In order to assess the difference of healing of the medial collateral ligament (MCL) of the knee according to the treatment methods, in vivo animal experiment using a rabbit model was perfoimed. Thirty six MCLs in eighteen rabbits were surgically transected at the mid-portion and treatm nt was done with two different methods, e.g. immobilization wiih plaster cast in right knees (Group I ), and non-immohilization in left knees (Group 2 ). Five rabhits were used as normal controis. To evaluate the biomechanical property of the femur-MCL-tibia complex (FMTC) in time progression, tensile stress tests using material testing machine (Model 8511, Instron company, 1993) were done at 6, 10, l2 weeks postoperatively and the results were as follows. 1. The ultimate load and stiffness (structural property) of the FMTC increased with time in both groups, but group ][ showed significantly higher values than group I . 2. The material property of the MCL checked by stress-strain curve showed higher Young s modulus in group ][ than in group ] . As a results, joint motion seems to improve the biomechanical propeity of the healed MCL.
Animal Experimentation ; Casts, Surgical ; Collateral Ligaments* ; Exercise Test ; Immobilization* ; Joints ; Knee ; Ligaments* ; Rabbits*

No abstract available.
Humans ; Lymphocytes* ; Radiotherapy*

PURPOSE: Delirium in the elderly is common in the postoperative period but there are only few reports on detailed studies of this condition. Number of urologic patients with postoperative delirium was increas ed in our hospital for recent 24 months. The clinical characteristics of patients with postoperative delirium was analyzed retrospectively. MATERIALS AND METHODS: We selected the patients with postoperative delirium from 1010 patients who had undergone urological surgery under general or spinal anesthesia in the period from Jan. 1997 to Dec. 1999. Diagnosis of postoperative delirium was established with Diagnostic and Statistical Manual of Mental Disorders(DAM-III-R) by psychiatric clinicians. Onset and recovery of symptoms, risk factors, previous psychiatric clinicians. Onset and recovery of symptoms, risk factors, previous psychiatric disorder, relationship with anesthesia, drugs, and surgical procedures, concomittant medical conditions, and complications were retrospectively reviewed. RESULTS: Postoperative delirium was observed in 13 patients (1.3%). All patients were male and mean age was 70.4 years (46-86 years). Surgical procedures included TURP(8 patients), cystectomy (3 patients), nephroureterectomy (1 patient), and bladder rupture repair (1 patient). Delirium became apparent between one day and two days after the operation (mean 32.2 hours) and lasted for up to 7 days (mean 53 hours). Several factors such as older age (>65 years), male patient, longterm medication, past history of CVA, memory impairment, hearing difficulty, traumatic brain contusion, and obsessive personality were thought to be risk factors of postoperative delirium. Treatment with Haloperidol(R) intramuscular injection (2.5-5mg, every 30 minutes, 2-4 times until symptom resolution was achieved) with or without Ativan(R) intravenous injection (2mg) were effective. Complete symptom recovery was seen in 92.3% (12/13) of patients. One patient (7.7%) with previous history of dementia had persistent memory disturbance and disorientation during follow-up periods. CONCLUSIONS: Generally, postoperative delirium is an acute transient confusional state without considerable sequeles. Treatment is sedation and prevention of inadvertent accident associated with confusional state. Urologic surgeon must be attentive to the development of this illness especially when high risk factors were present.
Aged ; Anesthesia ; Anesthesia, Spinal ; Brain Injuries ; Cystectomy ; Delirium* ; Dementia ; Diagnosis ; Follow-Up Studies ; Hearing ; Humans ; Injections, Intramuscular ; Injections, Intravenous ; Male ; Memory ; Postoperative Period ; Retrospective Studies ; Risk Factors ; Rupture ; Urinary Bladder

The treatment of intra-articular fractures of distal radius is difficult and has various problems. Maximum recovery of wrist function is dependent on accurate and stable reduction of the radial articular surface. We analysed one hundred and five cases of intra-articular fracture of distal radius followed for more than 6 months at Yonsei University from January 1980 to September 1988 and studied the result according to the type of treatment. The results of this study were as follows; 1. The incidence was high in female who aged over 6th decade, and in male who is active aged. 2. The main cause of this injury was fall down(34.3%). 3. In a group of closed reduction and cast immobilization, the functional result was satisfactory in 45.4%. 4. In a group of closed reduction and percutaneous pinning, the functional result was satisfactory in 50%. 5. In a group of open reduction and internal fixation, the functional result was satisfactory in 83. 3%. 6. In a group of external fixation, the functional result was satisfactory in 33.3%. 7. Overall result was mainly correlated with initial severity of the injury and anatomical reduction of the intra-articular surface.
Clinical Study ; Female ; Humans ; Immobilization ; Incidence ; Intra-Articular Fractures ; Male ; Radius ; Wrist

Augumentation rhinoplasty using autogenous cranial bone graft (outer table) can be used more successfully than other methods. In patients with congenital or posttraumatic severe saddle nose deformity and lateral deviation, cranial bone graft is an excellent method of augumentation. The advantages of cranial bone graft compared with traditional method of bone graft are summarized as follows; 1. Easy to reach donor site 2. Abundance of material 3. Little pain and functional disability 4. Shorter hospitalization period 5. Inconspicuous donor scar 6. No secondary deformity of donor site 7.Appropriate curvature can be obtained by proper selection of donor site. With the above advantages, we conclude that augumentation rhinoplasty using split cranial bone graft is a good method in correction of congenital or posttraumatic deformity of nose.
Cicatrix ; Congenital Abnormalities ; Hospitalization ; Humans ; Methods ; Nose ; Rhinoplasty* ; Tissue Donors ; Transplants*

No abstract available.

No abstract available.
Chlorpromazine* ; Nicotine* ; Skin*

BACKGROUNDS: Obstructive sleep apnea syndrome(OSA) can divided into two groups, positional (PP) and non-positional(NPP) obstructive sleep apnea syndrome, according to the body position while sleeping. In this study, we evaluated the differences of anthropometirc data and polysomnographic recordings between the two types of sleep apnea syndrome. MATERIALS: Fifty patients with OSA were divided two groups by Cartwright's criteria. The supine respiratory disturbance index (RDI) was at least two times higher than the lateral RDI in the PP group, and the supine RDI was less than twice the lateral RDI in the NPP group. This patients underwent standardized polysomnographic recordings. The anthropometirc data and polysomnographic data were analyzed, statistically. RESULTS: Of all 50 patients, 30% were found to be positional OSA. BMI was significantly higher in the PP group(p<0.05). Total sleep time was significantly longer in the PP group (350.6±46.0min, p<0.05). Sleep efficiency was high in the PP group(89.6± 6.4%, 85.6±9.9%, p<0.05). Deep sleep was significantly higher and light sleep was lower in the PP group than in the NPP group but no difference was observed in REM sleep between the two groups. Apnea index(AI) and RDI were significantly lower(17.0±10.6, 28.5±13.3, p<0.05) and mean arterial oxygen saturation was higher in the PP group(92.7 ±1.8%, p<0.05) than in the NPP group. CONCLUSION: Body position during sleep has a profound effect on the frequency and severity of breathing abnormalities in OSA patients. A polysomnographic evaluation for suspected OSA patients must include monitoring of the body position. Breathing function in OSA patients can be improved by controlling their obesity and through postural therapy.
Apnea ; Humans ; Obesity ; Oxygen ; Polysomnography ; Respiration ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Sleep, REM

BACKGROUND: Myocardial infarction(MI) in the rat is a model of ventricular dysfunction which is associated with activation of compensatory neurohumoral systems. This stydy was designed to determine the temporal evolution of the regulatory factors-atrial natriuretic peptide(ANP), endothelin(ET), plasma renin activity(PRA) in rats with more than moderate sized MI at 1,4,8 weeks in comparison to normal rats. METHODS AND RESULTS: MI was created in female Sprague Dawley rats weighing 250gms to 300gms by ligating the anterior descending artery. Before sacrifice, hemodynamics were measured and blood was drawn in control rats(n=8) and rats with MI(n=7), 4(n=10), and 8 weeks(n=9) after surgery. Heart weight index increased from 329.0+/-7.3mg/gm at baseline to 380.6+/-18.4mg/gm, 441.1+/-23.2mg/gm at the 1st, 4th, and 8th weeks after MI. Plasma ANP increased in the 1st weeks and remained elevated(16+/-7, 259+/-65, 404+/-72, 494+/-73pg/ml at baseline, 1st, 4th, 8th weeks after MI respectively). Plasma endothelin was suppressed at 4th weeks but elevated at 8th week(7.8+/-0.2, 5.3+/-0.3, 11.9+/-1.3pg/ml at baseline, 4th, 8th weeks respectively). PRA, indirect index of plasma angiotensin also decreased at 4th week but elevated at 8th week(14.9+/-0.3, 9.8+/-1.0, 20.3+/-1.8ng/ml/hr at baseline, 4th, 8th weeks resepctively). CONCLUSION: These results demonstrate a biphasic response of endothelin and PRA after MI despite the inhibitory effects of ANP. These data support the important differential regulation of humoral factors in the evolution of acute MI.
Angiotensins ; Animals ; Arteries ; Atrial Natriuretic Factor ; Endothelins ; Female ; Heart Failure* ; Heart* ; Hemodynamics ; Humans ; Models, Animal* ; Myocardial Infarction ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Renin ; Ventricular Dysfunction

Hand injury in children was increased due to multiple environmental risks and failed attention of parents to children in rapidly developing society. By the results of this evaluation in 37 cases, it was summarized as follows. First, hand injuries in children most commonly occurs in spring, and occurs more commonly in the children at the age of high activity. The most common level of injury is zone I by microreplantation zone, and zone II by tendon injury zone. The more desirable results were obtained by full thickness skin graft and composite graft if it were possible. For the better functional results compare to adults, the methods and procedures must be constructed after more evaluation with more clinical cases. In the cases of pediatric hand injury, the most important fact is prevention of injury, with the close attention by parents, and the second is appropriate diagnosis and treatment for more functional results.
Adult ; Child ; Diagnosis ; Hand Injuries* ; Hand* ; Humans ; Parents ; Skin ; Tendon Injuries ; Transplants