It is important to maintain normal calcium concentration especially ionized calcium concentration in chronic renal failure patients on hemodialysis. The direct measurement of ionized calcium is less commonly used due to a lack of automated equipment as well as the cost of laboratory equipment. Numerous formulas for adjusted total calcium and calculated ionized calcium are used in clinical practice. We examined the relationship between direct measured ionized calcium and total calcium, corrected total calcium, calculated ionized calcium (formula of Nordin et al) in 53 chronic renal failure patients on hemodialysis. The results were as follows; 1) In predialysis group, plasma total and ionized calcium levels were 2.36+/-0.26, 1.04+/-0.21mmol/L respectively, and higher than normal controls. The correlations between plasma ionized calcium and total calcium, calculated ionized calcium, corrected total calcium were r=0.72 (P=0.0001), r=0.81 (P=0.0001), r=0.65 (P=0.0001) respectively. The plasma ionized calcium level was not correlated with the level of albumin, pH, phosphate, parathyroid hormone. 2) The plasma total and ionized calcium levels were significantly increased with hemodialysis and values were 2.49+/-0.14mmol, 1.14+/-0.14mmol/L respectively. The correlation between ionized and total calcium was r=0.41 (P=0.0021). These results suggested that the calculated ionized calcium (formula of Nordin et al) and total calcium can be used to predict the plasma ionized calcium level in chronic renal patients on hemodialysis.
Calcium* ; Humans ; Hydrogen-Ion Concentration ; Kidney Failure, Chronic ; Parathyroid Hormone ; Plasma ; Renal Dialysis*

Osteoporosis, a disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to enhanced bone fragility and fracture risk, is a major public health problem. The diagnostic methods for osteoporosis include simple radiography, bone scan, DXA (Dual energy X-ray Absortiometry) and biochemical markers of bone turnover. Optimal treatment and prevention of osteoporosis require modification of risk factors, particularly smoking cessation, adequate physical activity, and attention to diet, in addition to pharmacologic intervention. The estrogens and raloxifene both prevent bone loss in postmenopausal women, and the estrogens probably also decrease the risk of first fracture. There is good evidence that raloxifene prevents further fractures in postmenopausal women who already have had fractures and some evidence that estrogen does as well. Bisphosphonate prevents bone loss and reduces fractures in healthy and osteoporotic postmenopausal women and in osteoporotic men as well. Risedronate is more potent and has fewer side effects than alendronate and reduces the incidence of fractures in osteoporotic women. Calcitonin increases bone mineral density in early postmenopausal women and men with idiopathic osteoporosis, and also reduces the risk of new fractures in osteoporotic women. All of the agents discussed above prevent bone resorption, whereas teriparatide and strontium increase bone formation and are effective in the treatment of osteoporotic women and men. New avenues for targeting osteoporosis will emerge as our knowledge of the regulatory mechanisms of bone remodeling increases, although issues of tissue specificity may remain to be addressed.
Absorptiometry, Photon ; Alendronate ; Biomarkers ; Bone and Bones ; Bone Density ; Bone Remodeling ; Bone Resorption ; Calcitonin ; Diet ; Estrogens ; Etidronic Acid ; Female ; Humans ; Incidence ; Male ; Motor Activity ; Organ Specificity ; Osteogenesis ; Osteoporosis ; Public Health ; Raloxifene Hydrochloride ; Risk Factors ; Smoking Cessation ; Strontium ; Teriparatide ; Risedronate Sodium

Management of the bulbous nasal tip with inadequate projection and drooping is challenging aesthetic plastic surgery. The bulbous nasal tip is influenced by several factors; 1) thick, non-elastic oily skin, 2) soft tissue bulkiness due to supratip fibrous fatty tissue, and 3) a wide intercrural angle or increased interdormal distance. Another common factor among caucasians, hypertrophic alar cartilage, is seen less in orientals. These variable factors can be corrected with various surgical maneuvers for proper tip projection and refined alar shape. All these procedures are performed through open rhinoplasty incision. The fibromuscular fatty tissue on the nasal tip is resected with subdermal tangential excision without violating the detmal blood supply. The proximal part of the lateral crus, dome and the part of medial crus which was isolated from the skin and nasal mucosa are replaced and plicated in midline in the role of a new columellar strut and skeletal support. If more skeletal supports are desired, the new columellar is reinforced with a silicone strut and conchal cartilage onlay grafts are applied. And for lengthening of the columella, a V-Y advancement incision on the columellar base with open rhinoplasty is applied. The pressure splint on the upper third of the columella and nasal tip is applied on the 7th postoperative day and maintained for two months. All procedures are focused on the preservation of catilaginous integrity and in providing skeletal support. We performed nasal tip plasty on the bulbous nasal tip and its simple technique and predictability resulted in improved nasal tip projection and contour.
Adipose Tissue ; Cartilage ; Inlays ; Nasal Mucosa ; Rhinoplasty ; Silicones ; Skin ; Splints ; Surgery, Plastic ; Transplants

PURPOSE: The aim of this study is to better understand the pattern and nature of reverse redistribution (RR) in myocardial perfusion imaging. MATERIALS AND METHODS: In consecutive 20 acute myocardial infarction (MI) patients, frequency of RR was correlated with that of subendocardial MI that was detected by myocardial contrast echocardiography (MCE). RR was judged to be present when there was more than one grade of worsening in perfusion at 24 hr delayed images compared with the initial rest images. MCE evaluated the significant lack of opacification in the subendocardial myocardium relative to the subepi-cardial myocardium to suggest the subendocardial MI. Kendall's nonparametric correlation coefficiency was calculated. RESULTS: Concordant cases were 15 of 20 (75%) and correlation was statistically significant (p=0.0285). CONCLUSION: Our results suggested that RR was correlated with MCE-detected nontransmural MI.
Echocardiography* ; Humans ; Myocardial Infarction* ; Myocardial Perfusion Imaging ; Myocardium ; Perfusion

Injectable Collagen Implan, is composed of purified bovine dermal collagen emulsified in saline and lidocaine(0.3%) base, and has been promoted for correction of soft tissue contour defects. Although collagen is a relatively nontoxic, nonimmunologic and biolegically nonreactive biomaterial, some side reactions have been reported. We report herein a case of cutaneous side reaction to collagen implantation in a 38-year-old female. The patient presented with puritic, irritating, multiple, erythematous nodules on both the temporal and interorbital area, which had been observed since 1 day after collagen(KOKEN ATELOCOLLA-GEN IMPLANT-Japan) implantation. Histopathologic findings showed dense infiltration of acute and chronic inflammatory cells in the dermis, especially the perivascular and periadnexal area.
Adult ; Collagen* ; Dermis ; Female ; Humans

Tolerance to contact hypersensitivity was induced by feeding of different DNCB doses in mice. A total of 40 mice were divided into 4 groups(control group, 6 mg feeding group, 10 mg feeding group, 14 mg feeding group) in experiment I, Degree of tolerance to contact hypersensitivity was rneasured by incremert rate of ear swelling after challenge with DNFB. Experiment 2 was performed in the same method of cxperiment: I with addition of 3 mg DNCB feeding group. The increment ratee were significantly decreased in DNCB feeding groups in experirnent 1 and 2(p<0.0l). But there were no differences statisticalIy between increment rates of DNCB feeding groups.
Animals ; Dermatitis, Contact ; Dinitrochlorobenzene* ; Dinitrofluorobenzene ; Ear ; Mice*

No abstract available.
Pneumocephalus*

In femorsl neck fracture, viability of the femoral head depends on the revascularization of the femoral head. The purpose of this study is to observe the effect of early fixation and anatomical reduction by measuring the Tc-99m-MDP uptake ratio of the femoral head in experimental animsls. Femoral neck region of 20 mature rabbits were osteotomized completely and divided into 2 groups ; each group consisted of 10 rsbbits. Group 1 had two Kirschner wire fixation after osteotomy and anatomic reduction. Group 2 had no fixation after osteotomy. The uptake ratio of Tc-99m-MDP of the femoral head in each group were measured st the intervals of 24 hours, 48 hours, 1 week, 2 weeks, 3 weeks, and 4 weeks, respectively. The results obtained were as follows ; 1. In experimental group 1, the mean uptake ratio of the femoral head was 0.72±0.13 at 1 day after operation, increased to a level of 1.44±0.14 at 1 week, increased to a maximal value of 2. 90±0.36 at 3 weeks and decreased to a level of 1.10+0.12 at 4 weeks. 2. In experimental group 2, the mean uptake ratio of the femoral head was 0.70±0.10 at 1 day, 0.64±0.13 at 1 week, decreased to a maximal value of 0.33±0.05 at 3 weeks and 0.47±0.05 at 4 weeks, showing decreased level below 1.0. The results suggest that early anatomicsl reduction and rigid fixation of femoral neck fracture is helpful for revascularization of the femoral head and prevention of non union.
Femoral Neck Fractures ; Femur Neck ; Head ; Neck ; Osteotomy ; Rabbits

Malignant osteoblastoma is very rare tumor which shows histological findings of an aggressive pattern and benign clinico-radiological features, and also called as aggressive or pseudomalignant osteoblstoma. The authors experienced one csse of malignant osteoblastoma involving diaphysis of left humerus in 22-year old man. The patient is healthy and maintains his normal activity without recurrence over five years after complete excision of cystic mass, curettage and bone graft.
Curettage ; Diaphyses ; Humans ; Humerus ; Osteoblastoma ; Recurrence ; Transplants

No abstract available.
Neurofibromatoses*