In order to investigate a hemodynamic complication associated with the resection of a large arteriovenous malformation, we planed the following experiment. We divided the left common caroted artery and the internal jugular vein for microsurgical anastomsis between the rostral carotid and caudal jugular vessel ends : the 2 remaining wessel stumps were ligated. This created an arteriovenous shunt with afferent flow from the contralateral caroted and the basilar artery and retrograde down to the carotid-jugular anastomosis. And then, we occluded the shunt vessels at the each stage of the first and fourth week after anteriovenous shunt. Forty adult cats weighing from 2.2 to 2.4kg were used in this study The animals were devided into 4 groups : group 1(acute occlusion-1 week after shunt, n=10), group 2(staged occlusion-1 week after shunt, n=10), group 3(acute occlusion-4 week after shunt, n=10), group 4(staged occlusion-4 week after shunt, n=10) respectively. The regional cerebral blood flow(rCBF), cardiopulmonary function were measured in each animal group and also observed the response of the cerebral blood flow on induced changes of the blood pressure and the arterial bicarbonate. The arteriovenous shunt patency was evaluated by serial angiography. The results were as follows ; 1) Considerable increases in the mean arterial blood pressure(mABP) as well as bradycardia were observed in acute occlusion groups(group 1, 3). After induced hyercarbia, the increments of mABP in acute occlusion groups were less than staged occlusion groups, considerbly. 2) Significant decreases in the mean pulse rate were observed in acute occlusion groups. the mean pulse rate were the highest decrease in group 3. 3) The values of rCBF of left frontal cortex in acute occlusion groups were more greater increase than those of staged occlusion groups considerably. 4) After induced hypercarbia, considerable increases of the rCBF were demonstrated in all groups and increases of the rCBF were lowest in group 3 compared with the other groups. After induced hypercarbia, considerable increases of the rCBF were demonstrated in all groups and reductions of the rCBF were lowest in group 3 compared with the other groups. 5) After induced hypercarbia, considerable increases of the rCBF were demonstrated in all groups. The rCBFs were the highest increase in group3 and lowest increase in group 2 compared with the other groups. After induced hypotension, considerable reductions of the rCBF were demonstrated in all groups. The rCBFs were the highest reduction in group 3 and lowest reduction in group 2 compared with the other groups. It might be infered from these results that patients with large arteriovenous malformations, particulary those with cerebral steal symptoms, are at risk to develp neurologic defictis related to perfusion breakthrough if their malformed vessels are abruptly removed, and staged or gradual occlusion of feeding arteries may prevent this potentially devastating complication.
Adult ; Angiography ; Animals ; Arteries ; Arteriovenous Malformations ; Basilar Artery ; Blood Pressure ; Bradycardia ; Cats ; Heart Rate ; Hemodynamics ; Homeostasis* ; Humans ; Hypotension ; Jugular Veins ; Perfusion

No abstract available.
Dermabrasion* ; Eyebrows* ; Foreign Bodies* ; Foreign-Body Reaction*

The Author reports here the statistical observation of poliomyelitis from the 46 cases during a 3 month period (June, August, 1971) at the department of Orthopaedic Surgery, Korea General Hospital under the support of Shrine Club in Korea. The statistical results were as follows: 1. Among 46 cases, 30 were male, age of infection of poliomyelitis ranged from 2 month to age of five. The majority of cases were under the age of one and 95% of total patients were under the age of three. 2. Among 46 cases, 78.2% was not vaccinated fer poliomyelitis. The sequela of paralysis were more prevalent in this group. 3. tibialis anterior muscle and quadriceps femoris muscle were paralized predominently, 78.2% and 60.8% respectively. 4. Seventy eight and two tenth percent (78.2%) of patient seeked Chinese medicine practitionar with herb and acupunture, following paralysis, only 39.1% reported to the hospital and 4.4% did not see any treatment at all.
Asian Continental Ancestry Group ; Hospitals, General ; Humans ; Korea ; Male ; Paralysis ; Poliomyelitis ; Quadriceps Muscle

After the success of total hip replacement arthroplasty by John Charnley in 1962, it was well known fact that total hip replacement arthroplasty can be applied to degenerative arthritis, rheumatoid arthritis, post-traumatic arthritis, ankylosing spondylitis, even on the fused hip. However the old dislocated hip gives arise a few problem for its total hip replacement with the follwing causes:, 1. floor of the falad acetabulum is very thin and inadequate to receive a socket. 2. distorted anatomy of the acetabulum and proximal femur. 3. short and atrophic abductor mechanism. Total hip replacement arthroplasty could be successful for the old dislocated hip, if the adequate size of cup ard prosthesis are available and there is adequate length of the hip abductor. Preoperatively we can measure the size of the acetabulum and the distorted femur with roentgenogram. But it is not known how to measure or predict whether or not there is enough length of the abductor muscle mechanism preoperatively. Therefore the question arises how to measure or predict the length of the hip abductor in the old dislocated hip. Although this is a preliminary report, it is our feeling that the more the range of motion the hip has, the better the length of the hip abductor muscle. In our series acetabular socket can be positioned at the original site and the osteomized greater trochanter reduced to the femur easily in the cases more than 190 of total range of motion of the affected hips, The range of motion of the affected hip can be measured preoperatively.
Acetabulum ; Arthritis ; Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Femur ; Hip ; Osteoarthritis ; Prostheses and Implants ; Range of Motion, Articular ; Spondylitis, Ankylosing

No abstract available.
Methods* ; Parturition*

No abstract available.
Classification* ; Lung Diseases*

Considerable controversy exists as to whether rhythm or rate control is the more appropriate management for the patients with persistent atrial fibrillation (AF). Until recently, it was our belief that the initial approach to rhythm management should give primary consideration to the restoration and maintenance of the sinus rhythm (SR), which provides the potential benefits of reducing the risk of thromboembolism and the need for anticoagulants, and improved the hemodynamics and quality of life. However, there are negative aspects of rhythm control, including the poor efficacy of the antiarrhythmic drugs and the potential of adverse effects. Five recent clinical trials; AFFIRM (The Atrial Fibrillation Follow-Up Investigation of Rhythm Management), RACE (Rate Control versus Electrical Cardioversion), PIAF (Pharmacological Intervention in Atrial Fibrillation), HOT CAFE (How to Treat patients with Chronic Atrial Fibrillation) and STAF (The Strategies of Treatment of Atrial Fibrillation), have looked specifically at the issue of the balance between the benefits and risks of restoration and maintenance of the SR, primarily with drug therapy. The conclusions of these trials were consistent, although the study subjects were heterogeneous;1) Rhythm control, with anti-arrhythmics, does not lead to an improvement in the symptom control, quality of life or a reduction in the short to median term clinical events, in fact, in the longer term the mortality may increase. 2) Maintenance of the SR remains poor, even with an aggressive strategy. Hence, long term anticoagulation is needed for most patients treated with rhythm control, even if the SR is restored in the short term. A number of non-pharmacological therapies have emerged, such as catheter ablation and pacing, for patients remaining highly symptomatic, despite the use of several anti-arrhythmics and serial electrical cardioversion. In conclusions, rate control should be considered as the initial strategy in the majority of the patients with persistent AF. For the minority that remain highly symptomatic, aggressive rhythm control, with invasive treatments, such as pulmonary vein isolation or rate control, with atrioventricular nodal ablation and ventricular pacing, should be considered.
Anti-Arrhythmia Agents ; Anticoagulants ; Atrial Fibrillation* ; Catheter Ablation ; Continental Population Groups ; Drug Therapy ; Electric Countershock ; Follow-Up Studies ; Hemodynamics ; Humans ; Mortality ; Pulmonary Veins ; Quality Control ; Quality of Life ; Risk Assessment ; Thromboembolism

No abstract available.
Lipid Metabolism* ; Peroxisomes*

The principle of antituberculosis therapy is to apply a combination regimen of at least two bactericidal drugs to which the bacteria are susceptible for sufficient duration, thus improving the efficacy of the therapy and preventing the development of resistant strains. If a certain side effect develops during the therapeutic trial, the next step includes identifying the causative drug, estimating the type and magnitude of the side effect, and finally deciding whether the regimen should be discontinued. In a clinical setting, however, these decisions cannot be made easily. Many antituberculosis drugs causes similar side effects, and even if the causative drug is identified, the decision to discontinue the drug must be based on its relative importance in the current antituberculosis regimen. Effective application of antituberculosis medication requires the physician to fully understand what adverse effects each drug is associated with, which side effect necessitates withdrawal of the drug, and how to rechallenge the drug with side effects when it is absolutely required in the regimen.
Bacteria

No abstract available.