Seventy cases of moderate to severe hallux valgus deformities were operated by proximal metatarsal chevron osteotomy combined with modified McBride procedures from September 1994 to September 1996. The hallux valgus angle improved from an average of 35.1 degrees to 12.1 degrees postoperatively. The first intermetatarsal angle improved from an average of 15.4 degrees to 7.9 degrees. The position of sesamoids was normalized and the metatarsal bone shortened minimally. Union occurred in 6 weeks. Subjectively, pain was relieved in 95% of the patients, while walking and standing abilities improved in 90%. The shoewear improved in only 60% of the patients, showing less satisfactory results compared to other factors. In terms of complications, two recurrences occured but were treated without repeat surgery. Two malunions and four superficial wound infections occurred. In conclusion, proximal chevron metatarsal osteotomy combined with modified McBride procedures is a reliable operation as regards stability, technical ease, low complications and satisfactory results for moderate to severe Hallux valgus deformities.
Congenital Abnormalities ; Hallux Valgus* ; Hallux* ; Humans ; Metatarsal Bones* ; Osteotomy* ; Recurrence ; Reoperation ; Walking ; Wound Infection

Haglunds deformity is a prominence at posterosuperior portion of the calcaneus. Extrinsic irritation on this prominence can give rise to retrocalcaneal bursitis or Achilles tendinitis. Partial resection of the posterosuperior aspect of the calcaneus was performed on 7 heels with Haglunds disease. All patients were reviewed both by radiographic examination and by questionnaire after an average 14.5 months. All but one patient showed an excellent result in a view point of pain relief. The average passive dorsiflexion angle of the ankle was improved from 5 to 25 degree, postoperatively. There was no complication such as recurrence, wound problem or paresthesia.
Ankle ; Bursitis ; Calcaneus ; Congenital Abnormalities ; Heel ; Humans ; Paresthesia ; Surveys and Questionnaires ; Recurrence ; Tendinopathy ; Wounds and Injuries

PURPOSE: Free nipple graft reduction mammaplasty is a simple and effective way to reduce huge breasts. However, this technique is frequently criticized for producing poor projection and hypopigmentation of the nipple areola complex(NAC). METHODS: Sixty three patients(126 breasts) underwent the procedure from 1998 to 2005. Authors' method is similar with the modified Gradinger's technique except the keyhole pattern. After skin flap closing, the position of NAC is determined considering symmetry. The NAC is initially harvested and then resection of the breast followed, leaving a deepithelized inferior parenchymal pedicle(5 x 5cm). The upper point of inferior pedicle is sutured to the fascia of the pectoralis to produce the upper bulge. The nipple is replaced as a free and composite graft. RESULTS: An average of 823grams of breast tissue per breast was removed. There was no major complications. All grafted nipples showed long lasting projection. And also, all NAC eventually regained their normal color except for 3 patients who needed medical tattoos. The overall results were good and patient satisfactory score was high. CONCLUSION: This useful technique greatly enhances long lasting projection and recovers nipple color.
Breast* ; Fascia ; Female ; Humans ; Hypopigmentation ; Mammaplasty ; Nipples* ; Skin ; Transplants*

PURPOSE: Free nipple graft reduction mammaplasty is a simple and effective way to reduce huge breasts. However, this technique is frequently criticized for producing poor projection and hypopigmentation of the nipple areola complex(NAC). METHODS: Sixty three patients(126 breasts) underwent the procedure from 1998 to 2005. Authors' method is similar with the modified Gradinger's technique except the keyhole pattern. After skin flap closing, the position of NAC is determined considering symmetry. The NAC is initially harvested and then resection of the breast followed, leaving a deepithelized inferior parenchymal pedicle(5 x 5cm). The upper point of inferior pedicle is sutured to the fascia of the pectoralis to produce the upper bulge. The nipple is replaced as a free and composite graft. RESULTS: An average of 823grams of breast tissue per breast was removed. There was no major complications. All grafted nipples showed long lasting projection. And also, all NAC eventually regained their normal color except for 3 patients who needed medical tattoos. The overall results were good and patient satisfactory score was high. CONCLUSION: This useful technique greatly enhances long lasting projection and recovers nipple color.
Breast* ; Fascia ; Female ; Humans ; Hypopigmentation ; Mammaplasty ; Nipples* ; Skin ; Transplants*

Ideal results of augmentation mammaplasty consist of symmetry, natural shape, soft feeling and inconspicuous scar. In addition, patient's preferences about size and shape should be included. Static implants could not perfectly satisfy patients' desires for size and shape, but expandable implants enable to change the volume after the operation. From September 2001 to September 2004, 76 patients(150 breasts) underwent breast augmentation using permanent expandable implant. The procedure was unilateral in 2 women and bilateral in 74 women. Age ranged from 19 to 50 years(mean, 29 years). Fifty nine patients underwent simple augmentation mammaplasty, 7 patients were corrected of their severe asymmetry, 2 patients with the congenital breast deformity underwent mammaplasty using this, and 2 patients who had undergone unilateral mastectomy were reconstructed of their breasts using expandable implant. There were no definite complications such as capsular contracture, implant rupture, asymmetry. And there reported little dissatisfaction about the size. The permanent expandable implants might be good alternatives in cases of ordinary breast augmentation as well as tissue deficient patients, asymmetry, congenital anomaly, and breast reconstruction.
Breast* ; Cicatrix ; Congenital Abnormalities ; Female ; Humans ; Implant Capsular Contracture ; Mammaplasty ; Mastectomy ; Rupture

Seventy-five patients with tumors of the head and neck treated with either radiation therapy alone or combined with surgery or chemotherapy were studied prospectively to evaluate the effects of radiation therapy to the neck on thyroid gland between September 1986 and October 1992. All patients were serially monitored for thyroid function tests before and after radiation therapy. Radiation dose to the thyroid gland ranged from 35 to 60 Gy with a median dose of 50 Gy. Median follow-up time was 30 months with a range of 11 to 85 months. The incidence of thyroid dysfunction was 40%; forty-five patients (60%) euthyroid, 2 patients (3%) clinical hypothyroidism, 27 patients (36%) subclinical hypothyroidism and 1 patient (1%) hyperthyroidism. No thyroid nodules or thyroid cancer were detected in any patients. Thyroid dysfunction appeared earlier in patients who underwent surgery than in those patients treated with radiation therapy alone or combination of chemotherapy and radiation therapy (p=0.0013). By multivariate analysis, risk factors that significantly influenced a higher incidence of thyroid dysfunction were female sex (p=0.0293) and combination of total larygectomy and radiation therapy (p=0.0045). In conclusion, evaluation of thyroid function before and after radiation therapy with periodic thyroid function tests are recommended to detect thyroid dysfunction in time and thyroid hormone replacement therapy is recommended whenever thyroid dysfunction develops.
Drug Therapy ; Female ; Follow-Up Studies ; Head* ; Hormone Replacement Therapy ; Humans ; Hyperthyroidism ; Hypothyroidism ; Incidence ; Multivariate Analysis ; Neck* ; Prospective Studies ; Risk Factors ; Thyroid Function Tests ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule

This study was done to compare the effects of nemonapride on cognitive and psychomotor performance and sedation with those of classical antipsychotics in normal adults. Single doses of three antipsychotics (chlorpromazine 50mg, haloperidol 2mg and nemonapride 3mg) and placebo were given to 8 healthy male volunteers at weekly intervals, in a double-blind Latin square design. All subjects completed a battery of cognitive and psychomotor pelformance tests (Critical Flicker Fusion Threshold : CFFT, Choice Reaction Time : CRT, Compensatory Tracking Test : CTT, Digit-Symbol Substitution Test DSST) and self-estimate for sedation using visual analog rating scales at pre-dose and 2, 4, 6, 8hr post-dose. The results were as follows : 1) Chlorpromazine 50mg significantly impaired CFFT, CRT, CTT and DSST compared to placebo and showed the most potent sedative effect among the test drugs. These effects occurred in almost all ranges of time points with peak effEct at 4hr post-dose. 2) Haloperidol 2 mg did not impair any cognitive or psychomotor performances. There was no sedative effect as well. 3) Nemo-napride 3 mg selectively impaired CFFT (at 2 and 6hr post-dose), total reaction time (at 4hr post-dose) of CRT and DSST (at 4 and 6hr post-dose). Sedative effect occurred more significantly than placebo at 4 and 6 hr post-dose. These results indicate that nemonapride 3mg seems to have the intermediate profiles between chlorpromazine 50mg and haloperidol 2mg in terms of cognitive and psychomotor effects as well as sedative effect. In addition, inspection of the results suggest that the cognitive and psychomotor effects could be secondary to sedative effect.
Adult* ; Antipsychotic Agents ; Chlorpromazine* ; Flicker Fusion ; Haloperidol* ; Humans ; Hypnotics and Sedatives ; Male ; Psychomotor Performance* ; Reaction Time ; Volunteers ; Weights and Measures

No abstract available.
Eclampsia* ; Female ; Pregnancy

Two cases of abnormalities of the left ventricular wall(left ventricular aneurysm or diverticulum) are presented. A saccular deformity of the left ventricle may be and aneurysm or a diverticulum. In one case, the defect seems to be subcalvular aneurysm(or fibrous diverticulum) or aneurysm of the membranous ventricular septum; this lesion seems to be a natural consequence of spontaneous closure of a defect of the membranous septum. The other case, it seems that the defect is ventricular aneurysm with syndrome of myocardial infarction and normal coronary arteries, or double or accessory chambered left ventricle. The thromboembolic phenomenon was noted on a left frontoparietal lobe of brain. Both cases have the diagnosis supported by cardiac catheterization and angiography. The clinical, angiographic and pathologic characteristic of diverticulum and aneurysm of the heart are reviewed, and an attempt is made to clarify the concept of aneurysm and diverticulum of the heart.
Aneurysm* ; Angiography ; Brain ; Cardiac Catheterization ; Cardiac Catheters ; Congenital Abnormalities ; Coronary Vessels ; Diagnosis ; Diverticulum* ; Heart ; Heart Ventricles* ; Myocardial Infarction ; Ventricular Septum

Tumors of the sacrum are relatively uncommon. The diagnosis is difficult, especially in the early phase of the disease, because the clinical manifestations are nonspecific, the clinical signs may be vague and the radiologic changes are needed to differentiate from intestinal gas shadow. The clinical features are sacral pain, sensory change on perineum, urination difficulty, constipation, and sciatica. Seven cases of sacral tumor were treated at the Department of Orthopaedic Surgery, Kyung Hee University, from October 1981 to October 1992, and the results were as follows: 1. Because of the variability of the sacral tumor, we cannot define the most common tumor. 2. There is difficult in early diagnosis of the tumor, because the symptoms of tumor are similar to that of lumbar disc herniation and the radiologic findings are subtle. 3. CT and MRI are very effective methods to detect the tumor in the sacrum. 4. Curettage, excision, resection, sacrectomy and internal fixation were done according to the kinds of tumors and the amount of bony destruction.
Constipation ; Curettage ; Diagnosis ; Early Diagnosis ; Magnetic Resonance Imaging ; Perineum ; Sacrum ; Sciatica ; Urination