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'Clinical Observation for the 226 Cases of CVA' (뇌졸중환자(腦卒中患者) 226예(例)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Lee, Seong-Hun;Jun, Chan-Yong;Park, Chong-Hyeong
    • The Journal of Korean Medicine
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    • v.18 no.1
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    • pp.5-24
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    • 1997
  • Clinical observation was made on 226 cases of CVA that were confirmed through brain CT, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from January to December in 1995. 1. The CVA cases were classified into the following kinds: cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage(SAH), transient ischemic attack, and the greatest in number among them were the cases of cerebral infarction. 2. The frequency of strokes was much the same between male and female cases and most cases were over 50 of age. 3. In the case of cerebral infarction the place of the most frequent occurrences was in the MCA territory, and as for cerebral hemorrhage, in the basal ganglia area. 4. The most ordinary preceding disease was hypertension. The next was diabetes mellitus. 5. Generally it is thought that CVA occurs frequently in winter. But on the contrary this study of observation confirmed that it occurs mostly in spring and summer. 6. The predisposing factors of cerebral infarction were usually initiated during the time of resting and sleeping and those of cerebral hemorrhage chiefly during the time of exercising. 7. As concerns the course of hospitalization, most patients passed through vestern medical hospitals or oriental medical hospitals. 8. For the patients the condition of whose consciousness was bad at the time of admission. the prognosis in most cases was bad. 9. The common symptoms were motor disability and verbal disturbance. 10. With regard to cerebral infarction, the average time to start physical theraphy was 6.4 days and with cerebral hemorrhage 9.7 days after stroke. 11. The duration of hospitalization was in most cases more than one month. 12. The main complication was urinary tract infection. 13. At the time of admission to hospital, the blood pressure in most cases was high, but it well controlled at the time of discharge. 14. Most cases were given simultaneous treatment in both ways of western and oriental medicine.

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THE SECOND MESIOBUCCAL CANAL OF UPPER PRIMARY MOLAR : CASE REPORT (제 2근심협측근관이 존재하는 상악유구치의 치험례)

  • Kim, Chang-Gi;Hong, Seong-Soo;Ko, Sung-Back;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.2
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    • pp.139-145
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    • 2002
  • In a primary teeth, dental caries is rapidly advanced the pulp disease, because the primary teeth have the thinner and the weaker enamel layer and the wider pulp chamber than relatively the permanent teeth. And the pulps of primary teeth are exposed during caries removal or even they are exposed by unexpected movement of the children or by trauma. For successive pulp treatment in primary teeth, it is necessary to understand completely about multiple canal morphology, variation of root canal anatomy and specific problem related to root formation and resorption of primary teeth. In upper primary molar, canal configuration of mesial root has the most variation same as upper molar. If not canal treatment is completely, most of all endodontic treatment should be failed. In a clinical case report, upper primary molars existed persistent pain or bleeding during treatment were founded the second MB canal and were performed the endodontic treatment of theirs. As a result, the upper primary molars have no symptom and good prognosis. In the examination of extracted upper primary molar, we found that 8 of 35 teeth(22.8%) in the upper primary first molars and 22 of 33 teeth(66.6%) in the upper primary second molar had the second mesiobuccal canal. It has revealed the high prevalence of two canals in mesiobuccal roots of upper primary molars. The frequency of occurrence of the second mesiobuccal canal must be taken into consideration when endodontic treatment is planned and as a possible cause of otherwise un explained failure.

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Review of the Radiation Risk and Clinical Efficacy Associated with Computed Tomography Cancer Screening (암의 조기발견을 위한 CT촬영에서의 임상적 효능과 방사선위해에 대한 고찰)

  • Kim, Hyun Ja
    • Journal of Radiation Protection and Research
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    • v.38 no.4
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    • pp.214-227
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    • 2013
  • Computed tomographic scan as a screening procedures in asymptomatic individuals has seen a steady increase with the introduction of multiple-raw detector CT scanners. This report provides a brief review of the current controversy surrounding CT cancer screening, with a focus on the radiation induced cancer risks and clinical efficacy. 1. A large study of patients at high risk of lung cancer(the National Lung Screening Trial[NLST]) showed that CT screening reduced cancer deaths by 20%(1.33% in those screened compared with 1.67% in those not screened). The rate of positive screening tests was 24.2% and 96.4% of the positive screening results in the low-dose CT group were false-positive. Radiation induced lung cancer risk was estimated the most important in screening population because ERR of radiation induced lung cancer does not show the decrease with increasing age and synergistic connection between smoking and radiation risk. Therefore, the radiation risk may be on the same order of magnitude as the benefit observed in the NLST. Optimal screening strategy remain uncertain, CT lung cancer screening is not yet ready for implementation. 2. Computed tomographic colonography is as good as colonoscopy for detecting colon cancer and is almost as good as colonoscopy for detecting advanced adenomas, but significantly less sensitive and specific for smaller lesions and disadvantageous for subsequent therapeutic optical colonoscopy if polyps are detected. The average effective dose from CT colonography was estimated 8-10 $mS{\nu}$, which could be a significant dose if administered routinely within the population over many years. CT colonography should a) achieve at least 90% sensitivity and specificity in the size category from 6 and 10 mm, b) offer non-cathartic bowl preparation and c) be optimized and standardized CT parameters if it is to be used for mass screening. 3. There is little evidence that demonstrates, for whole-body scanning, the benefit outweighs the detriment. This test found large portion of patient(86~90.8%) had at least one abnormal finding, whereas only 2% were estimated to have clinically significant disease. Annual scans from ages 45 to 75 years would accrue an estimated lifetime cancer mortality risk of 1.9%. There is no group within the medical community that recommends whole-body CT. No good studies indicate the accuracy of screening CT, at this time. The benefit/risk balance for any of the commonly suggested CT screening techniques has yet to be established. These areas need further research. Therefore wild screening should be avoided.

${\ll}$황제내경(黃帝內經)${\gg}$ 의 심(心)의 개념(槪念)과 장상(藏象)에 대한 연구(硏究)

  • Lee Yong-Beom;Bang Jeong-Gyun
    • Journal of Korean Medical classics
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    • v.13 no.1
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    • pp.269-303
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    • 2000
  • The xin(心) has various meanings in ${\ll}$Huangdineijing(黃帝內經)${\gg}$ but they sometimes contradict each other. This thesis divided the xin into the meaning and the Zang-xiang(藏象), and then analyzed the xin's notion in detail. The concept of the xin in ${\ll}$Huangdineijing(黃帝內經)${\gg}$ is sorted out into : the notion of space, yin-yang five elements(陰陽五行) and shen(神) The xin is the upper part of body and it possesses the character of yang(陽). So the concept of the breast has originated from this character and it rightly belonged to the top. The xin is assigned to fire among five elements, 'chang(長)', which has the energy of moving forward, noon at a day when yang-qi(陽氣) is properous and shows 'gu(鉤)' & 'keo(矩)' in pulse condition. The xin possesses the character, 'Taiyang of the yang(陽中之太陽)' along with the notion of space combined with five elements. That is, the notion of upper space means 'of the yang(陽中)', and, fire in five elements means 'yang'. This is similar to '=(Taiyang)' of Sasang(四象) at ${\ll}$the Book of Changes(周易)${\gg}$ Since the xin puts shen(神) in order, actions of spirit have effect on the xin. And it depends whether the sense of vitality is broad or narrow. The xin related with broad sense of spirit is 'monarch of the organs(君主之官)'. Therefore it has control over the human body. As it also directly effects the life or death, Pericardium(心句) substitutes the xin and protects the external invasion. In Shi-er-won(十二原) and Bonsu(本輸), instead of the Xin Channel the Pericardium Channel was used in healing patients. The xin can be interpretable as the mind, because the xin includes spirit. The mind can be distinguished into 'desire' and 'state of profound reason'. In ${\ll}$Huangdineijing(黃帝內徑)${\gg}$, the disease of the xin caused by emotion was mentioned many times. This emotion is 'desire' which resorted to the sentiment. The reason one mind has both character is; man preserves given principle (reason) and emotion reveals via the reason exercised. The above is about the xin related with the broad sense of vitality. Concerning the narrow sense of vitality, one of the five vitalities is stored with the others away in the five solid organs. Then it takes part in the operation of five body constituents and it is linked with the personified description of five solid organs. The xin, spleen, stomach and kidney are 'the ground of life'. Spleen and stomach are the origin of making qi and blood, which 'means the ground after birth'. Kidney keeps the essence of life, and manages the growing and generative function of human body. The xin keeps 'Shin-myung(神明)', in other words, it has control over and supervise whole activity of body. Therefore xin's role is needed for the appropriate working of spleen, stomach and kidney. And 'Shin-myung' is its motive power. In ${\ll}$Huangdineijing(黃帝內經)${\gg}$, the reason why xin was assigned to September and October is that yang-qi of the human body goes to the inner part, with xin at the same time. This explains that yang-qi of the human body is adapted to change of season and goes into xin-fire(心火) in order to get away from the cold. In this case, heart means more inner part than liver, spleen and lung. Mengzi(孟子), philosopher of the China's turbulent ages emphasized the thinking function of xin. Sunzi(荀子) asserted that xin is 'heaven monarch(天君)' and the other organs are 'heaven rninisters(天官)'. This conception is similar to 'monarch of the organs' of ${\ll}$Huangdineijing(黃帝內經)${\gg}$. After the Ming Dynasty, commentators of Huangdineijing(黃帝內經) explained the heart, as 'monarch of the organs', or 'the master of body(一身之主)'. This was due to the influence of Sung Confucianism.

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Thermographic Assessment in Dry Eye Syndrome, Compared with Normal Eyes by Using Thermography (열화상카메라를 이용한 정상안과 건성안의 서모그래피 비교)

  • Park, Chang Won;Lee, Ok Jin;Lee, Seung Won
    • Journal of Korean Ophthalmic Optics Society
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    • v.20 no.2
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    • pp.247-253
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    • 2015
  • Purpose: The purpose of this study was to compare and analyze the ocular surface and the palpebral conjunctiva of categorized subjects, which were divided into normal eye group and dry eye group, by using a thermal camera. Methods: Subjects were 144 eyes of 72 normal university students, who didn't have any corneal disease, abnormal lacrimal ducts, medical records regarding ocular surgeries, or experience of using contact lens. Subjects were divided into two groups, which were normal eye group and dry eye group, based on the results of TBUT, Schirmer I test, and McMonnies test. After categorizing the subjects, the temperature of the subjects' ocular surface and the palpebral conjunctiva were measured and analyzed by using a thermal camera (Cox CX series, Answer co., Korea). Results: In the normal eye group's Central Ar.1, Nasal Ar.2, Temporal Ar.3, Superior Ar.4, Inferior Ar.5, the measured amount of temperature change on each area was $-0.13{\pm}0.08$, $-0.14{\pm}0.08$, $-0.12{\pm}0.08$, $-0.14{\pm}0.08$, $-0.10{\pm}0.09(^{\circ}C/sec)$. The dry eye group's results were $-0.17{\pm}0.08$, $-0.16{\pm}0.07$, $-0.16{\pm}0.08$, $-0.17{\pm}0.09$, $-0.15{\pm}0.08(^{\circ}C/sec)$. When compared with the normal eye group, the values of Ar.1, Ar.3, Ar.5 were significantly different in the dry eye group(p<0.05). The amount of temperature change, which was observed on the palpebral conjunctiva(Ar.1:central, Ar.2: nasal, Ar.3: temporal) of the normal eyes, measured by thermography, was $34.36{\pm}1.12$, $34.17{\pm}1.10$, $34.07{\pm}1.12^{\circ}C$ on each area. Same values taken from the dry eye group was $33.55{\pm}0.94$, $33.43{\pm}0.97$, $33.51{\pm}1.06^{\circ}C$ on each area. The values of Ar.1, taken from the dry eye group, had a significant difference, compared to the values of the normal eye group(p=0.05). Conclusion: The temperature of the ocular surface decreased faster on the dry eyes, compared to the normal eyes. The temperature measured on the palpebral conjunctiva of the dry eyes were also lower than the normal eyes. The temperature changes on the ocular surface, observed with a thermal camera, were objective values to assess the stability of tear films, and might provide useful data for studies related to dry eye syndrome.

Mutational Analysis of MECP2 Gene in 34 Rett Syndrome (Rett 증후군 34례의 MECP2 유전자 변이에 관한 연구)

  • Park, Sang Jo;Hwang, Tae Gyu;Son, Byeong Hee;Kim, Chul Min
    • Clinical and Experimental Pediatrics
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    • v.45 no.10
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    • pp.1263-1272
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    • 2002
  • Purpose : Rett syndrome(RTT) is an X-linked dominant neurodevelopmental disorder affecting 1 per 10,000-15,000 female births worldwide. It was initially described by Andreas Rett in 1966. RTT involves developmental regression characterized stereotypic hand movements, tremors, gait apraxia, seizures, deceleration of head growth after the age of 6-18 months. The disease-causing gene was identified as MECP2 on chromosome Xq28. We carried out mutational analysis of MECP2 genes in RTT patients. Methods : Whole blood(5 cc) of 34 sporadic RTT patients was collected in EDTA-anticoagulated tubes. Genomic DNA was extracted from peripheral blood using the E.Z.N.A. blood DNA kit. Four exons of the MECP2 gene were amplified by PCR in 34 Korean with RTT. We carried out PCR divided the exon three into two parts and the exon four into five parts. Primer sequences designed by Amir et al. in 1999 were almost used(AF030876). Sequencing primers used were the same as PCR. DNA sequencing reactions were performed using an ABI 377 DNA sequencer and ABI PRISM dye terminator cycle sequencing reaction kit(Perkin-elmer). The results were compared with the normal DNA sequence(X99686). To confirm the change of sequence on novel mutations, RFLP analysis was performed. Results : The MECP2 mutations were detected in 23(67.6%) of the 34 patients. The mutations consisted of 12 different types including nine missense and three nonsense mutations. Of these, three (L100V, G161E and T311M) mutations were newly identified. Most of the mutations discovered are located within MBD(39.1%) and TRD(39.1%). In this study, three(T158M, R270X, R306C) mutations were identified high frequency. Conclusion : MECP2 gene was also an important cause of Korean RTT patients. MECP2 gene study is an important tool for diagnosis of Korean RTT patients.

Production and Inhibition of Cellulolytic and Pectolytic Enzymes by Cylindrocarpon destructans(Zins.) Scholten Causing Root Rot of Ginseng (인삼뿌리썩음병균, Cylindrocarpon destructans에 의한 섬유소분해효소 및 펙틴질분해효소의 분필 및 억제)

  • Lee Jin Woo;Chung Hoo Sup
    • Korean journal of applied entomology
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    • v.13 no.1 s.18
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    • pp.1-10
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    • 1974
  • The activities of pectolytic and cellulolytic enzymes produced from slices of ginseng root infected with Cylindrocarpon destructains(Zins.) Scholtern were proportional to each concentration and reaction time. Activities of cellulase(Cx), endo-polygalacturonase(endo-PG), endo-polymethylg-alacturonase(endo-PMG), exo-polygalacturonase(exe-PG), and exe-polymethylgalacturonase(exo-PMG) were maximum on the 4th day after inoculation. No endo-PG and endo-PMG were detected at the first and second days, while exo-PG exo-PMG were active. On the 6th day, all pectic enzymes were completely lost, whereas Cx remained at a high concentration. pH optima of Cx, endo-PG, endo-PMG, exo-PG, and exo-PMG were 6.0, 5.5, 8.0, 7.0 to 7.5, and 8.5, respectively. Temperature optima of Cx, endo-PG, endo-PMG exo-PG, and exo-PMG were $66^{\circ}C\;53^{\circ}C\;41^{\circ}C\;37^{\circ}C\;and\;40^{\circ}C$, respectively. Cx was only inhibited by $0.05M\; Hg^{++}$ among 16 ions tested. Inhibitory effects of ions on pectolytic enzymes varied, however$M Fe^{+++}\;and\;0.05M\;Al^{+++}$ were the best in general. Among 8 fungicides, none of them inhibited all the enzymes studied at $0.1\%$, active ingredients. Exo-PG were highly inhibited by all of the fungicides, of which difolatan was the most inhibitory to all the pectic enzymes. $Ca^{++}\; at\; 0.02M\; and\;Fe^{+++}\;at\;0.02M$ completely inhibited all the pectolytic enzymes, and Cx was inhibited $30\%$ and $70\%$ at the same concentration, respectively Formalin almost inhibited exo-PG and exe-PMG at $0.8\%$ but not the other enzymes especially Cx. Difolatan at $0.8\%$ inhibited all the enzymes concerned above $80\%$. The cellulolytic and pectolytic enzymes of C. destructans must be closely associated with the ginseng root rot and should be inhibited to control the disease effectively.

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Knowledge and Attitude toward Restaurant-Related Sanitation of New Restaurateurs (일반음식점 신규영업주의 위생관리지식 및 위생행정에 대한 태도)

  • Kim, Seun-Taek;Park, Jae-Yong;Kam, Sin;Han, Chang-Hyun
    • Korean Journal of Health Education and Promotion
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    • v.15 no.1
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    • pp.79-95
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    • 1998
  • The purpose of this study was to investigate the sanitation affairs of general restaurants. The questionnaire survey on the attitude and knowledge toward sanitation, the attitude for sanitary administration and the sanitary education was conducted against new 600 restaurateurs who were educated from June 20 to July 11, 1996, at the administration hall's division of Kyungsangbook-do in charge of food industry that offered regular sanitary education to new restaurateurs annually. And the visit survey on sanitary practice was also conducted over 93 restaurateurs who obtained the commercial license for food service business. The findings from the survey were as follows; In regard to food sanitation, some 87.1 to 88.3% got the right knowledge about the reason and precaution of food poisoning, food's frozen or cold-storage, and the disposal of products after expiration of validity term. But it was about 20.8% to 50.0% who knew right about major precaution, storage temperature in refrigerator, fermented milk product's storage temperature and validity term. There was therefore a necessity for education in food sanitation. 38.2% of the subjects placed an emphasis on sanitary storage of foodstuffs as the most important thing in sanitary management. 33.8% emphasized cooking sanitation. The environmental sanitation was counted as the most important thing by 19.2%, and personal sanitation of worker was counted by 8.8%. There was differences in what they thought the most important thing was, according to the respondent's educational level and cooker. 86.6% replied it necessary to improve the sanitary level. The respondents who were younger or had better educational level emphasized more the need for it. Concerning health examination, 90.2% replied it necessary. 81.4% answered the reason was because there was a potentiality Quests might be infected with contagious disease. 78.5% pointed the need for sanitary education, but respondents with higher educational level less emphasized its needs. As the reason for poor sanitation, restaurateur's poor awareness about it was most frequently pointed out, by 46.9%. Cooking sanitation was most frequently counted, by 38.5%, as the first thing to be improved. As the most critical point in sanitary education, 34.5% indicated food's sanitary Quality control 30.9% mentioned sanitary treatment of kitchen facilities and peripheral environment, and 27.1% emphasized the summary of the general food sanitation. 77.7% answered to correct immediately in case of violating the Food Hygiene Law, and 12.0% replied to correct in the same case if they would get the order from public official or administrative action would be taken. Respondents with higher educational level answered more to correct immediately. What they wanted the government office to do toward sanitary improvement was a fund aid an facilities and management which was pointed out by 38.9%, a periodical sanitary education by 26.3% and a on-the-spot guidance of sanitary officials by 22.3%. In view of the food service business's sanitary practice, the rate of wearing a sanitary clothes was 32.9% in city and 35.0% in county. The rate of hand-washing without soap or non-washing at cooking was 73.9%, 85%, respectively. The rate of personnel sanitation was 34.2% in city and 50.0% in county. These things indicated the sanitation was not well practiced. To improve the poor sanitary conditions of the food service businesses, it is recommended to offer institutional backing and financial aid from administrative office, and encourage restaurateurs to take pride in their job. and conduct the sanitary education effectively by sanitary education institution.

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A Clinical Analysis of Femur Neck Fracture in Elderly Patients (노년층에서 대퇴경부 골절의 치료)

  • Ihin, Joo-Choul;Ahn, Myun-Whan;Seo, Jae-Sung
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.11-22
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    • 1985
  • Femur neck fracture is well known as one of the major death cause after trauma in elderly patients, and unsolved fracture due to its frequent association with complications such as avascular necrosis and nonunion. Through meticulous evaluation of the patient, hip and surgeon's experiences, reduction of mortality and morbidity as well as rapid recovery of the patient to the preinjury social and ambulatory status without local complications and revision after treatment is urgently needed. Many factors about this fracture In itself were noted, but we have analyzed 18 femur neck fractures of the patients older than 50 years preliminarily according to age, fracture pattern, osteoporosis, etiology and method of treatment with its delay in association with major complications especially avascular necrosis and nonunion. The results are as follows; 1. Of these 18 fractures, 11 were in females, 8 were caused by minor trauma such as slip-down accident and 4 were associated with definite osteoporosis according to the Sing's classification. 2. Fracture pattern of these 18 are undisplaced in 4, displaced subcapital in 11, displaced transcervical in 3. 11 fractures in the patients older than 60 year are composed of 3 undisplaced or impacted fractures and 8 displaced subcapital fractures. 3. These 18 fractures were treated by closed reduction and Internal fixation with multiple pins in 13, and hemiarthroplasty in 4, but one was not treated to die after discharge from hospital. 4. 4 undisplaced or impacted fractures and 3 displaced transcervical fractures were not associated with any complications such as avascular necrosis or nonunion. But 4 of 6 displaced subcapital fractures were complicated by avascular necrosis, 3 of which were reduced in the varus position within 1 week, and the other was reduced in the good position on 1 week after trauma. There was no complication in 2 displaced subcapital fractures reduced in valgus position within 3 days after trauma. According to the above results, the prognosis of the femur neck fracture is dependent upon the fracture pattern and delay in its treatment. So it is inevitable to reduce the fracture in anatomical or valgus position as early as possible. But the arthroplasty may be needed in displaced subcapital fractures delayed for several days, with its reluction in extreme varus position or impossible and with pre-existing disease in the same hip Joint (total hip replacement).

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Diagnostic Value of Adenosine Deaminase(ADA) and its Isoenzyme in Pleural Effusion (흉수의 감별진단에서 Adenosine Deaminase (ADA) 및 동종효소의 유용성)

  • Kim, Keun-Youl;Kweon, Suk-Hoe;Park, Jae-Seuk;Jee, Young-Koo;Lee, Kye-Young;Kim, Youn-Seup;Chun, Yong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.2
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    • pp.388-396
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    • 1998
  • Background: Etiologic diagnosis of pleural effusion is usually made by clinical characteristics, pleural fluid analysis and pleural biopsy. But, despite careful diagnostic study, the cause of pleural effusion cannot be found in about 20 percent of patients, especially in loculated pleural effusions. Tuberculous pleurisy is one of the most common cause of pleural effusion in Korea. But, pleural fluid culture for Mycobacterium tuberculosis are positive in only 20 to 30 percent of patients and typical pleural biopsy finding in less than 50 percent of patients with this disease. In recent studies, adenosine deaminse(ADA) and its isoenzymes were proposed to be a useful diagnostic tool for differential diagnosis of pleural effusion. We investigated the pattern of ADA and its iscenzyme activities in various cause of pleural effusions to evaluate the diagnostic value of measuring ADA and its isoenzymes. Method: We measured total ADA and its isoenzyme activities in pleural fluid and serum from 54 patients with pleural effusion(25 tuberculous pleural effusion, 10 parapneumonic effusion, 14 malignant pleural effusion, 5 transudative pleural effusion), including 5 loculated tuberculous pleural effusions and 6 loculated parapneumonic effusions. Total ADA activity was measured by the spectrophotometric method and ADA2 isoenzyme activity was measured with same method using EHNA, potent inhibitor of ADA1 isoenzyme activity. Result: Total ADA activity of tuberculous pleural effusion was higher than malignant pleural effusion(p<0.01), but no significant difference was found between tuberculous pleural effusion and parapneumonic effusion(tuberculous pleural effusion: $148.9{\pm}89.9IU/L$, parapneumonic effusion: $129.0{\pm}119.4IU/L$, malignant pleural effusion: $48.7 {\pm}39.7IU/L$). Percentage of ADA2 activity to total ADA activity(ADA2%) of pleural effusion of tuberculous pleurisy was higher than parapneumonic effusion(p<0.05). but no significant difference was found between tuberculous pleural effusion and malignant pleural effusion(tuberculous pleural effusion: $57.2{\pm}10.7%$, parapneumonic effusion: $35.9{\pm}17.8%$, malignant pleural effusion: $60.7{\pm}4.1%$). In loculated pleural effusion, ADA2% of tuberculous pleural effusion was higher than parapneumonic effusion(tuberculous pleural effusion: $53.3{\pm}3.9%$, parapneumonic effusion: $27.8{\pm}7.9%$). Conclusion: Measurement of ADA isoenzyme activity is useful for differentiating tuberculous pleural effusion from parapneumonic effusion, especially in loculated pleural effusion.

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