This study was aimed to comprehend the pattern of renal response in bicarbonate reabsorption during various alterations in acid-base equilibrium in twelve dogs. In metabolic acidosis induced by infusion of hydrochloric acid, as the plasma bicarbonate and filtered load of bicarbonate decreased eminently, urinary excretion of bicarbonate was found to be negligible. which was attributable to almost complete reabsorption via the hydration of CO2. In metabolic alkalosis induced by infusion of sodium bicarbonate, along with an increment of plasma concentration of bicarbonate, all filtered bicarbonate was reabsorbed, with negligible amount of excretion until the plasma level attains the renal bicarbonate threshold. During the respiratory acidosis and alkalosis with higher or lower arterial Pco2, the bicarbonate reabsorption varied linearly with plasma Pco2. The linear relationship indicated that the hydration of CO, was an important source of hydrogen ion for the reabsorption of bicarbonate. In this regards, however, in metabolic alkalosis the renal bicarbonate threshold was found to be much higher than that of respiratory acidosis. The characteristics of renal bicarbonate reabsorption, during the mixed acid-base disturbances of metabolic and respiratory origin with no considerable alteration of plasma pH, induced by hydrochloric acid infusion with hyperventilation or sodium bicarbonate infusion with CO2 inhalation, were quite similar to those in metabolic acidosis and alkalosis caused by simple hydrochloric acid or sodium bicarbonate infusion, respectively.
Acid-Base Equilibrium ; Acidosis ; Acidosis, Respiratory ; Alkalosis ; Animals ; Dogs* ; Hydrochloric Acid ; Hydrogen-Ion Concentration* ; Hyperventilation ; Inhalation ; Plasma* ; Protons ; Sodium Bicarbonate

Seidel nail is one of locked humeral nail and Seidel himself reported excellent result in his preliminary report using his nail. But our early experience showed disappointing result with high rate of complications, So we reviewed our 16 cases of humeral shaft fracture with polytrauma treated with Seidel nail and studied anatomical fitness of the nail within the distal medullary space using CT scan. The most frequent complication was intraoperative fracture of the proximal humerus < 4 cases> and this seemed to be due to lateral placement of pilot hole. There were 3 cases of nonunion and these cases showed insufficient distal anchorage, either primarily or postoperatively. Anatomical fitness study showed insufficient spreading of nail flanges in 5 cases of distal canal width below 9mm and nonunion cases were in this group. Other problems of Seidel nail were technical difficulties due to occasionally incorrect proximal targeting device and frequent breakage of adaptor screw. Study of more cases may be needed to confirm the design problem of Seidel nail.
Humerus ; Multiple Trauma ; Tomography, X-Ray Computed

The clinical study was performed to 28 patients with the pericardiac effusion who were admitted in Busan university Hospital and Paik Hospital, In-Je Medical College, Busan, korea during March 1976 and July 1981. The results were as following; 1) 12 cases(42.9%) of total 28 pericardiac effusion occured in 3rd decade, 8(28.5%) in 2nd decade and 5 cases(17.9%) in 4th decade. Sex distribution showed male to female 2.5:1. 2) With etiological distribution there were 15 cases(53.6%) tuberculous, 5(17.9%) nonspecific, 3(10.7%) malignant, 2(7.1%) pyogenic, 2 traumatic and 1(3.6%) rheumatic. 3) On admission 28 cases(100%) complained of dyspnea, 24(85.7%) distant heart sound, 20(71.4%) each engorged jugular vein and edema, 18(64.3%) each cough and abdominal fullness, 17(60.7%) each sputum and chest discomfort and pain, 12(42.9%) fever, 11(39.1%) orthopnea, 10(35.7%) chilling, 7(25%) oliguria, 4(14.6%) palpitation and 3(17.2%) headache. Increased cardiac dullness was observed in 26 cases(71.4%), hepatomegaly 18(64.3%), pulmonary rales 17(60.7%), ascites 13(46.1%), fever 12(42.9%), pericardiac friction rub 10(35.7%), splenomegaly 7(25%), paradoxical pulse 6(21.4%) and jaundice 2(7.1%). 4) On amission SGOT and SGPT level was increased each in 15(53.6%) and 13(46.7%), TTT and CCF abnormal in 10(35.7%), and 8(28.5%), serum NPN, BUN, creatinine increased in each 10(35.7%), 11(39.1%), 8(28.5%), WBC increased in 6(21.4%), RBC decreased in 8(28.5%) and ESR increased in 16(57.1%). 5) Characteristics of pericardiac effusion showed hemorrhagic 17(60.7%), serosangeous 6(21.4%), sangeous 3(17.2%) and pyogenic 2 cases(7.1%). 6) The ECG on admission revealed low voltage in 25(89.1%), depressed ST segment in 13(46.1%) and inverted T wave in 12(42.9%). 7) Chest X-ray showing cardiomegaly 28(100%), pleural effusion in 20(71.4%), and pulmonary congestion in 16(57.1%). 8) The m mode and 2-D Echocardiogram showed echo free space in 28 cases and after pericardiocentesis the space was reduced or disappeared. 9) 19 cases of 28(67.5%) were improved clinically, while 5 cases(17.9%) were not improved and 4 cases(14.6%) died.
Alanine Transaminase ; Ascites ; Aspartate Aminotransferases ; Busan ; Cardiomegaly ; Cough ; Creatinine ; Dyspnea ; Edema ; Electrocardiography ; Estrogens, Conjugated (USP) ; Female ; Fever ; Friction ; Headache ; Heart Sounds ; Hepatomegaly ; Humans ; Jaundice ; Jugular Veins ; Korea ; Male ; Oliguria ; Pericardiocentesis ; Pleural Effusion ; Respiratory Sounds ; Sex Distribution ; Splenomegaly ; Sputum ; Thorax

Circling seizure in which the patient walks repetitively in samall circles is relatively uncommon and may either represent a benign form of primary generalized epilepsy or occur secondary to a focal epileptic activity. Especially circling due to focal seizure activity has been regarded as rare. The authors report 6-year old boy who showed many repetitive circling behavior toward the left side, running automatism, vocalization and mental confusion for 6 hours. He had a history of relatively intractable epilepsy for 3 years of adversive seizures(turning to the right side), staring and vocalzation followed by tonic fencing posturing with cyanosis. The electroencephalography demonstrated frequent focal spikes in the left fronto-temporal area.
Automatism ; Child ; Cyanosis ; Electroencephalography ; Epilepsy ; Epilepsy, Generalized ; Humans ; Male ; Running ; Seizures*

No abstract available.

We measured normal range and mean value of the posterior laxity of normal knee which might be reference for objective and accurate diagnosis, decision of operative indication and position of knee during fixation of ligament, and role of quadriceps building in posterior cruciate ligament injury patients. These results were obtained by measurement and analysis of posterior laxity of normal knee by means of KT-2000 Knee Ligament Arthrometer. We measured 184 Korean adults (100 males, 84 females), and their average age, height, weight, and thigh circumference were 29.8 years, 165.8cm, 59.8kg, 41.2cm, respectively. At 25 degrees of knee flexion, mean posterior displacement of normal knee was 21.2mm with 15lb posterior tibial loading, 2.41mm with 20lb posterior tibial loading. And when quadriceps were tense, laxity was 0.79mm and 0.95mm at the same degree of knee flexion. At 75 degrees of knee flexion, the results were 0.57mm, 0.58mm, 0.26mm, and 0.28mm respectively. Right to left difference of posterior displacement with 20lb posterior tibial loading was 0.07mm at 25 degrees of knee flexion and 0.06mm at 75 degrees of knee flexion. We thought that above 75 degrees of knee flexion is suitable for knee position at the time of graft fixation because 75 degrees of knee flexion markedly decreased(75%) posterior displacement compare to 25 degrees of knee flexion. When quadriceps were tense, remarkable decrease of posterior laxity of normal knee was checked(58%), so we noticed quadriceps building is important to management of posterior cruciate ligament injury patients.
Adult ; Diagnosis ; Humans ; Knee ; Ligaments ; Male ; Posterior Cruciate Ligament ; Reference Values ; Thigh ; Transcutaneous Electric Nerve Stimulation ; Transplants

Transient memory impairment can be occurred by many causes. One of them is acute focal brain lesion in strategic site. Caudate nucleus and medial basal ganglia (globus pallidus) are lesion of strategic site. They play its role in cognitive processing. But lateral basal ganglia (putamen) is known as a structure involving movement, not cognitive function. We report a interesting case of transient memory dysfunction with acute focal putamen ICH with old caudate nucleus infarction.
Basal Ganglia ; Brain ; Caudate Nucleus ; Infarction ; Intracranial Hemorrhages ; Memory ; Putamen

No abstract available.
Child* ; Hepatitis, Chronic* ; Humans ; Interferon-alpha*

PURPOSE: Application of a laparoscopic technique to common bile duct explorations has been limited due to technical difficulty. With increased experience and technique, laparoscopic surgery has become a possible option for the treatment of common bile duct stones. The purpose of this study was to assess the usefulness of laparoscopic surgery in the treatment of common bile duct stones. METHODS: Between March 1997 and August 1999, 35 patients with choledocholithiasis were treated with laparoscopic common bile duct exploration (4 had a previous biliary operative history). Intraoperative choledochoscopy was used to remove common bile duct stones. The stones were retrieved by using a saline flush, a basket, or a Fogarty catheter. The impacted stones were destroyed using electrohydraulic lithotripsy. RESULTS: Successful laparoscopic stone clearance was achieved in 33 cases (94.3%), and conversion to open surgery occurred in one case (2.9%). The morbidity was 5.7% without mortality. Two cases of retained stone were treated with postoperative choledochoscopic removal via fistula tract and postoperative endoscopic extraction. CONCLUSION: Laparoscopic common bile duct exploration is feasible and safe in most patients. With increased of experience, laparoscopic common bile duct exploration could be used widely.
Catheters ; Choledocholithiasis ; Common Bile Duct* ; Conversion to Open Surgery ; Fistula ; Humans ; Laparoscopy* ; Lithotripsy ; Mortality

BACKGROUND: Parkinson's disease (PD) is one of the most common movement disorders, yet the pathophysiology of its signs is not clear. A transcranial magnetic stimulation (TMS) was used to measure the amplitude and latency of the motor evoked potential(MEP) by stimulation of the corticomotoneuronal descending system. By means of this simple and nontraumatic technique we intended to analyze the abnormal motor signs of PD. METHODS: We studied 20 PD patients aged 35 to 78 years and 12 normal persons aged 37 to 67 years. Hoehn-Yahr scale of PD patients were as follows: I, 4 patients ; II ,11 patients ; III, 4 patients ; IV, 1 patient. The responses were was recorded from abductor polli-cis brevis (APB) muscles and abductor hallucis (AH) muscles. The TMS was performed on the cervical spine and ver-tex for APB muscle and on the lumbar spine and C3 or C4 for bilateral AH muscles. The responses were recorded with both target muscles relaxed and slightly contracted. We measured the threshold, latency, and amplitude of each MEP. The central motor conduction time (CMCT) was calculated by the latency difference between cortical stimulation and cervical or lumbar stimulation. RESULTS: The central motor conduction times were shorter in PD patients (P < 0.05) compared with normal subjects but there were no differences in motor evoked potentials. Also, PD patients showed a significant increase of stimulation threshold in the facilitation state. CONCLUSIONS: These results may suggest that con-trol of excitability of the motor system is abnormal in PD patients.
Evoked Potentials, Motor ; Humans ; Movement Disorders ; Muscles ; Parkinson Disease* ; Spine ; Transcranial Magnetic Stimulation*