No abstract available.
Diagnosis*

Achilles tendon is the most powerful and the biggest tendon of the body and its rupture is frequently sports-related. Many authors reported the effects of mobilization, electricity, ultrasound and various drugs as factors influencing the injured tendon. We studied the effects of early passive mobilization after firm suture using plantaris tendon as tension suture material and reinforcing membrane on the repair of a ruptured Achilles tendon. From March 1992 to December 1995, twenty-two operations on the Achilles tendon were carried out in our hospital. 1. Fourteen patients were male and eight patients were female. The mean patient age was 38 years, ranging from 13 to 68 years. Average follow-up periods was 2 years and 7 months, ranging from 12 months to 3 years and 8 months. 2. The rupture site was 4.7cm proximal to the tendon insertion into the calcaneus on average. 3. We performed the operations with end to end suture technique. After approximation of the ruptured ends of the tendon with a No. 5 Ethibond tension suture using a modified Kessler stitch, placed plantaris tendon in a fascial needle and pass it circumferentially and distal plantaris tendon is fanned out and tacked over the repair. 4. Postoperative treatment was done as following protocol Short leg cast was done with equinus position for initial 3 weeks, and then cast was removed, hydrotherapy and passive exercises was employed. About 6 weeks after operation when the foot can be brought to right angle, a reverse 90degrees ankle stop short leg brace was applied for additional 6 weeks and partial weight bearing was aUowed. 5. Follow-up results were classified according to the Arner-Lindholm scale. We had 16 excellent results and 6 satisfactory results. After rigid suture it may be possible to introduce a regimen of progressive isometric stimulation and protected loading and streching combined with removable orthosis. Such early exercises are likely to improve the rate of rehabilitation over plaster immobilization.
Achilles Tendon* ; Ankle ; Braces ; Calcaneus ; Electricity ; Exercise ; Female ; Follow-Up Studies ; Foot ; Humans ; Hydrotherapy ; Immobilization ; Leg ; Male ; Membranes ; Needles ; Orthotic Devices ; Rehabilitation ; Rupture* ; Suture Techniques ; Sutures ; Tendons ; Ultrasonography ; Weight-Bearing

We developed Extor pins for Extor external fixator, it made of stainless steel and applied it clinically to manage open fractures and chronic osteomyelitis from December, 1993 to January, 1995. The main aim of present study is to compare the mechanical strength and biocompatibillity between Extor pins and AO Schanz pins, and to determine the safety and possibility of clinical use. We performed the biomechanical test for bending, tension, and shearing of pin itself using universal testing machine (LR5OK) and pullout test in cadeveric cortical femur to determine the bone holding power. There was no significant difference between Extor and AO Schanz pin (p>0.05). Clinically, the incidence of pin site infection, pin lossening, radiological rarefaction, and pathological change were not different significantly (p>0.05). Although Extor pins are somewhat different from AO Shanz pins in material and design characteristics, we can find the safety and possibility of clinical use of Extor pins made in Korea.
External Fixators* ; Femur ; Fractures, Open ; Incidence ; Korea ; Osteomyelitis ; Stainless Steel

No abstract available.
Ligaments*

The elbow is the most frequent area of complaint in children and adolescent baseball players. The physical stresses associated with repetitive throwing create extra-ordinary forces, which may affect the normal osteochondral and soft tissue developmental process and are the important factors causing the decrease of competitive power and shortening of life as a baseball player in adolescents. We surveyed the 114 baseball players of middle & high school in Taegu in order to evaluate the prevalance of symptoms and radiologic findings of the elbow and correlation of these findings to career & position of the baseball game. The results were as follows. 1. Of 114 players, 83 were non-pitchers and 31 were pitchers. The mean career was 3.8 years (7 months to 6 years). 2. The 77 players (67.7%) had the pain on their elbow during or after daily exercise. Other clinical symptoms were locking (30.7%), limitation of motion (18.4%), swelling (16.6%) and clicks on motion (10.5%). 3. On the radiogram of the elbow, hypertrophy or separation of medial epicondyle were seen in 34% of players, loose bodies in 17%, hypertrophy of the humerus in 12% and cystic change of the capitellum in 11%. 4. The mean career of symptomatic players was 4.4 years but non-symptomatics was 2.7 years. The mean career of players who had abnormal radiologic findings was 5.1 years but 3.1 years in players who had no abnormal radiologic fingings. 5. Symptoms and pathologic changes were more common in the elbow of pitcher' s group due to throwing frequency & pitching style. 6. Among the 77 players who had any kinds of problem of the elbow, 49 players of them had no experience of visiting hospital. 7. To prevent these injuries of the elbow, the following recommendations were made. First, restrict the number of innings pitched per game. Second, avoid throwing the curve ball in this age group. Third, ensue an adequate warm up period before exercise or rest after games. Fourth, inform parents and coaches of possible harmful nature of excessive throwing.
Adolescent* ; Baseball* ; Child ; Daegu ; Elbow* ; Humans ; Humerus ; Hypertrophy ; Parents

PURPOSE: The purpose of this study is to describe the findings of the transligamnetous type of the herniated lumbar disc (HLD) with magnetic resonance MR imaging. MATERIALS AND METHODS: We retrospectively analyzed the MR images of surgically proven 20 cases of transligamentous type of HLD from January 1, 1992 to August 20, 1992. The MR imaging was performed with 1. 0T MR unit, using sagittal spin echo (SE) and axial gradient echo (GE) techniques. RESULTS: The results were as follows;1) the interruption of black line of the posterior longitudinal ligament (PLL) was identified in 19 levels and 17 levels in sagittal SE and axial GE images, retrospectively;2) the widening of adjacent epidural fat space was demonstrated in 16 cases of central or posterolateral HLD. The herniated disc material, as compared with the parent intervertebral disc, showed intermediate signal intensity (SI) in 19 and low SI in 1 level on T1WI, high SI in 10, intermediate SI in 7, low SI in levels on T2WI, and high SI in 10, intermediate SI in 9, low SI in 1 level on GE images. CONCLUSION: The most important sign of the transligamentous type HLD on MRI was the interruption of the black line with additional finding of the widening of adjacent epidural fat space. The MR signal intensity of the herniated disc was variable. Axial GE image was valuable for the evaluation of the direction of HLD and it relationship with neural structure, but had no addiational information for the degree and biochemical change of HLD over SE image.
Financial Management* ; Humans ; Intervertebral Disc ; Intervertebral Disc Displacement ; Longitudinal Ligaments ; Magnetic Resonance Imaging ; Parents ; Retrospective Studies

PURPOSE: The purpose of this study was to evaluate the safety, feasibility and effectiveness of an endoluminally-placed bifurcated stent-graft (Vanguard) for the treatment of infrarenal abdominal aortic aneurysm (AAA). METHODS: Transluminal endovascular stent-graft placements were attempted in 29 patients (28 male, mean age 69+/-7 years) with AAAs involving the common iliac arteries from Aug. 1997 to Jan. 1999. Endovascular therapy was performed in the cardiac catheterization laboratory with epidural anesthesia. One side of the femoral artery was opened by surgical cutdown for the bifurcated stent-graft entry and the other side was punctured percutaneously for the straight stent-graft. Computed tomography and/or intraarterial angiography were performed during an average follow-up of 10 months (2-18 months). RESULTS: Primary success rate was 75.9% (22 of 29 patients) and the overall success rate was 79.3% with successful correction of one perigraft leak. Twenty patients (69.0%) had significant coronary artery disease. There were two technical failure cases, the one was tortuous iliac vessel with spasm, the other was disconnection of the stent-graft connecting portion. Complications related to procedure occurred in 13.8% of patients (4 of 29 patients) and two of these four patients had procedure-related mortality because of acute renal failure following contrast overdose and sepsis after operation. CONCLUSIONS: Endovascular treatment of infrarenal AAA with bifurcated stent-graft (Vanguard<0A397>) is effective, feasible and relatively safe. However, further investigation for the outcome, complication and long-term follow-up are needed.
Acute Kidney Injury ; Anesthesia, Epidural ; Angiography ; Aortic Aneurysm, Abdominal* ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Artery Disease ; Endoleak ; Femoral Artery ; Follow-Up Studies ; Humans ; Iliac Artery ; Male ; Mortality ; Sepsis ; Spasm

OBJECTIVE: Peripartum emergency cesarean hysterectomy of 28 cases at our hospital for 10years were reviewed that the clinical indication, history, and annual incidence change. METHODS: A retrospective descriptive analysis from January, 1988 to December, 1997 was carried out. RESULTS: There were 28 cases of emergency cesarean hysterectomy identified during this period among total 24, 689 deliveries. The annual incidence of emergency cesarean hysterectomy was significantly declined statistically(p<0.005). Cesarean hysterectomy was performed in 20 of 6, 671 cesarean section(0.30%) and in 8 of 18, 018 vaginal deliveries(0.04%), so more frequently after cesarean section than vaginal delivery. The cesarean hysterectomy rate was more frequent in multiparous women(0, 22%) than in nulliparous women(0, 02%). The most common indication of cesarean hysterectomy was 13 cases of uterine atony(46%), followed by 5 cases uterine rupture(18%), 5 cases of placenta previa with placenta accreta(18%), 3 cases of placenta previa(11%), 2 cases of uterine myoma(7%). No significant difference in length of operating time, amount of blood loss and operative complications were found between total abdominal hysterectomy and subtotal hysterectomy. The all patient who had cesarean hysterectomy recieved from 1200ml to 15840ml of blood transfusion with a mean of 3673ml. In aspect of fetal outcome, 3 cases of FDIU(Fetal death in utero) in uterine rupture and 1 case of stillbirth in preterm were found. The maternal complications were wound disruption, DIC, wound hematoma, ureter injury, vaginal stump bleeding, UTI(Urinary tract infection) and retroperitoneal bleeding, CONCLUSION: We conclude that the incidence of emergency cesarean hysterectomy declined with prediction of antenatal risk factor, preparing of sufficient fresh blood, prophylactic antibiotics, vigorous uterotonics and close observation after delivery.
Anti-Bacterial Agents ; Blood Transfusion ; Cesarean Section ; Dacarbazine ; Emergencies* ; Female ; Hematoma ; Hemorrhage ; Humans ; Hysterectomy* ; Incidence ; Peripartum Period* ; Placenta ; Placenta Previa ; Pregnancy ; Retrospective Studies ; Risk Factors ; Stillbirth ; Ureter ; Uterine Rupture ; Wounds and Injuries

Delayed cutaneous hypersensitivity test had been demonstrated to correlate inversely with stage of disease and predict prognosis of tumor. We evaluated the delayed cutaneous hypersensitivity(D.C.H.) with Multitest CMI between the tumor group and normal control group in Department of Urology, Kosin, Medical College Hospital during the period from October 1986 to August 1988. The result were as follows: 1. D.C.H. with Multitest CMI was compared between the normal control and tumor group: mean total score of positive antigens was markedly decreased in the tumor group(11.3mm for tumor, 15.9mm for control p<0.01) and average number of positive reaction was also decreased in the tumor group(2.6 for tumor, 4.2 for control p<0.01). 2. The percentages of energic response were 11.9% for tumor and 0% for control and the incidence of hypoenergy was also increased in the tumor group (34.2% for tumor, 9% for control). 3. The percentages of Warning score were 27.6% for tumor and 6.8% for control. 4. In comparison with each antigens, there were the strongest reaction and the highest reaction with tuberculin in both group (98.3% for control, 82.9% for tumor) while the weakest reaction with tetanus (16.3% for control, 3.9% for tumor). 5. In comparison of D.C.H. between male and female, low cell mediated immunity was observed in female for the average number of positive antigens in control(4.8 for male, 3.7 for female) and for the average store of in tumor (11.7 mm for male, 9.6 mm for female). 6. In D.C.H. between age groups in control, the youth (17-25 years old) showed the strongest reaction (mean total score 19.1 mm) and 26-65 years old group had relatively stable immunity.
Adolescent ; Female ; Humans ; Hypersensitivity* ; Immunity, Cellular* ; Incidence ; Male ; Prognosis ; Tetanus ; Tuberculin ; Urology

The repair of superficially damaged intestinal epithelium is initiated by restitution. Restitution is the covering of damaged area by the movement of neighboring epithelial cells without cell proliferation. Phenotypic switching of cells (epithelial-mesenchymal transition) is necessary for the cell movement and this process is controlled by complex intracellular signaling pathways conducting dynamic remodeling of actin cytoskeleton. Restitution is regulated by a variety of cytokines and growth factors, and is modulated by integrin-dependent interactions with the extracellular matrix. Understanding the restitution process suggests several possible therapeutic strategies to enhance gastrointestinal wound healing.
Cell Movement ; Humans ; Intestinal Mucosa/*physiology ; Regeneration/*physiology