Recently, there were many cases which was associated with bone defect in the limb and skin defect. We had performed vascularized osteocutaneous fibular transfer with microsurgical technique and experienced early bone union and simutsneous external wound healing. So we, authers, reviewed 12 cases of vascularized osteocutaneous fibular transfer which were performed to the extensive bone defect of the tibia and associated soft tissue injury. And the following remarkable results were obtained. 1. With the uncontrolled bone infection, the vascularized osteocutaneous fibular transfer was able to be performed and there was no non-union. 2. During the follow up period, the grafted fibula had been hypertrophied. 3. In the cases which the fibula were grafted to the defect after the segmental and partial excision of the tibia, in general, the partial weight bearing was able to be started from 3 months to 5 months after the operation, In the cases with segmental and complete excision of the tibia, the partial weight bearing was able to be started from 5 months to 7 month after the operation. 4. In adult, free fibula can be obtained and grafted as 20cm as long and the fibula was a good donor for extensive long bone defect as a compact bone; the skin flap with fibula can be obtained and grafted as 17 × 9cm as large in our experience. 5. In the vascularized osteocutaneous fibula transfer, the skin flap could be confirmed wheather the vascular anastomosis is patent or not as a monitor.
Adult ; Clinical Study ; Extremities ; Fibula ; Follow-Up Studies ; Humans ; Microsurgery ; Skin ; Soft Tissue Injuries ; Tibia ; Tissue Donors ; Transplants ; Weight-Bearing ; Wound Healing

No abstract available.
Drainage* ; Pancreatic Pseudocyst*

OBJECTIVE: To evaluate the role of C-reactive protein and fetal fibronectin for patients with preterm labor and intact mxmbranes. STUDY DESIGN: The study group was comprised of sixty patients who presented to the Taegu Fatima Hospital between 24-36 gestational weeks who had a diagnosis of preterm labor. The study group underwent assay of C-reactive protein in the matemal serum, and fetal fibronectin from the external os and posterior fomix of the vagina by means of polyester fiber swabs. The study group was categorized to four groups according to the results of CRP and fetal fibronectin, that is 28 cases of CRP(-)/fetal fibronectin(-); group I, 12 cases of CRP(+)/fetal fibronectin (-); groupII, 9 cases of CRP(-)/fetal fibronectin(+); groupIII, 11 cases of CRP(+)/fetal fibronectin(+): grouplV, and the controls were 12 women without preterm labor. Outcome measures were occurrence of preterm delivery, the admission-to-delivery interval, matemal age and parity, fetal body weight, 1min/5min Apgar score, perinatal morbidity and mortality etc. Statistical analyses were performed by means of ANOVA test and Dunnett's t-test. RESULTS: The prevalence of study group were group I 46.7%, group II 20%, group III 15% and group IV 18.3%. There were no significant difference of matemal age, parity and gestational weeks at admission between study group and control group, but in all study group the admission to delivery interval was significantly shorter than that of control group. Analysis indicated also no significant difference of maternal hemoglobin between study group and conuol group but white blood cell count of group II and IV were significantly higher than that of control group. In perinatal outcomes, the mean birth weight and 1 minute Apgar score of study group except group I were significantly lower than those of control group but 5minutes Apgar score was lower only in group IV compared with control group. Perinatal morbidity and mortality of study group were higher than those of control group except group I. This study group was designed to compare the diagnostic performance of cervical fibronectin and of the serum CRP levels. The sensitivity and specificity of fetal fibronectin as a test to predict of preterm labor were 80% and 90%, which were slightly higher than those of CRP(70%, 78%). CONCLUSION: Both positive cervicovaginal fetal fibronectin and positive C-reactive protein in women with preterm uterine contraction can help identify the pregnancies at risk and to select proper management protocol.
Apgar Score ; Birth Weight ; C-Reactive Protein ; Daegu ; Diagnosis ; Female ; Fetal Weight ; Fibronectins ; Humans ; Leukocyte Count ; Membranes* ; Mortality ; Obstetric Labor, Premature* ; Outcome Assessment (Health Care) ; Parity ; Polyesters ; Pregnancy ; Prevalence ; Sensitivity and Specificity ; Uterine Contraction ; Vagina

PURPOSE: The purpose of this study were to describe the level of activities of daily living (ADLs) and fatigue of stroke patients and to identify related factors of ADLs and fatigue. METHOD: A sample of 132 were used who were recovering from stroke. The face-to-face interviews were conducted to collect data. The levels of ADLs and fatigue were evaluated using the Modified Barthel Index and Kim's fatigue scale respectively. A series of t-test and analysis of variance analyses were conducted to examine study purposes using SPSS 15.0. RESULTS: The levels of fatigue and ADLs were 65.6 (SD=16.52) and 74.6 (SD=22.32) respectively. Significantly poorer ADLs were found: women (t=2.05, p=.001), older people aged > or = 70 years (F=2.74, p=.046), the duration of onset (F=4.32, p=.006), the use of assist devices (F=35.64, p<.001), the parts of paralysis (F=4.25, p=.007), the time to attack (F=3.34, p=.039), and accompanying symptoms (F=15.23, p<.001). There was a significant difference in fatigue with patients with lower accompanying symptoms having lower fatigue (F=11.08, p<.001). CONCLUSION: These findings suggest gender, the duration from onset, the use of assist device, the parts of paralysis, the time to attack and accompanying symptoms were significant factors of the ADLs and fatigue post stroke. These factors should be considered when developing and testing nursing intervention programs for stroke survivors.
Activities of Daily Living ; Aged ; Fatigue ; Female ; Humans ; Paralysis ; Stroke ; Survivors

The weightlifting is a sort of the sport, which has objects to promote the physical condition and to develop the fundamental strength in the adolescent period, but thete been no interests from the view points of sports injuries for weightlifting. So the authors have studied the changes in the lumbosacral region and wrist of the adolescent weightlifters and the results obtained are as follows; 1. The increase in the lumbosacral angle has a statistically significant relationship with the low back pain in the adolescent weightlifters. 2. The ulnar variance shows statistically significant increase than the control group and its increase seems to be a causative factor in developing wrist pain among the adolescent weightlifters.
Adolescent ; Athletic Injuries ; Humans ; Low Back Pain ; Lumbosacral Region ; Sports ; Wrist

Owing to rapid development of laparoscopic thechnique and equipment, even to laparoscopic radical hysteretomy was possible. The objectives of this study were to evaluate the feasibilltiy, and operative and postoperative outcomes fo our intial experience of total laparoscopic hysteretomy(TLH) at the Department of Obstetrics nad gynecology, Kyong Pook National Unviersity Hospital from April 1995 to July 1995.20 cases were completely performed by laparoscopy(80%). 5case were conveted to vaginal procedure (20%) due to bleeidng and difficulty in dissection of parametrial tissue.None of these patient had laparotomy. The mean age of the patients was 46.6 +/- 6.2 years old. The most common indication was myoma (50%). Other indications were adenomyosis (25%), myoma with adenomyosis(15%), adenomysis with endometriosis(5%) and endometrial carcinoma(5%). The mean operative time was 148.0 +/- 51.0(100~245)minutes, the mean estimated blood loss was 99.9 +/- 84.9(20~350)ml, the mean uterine weight was 312.1 +/- 110.2(105~570)gm, and the mean hospital stay was 5.1 +/- 1.7(3~11) DAY. The complications of TLH were 2cases of vaginal cuff infection, and 4 transfusions due to anemia and blood loss during operation. The most common combined operation was bilateral salpingoophorectomy. Out sutdy suggested that even large sized myoma up to 570mg can be removed by laparoscopy without delayed bleeding. Even the technique of TLH was difficult and only performed by an experienced laparoscopic pelvic surgeon in the selected cases, but we had experience of many advatages by use of vaginal tube, such as avoiding ureter injury, reducing volume of parametrium and reducing gas loss during laparoscopic suturing. It is clear that not all patients requiring hysterectomuy will benefit from total laparoscopeic hysterectomy but some patients who were dificult for vaginal hysterectomy beacse of narrow and atrophic vagina and poor uterine mobility may have some benefits from TLH.
Adenomyosis ; Anemia ; Female ; Gynecology ; Hemorrhage ; Humans ; Hysterectomy ; Hysterectomy, Vaginal ; Laparoscopy ; Laparotomy ; Length of Stay ; Myoma ; NAD ; Obstetrics ; Operative Time ; Ureter ; Vagina

Owing to rapid development of laparoscopic thechnique and equipment, even to laparoscopic radical hysteretomy was possible. The objectives of this study were to evaluate the feasibilltiy, and operative and postoperative outcomes fo our intial experience of total laparoscopic hysteretomy(TLH) at the Department of Obstetrics nad gynecology, Kyong Pook National Unviersity Hospital from April 1995 to July 1995.20 cases were completely performed by laparoscopy(80%). 5case were conveted to vaginal procedure (20%) due to bleeidng and difficulty in dissection of parametrial tissue.None of these patient had laparotomy. The mean age of the patients was 46.6 +/- 6.2 years old. The most common indication was myoma (50%). Other indications were adenomyosis (25%), myoma with adenomyosis(15%), adenomysis with endometriosis(5%) and endometrial carcinoma(5%). The mean operative time was 148.0 +/- 51.0(100~245)minutes, the mean estimated blood loss was 99.9 +/- 84.9(20~350)ml, the mean uterine weight was 312.1 +/- 110.2(105~570)gm, and the mean hospital stay was 5.1 +/- 1.7(3~11) DAY. The complications of TLH were 2cases of vaginal cuff infection, and 4 transfusions due to anemia and blood loss during operation. The most common combined operation was bilateral salpingoophorectomy. Out sutdy suggested that even large sized myoma up to 570mg can be removed by laparoscopy without delayed bleeding. Even the technique of TLH was difficult and only performed by an experienced laparoscopic pelvic surgeon in the selected cases, but we had experience of many advatages by use of vaginal tube, such as avoiding ureter injury, reducing volume of parametrium and reducing gas loss during laparoscopic suturing. It is clear that not all patients requiring hysterectomuy will benefit from total laparoscopeic hysterectomy but some patients who were dificult for vaginal hysterectomy beacse of narrow and atrophic vagina and poor uterine mobility may have some benefits from TLH.
Adenomyosis ; Anemia ; Female ; Gynecology ; Hemorrhage ; Humans ; Hysterectomy ; Hysterectomy, Vaginal ; Laparoscopy ; Laparotomy ; Length of Stay ; Myoma ; NAD ; Obstetrics ; Operative Time ; Ureter ; Vagina

During the arthroscopic surgery of the shoulder, there was extravasation of fluid into the surrounding soft tissue due to the use of pressure pump irrigator. Clinically, the shoulder region became tense and intramuscular pressure of the deltoid could be elevated. To analyze the change of the intramuscular pressure of the deltoid and the efficiency of cryotherapy in the shoulder arthroscopy with pressure pump, we studied 35 consecutive patients who underwent various arthroscopic shoulder procedures at the Dankook University Hospital. We monitored intramuscular pressure using spinal needle connected to the patient monitoring system during arthroscopic procedures and postoperative period until return to preoperative pressure level. Twenty-seven patients were fitted with a cryotherapy. device in the operating room, and 8 were not according to the patient opinions. We evaluated the effect of cryotherapy with visual analog scales and amounts of analgisics for 3 days postoperatively. The results were followed; 1. Intraoperative highest intramuscular deltoid pressure was 293mmHg (average 169+/-68mmHg, 71293mmHg). 2. Immediate postoperative deltoid pressure was average 58.3+/-28.1mmHg (24-145mmHg). 3. Average time that the pressure had returned to the preoperative level was 114.3+/-38.6 minutes (p<0.05). There were no statistically significant between two groups, 113.9+/-41.1 min in the cryotherapy group and 115.7+/-32.6 min in the non-cryotherapy group. 4. Shoulder pain was less in the cryotherapy cases until second postoperative day. In conclusion, arthroscopic surgery of the shoulder can be performed with minimal complication in spite of high intramuscular deltoid pressure. More than 60 minutes may be needed for returning to normal intramuscular deltoid pressure. Cryotherapy is eftective in the pain relief but cannot minimize swelling postoperatively.
Arthroscopy* ; Cryotherapy* ; Humans ; Monitoring, Physiologic ; Needles ; Operating Rooms ; Postoperative Period ; Shoulder Pain ; Shoulder* ; Transcutaneous Electric Nerve Stimulation ; Visual Analog Scale

No abstract available.
Humans ; Lymphocytes*

PURPOSE: To identify the characteristic ultrasonographic findings of the normal appendix in children in order to detect it more easily and so to exclude acute appendicitis from a diagnosis with more confidence. MATERIALS AND METHODS: Among 64 patients presenting with right lower quadrant pain, 44 patients, excluding 15 patients diagnosed as acute appendicitis and 5 patients with non-visualization of the appendix due to severe ileus and obesity, were evaluated for the point of incidence, the thickness and the presence of folding of the inner hypoechoic band of the normal appendix. The age of the patients ranged from 3 to 15 years with a mean age of 6.5 years. Two patients were operated on and we correlated the preoperative ultrasonographic findings with the histologic findings. RESULTS: In all the cases of the 44 patients with normal appendix, the inner hypoechoic band was discovered, which was seen as a linear structure without folding along the whole length of appendix. This measured as 0.75 mm (0.3-1.5 mm) for the mean thickness. The inner hypoechoic band corresponded to the mucosal layer that had abundant lymphoid tissue on the histologic examination. CONCLUSION:For the pediatric normal appendix, the inner hypoechoic band without folding is present, and this corresponds to the mucosal layer with abundant lymphoid tissue.
Appendicitis ; Appendix* ; Child* ; Diagnosis ; Humans ; Ileus ; Incidence ; Lymphoid Tissue ; Obesity ; Ultrasonography*