Plasma col1 leukemia with motility-related morphological behavior is rarely studied. The plasma cells have variable degrees of cytoplasmic morphologies as dairy Projections, long extensions and pseudopods. These morphological evidences show the papa bility of wide spread and dissemination of disease itself. We present a case of a 38 year old woman who had back pain for 4 months and was diagnosed as a solitary plasmacytoma of the third lumbar vertebra. In spite of resection of the tumor and chemotherapy, the plasmacytoma was disseminated into both breasts and ovaries within less than a year. On her blood examination, we counted 34% of plasma cells in peripheral blood and 91.6% of plasma cells in bone marrow aspiration. Most of them resealed hairy projections and pseudopods of the cytoplasm.
Adult ; Back Pain ; Bone Marrow ; Breast ; Cytoplasm ; Drug Therapy ; Female ; Humans ; Leukemia ; Leukemia, Plasma Cell* ; Ovary ; Plasma Cells* ; Plasma* ; Plasmacytoma ; Spine

We analyzed the factors of importance for nonunion in series of 91 open fractures of tibial diaphysis which were treated with external fixation. Factors analyzed included, age and sex of the patients, the mechanism of injury, the amount of soft tissue damage, the grade of comminution, the level at which the tibia was fractured, the presence of an intact fibula, the presence of the multiple injuries, the type of the external fixation used(AO external fixator, EXTOR; monotube external fixator, Ilizarov), and the need to supplement the stability of the reduction. We found that the amount of soft tissue damage and comminution of the fracture played a role in the development of the nonunion.
Diaphyses ; External Fixators ; Fibula ; Fractures, Open ; Humans ; Multiple Trauma ; Tibia ; Tibial Fractures*

Fractures of the acetabulum are relatively uncommon, but because they involve a major weight bearing joint in the low extremity, they assume great clincal importance. The principle of management for this fracture is as for any other displaced intra-articular fracture, nsmely that anstomical reduction is essential for good long term function of the obtained by closed means, but more often, open reduction followed stable internsl fixation allowing early active or passive motion will be required. In the past, the achievement of this ideal, that is anatomical reduction, has been difficult because technical problems such as those caused by complicated anatomy, difficulty with surgical exposure, severe comminution in many cases, and major associated injuries. We classified the acetabular fractures of 71 patients with 72 hips from 1980 to 1987 and clinical analysis was performed on 51 hips allowing the possible follow-up evaluation beyond the 12 months. Following results were obtained. 1. The most common associated injury was the pelvic bone fracture(25.5%). 2. The most common types of fracture on each classification were posterior wall fracture in Letournel(37.5%), posterior acetabular fracture in Rowe & Lowell(42.3%), central fracture- dislocation without involving of weight bearing dome of acetabulum in Carnesale(23.9%). 3. According to calssification method, the interpretation for characteristics of fracture type and frequency of acetabular fracture was very different each other. 4. The Leournels classification was relatively simple and could contain with many types of fracture and was helpful to determine the index of treatment. 5. The prognosis of linear undisplaced fracture and posterior fracture was better than acetabular medial, superior and bursting fracture in both conservative and operative treatment. 6. The posterior wall fracture with widely displaced fracture or joint instability, acetabular dome fracture, intraarticular fragment was absolute indication for operative treatment. 7. The treatment result and prognosis was influenced to the accurate classification of fracture type, anatomical reduction and rigid internal fixation.
Acetabulum ; Classification ; Dislocations ; Extremities ; Follow-Up Studies ; Hip ; Humans ; Intra-Articular Fractures ; Joint Instability ; Joints ; Methods ; Pelvic Bones ; Prognosis ; Weight-Bearing

PURPOSE: We experienced six cases of late infection of the hydroxyapatite (HA) orbital implant treated with surgical procedures. METHODS: Exposures of the HA and pyogenic granulomas around conjunctival dehiscence helped us to confirm infections of the HA orbital implants. Infections were not controlled by medical therapies so the HA implants were exchanged by silicone implants in all cases. Finally, the silicone implants were replaced by Medpor(R) after the inflammation had been controlled. Dermis fat graft was also performed in two cases due to insufficient conjunctival sac. RESULTS: Infections of HA orbital implants occurred at 62 to 106 months postoperatively. Staphylococcus aureus and Pseudomonas aeruginosa were cultured from removed implants. All cases show successful outcomes during 12 to 42 months after Medpor(R) implantations. CONCLUSIONS: Infections of peg-inserted HA orbital implants occurred after five years due to exposure of HA orbital implants. To replace infected HA implants with Medpor(R) implants is considered a functionally and aesthetically effective therapeutic method.
Dermis ; Durapatite* ; Granuloma, Pyogenic ; Inflammation ; Orbit* ; Orbital Implants* ; Pseudomonas aeruginosa ; Silicones ; Staphylococcus aureus ; Transplants

The purpose of this study is to introduce a new method to reduce the donor morbidity of radial forearm free flap using ulnar forearm flap, and to evaluate its usefulness and results. 6 patients underwent radial forearm free flap designed by authors and we repaired radial forearm flap donor defect using ulnar forearm flap following ablative surgery for oropharyngeal cancers from June 1995 to February 1997. Radial forearm flap was designed just proximal to wrist crease, and its vascular pedicle was placed in the center of flap. Donor defect was repaired with V-Y fashion closure using ulnar artery axial pattern fasciocutaneous flap. Mean closing time of donor site was 30 minutes. and mean healing period of donor site was 10 days. There was no difficulty in closure. All donor sites healed completely without complication. Limitation of motion was not noticed in the wrist and forearm. We conclude that repair of radial forearm flap donor defect using ulnar forearm flap is new excellent method to prevent the prominent scar of forearm in cases of conventional skin graft for donor defect, and provide rapid healing of wound with low risk of complication
Cicatrix ; Forearm* ; Free Tissue Flaps* ; Humans ; Oropharyngeal Neoplasms ; Skin ; Tissue Donors* ; Transplants ; Ulnar Artery ; Wounds and Injuries ; Wrist

The purpose of this study is to introduce a new method to reduce the donor morbidity of radial forearm free flap using ulnar forearm flap, and to evaluate its usefulness and results. 6 patients underwent radial forearm free flap designed by authors and we repaired radial forearm flap donor defect using ulnar forearm flap following ablative surgery for oropharyngeal cancers from June 1995 to February 1997. Radial forearm flap was designed just proximal to wrist crease, and its vascular pedicle was placed in the center of flap. Donor defect was repaired with V-Y fashion closure using ulnar artery axial pattern fasciocutaneous flap. Mean closing time of donor site was 30 minutes. and mean healing period of donor site was 10 days. There was no difficulty in closure. All donor sites healed completely without complication. Limitation of motion was not noticed in the wrist and forearm. We conclude that repair of radial forearm flap donor defect using ulnar forearm flap is new excellent method to prevent the prominent scar of forearm in cases of conventional skin graft for donor defect, and provide rapid healing of wound with low risk of complication
Cicatrix ; Forearm* ; Free Tissue Flaps* ; Humans ; Oropharyngeal Neoplasms ; Skin ; Tissue Donors* ; Transplants ; Ulnar Artery ; Wounds and Injuries ; Wrist

Strength training is one of the most common exercises practiced in the field of physical therapy or sports training. However, limited methodology is available to evaluate its effect on the target muscle. This study aimed to test the hypothesis that surface electromyographic (EMG) data from both isometric and isotonic exercise can express changes within the muscle during a 12-week strength training program. Ten healthy male volunteer students (5 for training, 5 for controls) from Yonsei University were recruited for evaluation in this study. DeLorme's axiom was practiced for 12 weeks in the dominant elbow flexors and knee extensors of the training group. Tension for 1 repetition maximum and maximal voluntary isometric contraction, and surface EMG information such as the integrated EMG and three variables from the regression line of median frequency (MDF) data were measured at weeks 0, 3, 6, 9, and 12. The limb circumference was measured at weeks 0 and 12. During the strength training, which was enough for the increment of muscle strength and limb circumference, the rectified-integrated EMG and initial MDF increased with a significant linear pattern in both types of contraction. The two surface EMG variables were able to monitor the physiologic muscle changes during the training. Based on these results, we propose that these two surface EMG variables can be used for monitoring electrophysiological changes in the specific muscle that is undergoing the training program, under conditions where the contraction mode for EMG data collection is either static or dynamic.
Quadriceps Muscle/anatomy & histology/physiology ; Muscle, Skeletal/anatomy & histology/physiology ; Male ; Isotonic Contraction/physiology ; Isometric Contraction/physiology ; Humans ; Fourier Analysis ; Exercise Therapy/*methods ; Electromyography/*methods ; Body Weights and Measures ; Adult

One hundred and three patients with strabismus who were undergoing extraocular muscle surgery were studied to compare the incidence of arrhythmia following the traction of ex- traocular muscles under halothane and sevoflurane anesthesia. Fifty four patients were anesthetized with O2-halothane(halothane group) and forty nine patients with O2-sevoflurane (sevoflurane group). The incidences of arrhythmia were 74.1% and 71.4% in halothane and sevoflurane group, respectively. There was no significant change of blood pressure in either group when arrhythmia occurred. The incidence of arrhythmias in female patients of the sevoflurane group was higher than that in male patients, while not in the halothane group. In the sevoflurane group, the incidence of arrhythmia followed by the traction of medial rectus muscle was significantly higher than that of lateral rectus muscle. In conclusion, there was no significant difference in the incidence of arrhythmia following the traction of extraocular muscles between halothane and sevoflurane anesthesia, and sinus bradycardia was the most common arrhythmia with either anesthetic.
Anesthesia ; Anesthetics* ; Arrhythmias, Cardiac ; Blood Pressure ; Bradycardia ; Female ; Halothane ; Humans ; Incidence ; Male ; Muscles ; Solubility* ; Strabismus ; Traction

No abstract available.
Humans*

BACKGROUND: Varenicline is now very useful medication for cessation; however, there is only little result of researches with varenicline for cessation of hospitalized patients. This research attempted to analyze the cessation effect of medication and compliance of hospitalized patients. METHODS: This research included data for 52 patients who were prescribed varenicline among 280 patients who were consulted for cessation during their admission period. This research checked whether smoking was stopped or not after six months and analyzed their compliance, the factors for succeeding in smoking cessation. RESULTS: One hundred and ninety hospitalized patients participated in smoking cessation counseling among 280 patients who included consultation from their admission departments. And varenicline was prescribed for only 80 patients after counseling. Nineteen smokers were successful in smoking cessation among 52 final participants representing the rating of success of 36.5%. The linkage between compliance of varenicline and rate of smoking successful has no statistical significance. The factors for succeeding in smoking of hospitalized patients are admission departments, diseases, and economic states. CONCLUSION: Smoking cessation program has low inpatient compliance. Cooperation of each departments is very important for better compliance. Success rate of cessation was relatively high (36.5%). Cessation attempt during hospitalization is very effective strategy.
Compliance* ; Counseling ; Hospitalization ; Humans ; Inpatients ; Smoke* ; Smoking Cessation* ; Smoking* ; Varenicline