No abstract available.

No abstract available.
Gonadotropins* ; Oocytes*

A tibial plateau fracture was first described in the literature by Thamhayn, in 1852. It is a fracture of the proximal end of the tibia, usually involving an articular surface. The fracture is regarded as serious as it involves a major weight bearing joint and loss of function results in a high percentage disability of the extremity. Of the tibial plateau fractures treated at Hanyang University Hospital between June 1972 and August 1979, the 44 cases that could be followed for three months to two years have been analysed according to its cause, classification, treatment and result. Open reduction is indicated in anyone of or a combination of the following deformities as shown by roentgenograms: 1. a vertical depression in the plateau of greater than eight milimeters; 2. a horizontal displacement of the lateral or medial condyle of greater than four milimeters; 3. valgus or varus instability of the knee one or more milimeters in excess of that of the uninjured knee. Manipulation under anesthesia with skeletal traction is indicated in severe comminuted fracture that it is difficult to reduce with internal fixation, and open fracture that it is inevitable to delay operation. Plaster immobilization is indicated in the remaining situations except those of open reduction and skeletal traction. Anatomical considerations and a clinical end-result study of the 44 fractures emphasize the vulner-ability of the lateral tibial plateau to a valgus force on the extended knee. Among the 44 cases twenty-two (50 percent) were treated by plaster immobilization, 2 (4.5 percent) by skeletal traction, and 20 (45.5 percent) by operation. Thirty-nine cases (88.6 percent) out of 44 revealed the rating of “ACCEPTABLE” according to Hohl and Luck criteria.
Anesthesia ; Classification ; Clinical Study ; Congenital Abnormalities ; Depression ; Extremities ; Fractures, Comminuted ; Fractures, Open ; Immobilization ; Joints ; Knee ; Tibia ; Traction ; Weight-Bearing

BACKGROUND AND OBJECTIVES: Stroke onset is known to vary by several factors. Although it has been known that stroke may develop most frequently in the morning, its association with the type of activity has quite rarely been described. METHODS: We prospectively investigated by interview the time of and the activity during or before the onset of stroke in patients with acute cerebral infarction from Aug. 1995 to Mar. 1996. The activities were subdivided into basal metabolic rate state, sedentary, light, moderate, and heavy movements based on the caloric expenditure. RESULTS: One hundred-twenty five patients were enrolled. The time of day when ischemic stroke most frequently occurred was from 8:00 AM to noon. The type of activity was significantly associated with stroke onset in that it developed most commonly during and just after sleep or resting. The relationship between the onset of stroke and such patterns of onset time and the activity was found only in the atherothrombotic infarction, but not in the other stroke types. CONCLUSION: We demonstrated that stroke has clear diurnal variation. Our observations also suggested that the activity may be significantly associated with stroke onset. These findings may be useful for better understanding of the pathogenesis and prevention of ischemic stroke.
Basal Metabolism ; Cerebral Infarction* ; Health Expenditures ; Humans ; Infarction ; Prospective Studies ; Stroke

OBJECTIVE: This study is aimed to evaluate the various clinical characteristics, prognostic factors, and the treatment results in epidural hematomas on posterior cranial fossa. METHODS: Thirty-two patients with posterior fossa epidural hematomas(PFEDH) were managed in our institute from 1992 to 2001. In the same period, 414 patients with traumatic epidural hematomas were surgically treated and among these, 28 cases(6.8%) were PFEDH. Neurological state, findings of computed topography scans, and results of the treatment were evaluated in this study. RESULTS: The patients' ages ranged from 4 to 60 years, with predominance in adolescents. The male to female ratio was 3: 1. Twenty-nine patients presented with occipital trauma and twenty-eight cases had fracture in occipital bone. Fourteen patients suffered immediate unconsciousness and 6 patients with initial alert mentality experienced delayed progressive loss of consciousness. However, there were no changes on mentality in 12 cases. In 14 cases, the hematoma was localized exclusively within the posterior cranial fossa. In remaining 18 cases, the hematoma extended beyond the sinuses to the occipital area. In 13 cases, the amount of hematoma was increased in follow-up computed tomographic scan. All patients, managed with surgery or conservative treatment(4 cases), survived with a good recovery. CONCLUSION: The most important prognostic factor is prompt surgical evacuation of hematomas. For attaining good result, earlier diagnosis with consecutive computed tomographic scans are much important.
Adolescent ; Cranial Fossa, Posterior* ; Craniocerebral Trauma ; Diagnosis ; Female ; Fibrinogen ; Follow-Up Studies ; Hematoma* ; Humans ; Male ; Occipital Bone ; Prognosis ; Unconsciousness

Septic arthritis of the shoulder joint in a neonate is very rare. Damage to the growth plate and ossification center of the proximal humerus may lead to disability of the shoulder joint. Therefore, early diagnosis and proper treatment are very important. We treated septic arthritis of the shoulder joint in a 9-day old newborn baby by arthroscopic irrigation and debridement using a 2.4 mm wrist arthroscope instrument. We could achieve a satisfactory result by inspecting the inside condition of the joint directly, removing granulation tissues and debris and washing out the joint by arthroscopy.
Arthritis, Infectious ; Arthroscopes ; Arthroscopy ; Debridement ; Early Diagnosis ; Granulation Tissue ; Growth Plate ; Humans ; Humerus ; Infant, Newborn ; Joints ; Shoulder ; Shoulder Joint ; Wrist

No abstract available.
Heart Neoplasms*

No abstract available.
Tetracycline* ; Thyroid Gland* ; Thyroid Nodule*

A patient, 59 years old male, with paroxysmal AV reentrant tachycardia utilizing a concealed left lateral accessory pathway with long VA conduction time is presented. During tachycardia P waves were negative in leads I, aVL, and V6 and positive in leads aVR and V1. The R-P/P-R ratio was 1.6. Radiofrequency catheter ablation was successful to interrupt the VA conduction through the accessory pathway.
Catheter Ablation ; Humans ; Male ; Middle Aged ; Tachycardia*

BACKGROUND: The effective ventricular function during ejection and filling is likely to depend on the coordinated action of the longitudinally and circumferentially orientated myocardial fibers and the function of these longitudinal fibers has not been extensively studied. METHODS: The role of longitudinally and circumferentially orientated fibers in left ventricular wall motion was evaluated by M-mode echocardiograms of the mitral ring(whose motion reflect long axis change) and the standard minor axis(left ventricular posterior wall), simultaneous recordings of phonocardiograms and electrocardiograms on the paper (speed 100mm/sec), in 24 healty individuals, 17 patients with mitral stenosis, 11 patients with open mitral commissurotomy and 17 mitral valve replaced patients. RESULTS: In the controls long axis shortening significantly preceded minor axis shortening (phase difference between two axes : 20+/-3 msec, mean+/-SEM) during early systole, indicating left ventricle become more spherical. This phase difference was also observed in the patients with mitral stenosis and in those with open mitral commissurotomy. In patients with mitral valve replacement(MVR) whose papillary muscles had been sectioned, the onset of long axis shortening was more delayed during early systole than that of short axis(-33+/-6msec) and the end of shortening was also prolonged to early diastole more than that of normal controls (54+/-3 msec vs 90+/-8 msec, mean+/-SEM, p<0.01 by t-test). CONCLUSION: We observed the time relations between long and short axis motion in normal controls. It can be concluded that the reversed time relation in patients with MVR is one of the important factors which may effect negatively on ventricular function and long-term prognosis, thus the surgical procedures to preserve papillary annular continuity should be considered in patients with mitral valvular disease. And the controlled, prospective, clinical trials with homogenous groups of patients are needed to evaluate the potential benefits of papillary annular continuity in preserving atrio-ventricular interaction in patients undergoing mitral valvular surgery.
Axis, Cervical Vertebra* ; Diastole ; Echocardiography ; Electrocardiography ; Heart Valve Diseases* ; Heart Ventricles ; Humans ; Mitral Valve ; Mitral Valve Stenosis ; Papillary Muscles ; Prognosis ; Systole ; Ventricular Function