The injury of the epiphysis or epiphyseal plate produces undesirable effects on the normal growth of the bone, such as bone bridge, growth arrest and angular deformity. Authors performed vascularized fibular epiphysis and epiphyseal plate transplantation in 7 years old girl, who received the excision of the exostosis on distal ulna, followed by progressive varus deformity of right forearm and growth arrest of distal ulna. With follow
Congenital Abnormalities ; Epiphyses ; Exostoses ; Female ; Forearm ; Growth Plate ; Humans ; Methods ; Transplantation ; Ulna

No abstract available.
Humans ; Incidence* ; Radiculopathy* ; Shoulder Pain* ; Shoulder*

PURPOSE: evaluate the effectiveness of minimally invasive plate osteosynthesis (MIPO) in unstable fractures of the distal tibia. MATERIALS AND METHODS: From March 2001 to December 2003, 21 cases with unstable fractures of the distal tibia were treated with MIPO technique and followed for at least one year. Eighteen cases were extra-articular and three cases were intra-articular fractures. According to AO classification, six cases were 42-A, four 42-B, one 42-C, seven 43-A, and three 43-C. There was only one case of Gustilo-Anderson type II open fracture. We reviewed the results of fracture healing, axial and rotational deformity, ankle motion, and complications RESULTS: All fractures were healed in an average of 16.1 weeks (range, 11 to 24 weeks). There was only one case of 7-degree posterior angular deformity, but no cases of rotational malalignment. Recovery of ankle motion was satisfactory in all patients within 5-degree loss of motion. Subcutaneous abscess was developed in one case after fracture healing and cured by a drainage with implant removal. CONCLUSION: Although MIPO technique is technically more demanding than the traditional open technique, MIPO technique is an effective method for unstable fractures of the distal tibia because it minimizes incidence of soft-tissue compromise and infection and provides good fracture healing.
Abscess ; Ankle ; Classification ; Congenital Abnormalities ; Drainage ; Fracture Healing ; Fractures, Open ; Humans ; Incidence ; Intra-Articular Fractures ; Tibia*

It has been well known that dilated cardiomyopathy (D-CMP) has characterized by systolic dysfunction of left ventricle (LV). But there are few studies about LV diastolic and right ventricular (RV) dysfunction in D-CMP. The purpose of this study is to assess the LV and RV systolic function as well as diastolic function in D-CMP. The purpose of this tudy is to assess the LV and RV systolic function as well as diastolic function in D-CMP. The gated blood pool scan (GBPS) was undertaken in 14 patients with D-CMP and 14 normal controls. The results are as follows : 1) Compared to normal controls, the global and regional ejection fraction of LV were significantly reduced (P<0.001) in D-CMP. But, there was no significant difference in LV ejection time between the two groups. 2) Peak filling rate and peak filling time were significantly reduced (P<0.001, P<0.05) in D-CMP 3) Global ejection fraction of RV was also significantly reduced in D-CMP compared to normal controls (P<0.001) But there was no significant difference in ejection rate of right ventricle between the two groups. 4) There was close correlation (R=0.802) between ejection fraction and filling rate of LV : filling rate was also reduced as ejection fraction decreased. And LV filling rate was also reduced with reduction of ejection rate. It is concluded that D-CMP shows diastolic impairment as well as systolic pumping failure and this systolic dysfunction is accounted for the diastolic impairment in D-CMP. And D-CMP shows also right ventricular dysfunction in almost all cases, as well as left ventricular dysfunction.
Cardiomyopathy, Dilated* ; Heart Ventricles ; Humans ; Ventricular Dysfunction, Left ; Ventricular Dysfunction, Right

Sunitinib, a multi-targeted tyrosine kinase inhibitor, is used for the treatment of renal cell carcinoma and gastrointestinal stromal tumors. Many adverse effects associated with sunitinib, including hypertension, proteinuria, and thrombotic microangiopathy, have been reported; however, the other forms of glomerulonephritis are very rare. We report a case of biopsy-confirmed immune complex glomerulonephritis in a patient with a gastrointestinal tumor who received sunitinib treatment. The proteinuria subsided partially after sunitinib was discontinued, but when the drug was reintroduced, it recurred.
Antigen-Antibody Complex ; Carcinoma, Renal Cell ; Gastrointestinal Stromal Tumors ; Glomerulonephritis ; Humans ; Hypertension ; Indoles ; Protein-Tyrosine Kinases ; Proteinuria ; Pyrroles ; Thrombotic Microangiopathies

This is a retrospecitve analysis of 54 patients with stage I or II Non-odgkin's lymphoma involving the head and neck region treated with curative radiotherapy in the Department of Therapeutic Radiology, Seoul National University Hospital during the period of February 1979 through September 1982. The minimum follow-p period was 24 months. The review of histologic slides was available in 36 cases. Waldeyer's ring was the most common extranodal sites (46%). 41% of patients were in the stage I and 59% in the stage II by Ann Arbor classification. Of the 44 patients who responded after radiotherapy, 24 patients (54.5%) subsequently relapsed. Regional recurrence rate was 29%, distant metastasis was 54% and simultaneous regional recurrence and distant metastasis was 17%. The survival rate and disease free survival at 2 years were 57% and 45% respectively. Those patients with a large primary lesion (over 6cm in diameter), multiple conglomerated. extranodal site and diffuse cell type, experienced a high rate of distant metastasis. Therefore it seems desirable to study the use of adjuvant chemotherapy in those patients with a high probability of distant metastasis.
Chemotherapy, Adjuvant ; Classification ; Disease-Free Survival ; Head* ; Humans ; Lymphoma* ; Neck ; Neoplasm Metastasis ; Radiation Oncology ; Radiotherapy* ; Recurrence ; Seoul ; Survival Rate

Piriformis syndrome consists of pain, tingling sensation, and paresthesia in areas innervated by sciatic nerve and is one of the main causes of low back pain. A 43-year-old male made a visit for continuous left buttock pain and tingling sensation in lower limbs for three years. Medication, epidural block and sacroiliac joint block were performed, but without effect. Sciatic nerve block with local anesthetics and steroid, however, showed some improvement for a short period of time. The patient's symptoms, physical examination, and the fact that sciatic nerve block showed improvement for a while led to the suspicion of piriformis syndrome. Thus, pulsed radiofrequency was performed on sciatic nerve twice. Visual analog scale (VAS) was 8-9 on first visit, which decreased to 1 after treatment and lasted for more than 18 months.
Adult ; Anesthetics, Local ; Buttocks ; Catheter Ablation ; Humans ; Low Back Pain ; Lower Extremity ; Male ; Paresthesia ; Physical Examination ; Piriformis Muscle Syndrome ; Sacroiliac Joint ; Sciatic Nerve ; Sensation

PURPOSE: To compare the mechanism of cell loss and changes in the ventral prostate of young adult Sprague-Dawley rats after treatment with finasteride, a potent 5 alpha-reductase inhibitor, or castration. MATERIALS AND METHODS: Rats were divided into two group: finasteride treated and castrated. Finasteride-treated rats were given 1 mg/kg a day orally. The rats were sacrificed on days 1, 3, 5, 7, 10, 14, and 21. The ventral prostate was weighed and either prepared for histologic examination to detect apoptotic evidence or frozen in liquid nitrogen for the determination of the intraprostatic dihydrotestosterone (DHT) concentration and DNA content. RESULTS: Both finasteride and castration decreased prostate weight and DNA content, the decrease being more pronounced in the castrated group. By 3 days of finasteride treatment, the intraprostatic DHT concentration decreased to a greater extent with no further significant change thereafter, whereas castration gradually decreased the intraprostatic DHT concentration up to day 10, with no further significant decrease thereafter. Apoptotic bodies were typically observed in castrated but not finasteride-treated animals. CONCLUSIONS: Castration caused a more profound involution of rat ventral prostate than did finasteride. The extent of prostatic involution did not correlate with the intraprostatic DHT concentration. We could not find evidence of apoptosis in finasteride-treated animals.
Animals ; Apoptosis ; Castration* ; Cholestenone 5 alpha-Reductase ; Dihydrotestosterone ; DNA ; Finasteride* ; Humans ; Nitrogen ; Prostate* ; Rats* ; Rats, Sprague-Dawley ; Young Adult

PURPOSE: We conducted a multi-center randomized double-blind study to determine the effects of 6-month therapy with sulodexide on urinary protein excretion in patients with idiopathic Immunoglobulin A (IgA) nephropathy. MATERIALS AND METHODS: A total of seventy-seven patients participated in the study. They were randomly allocated to one of three groups: sulodexide 75 mg or 150 mg daily or the placebo for 6 months. The primary end point was the achievement, at 6 months, of at least 50% reduction in urine protein/creatinine ratio (UPCR) from the baseline value. RESULTS: At 6 months, the primary end point was achieved by 12.5% of the patients assigned to the placebo, 4.0% of the patients assigned to sulodexide 75 mg daily and 21.4% of those assigned to 150 mg (p=0.308). Treatment with sulodexide 150 mg daily for 6 months significantly reduced log UPCR from 6.38+/-0.77 at baseline to 5.98+/-0.94 at 6 months (p=0.045), while treatment with sulodexide 75 mg daily and placebo did not. CONCLUSION: A 6-month treatment with sulodexide did not achieve 50% reduction of urinary protein excretion in IgA nephropathy patients, but showed a tendency to increase the time-dependent anti-proteinuric effect. Therefore, long-term clinical trials on a larger scale are warranted to elucidate the hypothesis that sulodexide affords renal protection in IgA nephropathy patients.
Adult ; Anticoagulants/*therapeutic use ; Double-Blind Method ; Female ; Glomerulonephritis, IGA/complications/*drug therapy ; Glycosaminoglycans/*therapeutic use ; Humans ; Male ; Middle Aged ; Proteinuria/complications/*drug therapy

BACKGROUND: Postoperative nausea and vomiting (PONV) along with postoperative pain is one of the most frequently encountered complaints after the surgery. The goal of this study is to elucidate the probable high risks factors of PONV by making 24 hr-observations on 4008 patients undergone general anesthesia. METHODS: PONV scores (0: no PONV; 1, nausea; 2, retching; 3, vomiting) and characteristics of patient, surgery, anesthesia were recorded by patient interview and chart review at post anesthesia care unit and at ward 24 hours after operation. Risk factors of PONV were investigated by Odds ratio and P value. Multiple regression analysis was performed to produce the provability of PONV. RESULTS: Incidence of PONV was 26.1% at PACU and 22.9% at ward. Total incidence of PONV during 24 hrs was 39.3. High risk factors of PONV were as follows in decreasing order: 1) female, 2) history of PONV or motion sickness, 3) nonsmoker, 4) operative time of longer than 60 minutes and 5) patient controlled analgesia. P (probability of PONV) = 1/1 + e-Z Z = -1.928 + 0.899 (Gender) + 0.664 (Hx) + 0.558 (OP-duration) + 0.261 (Smoking Status) + 0.184 (Postop-opioid). CONCLUSIONS: We could identify 5 risk factors and developed a Korean PONV risk model enabling to predict the probability of PONV by this study of 4008 patients.
Analgesia, Patient-Controlled ; Anesthesia ; Anesthesia, General ; Female ; Humans ; Incidence ; Motion Sickness ; Nausea ; Odds Ratio ; Operative Time ; Pain, Postoperative ; Postoperative Nausea and Vomiting* ; Risk Factors*