No abstract available.
Suicide, Attempted*

No abstract available.
Extremities* ; Sarcoma*

No abstract available.
Biopsy* ; Fatty Liver* ; Hepatitis, Chronic* ; Liver*

No abstract available.
Neurofibromatoses* ; Neurofibromatosis 1* ; Neurofibromin 1 ; Vitiligo*

BACKGROUND: Transient global ischemia causes delayed neuronal death (DND) in the CA1 area, of which the mecha-nism is controversial. Induction of apoptosis-regulating proteins during the process of DND has been reported, howev-er ,the exact role of Bcl-2/Bax is not well understood. We tried to reveal the pattern of the Bax/Bcl-2 expression modi-fied by the duration of ischemia and hypothermia. METHODS: Global ischemia was induced in Mongolian gerbils for 2, 5, and 10 minutes under the temperature of 36 degrees C and 32 degrees C. Hippocampal sections were evaluated 48 hours after ischemia with H&E and immunohistochemical staining to Bcl-2/Bax. Viable neuronal density and semi-quantitative grading were compared. RESULTS: In the CA1 area, neurons were intact in 2 min ischemia, while partial or significant ischemic changes were observed in 5-10 min ischemia of 36 degrees C setting, which were less severe in 32 degrees C . Bcl-2 was posi-tive in 2 min ischemia, while negative in 5~10 min ischemia of 36 degrees C . Bax was negative in 2 and 10 min ischemia, while positive in 5 min ischemia. In 32 degrees C setting, Bcl-2 was also positive in 2 min ischemia and partially positive in 5- 10 min ischemia, although Bax expression was not different from 36 degrees C. CONCLUSIONS: The complex mechanism of DND, which is in the spectrum of apoptosis and necrosis, seems to be determined by the severity of ischemia. The bal-ance between Bcl-2 and Bax may determine the survival of neurons in mild to moderate ischemia. Further evidence remains to be determined by morphological and molecular biological methods.
Apoptosis ; Body Temperature* ; Gerbillinae ; Hypothermia ; Ischemia* ; Necrosis ; Neurons

OBJECTIVES: To determine if hysterectomy with or without ovarian preservation is asso-ciated with obesity in premenopausal women. METHODS: 581 women for routine check up from Jan. 1985 to Dec. 1995 in the depart-m ent of Gynecology at Korea Veterans Hospital were included. The obesity was evaluated by BMI(body mass index) scores. 80% of hysterectomy were confirmed from the hospital records. The age, weight, height, blood pressure, menstr- ual history, history of DM and hypertension, social history of alcohol and smoking and other cardiovascular risk factors such as cholesterol, HDL-cholesterol, triglycerides were checked. The 248 women with natural postmenopausal status before hysterectomy, taking hormonal replacement therapy after hysterectomy and having performed hysterectomy due to malign- ancy were excluded. RESULTS: All women performed hysterectomy were in premenopausal status in this study. Therefore, the final numbers of subjects included in the analysis was 333. Hysterectomy wit- hout ovarian preservation were performed in 58 cases and hysterectomy with ovarian pres- ervation were in 57 cases. The 218 premenopausal cases which did not performed hystere- ctomy were considered control group. BMI scores were higher in cases without ovarian pres- ervation than with ovarian preservation. And BMI score was associated with the postoper- ative duration in hysterectomy with ovarian preservation. CONCLUSIONS: We suggest that hysterectomy without ovarian preservation in premeno- paussal women were associated with increased obesity, especially BMI scores.
Blood Pressure ; Cholesterol ; Female ; Gynecology ; Hospital Records ; Hospitals, Veterans ; Humans ; Hypertension ; Hysterectomy* ; Korea ; Obesity* ; Risk Factors ; Smoke ; Smoking ; Triglycerides

Phrenic nerve palsy is a well-known complication following cardiac surgery in children. The incidence is approximately 1~2%. In infants and young children, it often causes a life-threatening respiratory distress. They must be treated with mechanical ventilation in the ICU. Many patients with phrenic nerve injury who is impossible to wean from a ventilator are candidates of diaphragmatic plication. Diaphragmatic plication is performed to restore the normal pulmonary parenchymal volume by replacing the diaphragm to its proper location. This is a case of 2-months-old infant who had phrenic nerve palsy after the removal of cavernous lymphangioma of the chest. He underwent 4 operations to remove the mass and to have pericardiotomy. We tried to wean him from the ventilator but failed several times in the ICU. After 4th operation, right diaphragmatic elevation was noted from the chest X ray. Phrenic nerve palsy was confirmed with fluoroscopy and he underwent diaphragmatic plication on 42 days after his 4th operation. Three days after the diaphragmatic plication, weaning was successfully carried out.
Child ; Diaphragm ; Fluoroscopy ; Humans ; Incidence ; Infant* ; Lymphangioma* ; Paralysis* ; Pericardiectomy ; Phrenic Nerve* ; Respiration, Artificial ; Thoracic Surgery ; Thorax ; Ventilators, Mechanical ; Weaning*

STUDY DESIGN: A retrospective study. OBJECTIVES: To assess the efficiency of undercorrection and transpedicular screw fixation through a posterior approach in osteoporotic spine fractures with a thoracolumbar kyphotic deformity. SUMMARY OF LITERATURE REVIEW: The surgical treatment of osteoporotic spine fractures with a thoracolumbar kyphotic deformity requires extensive surgical procedures to obtain complete restoration of the sagittal alignment, but it has a few technical limitations due to insufficient mechanical stability at the bone-screw interface. A special strategy is essential for transpedicular screw fixation for osteoporotic spine fractures with a thoracolumbar kyphotic deformity. MATERIALS AND METHODS: We reviewed 14 osteoporotic spine fracture cases, with a thoracolumbar kyphotic deformity, which had undergone undercorrection and transpedicular screw fixation through a posterior approach, between March 2000 and June 2003, with an average follow-up period of 15. 2 months. According to the Jikei grade of the osteoporosis, 9 and 5 cases were grades 2 and 3, respectively. As a radiographic assessment, we measured the kyphotic angles of the fused segments on the preoperative, postoperative and last follow up thoracolumbar lateral views on standing using Cobb's method, and also assessed the kyphotic angle correction (KAC). The clinical results were evaluated at the last follow-up. RESULTS: The kyphotic angles at the preoperative, postoperative and last follow-up were 33.5 degrees +/- 9.3, 22.4 degrees +/- 6.9 and 24.7 degrees +/- 6.8, respectively. We obtained a mean KAC gain of 11.1 degrees postoperatively (p<0.05), but a loss of 2.3 degrees at the last follow-up (p>0.05). The clinical results were analyzed as good, fair and poor in 8, 5 and 1 case, respectively. Fusions were achieved in all cases. CONCLUSIONS: Undercorrection and transpedicular screw fixation for a thoracolumbar kyphotic deformity in osteoporotic spine fractures can be one of the alternatives to avoid fixation failure and an extensive surgical procedure.
Congenital Abnormalities* ; Follow-Up Studies ; Kyphosis ; Osteoporosis ; Retrospective Studies ; Spine*

BACKGROUND: Vascular endothelial growth factor (VEGF) is an angiogenic peptide that enhances microvascular perfusion. Recently, VEGF is known to have neurotrophic effect and rescues neurons from cell death induced by serum deprivation. To investigate the serial changes in VEGF expression and neuroprotective properties of VEGF during acute ischemia. METHODS: Human cortical-neuroblastoma hybrid cell line (A1G11), human neuroglioma cell line (H4), and human vascular endothelial cell line (ECV304) were placed in the glucose/serum free media and incubated in the hypoxic chamber (94% N2/5% CO2/1% room air) at 37 degrees C. Cell viability was determined by MTT assay. Western blot analysis was performed to detect VEGF and its receptor (VEGFR) expression. To test the protective effect of VEGF, human recombinant VEGF165 was used. RESULTS: Morphological changes and the decrease of cell viability were observed following 6 hr ischemia. In A1G11 cells, VEGF expression was not noted until 3 hr ischemia, but was induced after 6hr and continued to 12 hr and then diminished. In H4 and ECV304, the change of VEGF expression was not observed. VEGFR-2/Flk-1 expression was induced from 6 hr (peak level) to 12 hr in A1G11, and induced after 3 hr and continued to 12hr in ECV304. Administration of VEGF increased cell viability in A1G11 cells at 6 hr, 12 hr and 18 hr ischemia (p=0.009, p=0.01 p=0.013), but not in H4 or ECV304 cells ( p>0.05). CONCLUSION: Ischemia induces VEGF production in neurons and VEGF may exert a direct neuron-specific protective effect through VEGFR-2/Flk receptors during the acute phase of ischemic neuronal injury.
Blotting, Western ; Cell Death ; Cell Line ; Cell Survival ; Endothelial Cells ; Humans ; Hybrid Cells ; Ischemia* ; Neurons ; Perfusion ; Vascular Endothelial Growth Factor A*

BACKGROUND: Antibiotics are often indiscriminately prescribed for respiratory tract infections. This study was conducted to describe the prescription pattern of family physicians for respiratory tract infections. METHODS: In each clinic of 50 representative family practitioners, about 20 consecutive patients with diagnosis of respiratory tract infection were enrolled into the study. The data were collected by questionnaire to physicians just after patient interview. RESULTS: The number of study subjects was 1020, of which 55.7% was less than 15 year old. Antibiotics were prescribed to 73.9% of total subjects. According to diagnosis, the antibiotic prescription rate was 51.5% in common cold, 86.0% in pharyngitis, 88.6% in bronchitis, 98.9% in sinusitis, and 100% in otitis media. In common cold, the factors which significantly increased the antibiotic prescription were 1)patient age less than 15 year old (OR=1.70, CI=1.06-2.73), 2)more than two visits during the same episode(OR=1.95, CI=1.27-2.99), 3)yellow and thick rhinorrhea(OR=2.22, CI=1.16-4.25), 4)yellow and thick sputum(OR=3.31, CI=1.34-8.19), and 5)throat injection(OR=2.50, CI=1.42-4.39). Among patients to whom antibiotics were prescribed, 48.7% of patients were given the antibiotics by intramuscular injection. The most frequently prescribed antibiotics were penicillin and macroride among per-oral medicine and ribostamycin and lincomycin among intramuscular medicine. The reason for antibiotic prescription were 1)posssibility of bacterial infection(43.4%), 2)prevention of bacterial complication(23.7%), and 3)definite evidence of bacterial infection(22.5%). CONCLUSION: Family practitioners prescribe antibiotics indiscriminately for the respiratory tract infection. The prescription was influence by patient's age, number of clinic-visit, and clinical symptoms and signs.
Adolescent ; Anti-Bacterial Agents* ; Bronchitis ; Common Cold ; Diagnosis ; Humans ; Injections, Intramuscular ; Lincomycin ; Otitis Media ; Penicillins ; Pharyngitis ; Physicians, Family ; Prescriptions* ; Respiratory System* ; Respiratory Tract Infections* ; Ribostamycin ; Sinusitis ; Surveys and Questionnaires