No abstract available.
Prostate*

One may sometimes complicated with non-union of the tibia with intact fibula or comparatively early united fibular fracture during the cause of treatment of crural fractures. So that the fibula is to strut the tibial fragment preventing effective contact. Several authors have sporadically reported the removal of a portion of fibula may increase potential compression force across the tibial fracture site and promote bony union of non-delayed union of the tibia. Partial fibulectomy was performed in 9 patients with established nonunion of the tibia at National Medical Center from 1975 to 1982. The results were as follows: 1. Healing occurred in 8 of the 9 cases, and average time to union was 7.4months after fibulectomy. 2. In one case performed B-K amputation due to intractable infection after partial fibulectomy. 3. The average shortening of the involved lower limb was about 1.9cm. 4. All cases did not have significant symptoms at the fibulectomy site after union. 5. Partial fibulectomy proved to be a relatively effective method for the treatment of nonunion of the tibia.
Amputation ; Fibula ; Humans ; Lower Extremity ; Methods ; Tibia ; Tibial Fractures

The Ilizarov technique for gradual distraction osteogenesis was developed in the 1950s. A correctly performed osteotomy is essential to the success of distraction osteogenesis and prepares for limb lengthening. Between Sept. of 1991 and 1994, thirty-four patients were treated by Ilizarov technique at St. Benedict Hosp. and Gang-Dong Hosp.. And then assigned to two separate groups : a corticotomy group (group A) and osteotomy group (group B; osteotomy with Gigli saw or osteotomy with multiple drill holes and osteotome). The regenerate segments were evaluated weekly for the first six weeks after operation. After the initial six-week evaluation period, observations of these segments were continued through a series of monthly radiographs. Distraction began on postoperative day seven in group A and on day eleven in group B; and continued at a rate of 1 mm/day and a frequency of 4 times/day. Group A displayed new bone formation earlier than group B: group A's mean was 16.5 ± 4.9 days, while B's mean was 25.3 ± 4.6 days. The first bridging callus occurred earlier in group A than it did in group B: A's mean was time of 36.7 ± 9.9 days, while B's mean was 44.0 ± 7.9 days. There was no significant difference between groups A & B in terms of first cortical formation : A's mean was 86.9 ± 24.0 days, and B's mean was 100.6 ± 25.2 days. There was no significant difference between groups A & B in terms of the bone healing index : A's mean was 41.6 ± 13.5 days and B's mean was 41.15 ± 8.10 days.
Bony Callus ; Extremities ; Humans ; Ilizarov Technique ; Methods ; Osteogenesis ; Osteogenesis, Distraction ; Osteotomy

The general consensus of the treatment for ankle fracture is anatomical reduction and restoration of the distal tibiofibular relationship. In general, stabilization of the disrupted syndesmosis may be achieved by repairing ruptured ligament; fixing associated fractures of the fibular, avulsed tubercles, and medial malleolus; or by placing a screw between the tibia and the fibular to hold the syndesmosis in position until some degree of syndesmotic ligament healing can occur. However, the managements of syndesmosis remain controversial. The purpose of this study is to evaluate the effect of the syndesmotic fixation in the ankle fractures. The patients with syndesmotic disrupted ankle fracture, who were treated operatively between 1990 and 1995 at St. Benedict Hospital, were divided into the two groups based on whether trans-syndesmotic screw was used or not. The group I included 42 ankle fractures that were treated with trans-syndesmotic screw, while the group II included 28 ankle fractures that were treated without syndesmotic screw. The results obtained from this study were as follows. 1). There was no significant difference of the clinical result between the two groups. 2).When the diastasis was satisfactorily reduced after rigid, anatomic medial and lateral fixation, syndesmotic screw fixation was not required to maintain the integrity of the tibiofibular joint.
Ankle Fractures* ; Ankle* ; Consensus ; Humans ; Joints ; Ligaments ; Tibia

PURPOSE: To evaluate the results of surgical treatment and relationship between the recurrence and characteristics of ganglions in foot and ankle. MATHERIALS AND METHODS: Seventeen cases of ganglions located in foot and ankle, excised at St. Benedict Hospital from Mar. 1993 to Apr. 2003, were included in the study. All of cases were analyzed retrospectively in terms of age, sex of the patients, location and size of the ganglion, symptom, operative method as well as recurrence rate were evaluated. The mean follow up was 1.8 years (11 months~6.5 years). RESULTS: The size of ganglion ranged from 0.5 cm to 5.0 cm with mean size of 2.5 cm. The most common area of ganglion was the dorsum of foot and pain was the primary chief complain The recurrence was found in 4 cases (23.5%): 1 of them occurred among 8 cases the diameter of which was less the 2.5cm and other 3 occurred among 9 casees larger than 2.5cm. 12 cases were completely excised mass with no recurrence. But 5 cases were incompletely excised & ligated stalk of mass and 4 cases of them were recurred. A correlation was only observed between complete excision and low recurrence rate. CONCLUSION: Recurrence rate of ganglions in foot and ankle was high and the correlation was obstained between complete excision and low recurrence rate.
Ankle* ; Follow-Up Studies ; Foot* ; Ganglion Cysts* ; Humans ; Recurrence ; Retrospective Studies

BACKGROUND: Lipoprotein(a)[Lp(a)], an independent risk factor for athrosclerosis, consist of low density lipoprotein like particle and specific glycoprotein, apolipoprotein(a). The levels of Lp(a) are mainly determined by the genetic pleomorphism of apolipoprotein(a) and has been though not to be influenced by age, sex and other biochemical parameters. Recent reports have shown that the concentrations of Lp(a) are correlated with age in women. The purpose of this study was to invastigate the association of Lp(a) concentration with sex and age. METHODS: The concentrations of Lp(a) were measured in 3,707 women and 389 men, free of diseases and medications known to affect the lipid levels. Plasma Lp(a) concentration were measured by commercial radioimmunoassay kit and other lipid profiles by conventional method. RESULTS: In female, median Lp(a) concentration increased with age till the early sixth decade (P=.0000) and then decreased. If peri- and postmenopausal women were excluded in the fifth decades, the relation between age and Lp(a) disappeared. In male, Lp(a) concentration were not associated with age. Median Lp(a) concentrations were higher in females than in males in the fifth(p=.0039) and the sixth decades(p=.0007), The difference became negligible after the exclusion of peri- and postmenopausal woman in the fifth decade. CONCLUSION: The concentrations of Lp(a) were corrected with age only in female. Females had higher levels than males in the fifth and the sixth decades. The relations are thought to be nither due to aging process nor sex but due to postmenopausal increase of Lp(a).
Aging ; Apoprotein(a) ; Female ; Glycoproteins ; Humans ; Lipoprotein(a)* ; Lipoproteins ; Male ; Menopause ; Plasma ; Radioimmunoassay ; Risk Factors

BACKGROUND: Lipoprotein(a)[Lp(a)], an independent risk factor for athrosclerosis, consist of low density lipoprotein like particle and specific glycoprotein, apolipoprotein(a). The levels of Lp(a) are mainly determined by the genetic pleomorphism of apolipoprotein(a) and has been though not to be influenced by age, sex and other biochemical parameters. Recent reports have shown that the concentrations of Lp(a) are correlated with age in women. The purpose of this study was to invastigate the association of Lp(a) concentration with sex and age. METHODS: The concentrations of Lp(a) were measured in 3,707 women and 389 men, free of diseases and medications known to affect the lipid levels. Plasma Lp(a) concentration were measured by commercial radioimmunoassay kit and other lipid profiles by conventional method. RESULTS: In female, median Lp(a) concentration increased with age till the early sixth decade (P=.0000) and then decreased. If peri- and postmenopausal women were excluded in the fifth decades, the relation between age and Lp(a) disappeared. In male, Lp(a) concentration were not associated with age. Median Lp(a) concentrations were higher in females than in males in the fifth(p=.0039) and the sixth decades(p=.0007), The difference became negligible after the exclusion of peri- and postmenopausal woman in the fifth decade. CONCLUSION: The concentrations of Lp(a) were corrected with age only in female. Females had higher levels than males in the fifth and the sixth decades. The relations are thought to be nither due to aging process nor sex but due to postmenopausal increase of Lp(a).
Aging ; Apoprotein(a) ; Female ; Glycoproteins ; Humans ; Lipoprotein(a)* ; Lipoproteins ; Male ; Menopause ; Plasma ; Radioimmunoassay ; Risk Factors

PURPOSE: We tried to find out whether the nadir PSA level after hormone therapy affected the progression into hormone-refractory prostate cancer (HRPC). MATERIALS AND METHODS: We reviewed the progressive status and the survival of the 177 patients with stage C or D prostate cancer who had received hormone therapies. The relative efficacy of the nadir PSA level for predicting the progression into HRPC was evaluated by the receiver operating characteristic (ROC) analysis. RESULTS: 85.4% of patients responded to the treatment and 78% of responders progressed into HRPC. Median time to nadir PSA level after hormone therapy and to HRPC were 8.1 and 24.0 months, respectively. The nadir PSA levels were under 0.2ng/ml in 31%, 0.2-1.0ng/ml in 23%, 1.1-10ng/ml in 42%, and over 10ng/ml in 5% of the responders (n=151). As the nadir PSA levels were lower, pretreatment PSA levels, Gleason score and the number of cases progressing into HRPC were significantly lower (p<0.05). In addition, the nadir PSA level was inversely correlated with the interval to the establishment of HRPC (r= 0.465, p<0.05). By univariate analysis, the bone metastasis, the nadir PSA level, PSA level at six months after treatment and pretreatment PSA level were associated with the progression into HRPC. Only the nadir PSA level was an independent factor by multivariate analysis. ROC analysis disclosed an accuracy of 86.2% for the nadir PSA level to predict the progression into HRPC after two years. By setting the lower limit of the nadir PSA level to 1.1ng/ml, the sensitivity was 80.3% and the specificity was 83.8%, being most adequate. CONCLUSIONS: The nadir PSA level after hormone therapy may be the most important factor that can predict the progression into HRPC. Also, in consideration of sensitivity and specificity, it would be adequate to set the lower limit of the nadir PSA level to 1.1ng/ml.
Humans ; Multivariate Analysis ; Neoplasm Grading ; Neoplasm Metastasis ; Prognosis ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms* ; ROC Curve ; Sensitivity and Specificity

BACKGROUND: Verapamil, a calcium channel blocker, is known to protect the myocardium against ischemia and reperfusion injury. The hypertrophied myocardium is at greater risk for ischemic damage compared to the normal heart during cardiopulmonary bypass (CPB). We evaluated the myocardial protective effect of verapamil cardioplegia on the hypertrophied left ventricle during CPB. METHODS: Seventeen patients with end-diastolic anterior wall thickness (DAWT) greater than 11 mm in an M-mode echocardiogram were consented to participate in this study. Patients were randomized to receive either standard hyperkalemic blood cardioplegic solution (n = 8) or the same solution with verapamil (n = 9). End systolic anterior wall thickeness (SAWT) and DAWT were measured by an M-mode echocardiogram and the left ventricular ejection fraction (LVEF) was calculated with a 2-dimension echocardiogram before and after CPB. Simultaneously, hemodynamic variables were measured. RESULTS: There was no significant difference of DAWT and LVEF between both groups before and after CPB. DAWT was increased after CPB but this increase was attenuated by verapamil in patients with LVH. LVEF was decreased in both groups after CPB and the decrease in the verapamil group was not statistically significant but in the control group. Cardiac index and stroke volume index didn't show any significant differences between the two groups after CPB, either. CONCLUSIONS: DAWT increased which means myocardial edema was significant in patients with LVH; however, a verapamil cardioplegic solution decreased the amount of increase in DAWT. However, theverapamil cardioplegic solution didn't improve the hypertophied ventricular systolic function after CPB.
Calcium Channels ; Cardioplegic Solutions ; Cardiopulmonary Bypass* ; Edema ; Heart ; Heart Arrest, Induced* ; Heart Ventricles* ; Hemodynamics ; Humans ; Ischemia ; Myocardium ; Reperfusion Injury ; Stroke Volume ; Verapamil*

PURPOSE: To compare clinical characteristics of ganglions in hand & Foot. MATERIALS AND METHODS: Seventeen cases of ganglions located in foot and fifty-five cases in hand. Excised from Mar.1988 to Apr.2003, were included in the study. The clinical characteristics and recurrence ratio were evaluated RESULTS: The mean size of 2.2 cm in hand and 2.5 cm in foot. The most common area of ganglions are dorsum of foot and wrist. The cosmetic problem of palpable mass is the primary chief complaint of ganglions on hand and the pain is that of foot. The recurrence was found in 5 cases in hand and 4 cases in foot. The recurrence was related to incomplete excision of ganglion in foot and the large size of ganglion and incomplete excision of ganglion in hand. CONCLUSION: recurrence ratio in the cases of foot is higher than that of hand. The ganglions in foot and hand need to treated by meticulous surgical excision to prevent the recurrence.
Foot* ; Ganglion Cysts* ; Hand* ; Recurrence ; Wrist