergide pretreatment(M+ECT) by radioimmunoassay method in 14 psychiatric patients. ECT was induced by the application of 110 volts for a period 0.3-1.0 second, using bitemporal electrodes. RESULTS: 1) Serum growth hormone levels at 15, 30, and 60 minutes after ECT were significantly increased in the ECT alone group than in the No ECT group(p<0.05). 2) Serum growth hormone levels at 15, 30, and 60 minites after ECT were significantly decreased in the M+ECT group than in the ECT alone group(p<0.05). CONCLUSION: These results suggest that the response of growth hormone after ECT seems to be mediated by the activation of serotonergic system.
Electroconvulsive Therapy* ; Electrodes ; Growth Hormone* ; Humans ; Methysergide* ; Radioimmunoassay

BACKGROUND: The extended latissimus dorsi flap is important for breast reconstruction. Unfortunately, donor site seroma is the most common complication of extended latissimus dorsi flap for breast reconstruction. Although using fibrin sealant in the donor site reduces the rate of seroma formation, donor site seroma remains a troublesome complication. The purpose of this study was to analyze the effectiveness of the combination of quilting sutures and fibrin sealant in the latissimus dorsi donor site for the prevention of seroma. METHODS: Forty-six patients who underwent breast reconstruction with extended latissimus flap were enrolled in the study. The patients received either fibrin sealant (group 1, n=25) or a combination of fibrin sealant and quilting sutures (group 2, n=21) in the extended latissimus dorsi donor site. Outcome measures were obtained from the incidence, volume of postoperative seroma, total drainage amount, indwelling period of drainage, and duration of hospital stay. RESULTS: The incidence of seroma was 76% in group 1 and 42.9% in group 2 (P=0.022). We also found significant reductions in seroma volume (P=0.043), total drainage amount (P=0.002), indwelling period of drainage (P=0.01), and frequency of aspiration (P=0.043). The quilting sutures did not affect the rate of drainage, tube reinsertion, or hospital stay. CONCLUSIONS: The use of quilting sutures combined with fibrin sealant on the latissimus dorsi flap donor site is helpful for reducing the overall seroma volume, frequency of aspiration, and total drainage amount.
Drainage ; Female ; Fibrin ; Fibrin Tissue Adhesive ; Humans ; Incidence ; Mammaplasty ; Outcome Assessment (Health Care) ; Seroma ; Surgical Flaps ; Suture Techniques ; Sutures ; Tissue Donors

PURPOSE: We report two brothers having dissociated vertical deviation with microtia and familial history of the condition. METHODS: The subjects of this report are a 7-year-old patient with bilateral dissociated vertical deviation, exotropia, bilateral inferior oblique muscle overaction, and microtia, and his brother, a 6-year-old with bilateral dissociated vertical deviation, right dissociated horizontal deviation and microtia. RESULTS: The first patient underwent asymmetric bilateral lateral rectus muscle recession and bilateral inferior oblique muscle myotomy, while the second patient had asymmetric bilateral lateral rectus muscle recession. In the first patient, the exotropia was corrected, but the bilateral dissociated vertical deviation and left dissociated horizontal deviation remained. The right dissociated horizontal deviation improved in the second patient. Their father, two aunts and paternal grandmother also had strabismus and microtia. CONCLUSIONS: Physicians must investigate familial history in examining the strabismus patient with microtia. Additionally, genetic investigation is in need in more subjects of this study.
Child ; Exotropia ; Fathers ; Humans ; Siblings ; Strabismus

PURPOSE: This study investigated the anatomy of the anterior ethmoidal foramen, posterior ethmoidal foramen, optic foramen, and nasolacrimal duct located in the medial orbit. METHODS: The subjects of this investigation were 20 eyes of 10 cadavers, three were male and seven were female. After exenteration, anatomic evaluation of medial orbit and nasolacrimal duct were performed. The results were verified by Mann-Whitney U test. RESULTS: The distance from the posterior lacrimal crest is 16.10+/-1.07 mm to the anterior ethmoidal foramen, 30.35+/-4.08 mm to the posterior ethmoidal foramen and 37.40+/-2.03 mm to the optic foramen. The distance is 13.95+/-1.16 mm between the anterior and posterior ethmoidal foramen, 6.45+/-1.86 mm between the posterior ethmoidal foramen and optic foramen. The distance from the anterior ethmoidal foramen to its vertical contact point from the anterior ethmoidal foramen to the base line between the posterior lacrimal crest and optic foramen is 14.68+/-2.56 mm, from This vertical contact point to the posterior lacrimal crest is 4.00+/-1.35 mm and the angle between line from the anterior ethmoidal foramen to the posterior lacrimal crest and the line from the optic foramen to the posterior lacrimal crest is 16.15+/-7.03. The distance from the posterior ethmoidal foramen to its vertical contact point from the posterior ethmoidal foramen to the base line between the posterior lacrimal crest and optic foramen is 30.88+/-2.27 mm, from this vertical contact point to the posterior lacrimal crest is 2.30+/-0.71 mm and the angle between the line from the posterior ethmoidal foramen to the posterior lacrimal crest and the line from the optic foramen to the posterior lacrimal crest is 4.43+/-1.47. The total length is 33.55+/-5.34mm, the angle are 44.98+/-6.61 degrees between the coronal plane and 36.60+/-2.19 degrees between the sagittal palne in nasolacrimal duct. CONCLUSIONS: Our study evaluate normal anatomy of the medial orbit, suggest surgical index in Korean.
Cadaver* ; Female ; Humans* ; Male ; Nasolacrimal Duct ; Orbit*