BACKGROUND: Heparin salts induce negative proportional bias according to anticoagulant concentration for analysis of ionized calcium (iCa) However, D-phenylalanyl -L-prolyl- L-arginine chloromethyl ketone (PPACK), a selective thrombin inhibitor, do not bind to ionized calcium. Therefore, we evaluated PPACK as an alternative anticoagulant to lithium heparin (Li-Hep) for analysis of ira, blood gases and electrolytes. METHODS: The concentration of iCa in whole blood anticoagulated with heparin was compared with that in serum of patients admitted to Chungbuk National University Hospital (n=27). The blood gases, electrolytes and iCa according to each anticoagulant concentration (Ll-Hep or PFACK) were analyzed. The concentrations of anticoagulated whole blood (Li-Hep; 50 kIU/L, PPACK ; 75 mumol/L) were compared with those of nonanticoagulated whole blood for blood gases, electrolytes and iCa (n=17), RESULTS: The results were as follows; whole blood anticoagulated with Li-Hep demonstrated -0.28+/-0.15 mmol/L (26.6%) bias for ira compared with serum. No bias according to each anticoagulated concentrations were observed in analysis of blood gases, potassium and chloride. Negative proportional bias for iCa and sodium in serum anticoagulated with Li-HeP was observed. In comparison, no bias for ira and sodium was observed with PPACK. No bias was observed in analysis of blood gas or electrolytes with each anticoagulated whole blood except for sodium and chloride that had clinically nonsignificant bias. Whole blood anticoagulated with Li-Hep demonstrated a consistent -0.08+/-0.02 mmol/L (6.3%) bias for ira compared with nonanticoagulated whole blood. In comparison, no bias was observed with PPACK-anticoagulated whole blood for iCa. CONCLUSIONS: We concluded that PPACK is an ideal anticoagulant without bias for analysis of iCa, blood gases and electrolytes.
Arginine ; Bias (Epidemiology) ; Calcium* ; Chungcheongbuk-do ; Electrolytes* ; Gases ; Heparin* ; Humans ; Lithium ; Potassium ; Salts* ; Sodium ; Thrombin

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

Multidirectional shoulder instability is often difficult to diagnose and treat and can be cause of significant disability. Nonoperative rehabilitations and life tyle modifications are the primary treatments. Hiwever, the inferior capsular shift procedure, performed either from an anterior or posterior approach, as described by Neer and Foster, is recommended for symptomatic multidirectional instability that is unresponsive to nonoperative therapy. Twenty-seven shoulders in twenty-seven patients with inferior and multidirectional instability were managed with Neer s inferior capsular shift, through anterior or posterior approach depending on the direction in which the shoulder is most unstable. All of the patients were followed up for an average of 3 years (range one to seven years). The postoperative range of motion of the shoulders was well maintained except 1 patient. Three patients had recurrence of symptomatic and disabling multidirectional instability, but twenty-four (89%) of the shoulders continued to function well with no instability, no pain, no recurrence and no remarkable limitation of motion.
Humans ; Range of Motion, Articular ; Recurrence ; Shoulder*

PURPOSE: To compare MRI appearance between plicae syndrome and normal plicae. MATERIALS AND METHODS: MR images of 60 cases of arthroscopically-confirmed plicae syndrome and 18 of arthroscopically-proven normal plicae were retrospectively analyzed. Sagittal T2-weighted MR images in all cases and MPGR(200) in 37 cases of plicae syndrome were obtained. Statistical analysis was performed using the chi-square test. RESULTS: On the basis of operatingresults, we observed 55 medial plicae, eight combined medial and suprapatellar plicae, four suprapatellar plicae,and one lateral plica. T2-weighted sagittal MR scans of the 60 cases demonstrated 37 medial plicae, 8 suprapatellar and one lateral plica. Joint effusion was found in 26 cases of 55 medial plicae. In T2-weighted sagittal MR scans, the identification of medial plicae was superior in the presence of joint effusion than its absence(plicae syndrome, p < 0.001 ; normal plicae group, p < 0.05). Medial plicae were well demonstrated onMPGR(200) axial images; on T2-weighted sagittal MR scans, they could be more frequently identified in the plicae syndrome group than in the normal control group(p < 0.001). Plicae syndrome-associated pathology included degenerative change of the articular cartilage of the medial femoral condyle in eight cases(14.5%), discoidmeniscus in nine(16.4%), lateral meniscus tear in 12(21.8%), medial meniscus tear in 21(38.1%), anterior cruciate ligament tear in three(5.5%), medial collateral ligament tear and osteochondritis dissecans in one case. CONCLUSION: The present study revealed that synovial plicae were well demonstrated in T2-weighted sagittal images, particularly on the presence of joint effusion. Medial plicae could be more frequently identified in the plicae syndrome group than in the normal control group, especially on T2-weighted sagittal MR scans.
Cartilage, Articular ; Collateral Ligaments ; Humans ; Joints ; Magnetic Resonance Imaging ; Menisci, Tibial ; Osteochondritis Dissecans ; Pathology

Specular microscope has been used to examine the corneal endothelium of humans as a function of age. 82 normal eyes of 42 korean, 8 to 65 years of age, were examined with the contact-type specular microscope, and photographs of the central endothelium were obtained. The endothelial photographs were analyzed to determine mean endothelial cell density and the frequency distribution of cell density for each subject. The mean endothelial cell density was 2686 cell/mm2. The correlation coefficient between age and cell count showed that endothelial cell density decreased significantly with increasing age(p<0.01). No appreciable difference in cell density was found between the right and left eyes of the subjects nor between male and female subjects of similar age.
Cell Count ; Cornea* ; Endothelial Cells* ; Endothelium ; Endothelium, Corneal ; Female ; Humans ; Male

We encountered a case of neonatal altoimmune thrombocytopenia(NAIT) due to anti-HLA-B7+B60+B61. Bilateral cephal hematoma and umbilical hematoma were noted at the time of birth. Purpura developed at the third day. Platelet count was 110,000 at birth and decreased to 66,000/micro liter at the day 4. Prothrombin time and partial prothrombin time were within normal limit. The mother's platelet count was 220,000/micro liter and she had no history of abnormal bleeding. Platelet antibody tests empolying mixed passive hemagglutination and immunofluorescence revealed that the mother's serum was reactive against the platelets from the father and the neonate, but was not reactive with her own platelets. Platelets from eight volunteer group 0 donors were tested with the mother's serum; seven were reactive and one was negative. The positive reactions were lost after chloroquine treatment of platelets. Antigen capture ELISA(ACE) and modified antigen capture ELISA employing monoclonal antibodies against platelet glycoproteins In, IIa, IIb, and IIIa were negative. Mother's serum was tested for lymphocytotoxicity against 49 donor ]ymphocytes and the specificity was found to be anti-HLA-B7+B60+B61. At the 9th day, one unit of platelet concentrate from the mother was transfused and the platelet count of the neonate rose up to 340,000/micro liter. The neonate was discharged at the day of sixteenth and the platelet count remained high thereafter.
Antibodies, Monoclonal ; Blood Platelets ; Chloroquine ; Enzyme-Linked Immunosorbent Assay ; Fathers ; Fluorescent Antibody Technique ; Hemagglutination ; Hematoma ; Hemorrhage ; Humans ; Infant, Newborn ; Mothers ; Parturition ; Platelet Count ; Platelet Membrane Glycoproteins ; Prothrombin Time ; Purpura ; Sensitivity and Specificity ; Thrombocytopenia* ; Tissue Donors ; Volunteers

Authors report the clinical study on the usefulness of thyrotropin-releasing hormone tartrate(TRH-T) in the treatment of mild disturbance of consciousness. 20 patients suffering head trauma, subarachnoid hemorrhage, and intracerebral hemorrhage were given TRH-T intravenously for ten days. TRH-T was effective for the patients in whom the consciousness disturbance was mild, the duration in fixed consciousness level was short, and the brain was not distorted on CT scan. These features were most prominent in patients with subarachnoid hemorrhage. Three was no significant side effect, and TRH-T turned out to be safe.
Brain ; Cerebral Hemorrhage ; Consciousness* ; Craniocerebral Trauma ; Humans ; Subarachnoid Hemorrhage ; Thyrotropin-Releasing Hormone ; Tomography, X-Ray Computed

Mooren's ulcer is a chronic, painful ulceration of unknown etiology beginning in the corneal periphery and progressing relentlessly, first circumferentially and then centrally, to involve the entire cornea. The treatment of Mooren's ulcer has had limited sucess. We have experienced a case of bilateral Mooren's ulcer in 68-year-old female, who has been poor general condition. Delimiting lamellar keratectomy and conjunctival excision have been performed. Excised tissues have been examined by histopathologic and immunopathologic method. A brief review of literature is discribed.
Aged ; Cornea ; Female ; Humans ; Ulcer*

The aneurysm nature and configuration in a giant aneurysm of the PCA is important and careful angiographic examination is needed. We present a case of dissecting aneurysm of the posterior cerebral artery masquerading as saccular giant aneurysm. A 17-year-old man presented with subarachnoid haemorrhage. Cerebral angiograms on admission showed a giant saccular aneurysm with wide neck at P1-P2 junction. The patient underwent endovascular coils embolization and extraventricular drainage of cerebrospinal fluid successfully. However, the patient was aggravated neurologically and got the rebleeding on postembolization 8 days. Repeat cerebral angiograms revealed dilated P1 segment with aneurysmal change of P2 segment. We report the angiographic feature and unusual clinical course and discuss the endovascular treatment of dissecting aneurysms.
Adolescent ; Aneurysm* ; Aneurysm, Dissecting* ; Cerebrospinal Fluid ; Drainage ; Humans ; Intracranial Aneurysm ; Neck ; Passive Cutaneous Anaphylaxis ; Posterior Cerebral Artery*

In cases of opacity of ocular optical media, we can predict postoperative visual outcome vaguely with electroretiongram, Visual evoked potential, Two point discrimination, Blue field entoptoscope, Laser interferometer, Lotmar visometer, Potential acuity meter, Visual display terminal. The Lotmar visometer which is attached to the slit lamp provides simple and inexpensive method to check for fringe acuity. It distinguishes the interval of changeable moire fringes for the measurement of postoperative visual acuity in spite of opacity in ocular media. We compared the preoperative Lotmar visometer fringe acuity with the postoperative final corrected visual acuity in 82 cases of cataract and 15 cases of vitreous opacity at the department of Ophthalmology, Pusan Paik Hospital, Inje University Medical college from January to August 1989. We tested the clinical use of the Lotmar visometer and the results were as follows: 1. The visual acuity when checked by preoperative Lotmar visometer acuity and postoperatIve visual acuity differed in mature cataract and dense vitreous opacity cases. 2. The preoperative Lotmar visometer acuity was within one line of postoperative visual acuity in 47.4% with ECCE only, 34.1% with ECCE and PCL, 53.3% with vitrectomy. 3. The preoperative Lotmar visometer acuity which is included +/-25% of postoperative visual acuity in cases with ECCE only is 58.62%, in cases with ECCE and PCL is 46.15%, in cases with vitrectomy is 66.6% except in mature cataract and dense vitreous opacity. 4. There is a high correlation(r=0.8407)in the cases of vitreous opacity between preoperative Lotmar visometer acuity and postoperative visual acuity except in mature cataract and dense vitreous opacity.
Busan ; Cataract ; Discrimination (Psychology) ; Evoked Potentials, Visual ; Ophthalmology ; Visual Acuity ; Vitrectomy