Histocytic medullary reticulosis, known as malignant histiocytosis, is a disorder characterized by a systemicproliferation of morphologically abnormal histiocytes with prominent erythrophagocytosis. Fever, wasting, lymphdenopathy, hepatosplenomegaly and pancytopenia are the main clinical pictures. Prognosis is very poor andinvariably die within several months. Authors present radiological findings of pulmonary involvement in 5 cases of histologically proven histiocytic medullary reticulosis. The findings are progressive interstitial, alveolar ormixed infiltrations, small amount of pleural effusion, hilar and/or mediastineal lymph node enlargement and cardiomegaly. Histiocytic medullary reticulosis should be borne in mind in differential diagnosis of any patientswho has unexplanable above radiological findings.
Cardiomegaly ; Diagnosis, Differential ; Fever ; Histiocytes ; Histiocytic Sarcoma ; Lung ; Lymph Nodes ; Pancytopenia ; Pleural Effusion ; Prognosis

No abstract available.
Hip Joint* ; Hip*

There are many reports that d-tubocurarine has marked species and individual variations in the matter of muscle relaxation. Therefore the dose-related neuromuscular blocking effect of d-tubocurarine was studied in anesthetized patients. Eighty adult patients were studied during halothane-N2O-O2 anesthesia for various kinds of surgery. These patients were in good physical shape, without known or suspected liver, kidney, neuromuscular or hormonal disease, and were not taking medication known to influence the action of relaxants. Preanesthetic medication consisted of atropine 0.01mg/kg and valium 0.18 mg/kg intramuscularly 60 minutes before anesthesia. Anesthesia was induced with thiopental 4~5mg/kg. Succinylcholine 1mg/kg was used to faciliate tracheal intubation. Moderate hyperventilation was maintained throughout by a mechanical ventilator and patient temperature was maintained at 35~36 degrees C during the study. Forty patients received a single intravenous d-tubocurarine 0.1mg/kg(group A) after the succinylcholine effect had worn off and the other forty patients received a single intravenous d-tubocurarine 0.2mg/kg(group B) after the succinylcholine effect had disappered. Prior to the administration of d-tubocurarine, the patient's forearm and hand were firmly fixed to a specially constructed metal armboard. The thumb was abducted, fixed and connected to a electrical kymograph, Harvard apparatus. The ulnar nerve was stimulated at the wrist subcutaneous needle electrodes by means of supramaximal stimull from a peripheral nerve stimulator(model 91-M3, Emerson, USA). Square wave of "Train of Four" stimuli of 0.2msec duration were delivered at a frequency of 0.1Hz. The evoked twitch and tracing of the adductor muscle of the thumb was recorded continuously on a electrical kymograph. Upon recovery from the initial dose of succinylcholine, a stable baseline twitch tension was recorded for 15 minuts. At this point a single intravenous injection of d-tubocurarine, either 0.1mg/kg or 0.2mg/kg, was given. The data were plotted as onset time of twitch depression and percentage depression of twitch height and the recovery time of "Train of four" response were analysed in each group. The results were as follows: 1) In d-tubocurarine 0.1mg/kg group: the effect of d-tubocurarine was variable, ranging from no effect on twitch tension to abolition of the twitch response. Mean maximal twitch depression was 59.4%. Recovery index which showed more than 75% twitch depression was 39.9minutes. 2) In d-tubocurarine 0.2mg/kg group: the effect of d-tubocurarine obtained consistent and solid neuromuscular relaxation. Mean maximal twitch depression was 95.2%. Recovery index was 58.1 minutes.
Adult ; Male ; Female ; Humans

Mail questionnaire was administrated to 370 practising physicians and 388 pharmacists in Taegu city selected by systematic sampling to examine utilization states and opinion of pharmacy under medical care insurance programme and the attitude to the functional division between physicians and pharmacists from April to May 1992. Regarding the opinion on the outcome of drug-store under medical insurance, 71.2 percent of practicing physician answered failure but 13.4 percent of practicing pharmacists answered failure in contrast. Fifty percent of practicing physician asserted introducing functional division between physician and pharmacist while 66.9 percent of practicing pharmacist answered drug-store under medical insurance itself is successful programme. Average daily numbers of preparation of medicine was 32.2 case. Percentage of utilization of drug-store under medical insurance to average daily cases of preparing of medicine was 20 percent, percentage of utilization with physician's prescription was 0.7 percent. And 58.7 percent of practicing physician experienced outside the institute prescription. Regarding the opinion on the pros and cons of enforcing functional division between physician and pharmacist, 59.2 percent of practicing physician preferred pros and 17.7 percent cons ,but 38 percent of practicing pharmacist preferred pros and 45.5 percent cons. And pharmacist know better the content of functional division between physician and pharmacist, practicing emphasized to prevent misuse or abuse of medicine but practicing pharmacist emphasized to display physician and pharmacist's professional ability. And as an opinion on implementation style of functional division between physician and pharmacist in pros respondents, practicing physician favored mandatory enforcement (52.3%), while practicing pharmacist favored partial incomplete functional division (81.7%). As the method of prescription if functional division between physician and pharmacist will be enforced, both practicing physician and pharmacist preferred generic name (44.0%, 89%) mostly, but physician preferred brand name (35.3%) secondly. Regarding the reason for not implementing functional division between physician and pharmacist up to date, both physician and pharmacist answered problem of business right between physician and pharmacist, followed by lack of recognition, and interest of people and lack of the governmental willness. Regarding the opinion on prior decision of condition for enforcing functional division between physician and pharmacist, practicing physician and pharmacist named uneven distribution of medical facilities and drug-store between rural and urban, inequality of physician and pharmacist manpower and the problem of manpower demand and supply mostly, and practicing physician pointed out establishing attitude of acceptance on the part of pharmacist and practicing pharmacist favored establishing attitude of acceptance on the part of physician, which was different attitudes between physician and pharmacist. Following conclusion was reached; 1. Current drug-store under medical insurance program yield insufficient outcome, so we should consider program conversion from drug-store under medical insurance program to functional division between physician and pharmacist. 2. There were problem of business right and conflicts between physician and pharmacist at enforcing functional division between physician and pharmacist, so the government should search for formulating plan to resolve the problem and have neutral willness for the protection of the national health.
Commerce ; Daegu* ; Surveys and Questionnaires ; Humans ; Insurance ; Pharmacists* ; Pharmacy ; Postal Service ; Prescriptions ; Surveys and Questionnaires ; Socioeconomic Factors

No abstract available.
Cachexia* ; Ductus Arteriosus, Patent* ; Heart Failure* ; Heart* ; Humans ; Infant*

Inhibin is a glycoprotein usually produced by granulosa cell of ovary and is known as regulator of FSH secretion. Inhibin is consisted of two heterodimeric subunit of a, B . There are two distinct molecular forms of the B subunit that exist (BA and BB) and when combined with an a subunit, form inhibin A, and inhibin B, respectively. Ovarian reserve describes women's reproductive potential, which usually decreased according to chronological age. Because useful markers claimed for the prediction of ovarian response during controlled ovarian hyperstimulation for IVF-ET have not been always successful, new biomarker has been investigated. The purpose of this study was to observe the changes in serum and ovarian follicular inhibin A concentration during controlled ovarian hyperstimulation for IVF-ET program and to evaluate the clinical significance of inhibin A as a prognostic marker for assisted reproductive technology outcomes. From Jan 1996 to Dec 1996, 48 patients who underwent IVF-ET were included. In each patient, the Day 3 FSH, LH, E2q were measured in the first month of cycle before commencing GnRH agonist administration, In the stimulation period after pituitary down regulation, blood samples for inhibin A were collected at the day 3, day 7, day of hCG injection, day of oocytes aspiration, and day of embryo transfer. Ovarian follicular inhibin A was collected at the day of oocyte aspiration. Inhibin A concentration was measured using test kit for inhibin A (INHIBIN-EASIA (code 40.134.00), Belgium Medgenix). The changes in serum inhibin A, E2 concentration during IVF-ET program showed increasing pattern throughout controlled ovarian hyperstimulation periods. If the cut-off value of day 3 serum inhibin A determined to 0.28 U/ml, the sensitivity and specificity were 80.0%, 75.0% respectively in predicting the number of oocytes retrieved being more than five. If the cut-off value of peak serum E determined to 1316 pg/ml, the sensitivity and specificity were 89.0%, 100.0% respectively in predicting the number of oocytes retrieved being more than five. In conclusion, measurement of serum inhibin A concentration on the day of starting stimulation (day 3) could be used as a useful marker for predicting the ovarian response in IVF-ET program.
Belgium ; Down-Regulation ; Embryo Transfer ; Female ; Glycoproteins ; Gonadotropin-Releasing Hormone ; Granulosa Cells ; Humans ; Inhibins* ; Oocyte Retrieval ; Oocytes ; Ovary ; Reproductive Techniques, Assisted ; Sensitivity and Specificity ; Serum

The hypertensive lower esophageal sphincter(LES)(mean LES pressure>45mmHg; LES relaxation>75%;normal peristalsis) is an uncommon primary esophageal motor disorder associated with chest pain, dysphagia and globus sensation. We carried out this study to evaluate clinical features, esophageal pressure profiles, endoscopic ultrasonographic findings, and assess the effect of oral nifedipine(30 mg/day for 8 weeks) in patients with hypertensive LES(mean age 53.8 years, M: F:=2:7) and l3 controls(mean age 47.5 years, M:F=4:9), Chief complaints were chest pain(77.8%), dysphagia(33.3%) and globus sensation(22.2%). Esophageal manometry showed a significant(p<0.01) increase in LES pressure and higher trend of residual pressure and body contraction amplitude in patients compared with controls. Two cases of nutcracker esophagus and one case of nonspecific esophageal motor disorder were associated with hypertensive LES patients by eeophageal manometry. Five patients were examined by endoscopic ultrasonography(EUS). Three of them showed a normal ultrasonic structure of the wall of the gastro-esophageal junction. Focal and/ or diffuse thickening of muscularis propria were observed in remaining 2 patients. Oral nifedipine significantly decreased the LES pressure and alleviated most of dysphagia and chest pain in patients with normal EUS finding. In conclusion, hypertensive LES was a heterogenous esophageal motor disorder characterized by high LES pressure, residual pressure and body contraction amplitude. The clinical relevance of endoscopic ultrasonographic finding is yet to be determined, but it may be speculated that nifedipines lack of effect on esophageal pressure profiles in some patients is responsible for thickening of muscularis propria in the area of lower esophageal sphincter. Collecting further data regarding treatment response according to EUS finding is required to validate our speculation.
Chest Pain ; Deglutition Disorders ; Esophageal Motility Disorders ; Esophageal Sphincter, Lower* ; Humans ; Manometry ; Nifedipine ; Sensation ; Thorax ; Ultrasonics

The hypertensive lower esophageal sphincter(LES)(mean LES pressure>45mmHg; LES relaxation>75%;normal peristalsis) is an uncommon primary esophageal motor disorder associated with chest pain, dysphagia and globus sensation. We carried out this study to evaluate clinical features, esophageal pressure profiles, endoscopic ultrasonographic findings, and assess the effect of oral nifedipine(30 mg/day for 8 weeks) in patients with hypertensive LES(mean age 53.8 years, M: F:=2:7) and l3 controls(mean age 47.5 years, M:F=4:9), Chief complaints were chest pain(77.8%), dysphagia(33.3%) and globus sensation(22.2%). Esophageal manometry showed a significant(p<0.01) increase in LES pressure and higher trend of residual pressure and body contraction amplitude in patients compared with controls. Two cases of nutcracker esophagus and one case of nonspecific esophageal motor disorder were associated with hypertensive LES patients by eeophageal manometry. Five patients were examined by endoscopic ultrasonography(EUS). Three of them showed a normal ultrasonic structure of the wall of the gastro-esophageal junction. Focal and/ or diffuse thickening of muscularis propria were observed in remaining 2 patients. Oral nifedipine significantly decreased the LES pressure and alleviated most of dysphagia and chest pain in patients with normal EUS finding. In conclusion, hypertensive LES was a heterogenous esophageal motor disorder characterized by high LES pressure, residual pressure and body contraction amplitude. The clinical relevance of endoscopic ultrasonographic finding is yet to be determined, but it may be speculated that nifedipines lack of effect on esophageal pressure profiles in some patients is responsible for thickening of muscularis propria in the area of lower esophageal sphincter. Collecting further data regarding treatment response according to EUS finding is required to validate our speculation.
Chest Pain ; Deglutition Disorders ; Esophageal Motility Disorders ; Esophageal Sphincter, Lower* ; Humans ; Manometry ; Nifedipine ; Sensation ; Thorax ; Ultrasonics

No abstract available.
Female ; Ovarian Hyperstimulation Syndrome* ; Ovulation Induction* ; Ovulation*

No abstract available.
Pressure Ulcer*