No abstract available.
Hernia, Inguinal* ; Humans

No abstract available.
Cholecystectomy* ; Common Bile Duct* ; Humans

PURPOSE: To obtain magnetization transfer ratio(MTR) of the annulus fibrosus and nucleus pulposus and to assess the feasibility of utilizing the changes of these MTRs as an early indicator of disk degeneration. MATERIALS AND METHODS: MR images of lumbar spine with magnetization transfer(MT) technique in 42 patients were obtained. spin echo techniques (600/14) with same TR/TE with 1KHz off-resonance saturation were employed in 1.0T MR system. MTRs were calculated in two regions, anterior annulus fibrosus and nucleus pulposus, and the results were compared between the normal and degenerative disks, from grade I to IV, on T2-weighted images. RESULTS: MTRs of the nucleus pulposus were 17.6% in the normal disks, and 26.7%, 28.4%, 29.1%, 29.7% in degenerative disks, from grade I to IV, respectively, with a significant difference(P<0.05). On the other hand, MTRs in the annulus fibrosus were 30.2% in the normal disks and 31.5%, 33.2%, 32.1% and 35.6% in degenerative disks, from grade I to IV, respectively, without significant difference. CONCLUSION: Since MTRs are significantly higher in degenerative nucleus pulposus than those of the normal disks, increased MTRs in the nucleus pulposus can be used as an early sign of the degeneration of the nucleus pulposus.
Hand ; Humans ; Intervertebral Disc Degeneration* ; Magnetic Resonance Imaging* ; Spine

We studied 193 Diabetics without any symptoms of coronary artery disease and 39 Normal healthy subjects as Control group, using treadmill exercise test and obtained following results. 1) The positive rate was significantly higher in Diabetics(19.4% in Normal ECG groups and 25.4% in total Diabetics)than Control groups(5.1%)(0.010.05). 5) There was no difference in HbAIC, Total cholesterol and Triglyceride between positive and negative groups(P>0.05). In summary, with exercise test, the positive rate was higher in Diabetics than in Normal control groups and it seemed to be treadmill exercise test is a useful screening method for evaluation of coronary artery disease as well as for assesment of treatment and follow up care.
Blood Pressure ; Cholesterol ; Coronary Artery Disease ; Diabetes Mellitus* ; Electrocardiography ; Equidae ; Exercise Test* ; Heart Rate ; Mass Screening ; Triglycerides

BACKGROUND: The decision to institute mechanical ventilation for patients with COPD is very difficult. The accurate informaiton regarding weaning success and long-term survival will improve communication with patients and family and enhance informed consent. The aims of this study are to describe outcomes and identify variables associated with survival for patients experiencing mechanical ventilation with an acute respiratory failure of COPD. METHODS: The 53 cases of mechanical ventilation in the intensive care unit in the National Medical Center from 1989 to 1998 were included. Data were collected retrospectively from medical records. Weaning success rate and 3 month and 1 year survival rates were estimated. Factors associated with weaning success and survival were determined. RESULTS: Weaning success was 55%. For success group with 29 cases, 3 months survival rate was 61% and 1 year survival rate 37%. APACHE II scores in weaning success group were significantly lower than those in the failure group. Factors such as age, sex, comorbid-illnes, previous steroid use, causes of respiratory failure, RVH or arrhythmia on EKG, serum albumin level, arterial blood pH, PaO2, PaCO2, FEV1, duration of mechanical ventilation and steroid use during mechanical ventilation were not associated with weaning success. Only age and serum albumin level were associated with 3 month and 1 year survival. No COPD patients of age more than 75 years and serum albumin level less than 3g/dl had survived at 1 year after weaning success. CONCLUSION: While seaning success from mechanical ventilation can be predicted by APACHE IIscore in COPD patients, long-term outcomes of survivors may be influenced by nutritional status and age.
APACHE ; Arrhythmias, Cardiac ; Electrocardiography ; Humans ; Hydrogen-Ion Concentration ; Informed Consent ; Intensive Care Units ; Medical Records ; Nutritional Status ; Pulmonary Disease, Chronic Obstructive* ; Respiration, Artificial* ; Respiratory Insufficiency ; Retrospective Studies ; Serum Albumin ; Survival Rate ; Survivors ; Weaning

BACKGROUND: Joint symptoms frequently occur in the course of antituberculous chemotherapy and tend to be ignored and overlooked, but in some cases, they are often very troublesome in obstructing ordinary life. Joint symptoms that develop during antituberculous chemotherapy need to be understood, but there are few materials describing them systematically. METHOD: This study enrolled 33 patients with tuberculosis treated with first line antituberculous agents for more than 6months. In the course of treatment, joint symptoms not associated with specific cause, such as pre-existing joint disease or trauma, were investigated and compared with those of the asymptomatic group, We confirmed the incidence of joint symptoms and factors associated with them. RESULTS: Nineteen of 33 patients (58%) had joint symptoms. Joint symptoms developed 1.9±1.4 months after the beginning of chemotherapy and lasted for 3.6±2.5 months. IN 18 of 19 symptomatic patients, multiple joints were involved : shoulder(10 patients, 53%), knee(10,53%), finger(6,32%). Joint symptoms were expressed as pain(19 patients, 100%), stiffness(7,37%) and/or swelling (3,16%). Fourteen patients (74%) took analgesics to relieve their symptoms and in 2 patients, antituberculous agents were discontinued because of the severity of their symptoms. The symptoms seem to be caused by agents other than pyrazinamide, but it was very difficult to identify the definite causative agent. In age, sex, underlying disease and serum uric acid level, no significant differences were noted between the two groups. CONCLUSIONS: Although joint symptoms are common during antituberculous chemotherapy, their development is difficult to predict. Because some joint symptoms can become very bothersome, the physician should pay close attention to these symptoms.
Analgesics ; Arthralgia ; Drug Therapy* ; Humans ; Incidence ; Joint Diseases ; Joints* ; Pyrazinamide ; Tuberculosis ; Uric Acid

A 54-year-old diabetic man presented to the hospital with shock and bradycardia. His initial estimated left ventricular ejection fraction (LVEF) was 15% and the electrocardiogram showed a junctional escape rhythm with a wide QRS complex and no P wave. Intensive supportive therapy was initiated after inserting a pacemaker and starting extracorporeal membrane oxygenation. A myocardial biopsy confirmed acute lymphocytic myocarditis with extensive myocyte necrosis, and cardiac transplantation was planned. However, the patient survived without transplantation after vigorous hemodynamic support for 2 weeks. After discharge, he had limited activity for 4 months due to dyspnea caused by a reduced systolic heart function (LVEF, 21%) with a junctional escaped beat. His systolic function recovered markedly 6 months after stopping the hemodynamic support, with the presence of a P wave and narrowed QRS complex.
Biopsy ; Bradycardia ; Dyspnea ; Electrocardiography ; Extracorporeal Membrane Oxygenation ; Heart ; Heart Failure ; Heart Transplantation ; Hemodynamics ; Humans ; Middle Aged ; Muscle Cells ; Myocarditis* ; Necrosis ; Shock ; Stroke Volume ; United Nations

No abstract available.
Acute Kidney Injury* ; Edema* ; Hemofiltration*

No abstract available.
Acute Kidney Injury* ; Edema* ; Hemofiltration*

Bone grafts are an integral and important aspect of craniofacial reconstruction. Rips, tibia, and iliac bone have traditionally used as donor site but each of these has various problems, however using to the calvarial bone as a donor site has several advantage. These are as follows; there are abundance of material, easy to reach the donor site through coronal incision, minimal pain of donor area, less functional inability, shorter hospitalization, no need of immobilization, hidden scar at donor site, no secondary deformity and appropriate curvature obtained properly selected. From March to December 1987, we experienced three cases of autogenous calvarial bone graft such as congenital saddle nose deformity, fibrous dysplasia on the right side frontal bone, and deviated nose. The results were very excellent without any significant complication. The detail technique of autogenous calvarial bone graft and its advantages compared with the traditional methods of bone grafts are discussed.
Cicatrix ; Congenital Abnormalities ; Frontal Bone ; Hospitalization ; Humans ; Immobilization ; Nose ; Tibia ; Tissue Donors ; Transplants*