In this experiment, examined were short-term effect of alpha-2 adrenoreceptor agonist yohimbine on physiological, behavioral changes and ulceration induced by the 48 hr. conflict-stress session and compared with effect of conflict-stress condition. The experimental animals were 35 rats. each of which was distributes to one of the five group : yogimbine and conflict treatment group (experimental group N=10), conflict treatment without yohimbine group(control group N=10), yoked yohimbine without conflict group(compared group 1 N=4), yoked conflict without yohimbine group(compared group 2 N=4) and no stress treatment group(compared guoup 3 N=7). The experiment was conducted for 48 hours. During the first 24 hr. session, the animals received the feedback of ter shock termination or delay by their lever-pressing coping behavior so that could escape the stree stimulation. However, during the second 24 hr. conflict-stress session, they were provided a brief shock as a first feedback and the shock termination or delay as the second feedback of the lever-pressing coping behavior as in the first session. In this way avoidance-avoudance conflict condition was induced experimentally. Yohimbine(2cc/kg) was administrated twice during the entire experiment. Thus experimental group received the conflict stress and yohimvine, and control group took lnly conflict stress without yohimvine treatment. The compared 1 group which was yorked to experimental group which was yorked to control group took only uncontrollable stress without conflict, compared 2 group which was yorked to control group took only uncontrollable stress without yohimvine treatment and conflict, and compared 3 group did not receive any stress stimulation.

The results of the experiment were as follow. The effect of yohimbine and conflict were found in terms of stress ulceration aggravation and coping behavior fecrease but not weight loss and water intake. the experimental group showed more severe ulcerarion than the other groups. The control group showed the stress reaction in terms of coping behavior decreasment and mild level unceration. Two yoked groups also suggested the mild level ulceration but not coping behavior.

Based ojn this result from this experiment, it was found that the phychological conflict induced experimentally and yohimbine had the definitive effect of the ulceration aggravaion and suggested neither psychological conflict nor yohimbgine treatment sufficient for stress ulceration nevertheless psychological conflict or uncontrollable condition or yohimbine treatment induced mild ulceration stress response.

It has been known that the hemiarthroplasty of the hip with bipolar prosthesis is the one of primary treatment methods for management of unstable intertrochanteric hip fracture, especially in severe osteoprotic patients. Additionally this operative treatment allows early full weight bearing and has many merits for the patient to return to the preinjury functional level. But we think that this operative method has several considerable points for the more effective treatment technique in unstable osteoporotic intertrochanteric fractures. We review the nine interochanteric comminuted fractture patients treated with bipolar prostheses at the Department of Orthopedie Surgery of Ewha Womans University Mok-Dong Hospital from September, 1993 to June, 1994. The considered points are as follows:

1) The difficult problem is to judge the intraoperative head-neck length. which is reduced by the tension of the fascia between gluteus medius and vastus lateralis fascia, preoperative measuring the head-neck length with transparent template, level of the tip of greater trochanter and prosthetic femoral head, and range of motion of hip of greater trochanter and prosthetic femoral head, and range of motion of hip joint under the tr1al reduction.

2) The operative approach is the other considerable point for the exposure of medial cortical buttress and lesser trochanter in reducing and maintaining principal fragments, and for the accurate anteversion angle of femur.

3) Bipolar hemiathroplasty technique is not effective in reducing the operative time and the blood loss amount in operative field, wspecially in comminuted interochanteric fracture treatment.

Flap surgery and its survival is a major interest of the plastic surgeon. There have been numerous investigations concerned with finding a safe and effective method for increasing the area of skin flap survival. As the delay phenomenon theory, that is vascular smooth muscle relaxation auguments the blood flow to the capillary bed of the skin flap, experimental study using the Sprague-Dawley rats was perforned with the calcium antagonists which cause the dilatation of vascular smooth muscle by blocking the calcium influx into the cells.

The experimental results were as followings :

Survival area increased up to 72.7% with verapamil treatment and 81.22% with nimodipine treatment compared to 58.62% in the control. There was no significant difference between verapamil and nimodipine treatment groups.

In order to investigate the effect of bovine serum albumin of in vitro growth and development of F₁ hybrid mouse(C57BL×CBA) two cell stage embryos fertilized in vivo in simple(m-KRB) and complex(Ham's F-10) media, this study was performed and the results as follows are obtained.

1) When the early preimplantation in vitro grown and development to the stage of 4 cell or more was observed, in simple media the growth and development was suppressed significantly with an addition of bovine serum albumin and in complex media the growth and development was enhanced significantly with an addition of bovine serum albumin.

When the comparison was made between simple media with bovine serum albumin and complex media with bovine serum albumin, the growth and development in complex media with bovine serum albumin was significantly greater.

2) When the late perimplantation in vitro growth and development to the stage of blastocyst or hatched blastocyst was observed, in simple media the growth and development was suppressed significantly with an addition of bovine serum albumin and in complex media the growth and development was enhanced significantly eith an addation of bovine serum albumin.

When the comparison was made between simple media with bovine serum albumin and complex media with bovine serum albumin was significantly greater.

Judging from this, in preimplantation in vivo growth and development of two cell stage mouse(C57BL×CBA) embryos feritlized in vivo the media with additional nutrients and protein substances that might be mush larger amount than usual would be necessary.

However, as the preimplantation in vitro growth and development might be variant according to the strains of mouse and different stages of the growth and development every effort should be made to clearify the characteristics of preimplantation in vitro growth and development among various animal species and different development stages.

So, therefore, human in vitro fertilization and embryo transfer program would be much progressed with an aid of such experimental researches.

Coagulase-negative staphylococci(CNS) once considered nonpathogenic contaminants, recently represent the leading organisms of hospital-acquire bacteremia in catheter-associated infections, immunocompromised patients and neonates. patients and neonates.

We reviewed 141 caews of CNS isolated from blood in Ehwa Womans University Dongdaemoon Hospital, from March 1993 to February 1994 and deagnosed as pathogens or contaminants by clinical data and performed species identification and antimicrobial susceptibility test.

The results were as follows:

1) 46.8% of isolated CNS from blood was diagnosed as pathogens and most common age of CNS bacteremia was less than 1 month(39.0%). The most frequent underlying desease was respiratory tract infection(28.1%) followed by neonatal desorder(17.2%), malignancy(12.5%) and urinary tract infection(6.3%).

2) The most common identified species of CNS bacteremia was S.epidermidis(34.4%) folloewd by S. hominis(9.4%), S.auricularis(9.4%), S.haemolyticus(6.3%), S.dimulans(6.3%), S.capitis(3.1%), S.cohnii(1.5%) and S.warneri(1.5%). S.epidermidis, S.haemolyticus and S.simlans were more common identified as pathogens than contaminants(p<0.05) but S.auriculares, S. hominis, S.capitis, S.cohnii and S.ciuri were more common identified as contaminants than pathogens(p<0.05).

3) The antimicrobial susceptibility results of CNS bacteremia showed multi-drug resistance to penicillin(96.9%), cephalothin(75.0%), ampicillin/sulbactam(70.3%), oxacillin(70.3%), tetracycline(67.1%) and erythromycin(48.4%). But vancomycin resistance showed 1.6% of CNS bacteremia. Among CNS species, S.haemolyticus showed the highest resistance to multiple antibiotics. The resistance retes to penicillin, oxacillin among CNS species were S.haemolyticus, S.epidermidis and S.simulans higher than S.auricularis, S.hominis(p<0.05).

These results that species identification and antimicrobial susceptibility test of CNS isolated from blood will be useful diagnostic tool of CNS bacteremia.

The application of the fine needle aspiration(FNA) cytology to the soft tissue tumors has been used increasingly in the preoperative diagnosis of these tumors due to its usefulness and accuracy.

We present a case of liposarcoma, showing mosly myxoid component, but small portions of round cell and dedifferentiated component, diagnosed by FNA cytology with histologic confirmation. Good correlation between histologic and FNA cytologic findings was found. Although the cytologic appearances of liposarcomas varied with histologic type, the main criterion was the presence of atpical multivacuolated lipoblast with characgteristically scalloped nuclei.

Among the hematologic complications of solid tumors, leukoerythroblastosis, DIO and MAHA have been known to be clinically significant According to the recent increasing incidence of cancer, these hematologic complications have been reported frequently. However, the simutaneous developement of such manifestations is rare. Recently, we have experienced a patient with gastric adenocarcinoma in which case severe bleeding tendency were observed and laboratory studies including bone marrow examination demonstrated the findings of leukoerythroblastosis, DIC and MAHA. She died of upper gastrointestinal bleeding despite the supportive care such as vlood transfusions. We should give attention to the findings of peripheral golld smear for the patient with malignancy and it is mandatory for therapeutic plan to perform bone marrow examination if the above mentioned hemorrhagic complications are suspected.

Merkel cell carcinoma is a rare aggressive tumor of uncertain origin. The tumor occurres most commonly in the head and neck region of the eldery.

The patient was a 62-year-old female with a reddish nonulcerative movable hard nodule on her left temple area for 2 months. Histopathologically, the tumor cells with large vesicular nuclei and scanty cytoplasm were arranged in trabecular and cord-like pattern in the dermis. The majority of the tumor cells were positive for neuron specific enolase, chromogranin and neurofilament.

1) The peptic ulcer perforation is most common disease, it has been estimated that about 10% of the population of Western Countries at some time during life and duodenal perforation about 2.5%, stomach perforation about 22.2% in case of Korea.

2) The peptic ulcer perforation are one of the complications : Hemorrhage, Obstruction, Intractability.

3) The sex ratio between male and female was 12:1 in gastric ulcer and 8.8:1 in duodenal ulcer.

4) In age distribution, the peak incidence was 5th decade in gastric ulcer and 20-40 age in duodenal ulcer.

5) Positive finding of physical examination were epigastric tenderness, abdominal rigidity and rebound tenderness.

6) The dignosis was done by chest and abdominal plain films were revealed subdiaphragmatic free air shadow.

7) The treatment is extremity rare in conservative and then all most surgical procedure.

While odontoid fractures are common injuries, disagreement exists regarding treatment. Because of the high risk of nonunion in type II odontoid fractures, surgical fusion should be considered in the initial treatment of odontoid fractures, surgical fusion should be considered in the initial treatment of odontoid fractures.

Surgical fusion of odontoid fractures has usually been carried out by posterior C1-2 arthrodesis rather than fracture fixation. The former approach has been associated with significant mortality and morbidity. In addition, it results in a decreased range of motion, particularly lateral rotation and requires postoperative external immobilization. Recently several authors aors have advocated anterior scrow fixation of the fracture as an alternative to posterior cervical fusion.

This paper presents a descuddion of different fusion methods and a limmited experience of screw fixation method.

Direct anterior odentoid screw fixation can be used for the successful treatment of selected odontoid fractures and nonunions.

Thanatophoric dwarfism is a short limb dwarf condition which usually results in death shortly after birth. It has been confused with achondroplastic and another congenital short limb dwarf condition. We now report a case of thanatophoric dwarfism in a 29-year-old woman, based on prenatal sonographic, radiological and autopsy findings with a review of literatures.

Leiomonas of the vulva are extremely uncommon tumors. Recently we experienced a case of vulva leiomyoma thus it is presented with a brief review of the case and its literature.

We report a case of carcinosarcoma of the bladder in a 78 year-old female patient. Carcinosar-voma is a tumor consisting of malignant epithelial and mesenchymal elements, which occurs rarely in the bladder. The prognosis of bladder carcinosarcoma is poor and the best methods of treatment are uncertain. The literature is reviewed and the clinicopathologic condition of carcimosarcoma of the bladder id discussed.