No abstract available.
Adult* ; Anatomic Landmarks* ; Humans ; Vertical Dimension*

Since introduction of venous flap in 1980, many experimental studies and clinical applications of various kinds of venous flaps were reported. Venous flap has the following advantages : (1) nonbulky and goo-quality of flap (2) long & large vascular pedicle (3) easy & rapid elevation of flap (4) no sacrifice of major arteries (5) a single operative field. But, we also have some disadvantages of difficult handling of the pliable veins and the tmcertainty of flap survival. For the better result we had to design the size of the flap larger than that of defect and increase the number of draining vein to reduce the postoperative edema of the flap. We have treated the defects of soft tissue of the hand using free arterialized venous flap from the flexor aspect of the forearm & had an excellent results.
Arteries ; Edema ; Forearm ; Hand* ; Veins ; Wounds and Injuries*

No abstract available.
Erythropoietin* ; Humans* ; Renal Dialysis*

No abstract available.
Ankle*

No abstract available.

BACKGROUND: Esmolol is a short acting sympathetic beta receptor antagonist, and it was successfully applied to induced hypotension. Esmolol lowers blood pressure by decreasing cardiac output, and does not cause vasodilation. This property of esmolol may help to decrease bleeding during induced hypotension. In this study, we tried to elucidate the effect of esmolol on induced hypotension for total hip arthroplasty. METHOD: Twenty patients receiving total hip arthroplasty were randomly divided to two groups. Esmolol group (10 patients) received esmolol as a hypotensive agent, and sodium nitroprusside (SNP) group (10 patients) received SNP as a hypotensive agent. We measured arterial blood gas analysis, vital sign, amounts of bleeding, amounts of transfusion and administered fluid, and various laboratory findings. RESULTS: Induced hypotension was successfully performed in either esmolol and SNP group. Heart rate increased by SNP, and decreased by esmolol. There were no statistically significant differences between the two groups in amounts of bleeding, amounts of transfusion or administered fluid, and laboratory findings. Arterial oxygen tension was relatively constant in esmolol group, but decreased in SNP group. CONCLUSION: Esmolol can be used as a single hypotensive agent during induced hypotension without significant side effects during total hip arthroplasty.
Arthroplasty, Replacement, Hip* ; Blood Gas Analysis ; Blood Pressure ; Cardiac Output ; Heart Rate ; Hemorrhage ; Humans ; Hypotension* ; Nitroprusside* ; Oxygen ; Sodium* ; Vasodilation ; Vital Signs

As one of many cell-many cell-based cartilage repairing methods, transplantation of chondrocyte-embedded-collagen gels in cartilage defect was performed for more satisfactory regeneration of cartilage. The authors performed this study to investigate whether the TGF-beta1 treatment of chondrocytes can do some additional synergistic effect on the transplantation of chondrocyte-embedded-collagen gels for crtilage repair. Chondrocytes were isolated from the articular cartilage of newborn Sprague-Dawley rats. Chondrocytes cultured for 10 days in monolayer were embedded in the 0.45% type I collagen gel. Full-thickness cartilage defect was made in the patellar groove of adult Sprague-Dawley rats. Chondrocytes culdefect was made in the patellar groove of adult Sprague-Dawley rats. The cartilage defects were treated with the following methods in a total of 200 animals, which were assigned to 5 different groups of 40 rats. In the control group, the deffect was left without any treatment, in group I, the defect was filled with collagen gel only, in group II, with collagen gel coontaining 10 ng/ml concentration of TGF-beta1, in group III, with collagen gel containing chondrocytes, and in group IV, with collagen gel containing chondrocytes and TGF-beta1. At 1, 2, 4, 8, 12 weeks after the operation, eight rats of each group were sacrificed, and their distal femurs were harvested for the histologic and biomechanical tests. The section s were stained with hematoxilin and eosin. Alcian-blue, and Safranin-O. Regenerated cartilage was analyzed by the semiquantitative histological grading system. Point indentation test was performed as a biomechanical evaluation, and the stiffness was calculated. The results of the histological grading system revealed that the scores gradually increased with time in all groups, and the scores of group III and IV were higher than those of control, group I and II. The biomechanical study showed that the stiffness gradually increased to reach a plateau level in each group. In control, group I and II, the stiffness increased up to the eighth week and remained around the increased level at the twelfth week, and did not show any statistically significant difference between the groups. In group III and IV, the stiffness was higher than in control group, and increased markedly at the fourth week and the increased level was maintained onwards. The results of this study showed that the transplantation of chondrocyte-embedded-collagen gels enhanced the healing process, and the treatment of TGF-beta1 demonstrated at least partially significant improvement.
Adult ; Animals ; Cartilage ; Cartilage, Articular* ; Chondrocytes ; Collagen ; Collagen Type I ; Eosine Yellowish-(YS) ; Femur ; Gels ; Humans ; Infant, Newborn ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Transforming Growth Factor beta1

BACKGROUND: The purpose of this study was to evaluate the usefulness and safety of the anterosuperior deltoid splitting approach for fixation of displaced proximal humeral fractures by analyzing the surgical outcomes. METHODS: Twenty-three patients who could be followed-up for at least 8 months after the treatment of displaced proximal humeral fractures through the anterosuperior deltoid splitting approach were enrolled. We evaluated the reduction of the fractures and surgery-related complications at the last follow-up using X-ray results and clinical outcomes comprising the University of California at Los Angeles (UCLA) scoring system and the Korean Shoulder Society (KSS) score. RESULTS: At the last follow-up of patients treated using the anterosuperior deltoid splitting approach for internal fixation of proximal humeral fractures, we found 22 cases (95.6%) of bone union, a mean UCLA score of 28.3 (range, 15 to 34) and a mean KSS score of 82.1 (range, 67 to 95). Various surgery-related complications were noted; a case of varus malunion after fracture displacement, a case of nonunion, a case of delayed union, two cases of impingement, and a case of partial axillary nerve injury, which recovered completely through the follow-up. CONCLUSIONS: Plate fixation using the anterosuperior deltoid splitting approach could be another reliable option for treating displaced proximal humeral fractures.
California ; Follow-Up Studies ; Humans ; Humerus ; Shoulder ; Shoulder Fractures*

Intracavernous self-injection therapy is now being widely used to treat patients with erectile dysfunction. Many men with erectile dysfunction can achieve normal erection with this therapy, but about 50% of men using this therapy eventually discontinue treatment for reasons relating to penile pain, needle-phobia and side effects including corporeal scarring, penile hematoma and priapism. Therefore, the less invasive route of drug administration is highly recommended. We investigated the efficacy and safety of transurethral instillation of PGE1 solution for the treatment of erectile dysfunction in comparison with an intracavernous injection of PGE1. Forty seven normal males and nine neurogenic impotent patients due to spinal cord injury (SCI) were enrolled in this study and all subjects were evaluated with the penile duplex color doppler ultrasonography before and after the drug administration. Penile length and circumference were measured before and after the drug administration. The erectile response was recorded on a five-point erection assessment scale by Padma-Nathan. Of 12 normal males used transurethral instillation of PGE1 solution 5 (42%) were achieved erection allowing sexual intercourse (score 4 or 5). The mean peak systolic velocity at 30 minutes was 75.82+/-56.84cm/sec, 63.11 +/- 48.11cm/sec and end diastolic velocity at 30 minutes was 3.49+/-8.10cm/sec, 10.51 +/- 1.12cm/sec and resistance index was 0.96+/-0.15, 0.78+/-0.15 in normal males and SCI patients respectively. Mean length and circumference of penile shaft before and after transurethral instillation of PGE1 showed significant difference. Of 9 patients, 5 (55.5%) were achieved erection allowing sexual intercourse. With the transurethral instillation of PGE1 solution, urethral pain and burning sense were noticeable complication but systemic side effect was not noticed. In conclusion, transurethral PGE1 instillation can be satisfactorily used for the patients with erectile dysfunction of less prominent organic and neurogenic origin, although the effect of transurethral instillation of PGE1 is obviously less than that of intracavernosal injection.
Alprostadil* ; Burns ; Cicatrix ; Coitus ; Erectile Dysfunction ; Hematoma ; Humans ; Male* ; Priapism ; Spinal Cord Injuries ; Ultrasonography, Doppler, Color

Pancreatic islet cell adenoma is a benign tumor of pancreatic beta-cell and a rare cause of hyperinsulinemic hypoglycemia in children. The authors experienced a case of pancreatic islet cell adenoma(Insulinoma)in a 11 year and 8 month old male who had frequent loss of consciousness and seizure. Enucleation was done after localization of tumor by selective celiac artery angiography and abdominal computed tomography. Diagnosis was confirmed by histologic findings as pancreatic-adenoma, gyriform growth pattern. A brief review of related literature was made.
Adenoma* ; Angiography ; Celiac Artery ; Child ; Diagnosis ; Humans ; Hyperinsulinism ; Hypoglycemia ; Infant ; Islets of Langerhans ; Male ; Seizures ; Unconsciousness