This study includes 19 cases of complicated low extremity injury to whom underwent microvascular free-tissue transfer in cases of open comminuted fracture, osteomyelitis, and vascular compromise or extensive soft tissue defect from Nov. 1994 to July 1997. The average time after injury to coverage was 25 days. The nineteen patients underwent a total of nineteen free tissue transfers primarily, and eighteen (94.7 per cent) of the transfers survived. Major complications were encountered recurrent failure of the free tissue transfer in one patient and partial necrosis in the other flap, which were successfully treated by flow-through radial forearm free flap and distally based superficial sural artery flap respectively. Two patients were sustained below knee amputation, one above knee amputation, despite of survival of flaps. This reveals limb salvage in 84 percent. The microvascular reconstruction is a versatile and reliable methods in complicated cases after severe trauma. Free tissue transplantation should be considered as a primary treatment in such complicated cases.
Amputation ; Arteries ; Extremities ; Forearm ; Fractures, Comminuted ; Free Tissue Flaps ; Humans ; Knee ; Limb Salvage ; Lower Extremity* ; Necrosis ; Osteomyelitis ; Tissue Transplantation ; Transplants

BACKGROUND: The obese patients increased recently in Korea due to excessive energy intake and decreased physical activity. We are well known that obesity is associted with an increased risk of cardiovascular disease, angina pectoris, hypertension, but not known to influence of weight gain to change in cardio-vascular risk factors. Once, the study of obesity are many but the study of influence of weight gain are small in Korea. This study investigated to influence of weight gain in cardio-vascular risk factors. METHODS: We gatherd case and control group among persons who has taken twice medical examination except disease person from October 1990 to October 1995 at SungAe General hospital. In our study, total 167 case, compare weight gain group(>3kg) with control group to change in cardiovascular risk factor. RESULTS: Sex, age, smoking history, obesity index were not statistically significant difference between two group in the first medical examination. systolic blood pressure, diastolic blood pressure, fasting blood sugar, HDL, total cholesterol/HDL were not statistically significant difference between two group for weight gain. Total cholesterol and triglyceride, LDL were stastistically significant increased. CONCLUSIONS: Weight gain was increased of total cholestrol and triglyceride, LDL, so weight control was important.
Angina Pectoris ; Blood Glucose ; Blood Pressure ; Cardiovascular Diseases ; Cholesterol ; Energy Intake ; Fasting ; Hospitals, General ; Humans ; Hypertension ; Korea ; Motor Activity ; Obesity ; Risk Factors* ; Smoke ; Smoking ; Triglycerides ; Weight Gain*

Cardiac Arrest victims are increasing but EMS is not ready for them, in Korea. At this time, we need to know the exact status about the chain of survival of CPR and the outcome after out-of-hospital arrest. More than 90% of out-of-hospital arrest was witnessed, and about a half at home, but bystander CPR was done in only about 10%. EMS is activated by the unified phone number (119), but in only 1%, EMS was dispatched for CPR, nationwide. EMS responders were not educated and organized specific for CPR situation. BLS and equipped AED were not always utilized to whom needed. Pre-hospital ACLS were exceptionally done by first responder. Initial ECG findings, most of which were recorded at Hospital ED(more than 20 minutes after collapse), were VF/Pulseless VT(11-12%), Asystole(63-64%), and PEA(24-26%). Initial ROSC rate was 44-45%, and final Discharge Alive rate was 5-10%. The outcome of out-of-hospital arrest was dependent on bystander CPR and initial ECG finding. Most of lay-person are aware to CPR, but not adequately educated to do CPR when needed. We should organize the efforts to improve the quality of EMS and build up the education system of CPR nationwide, at now.
Cardiopulmonary Resuscitation* ; Education ; Electrocardiography ; Heart Arrest ; Korea* ; Out-of-Hospital Cardiac Arrest

No abstract available.
Animals ; Euonymus* ; Liver* ; Mice*

Arteriovenous fistula could occur rarely followed by lumbar disk operation. There are very few case reports in the literature. We have experienced a case of arteriovenous fistula, which has been corrected surgically.
Arteriovenous Fistula ; Diskectomy

OBJECTIVES: Both the valence and arousal components of affect are important considerations when managing mental healthcare because they are associated with affective and physiological responses. Research on arousal and valence analysis, which uses images, texts, and physiological signals that employ deep learning, is actively underway; research investigating how to improve the recognition rate is needed. The goal of this research was to design a deep learning framework and model to classify arousal and valence, indicating positive and negative degrees of emotion as high or low. METHODS: The proposed arousal and valence classification model to analyze the affective state was tested using data from 40 channels provided by a dataset for emotion analysis using electrocardiography (EEG), physiological, and video signals (the DEAP dataset). Experiments were based on 10 selected featured central and peripheral nervous system data points, using long short-term memory (LSTM) as a deep learning method. RESULTS: The arousal and valence were classified and visualized on a two-dimensional coordinate plane. Profiles were designed depending on the number of hidden layers, nodes, and hyperparameters according to the error rate. The experimental results show an arousal and valence classification model accuracy of 74.65 and 78%, respectively. The proposed model performed better than previous other models. CONCLUSIONS: The proposed model appears to be effective in analyzing arousal and valence; specifically, it is expected that affective analysis using physiological signals based on LSTM will be possible without manual feature extraction. In a future study, the classification model will be adopted in mental healthcare management systems.
Arousal* ; Classification* ; Dataset ; Delivery of Health Care* ; Electrocardiography ; Learning ; Machine Learning ; Memory, Short-Term* ; Methods ; Peripheral Nervous System ; Supervised Machine Learning

INTRODUCTION: This study examined the effect of autogenous tooth bone used as a graft material for bone regeneration in an artificial bony defect of minipigs. MATERIALS AND METHODS: Four healthy minipigs, weighing approximately 35-40 kg, were used. Four standardized artificial two-walled bony defects, 5 mm in length and depth, were made on the bilateral partial edentulous alveolar ridge on the mandible of minipigs, and autogenous tooth bone was augmented in the right side as the experimental group. On the other hand, only alloplastic bone graft material HA was grafted with the same size and manner in the left side as the control group. All minipigs were sacrificed at 4 weeks after a bone graft and evaluated histologically by Haematoxylin-eosin staining. The specimens were also evaluated semi-quantitatively via a histomorphometric study. The percentage of new bone over the total area was evaluated using digital software for an area calculation. RESULTS: All specimens were available but one in the left side (control group) and two in the right side (experimental group) were missing during specimen preparation. The amount of bone formation and remodeling were higher in all experimental groups than the control. The mean percentage area for new bone in the experimental and control groups was 43.74+/-11.96% and 30.79+/-2.93%, respectively. CONCLUSION: Autogenous tooth bone is a good alternative to autogenous bone with the possible clinical feasibility of an autogenous tooth bone graft in the reconstruction of bony defects.
Alveolar Process ; Bone Regeneration ; Hand ; Mandible ; Osteogenesis ; Regeneration ; Swine, Miniature ; Tooth ; Transplants

PURPOSE: The purpose of this study was to compare the fracture strength of the zirconia ceramic crowns according to tooth position. MATERIAL AND METHODS: After 10 metal dies were made for each group, the zirconia ceramic crowns were fabricated using CAD/CAM system (Lava(TM) All-Ceramic System) and each crown was cemented on each metal die with resin cement (Rely X(TM) Unicem). The cemented zirconia ceramic crowns mounted on the testing jig were inclined with 30 degrees to the long axis of the tooth and the universal testing machine was used to measure the fracture strength. RESULTS: 1. The fracture strength of the zirconia ceramic crown in the lower 1st molar (2963 N) had the highest and that in the lower central incisor (1035 N) had the lowest. 2. The fracture strength of zirconia ceramic crown was higher than that of the IPS Empress crowns in all tooth position. 3. The fracture mode of the crowns was similar. Most of fracture lines began at the loading area and extended through proximal surface perpendicular to the long axis of the crowns. 4. There were no significant differences on the fracture strength of the zirconia ceramic crowns according to tooth position except in premolar group. CONCLUSION: Within the limitations of this study, the results suggested that strength of zirconia ceramic crown is satisfactory for clinical use.
Axis, Cervical Vertebra ; Bicuspid ; Ceramics ; Collodion ; Crowns ; Incisor ; Molar ; Resin Cements ; Tooth ; Zirconium

PURPOSE: The survival of bone marrow derived stem cell was reported several times. But the survival of adipose tissue derived stem cells(hASCs) was not mentioned on. We studied the adipose tissue derived stem cell's survival and effect on articular cartilage in rabbits. METHODS: Osteoarthritis was induced in twenty New Zealand white rabbits by intraarticular injection of monosodium iodoacetate(MIA). After four weeks, hASCs were also injected into the knee joints space without any vehicle, but the control group received phosphate buffered saline only. The histologic grade of articular cartilage was measured in 4 and 8 weeks after the transplantation of hASC and the viability of injected stem cells measured by Fluorescent in situ Hybridization (FISH) examination. RESULTS: After 4 and 8 weeks from hASCs transplantation, histologic grade was not significantly difference between two groups(p>0.05), and the Y chromosome of the transplanted hASCs was not detected in articular cartilage. CONCLUSION: We found that direct injection of hASC in joint space didn't work on damaged articular cartilage repair.
Adipose Tissue ; Bone Marrow ; Cartilage, Articular ; Humans ; In Situ Hybridization, Fluorescence ; Injections, Intra-Articular ; Joints ; Knee ; Knee Joint ; Osteoarthritis ; Rabbits ; Stem Cells ; Transplants ; Y Chromosome

PURPOSE: To compare the diagnostic accuracy between fine needle and large cutting needle biopies. METHODS & MATERIALS: Chest lesion was biopsied consecutively by 19 G or 22 G fine needle and 14 G large cutting needle with interval of 10-20 min. 119 patients confirmed by operation or clinical follow-up were evaluated. RESULTS: There were 65 patient confirmed as malignant lesion and 54 confirmed as benign lesions. Diagnostic accuracy was 87.7%(57/65) for malignancy and 85.2%(46/54) for benign lesion with fine needle. With large cutting needle, it was 90.8%(59/65) for malignancy and 88.9%(48/54) for benign lesion. In the benign lesion, specific diagnostic accuray was 48.1%(26/54) with fine needle, and 64.8%(35/54) with large cutting needle biopsy, respectively. Complications were hemoptysis(n=13, 10.9%), pneumothorax(n=7, 5.9%) and mild to moderate chest pain. Although, it is impossible to compare the complications by the two types of biopsy on same lesion, 10 cases of immediate hemopytsis and more severe chest pain occurred when large cutting needle biopsy was done. CONCLUSION: No significant difference in diagnostic accuracy between fine needle and large cutting needle biopsies was observed in malignant lesion. In benign lesions, larger sample volume may increase the chance of obtaining a specific diagnosis but has no influence on overall diagnostic accuracy of benignity. Thus, we believe that fine needle aspiration biopsy is an accurate, safe, and more tolerable means to be performed as first step for diagnosis of chest lesions.
Biopsy* ; Biopsy, Fine-Needle* ; Biopsy, Needle ; Chest Pain ; Diagnosis ; Follow-Up Studies ; Humans ; Needles* ; Thorax