PURPOSE: Prostaglandins(PGs) are known to produce a remarkably broad spectrum of effects that embraces practically every biological function, and has a particular physiological role in the central nervous system. Significant increases of PGs levels are seen in certain diseases, such as febrile infection, stroke, schizophrenia, and epilepsy. Prostaglandin is also increased in a response to rising body temperature, and prostaglandin E-2(PGE-2) in lumber cerebrospinal fluid is also increased in febrile convulsion. Intracerebroventricular injection of PGE produces a rise in body temperature and also antagonizes convulsions induced by pentylenetetrazole, penicillin, electric shock. Therefore we studied PGE-2 levels in cerebrospinal fluid of afebrile children, children with febrile convulsion, and febrile children without convulsion. METHODS: The subjects comprised 57 cases with febrile convulsion, 24 cases of afebrile diseases and 9 febrile children without convulsion. All patients were undergoing lumbar puncture and PGE-2 levels in CSF were determined by highly specific radio-immunoassay(Prostaglandin E2 [125I] assay system, Biotra Assays, Amersham Inc.). RESULTS: 1) The CSF PGE-2 levels were significantly higher in children with febrile convulsion(147.3+/-79.3pg/ml) than those in febrile children without convulsion(72.4+/-75.4pg/ml) and afebrile children(19.2+/-28.4pg/ml)(p<0.05). 2) There were no statistical significances of the CSF PGE-2 levels between age and fever in both groups. 3) The CSF PGE-2 levels within 4 hours(176.5+/-65.7pg/m1) after convulsions were significantly higher than those 4 hours after convulsion(93.3+/-74.9pg/ml). CONCLUSION: The CSF PGE-2 levels were significantly higher in children with febrile convulsion than those in febrile children without convulsion and those in afebrile child ran. The CSF PGE-2 levels within 4 hours after convulsion were significantly higher than those 4 hours after convulsion.
Body Temperature ; Central Nervous System ; Cerebrospinal Fluid* ; Child* ; Epilepsy ; Fever ; Humans ; Penicillins ; Pentylenetetrazole ; Prostaglandins E ; Prostaglandins I ; Schizophrenia ; Seizures ; Seizures, Febrile* ; Shock ; Spinal Puncture ; Stroke

When the effusion and pain of the joint caused by rheumatoid arthritis, osteoarthritis, and non-specific synovitis is persistent in spite of various conservative measures, the intra-articular injection of radioactive colloidal gold is recommended. Although the cause of rheumatoid arthritis and similiar types of inflammatory arthritis is not well known, the basic pathology appears to be in the synovium Colloidal particles of radioactive coiloidal gold injected into an inflamed joint are phagocytosed and dispersed uniformly on the superficial layers of the synovium Radioactive colloidal gold was first introduced in the malignant peritoneal effusions by Muller in 1950, and it was later used by Andrew and Mackay in malignant pleural effusion in 1953 and 1957. The malignant ascite, pleural effusion, and synovial effusion are collections of fluid in closed cavities lined by a thin sensitive endothelial layers; and apart from repeated aspirations, accepted forms of treatment frequently fail to cure or even control the effusions. Because of this resemblance it was decided in 1957 to attempt to treat persistent synovial effusions by intra-articular injection of radioactive colloidal gold. 198Au has a half-life of 2.7 days and emits both beta and gamma rays, Beta rays, which produce 90% of the therapeutic effect, penetrate tissue to an average depth of 1 to 2 mm. The particle of colloidal suspension of 198Au is 20 to 50 mu. The colloidal state of the preparation aids in limiting radiation to the synovial surface, and it has been shown that large colloidal particles are not absorbed into the blood or lymphatic systems after intra-articular injection and penetrate no deeper than the synovial tissues as a result of phagocytic activity. Good results have been reported since the radioactive colloidal gold was introduced in the treatment of persistent effusion of the human knee by Makin in 1963. The knee is chosen as the most suitable joint for this trial because of the ease of performing accurately intra-articular injections and the ease with which knee effusions can be recognized and measured. Furthermore, the knee joint is superficial and distant from vital structures which may be radio-sensitive. In this study, thirty-nine knee and three ankle effusions and pains unresponsive to the usual methods of therapy were treated by intra-articular injection of radioactive colloidal gold from November 1964 to January 1979 with follow up. Thirteen cases had classical rheumatoid arthritis; ten osteoarthritis; fifteen non-specific synovitis; two pigmented villonodular synovitis; one post-synovectomy, and one tuberculous arthritis. The results were as follows; 1. In eleven cases(84.6%) of rheumatoid arthritis, fourteen cases (93.3%) of nonspecific synovitis, and five cases(50.0%) of osteoarthritis, the effusion disappeared. 2. In twelve cases(92.3%) of rheumatoid arthritis thirteen cases(86.7%) of non-specific synovitis, and only two cases(20.0%) of osteoarthritis, the pain disappeared. 3. As a whole, in thirty-three cases(78.6%), the effusion disappeared and in twenty-eight cases (66.7%), the pain disappeared.
Ankle ; Arthritis ; Arthritis, Rheumatoid ; Ascitic Fluid ; Aspirations (Psychology) ; Beta Particles ; Colloids ; Follow-Up Studies ; Gamma Rays ; Gold Colloid ; Half-Life ; Humans ; Injections, Intra-Articular ; Joints ; Knee ; Knee Joint ; Lymphatic System ; Osteoarthritis ; Pathology ; Pleural Effusion ; Pleural Effusion, Malignant ; Synovial Membrane ; Synovitis ; Synovitis, Pigmented Villonodular

This article reviewed achievements and challenges of the National Health Insurance of the Republic of Korea and shared thoughts on its future directions. Starting with large workplaces of 500 or more employees in 1977, Korea's National Health Insurance successfully achieved universal coverage within just 12 yr in 1989. This amazing pace of growth was possible due to a positive combination of strong political will and rapid economic growth. Key features of Korea's experience in achieving universal coverage include 1) gradual expansion of coverage, 2) careful consideration to maintain sound insurance finances, and 3) introducing multiple health insurance societies (multiple payer system) at the initial stage. Introduction of the health insurance has dramatically improved Korea's health indicators and has fueled the rapid growth of basic medical infrastructure including medical institutions and professionals. On the other hand, the successful expansion was not free from side-effects. Although coverage has gradually expanded, benefits are still relatively low. The current situation warrants concern because coverage expansion is driven by welfare populism asserted by irresponsible political slogans and lacks a social consensus on basic principles and philosophy regarding the expansion. Concentration of patients to a few large prestigious hospitals as well as the inefficiencies resulting from a colossal single-payer system should also be pointed out.
Delivery of Health Care/*economics ; Humans ; National Health Programs/*economics ; Republic of Korea ; Social Welfare

No abstract available.
Prostheses and Implants* ; Tooth*

No abstract available.
Child* ; Epilepsy* ; Humans

No abstract available.
Asthma* ; Immunotherapy*

In the classical ballet dancers, ankle joints are frequently overused. Especially the Pointe and the Releve are the two basic steps of ballet dance which cause the narrowing of the posterior aspect of the ankle joint. Posterior impingement syndrome of the ankle joint is defined as impingement occuring at the anatomical interval between the posterior tibial articular surface and os calcis. The purpose of this study is to describe the anatomy and etiology of this injury and to review the non-operative and operative treatments. Sixteen cases of posterior impingment syndrome had been treated between March 1994 and March 1995. Ten dancers were professional and six were students. The patients was divided 3groups by etiologic factor. Group 1 is anatomical problem factor, Group 2 is overuse factor and Group 3 is ankle sprain factor. Thirteen dancers (81.2%) improved with conservative treatment including local steroid injection. Among the other three dancers, operation was performed in one case. The other two cases stopped dancing. The result was good in one dancer after operation. In the classic ballet dancers, posrerior impingement syndrome was frequent disorder and major etiologic factors are anatomical problem and overuse. Operation was necessary in only group l. It is good result in conservative treatment and operation.
Ankle Injuries ; Ankle Joint* ; Ankle* ; Dancing ; Humans

No abstract available.
Humans ; Osteosarcoma*

Miller-Dieter syndrome consists of severe type I lissencephaly, abnormal facial appearance, and sometimes other birth defects. Lissencephaly is a brain malformation manifested by a smooth cerebral surface, thickened cortical mantle, and microscopic evidence of incomplete neuronal migration. It comprises the agyria-pachygyria spectrum of malformation, thus excluding polymicrogyria and other cortical dysplasia. Type I lissencephaly results from abnormal migration between about 10 and 14 weeks gestaion. The brain is often small, and the ventricle is enlarged posteriorly The corpus callosum may be small or absent. The structural pattern of the cerebral hemispheres and ventricles is distintly immature, reminiscent of fetal brain. The superficial cellular layer resembles an immature cortex, with some separation into zones similar to layers III, V, and VI of normal cortex, although the cell population is decreased. In 1963 Miller described a malformation syndrome in a brother and sister with postnatal growth deficiency, craniofacial defects, and serious abnormalities of neurologic function. Autopsy at 3 and 4month of age, respectively, revealed lissencephaly. Subsequently, Dieker reported four additional patients with this disorder and referred to it as the 'lissencephaly syndrome'. We have experienced a case with this syndrome. Then we report this rare case with brief review of literature.
Autopsy ; Brain ; Cerebrum ; Congenital Abnormalities ; Corpus Callosum ; Humans ; Lissencephaly ; Malformations of Cortical Development ; Neurons ; Siblings

Raynaud's phenomenon manifests as triphasic color change episodes of blanching, cyanosis, and reddening of the digits, induced by exposure to low temperature or emotional stress. It is a relatively common disorder, estimated to affect 5-10% of the general population and 20-30% of otherwise healthy women. Most cases of primary Raynaud's phenomenon also called Raynaud's disease, are mild and self-limited. Secondary Raynaud's phenomenon presents as a secondary manifestation of an underlying disease and are complicated by ulcerations and tissue necrosis. From March 1996 to August 1998, we experienced 4 patients with Raynaud's phenomenon. Two patients were diagnosed Raynaud's disease and the other two were secondary. Raynaud's disease responded to drug therapy and sympatetic ganglion block. Secondary Raynaud's syndrome was treated with vein graft and free tissue transfer. During postoperative follow-up of 33-49 months, both severity and symptomatic intervals were improved.
Cyanosis ; Drug Therapy ; Female ; Follow-Up Studies ; Ganglion Cysts ; Humans ; Necrosis ; Raynaud Disease ; Stress, Psychological ; Transplants ; Ulcer ; Veins