To increase the understanding of the pathophysiologic mechanisms present in epileptic seizures, and to correlate the clinical features with the EEG findings, a review of the recent literature has been made. Epileptic seizures are classified into three types:focal(or partial), generalized and unilateral seizures. In the first type, the focal seizure, there are two sites which have been thought to have one or the other of an initial discharge. The first site is the cortical pole, and the second is the end pole of the interconnected subcortical nuclear system. the cortical pole, and the second is the end pole of the interconnected subcortical nuclear system, the cortical pole is more accessible and vulnerable to seizures. The end pole of the interconnected subcortical nuclear system has two sectors which may be involved. the first sector, the cortico-thalamic system, includes filstly the specific cortico-thalamic system in which the focal stimulation is related to relatively simple somato-motor, sensory and autonomic nervous functions. Secondly, in this first sector, is the non-specific corticothalamic systems which includes the body integrative functions which underlie psychic elaboration of primary sense data. The second sector in the subcortical nuclear system is the amygdalo-brain stem sector. In this non-thalamic system there are the deep temporal structures of the brain such as the amygdalahippocampal complex. These structures are involved in the regulation of emotions, in memory functions and in the maintenance of consciousness. A schematic diagram is prepared to explain the mode of propagation of the epileptic discharge from the initial focus along pathways in the brain structures. This diagram is explained and discussed. The second type of seizure is the generalized seizure. This type is subdivided into two groups:convulsive and non-convulsive. The convulsive group of seizures includes tonic clonic(grandmal), tonic, clonic, infantile spastic, and bilateral myoclonic seizures. These are discussed. The non-convulsive group of seizures includes the following kinds:typical absence(petitmal), atypical absence(petitmal varient), absence status, and atonic seizures. In this group of seizures the initial discharge occurs at the centrencephalon(diencephalo-mesencephalo-rhombencephalon). The intricate mode of propagation of this type of discharge, which involve the recruiting and inhibitory systems, was discussed and also presented schematically.
Brain ; Consciousness ; Electroencephalography* ; Epilepsy ; Memory ; Muscle Spasticity ; Seizures ; Status Epilepticus

The therapeutie efficacy of ranitidine was evaluated itn 48 in- and out- patients with endoscopically diagnosed 18 cases of gaetric ulcer and 30 casea of ducnienal ulcer. In the open study, every pabenta was treated with ranitidine 150 mg b.i.d. for 4 weeks, and waa followed up by gastroscopy after 4 weeks of the treatment. The reeults obtained were summarized as follows; 1) 15 out of 18 cases (83. 3%) of gastric ulcers and 26 out of 30 cases (86. 7%) of duodenal ulcers had been completely healed up in 4 weeks. 2) There was a significant relationship between healing of ulcer and the relief of symptoms (x =6.12, P<0.005).3) There were no significant untoward reactions, efther subjective or objective, to the administration of the drug, except one case of severe epigastic discomfort. In conclusion ranitidine appears to be fairy effective and safe for the treatment of patient with peptic ulcr diseases.
Duodenal Ulcer ; Gastroscopy ; Humans ; Peptic Ulcer* ; Ranitidine* ; Stomach Ulcer ; Ulcer

The reconstruction of soft tissue defects with open fracture around the knee joint is limited by its unique location. Free tissue transfer is hindered by the selection of the recipient vessel and problems of microsurgery. The arc of rotation, defect size, and location must be taken into consideration in the use of regional muscle transfer such as gastrocnemius. According to Mathes et al, the flap survival can be enhanced by selective division of the dominant segmental pedicles, only a part of which can normally be transposed safely on its minor segmental pedicle. Neovascularization, vascular proliferation, and dilatation have also been produced by the delay procedure using silicone sheets. The authors have used the delay procedures with wrapping of the gracilis or sartorius muscle which enabled distally-based transposition of these muscles. The method showed satisfactory outcome in resurfacing the wound around the knee joint. The indictions for this procedure were defects of moderate size and those difficult to reach with conventional muscle flaps. The flap could reach the upper one-third of the lower leg. Other merits are relative simplicity and reliability without significant extension of hospital stay. The drawbacks are the two operative procedures necessary and the risk of infection due to silicone sheets.
Dilatation ; Fractures, Open ; Knee Joint* ; Knee* ; Leg ; Length of Stay ; Microsurgery ; Muscles ; Silicones ; Surgical Procedures, Operative ; Wounds and Injuries*

Lymphomatous involvement of the gallbladder is rarely identified and manifests mostly as a local involvement of disseminated disease. There have been reported only about 20 primary malignant lymphomas of the gallbladder without involvement of other sites. A 63-year-old woman presented with jaundice, epigastric pain, and weight olss of two months duration. There was no systemic lymphadenopathy elsewhere. Abdominal computed tomograph revealed a focal thickening of the gallbladder wall. The removed gallbladder contained a well circumscribed, 5x3 cm-sized, slightly elevated firm area with accentuated mucosal papillary excrescences near the neck protion. The lesion involved whole thickness of the wall, and was made up of diffuse atypical lymphoid cell infiltrates of variable size accompanying plasmacytoid differentiation in areas. Some large tumor cells were pleomorphic and contained prominent nucleoli. To our knowledge, this is the first case of primary malignant lymphoma of the gallbladder in Korean literature.
Female ; Humans

We analyzed the mRNA expression patterns of major potassium channel genes to determine the mechanism of hypokalemia in familial hypokalemic periodic paralysis. We used quantitative RT-PCR to examine the mRNA levels of both inward (KCNJ2, KCNJ6, and KCNJ14) and delayed rectifi er (KCNQ1 and KCNA2) potassium channel genes in skeletal muscle cells from both normal and patient groups, prior to and after exposure to 4 mM and 50 mM potassium buffers. Quantitative RT-PCR analysis revealed no changes in the mRNA levels of these genes in normal and patient cells on exposure to 4 mM potassium buffer. However, after exposure to 50 mM potassium buffer, which was used to induce depolarization, normal cells showed a signifi cant decrease in KCNJ2, KCNJ6, and KCNJ14 expression, but no change in KCNQ1 and KCNA2 expression. In contrast, patient cells showed no change in KCNJ2 and KCNJ6 expression, but an increase in KCNJ14 expression. Furthermore, KCNQ1 and KCNA2 showed decreased expression. We found that the expression levels of both inward and delayed rectifi er potassium channel genes in patient cells differ from those in normal cells. Altered potassium channel gene expression in patient cells may suggest a possible mechanism for hypokalemia in familial hypokalemic periodic paralysis.

For the last 20 years, several different techniques of fat injections have been developed. However, a standard technique of fat grafts has not yet been adopted for all practitioners. The purpose of this study was to evaluate the safety and long-term results of fat grafts using the modified Colman's technique. A total of 234 patients who underwent fat injections were retrospectively reviewed. The results were evaluated by patient satisfaction and photographs. The patient satisfaction was assessed using visual analogous scale(VAS), and photographs were evaluated by medical professionals. The fat was harvested using tumescent liposuction with a two hole Coleman harvesting cannula, and centrifuged at 3000rpm for 3 minutes. The refined fatty tissue was then transferred into a 1-ml syringe, and injected subcutaneously using 17-gauge cannula. The amount of fat tissue placed with each withdrawal of a cannula was 0.3~0.5mL. This technique showed good results with long-lasting volume consistency and few complications. The average value of VAS scored by patients was 8.7, and that by surgeons was 8.5, showing statistically no significant difference between the values evaluated by patients and surgeons. Author's fat injection procedure is a good choice for the correction of cosmetic defects and facial rejuvenation.
Adipose Tissue ; Catheters ; Cosmetics ; Follow-Up Studies ; Humans ; Lipectomy ; Patient Satisfaction ; Rejuvenation ; Retrospective Studies ; Syringes ; Transplants

BACKGROUND: When used to reverse the anticoagulant effect of heparin, protamine administration after cardiovascular bypass often can lead to systemic hypotension. During the reversal of heparin-induced anticoagulation, the effects of protamine on both a heparin-protamine complex and free protamine on the cardiovascular system should be considered. METHOD: To determine whether the hypotensive effect of heparin-protamine and/or protamine could be caused by endothelium-dependent and-independent component, we studied rings of the arotic arteries in rats suspended in organ chambers containing Tris Tyrode solution at 37oC and 100% O2. Arterial rings with or without endothelium were contracted with 40 mM KCl or 3 +/- 10-6M phenylephrine and then exposed to increasing concentrations of protamine (final organ bath concentration, 40~400 g/ml) both in the absence and presence of heparin (200 U/ml). RESULTS: Protamine induced concentration-dependent relaxation in arterial rings with endothelium, which were significantly greater than in rings without endothelium. The endothelium-dependent relaxation induced by protamine was inhibited by NG-monomethyl-L-arginine (L-NMMA) (10-5M) pretreatment, but was not inhibited by indomethacin (3x10-6M) pretreatment on rings with endothelium. Furthermore, the contractile inhibition was enhanced by superoxide dismutase (100 U/ml). Also, such vasodilating actions were not influenced in the presence of heparin (200 U/ml). In endothelium-denuded strips, protamine (400ug/ml) inhibited Ca++ induced contraction, which was evoked in Ca++-free solution containing 40 mM K+, and also inhibited the norepinephrine (NE)-induced contraction. Protamine inhibited on the NE-induced contraction, but not the caffein-induced contration in Ca++ free, 2 mM EGTA solution. Also, such inhibition of contracions were not inluenced in the presence of heparin (40 U/ml). CONCLUSION: This study demonstrates that protamine (in the presence or absence of heparin) acts on endothelial cell receptors to stimulate the production of nitric oxide and inhibits both Ca++-influx and the NE-induced Ca++ release from intracellular stores.
Animals ; Arteries* ; Baths ; Cardiovascular System ; Egtazic Acid ; Endothelial Cells ; Endothelium ; Heparin* ; Hypotension ; Indomethacin ; Nitric Oxide ; Norepinephrine ; omega-N-Methylarginine ; Phenylephrine ; Rats* ; Relaxation ; Superoxide Dismutase ; Vasodilation*

No abstract available.
Adult* ; Growth Hormone* ; Humans

The search for a new flap with minimal donor morbidity has been pursued by many plastic surgeons. Numerous donor sites available for microsurgical composite tissue transplantation have been described owing to the tremendous advances made in the field of microsurgery. To be suifable for use as a free flap, a sizable vessel must be included within the tissue, leading to significant donor morbidity. There have been studies for prefabrication of an axial pattern flap in an effort to create a new flap, but most of these methods relied solely on revascularization of a preexisting composite tissue. Our experiment, using an isolated femoral artery and vein as the main pedicle, led to formation of a capsule flap through a normal foreign body reaction between 2 silastic sheet implants. On this induced capsule flap, a skin graft was performed and a total of 40 axial pattern capsulo-cutaneous flaps from 20 Sprague-Dawley rats were successfully obtained after nearly 12 weeks through 4 stages of experiment, including a delay procedure at the second stage. Pathology revealed neovascularization, and abundantly impregnated vascular structures near the pedicle were observed along with random pattern collagen fibers. The skin graft took 100% on this newlyformed axial pattern capsular flap and thus implied that the capsule structure was able to survive on it`s own and was able to support skin grafts. This new flap using only the isolated artery and vein structure can be induced according to various needs with minimal donor morbidity.
Arteries ; Collagen ; Femoral Artery ; Foreign-Body Reaction ; Free Tissue Flaps ; Humans ; Microsurgery ; Pathology ; Rats, Sprague-Dawley ; Skin ; Tissue Donors ; Tissue Transplantation ; Transplants ; Veins

OBJECTIVE: This study was done to evaluate the risk factors and prevalence of symptom-giving pelvic girdle relaxation in pregnant women. METHODS: Three hundreds thirty-two postpartum women were asked to fill out a questionnaire within one week after their parturition. The diagnostic criteria of this lesion were adopted from the Norwegian Medical Association's and Larsen's criteria. The questionnaire were included age, parity, BMI(kg/cm2), weight gain during the pregnancy, history of symptom giving pelvic girdle relaxation in previous pregnancy, level of exercise and vocational status during and before the pregnancy and baby's birth weight. The answers were evaluated to determine the risk factors. The correlation was tested by student t-test and logistic regression. RESULTS: The prevalence of symptom-giving pelvic girdle relaxation during pregnancy was 18.9%. The history of symptom-giving pelvic girdle relaxation in previous pregnancy, multiparity and the absence of regular exercise before and during pregnancy showed correlation with symptom-giving pelvic girdle relaxation in pregnancy (p<0.05). CONCLUSION: It is suggested that women who experienced symptom-giving pelvic girdle relaxation in previous pregnancy should be checked for this lesion before pregnancy. Regular exercise is required to lower the incidence and lessen the severity of this lesion in pregnancy.
Birth Weight ; Female ; Humans ; Incidence ; Logistic Models ; Parity ; Parturition ; Postpartum Period ; Pregnancy ; Pregnant Women* ; Prevalence* ; Surveys and Questionnaire ; Relaxation* ; Risk Factors* ; Weight Gain