Tuberculosis of the spine is still prevalent in many parts of the world and still remains as an important orthopaedic problem in Korea. Moreover, spinal tuberculosis is the most common and dangerous form of skeletal tuberculosis. With the availability of very effective antituberculous drugs two divergent controversy in the management of tuberculosis of the spine have been reported. A large group of surgeons has advocated the radical excision of the tuberculous focus and replacement of the defect with autogenous bone grafts under cover of chemo-therapy, and another practise is typified by regimen of Friedman, Konstam, Kaplan, and Stevenson and Manning, who treated a large number of patients with spinal tuberculosis using antiuberculous drugs alone. Even now, because of the shortage of hospital beds and ancillary help, private poor economy and patients general condition, some group of patient with tuberclous spine have been treated conservatively using effective antituberculous drugs. In this study authors clinically analysed the 75 patients who had conservative treatment with triple drug therapy for 18 months at the department of Orthopaedics, Catholic Medical College and Center during the past 10 years, and the results were as follows: 1. There were two prevalent age groups. One is the first decade (30.6%) and the other is the third decade(30.7%). The age prevalence in children was 6 to 10 years of age. 2. The lesions were common in the lumbar spine(56.0%) and the most commonly involved vertebra was L3. The average initial number of involved vertebral body was 1.9 vertebrae and it was changed to 2.3 vertebrae at the end of treatment(18 months). 3. Active pulmonary foci was associated in 17.4%(6.7% of tuberculous pleurisy included). 4. Out of 75 cases twenty-six(34.7%) had new involvement at the adjacent vertebra within 18 months after treatment. 5. The radiographic activity was assessed as active in all cases initially, but at 18 months after treatment 83% of the cases were in quiescent condition, and this percentage was increased to 78.7% at 36 months. 6. Spontaneous fusion rate of involved vertebral bodies was 24% at 18 months and 36% at 36 months after treatment, respectively. 7. Radiologically observed deep seated abscess shadow disappeared slowly over 3 to 20 months, but this disappearance was observed mainly within 8 months after treatment. 8. Mean increment of the kyphosis was average 7.5 degree (9.3° in children and 6.6° in adults) at the end of the treatment(18 months), and average 8.6 degree(10.9° in children and 7.3° in adults) at 36 months, by. internal gibbus angle. 9. Almost in all the adult patients, kyphosis developed during the active phase of the disease, while in children kyphosis progressed even after the healing of the disease. Children who had multiple vertebral involvement at the dorsal area had a tendency to develop more severe kyphosis. 10. Decrement of the kyphosis angle which located at the lumbar area after the end of the treatment was considered to be an effect of narmal lordotic curvature. 11. Generally representation of the changes seen in children was almost osteolytic change without sequestrum in comparison to adults who had more sequestrum formation. 12. In 95% of cases a favourable results were obtained.
Abscess ; Adult ; Child ; Drug Therapy ; Humans ; Korea ; Kyphosis ; Prevalence ; Spine ; Surgeons ; Transplants ; Tuberculosis ; Tuberculosis, Pleural ; Tuberculosis, Spinal

No abstract available.
Female ; Ovulation*

BACKGROUND: Neostigmine, a cholinesterase inhibitor, is known to reverse the neuromuscular blocking action induced by nondepolarizing muscle relaxants at the end of general anesthesia. Some authors, however, reported that neostigmine has the properties of a neuromuscular block in skeletal muscles while others reported that neostigmine caused the smooth muscles such as the diaphragm to relax rather than to contract. The purpose of this study was to evaluate the effect of neostigmine at different doses on the tracheal smooth muscle in rabbits. METHODS: Isolated tracheal ring preparation in rabbits was used. Groups were divided into 7 groups; acetylcholine group (acetylcholine cumulative administered at doses of 10 8, 10 7, 10 6, 10 5, 10 4 and 10 3 M), neostigmine group (neostigmine cumulative administered at doses of 10 8, 10 7, 10 6, 10 5, 10 4 and 10 3 M), acetylcholine 10 6 M + neostigmine group (acetylcholine 10 6 M prior to neostigmine administered at doses of 10 8, 10 7, 10 6, 10 5, 10 4 and 10 3 M), acetylcholine 10 4 M + neostigmine group (acetylcholine 10 4 M prior to neostigmine administered at doses of 10 8, 10 7, 10 6, 10 5, 10 4 and 10 3 M), neostigmine 10 5, 10 4 and 10 3 M groups (neostigmine administered at doses of 10 5, 10 4 and 10 3 M). Smooth muscle contraction was evaluated in isometric tension per gram of tissue. RESULTS: In the acetylcholine group, the contractions increased as the dosage increased (10 8 10 3 M). In the neostigmine group, the contractions increased as the dosage increased (10 8 10 4 M), but at 10 3 M of neostigmine, contractions suddenly decreased. In addition when acetylcholine 10 6 M was given as a pretreatment, there was a sudden decrease in muscle contractions induced by neostigmine at 10 3 M. Also the contractions induced by 10 3 M neostigmine were less than that of 10 4 and 10 5 M. CONCLUSIONS: We concluded that neostigmine caused smooth muscle contraction at low concentrations by blocking acetylcholine metabolism, but at high concentrations, smooth muscle contractions were decreased and this might be due to direct action at the acetylcholine receptor.
Acetylcholine ; Anesthesia, General ; Cholinesterases ; Diaphragm ; Metabolism ; Muscle Contraction ; Muscle, Skeletal ; Muscle, Smooth* ; Neostigmine* ; Neuromuscular Blockade ; Rabbits*

No Abstract Available.
Depression* ; Primary Health Care*

No Abstract Available.
Depression* ; Primary Health Care*

Isoflurane, which has only recently been introduced into clinical practice, is a nonflammable halogenated ether used as an inhalation anesthetic. It has pharmacological, physical, and clinical properties similar to those of halothane and enflurane: however, it differs from botn in several important aspecs. The potent neuromuscular blocking action of sioflurane in desirable, because it reduces the requirement for muscle relaxants and allows lower doses of anesthesis. To quantitatively clarify the neuromuscular blocking effect of isoflurane, neuromuscular function was monitored by "Train of Four" stimulus with and without administration of muscle relaxants under halothane and isoflurane anesthesis, respectively, in 60 patients. The patients were divided into 4 groups(halothane anesthesia without muscle relaxants, halothane anesthesis with muscle relaxants, isoflurane anesthesia without muscle relaxants and isoflurane anesthesia with muscle relaxants). Twich responses of thenar muscle were monitored and analysed for the value of maximaum twich depression by halothane and isoflurane anesthesia, respectively, and the onset time, degree of maximal neuromuscular blockade, duration of action and recovery index of pnscuronium bromide under halothane and isoflurane anesthesia, respectively. The results were as follows: 1) Isoflurane exhibited a neuromuscular blocking effect 2,3 times more potent than halothane. 2) Neuromuscular depression by halothane and isoflurane was not accompanied by "fade". 3) The recovery time from nuromuscular blockade by succinylcholine in isoflurane anesthesia was increased significantly compared with halothane anesthesia. 4) The duration of action and the recovery index were increased significantly in isoflurane anesthesia compared with halothane anesthesia.
Anesthesia ; Depression ; Enflurane ; Ether ; Halothane ; Humans ; Inhalation ; Isoflurane* ; Neuromuscular Blockade ; Succinylcholine

The definition of C1q nephropathy has been categorized since 1985. However, the clinical correlation and pathophysiology has not yet been fully revealed. Therefore, the treatment of C1q nephropathy has not been established. Our subject was a 23 year-old female patient with both leg edema and oliguria, who was presented with weight gain. Renal biopsy confirmed C1q nephropathy. Prednisolone and cyclosporine therapy was selected for treatment. After 2 weeks of treatment, the patient lost 8 kg of body weight and all laboratory examination results were normalized. Both leg edema and oliguria were resolved. After 21 weeks of regular follow-up, she stopped the medicine by herself. Eight weeks later, the patient came to the Emergency room because both leg edema recurred. Same regimen was administered for 3 weeks, and complete remission was achieved again.
Biopsy ; Body Weight ; Cyclosporine ; Edema ; Emergencies ; Female ; Follow-Up Studies ; Humans ; Leg ; Oliguria ; Porphyrins ; Prednisolone ; Weight Gain

PURPOSE: Levodopa is the most effective anti-Parkinsonian agent. It has also been known to exhibit analgesic properties in laboratory and clinical settings. However, studies evaluating its effects on neuropathic pain are limited. The aim of the present study was to examine the anti-allodynic effects of levodopa in neuropathic rats. MATERIALS AND METHODS: Sprague-Dawley male rats underwent the surgical procedure for L5 and L6 spinal nerves ligation. Sixty neuropathic rats were randomly divided into 6 groups for the oral administration of distilled water and levodopa at 10, 30, 50, 70, and 100 mg/kg, respectively. We co-administered carbidopa with levodopa to prevent peripheral synthesis of dopamine from levodopa, and observed tactile, cold, and heat allodynia pre-administration, and at 15, 30, 60, 90, 120, 150, 180, and 240 min after drug administration. We also measured locomotor function of neuropathic rats using rotarod test to examine whether levodopa caused side effects or not. RESULTS: Distilled water group didn't show any difference in all allodynia. For the levodopa groups (10-100 mg/kg), tactile and heat withdrawal thresholds were increased, and cold withdrawal frequency was decreased dose-dependently (p<0.01). In addition, levodopa induced biphasic analgesia. Different dosage of levodopa did not impact on the rotarod time (p>0.05). CONCLUSION: Levodopa reversed tactile, cold and heat allodynia in neuropathic rat without any side effects.
Animals ; Carbidopa/administration & dosage/adverse effects/therapeutic use ; Dopamine Agents/administration & dosage/adverse effects/*therapeutic use ; Hyperalgesia/*drug therapy ; Levodopa/administration & dosage/adverse effects/*therapeutic use ; Male ; Neuralgia/*drug therapy ; Rats ; Rats, Sprague-Dawley ; Rotarod Performance Test

OBJECTIVES: The objective of this health assessment is to evaluate the health risks that may result from exposure to abandoned mine tailings in Gyeongsangbuk-do. The tailings are remnants from an earlier flotation mill and mining operation that was in business from the early 1930's until 1970. METHODS: The soil, stream water, and drinking water in and around three abandoned mine areas, Soochul, Gumjang, Darock, and three control areas located in Gyeongsangbuk-do were analyzed for level of Cd, Pb, Cu, As, and Hg. Potential chronic health effects were evaluated by interview and medical examination. RESULTS: Some soil and stream samples exceeded the Korean standard for soil contamination in farmland and the Korean standard of water contamination in streams respectively. Blood lead (5.37 microgram/dl) and urine cadmium (2.79 microgram/g Cr) levels of the residents in the vicinity of the abandoned mine sites were significantly higher than of the residents in the control areas (blood lead, 4.34 microgram/dl; urine cadmium, 1.62 microgram/g Cr). There were no significant differences between the mining and control areas in terms of blood pressure, Hb, BUN, creatinine, SGOT, SGPT, fasting blood sugar, and the prevalence of potential chronic diseases. CONCLUSIONS: The results of the assessment suggested that the three abandoned mine sites do not pose an apparent health risk to nearby residents. Nevertheless, the elevated blood lead and urine cadmium levels in the residents of the abandoned mine site suggested that it might be an important source of heavy metals contamination. Therefore, a nationwide evaluation program is needed to assess the potential health risks of residents living in the vicinity of abandoned mine sites.
Alanine Transaminase ; Aspartate Aminotransferases ; Blood Glucose ; Blood Pressure ; Cadmium ; Chronic Disease ; Commerce ; Creatinine ; Drinking Water ; Fasting ; Gyeongsangbuk-do* ; Metals, Heavy ; Mining ; Prevalence ; Rivers ; Soil ; Water