No abstract available.
Tissue Expansion Devices*

Twenty nine cases of segmental tibial fracture were treated at Ewha Womans University Hopital, Department of Orthopedic Surgery, during the period from January, 1970 to December, 1984. The following results were obtained. 1. Most common fracture level was type I, high middle segment, occurred about 12 cases (41.4%). 2. In view of the higher incidence of open fracture (16 cases, 55.1%) and comminuted fracture (22 cases, 75.9%), fracture was caused by high velocity. 3. Various external and internal fixation methods were applied, but higher union rate was seen in the cases of Küntscher nailing and plating with bone graft. 4. Excluding the cases of type V, average union rate was 28.5 weeks and open fracture (ave. 29.6 weeks) required more longer union rate than closed fracture (ave. 26 weeks). 5. Higher rate of complication (21 cases, 72.4%) was noted than other types of tibial fracture. 6. Good result was obtained for treatment of 5 cases of delayed union or non-union by plating and bone graft than any other methods.
Clinical Study ; Female ; Fractures, Closed ; Fractures, Comminuted ; Fractures, Open ; Humans ; Incidence ; Orthopedics ; Tibia ; Tibial Fractures ; Transplants

No abstract available.
Mitral Valve* ; Quinidine*

BACKGROUND: Caudal anesthesia has gained wide acceptance in pediatric anesthesia as a technique for providing postoperative pain relief and reducing general anesthetic requirement for surgical procedures below umbilicus. Although blood pressure has been shown to be well maintained with caudal anesthesia in pediatrics, little is known about the change in hemodynamics with combined general and caudal anesthesia. This study was designed to investigate the hemodynamic changes of combined general and caudal anesthesia for lower abdominal surgery in children. METHODS: Sixty children scheduled for lower abdominal surgery were involved. They were randomly divided into 2 groups: group G (n = 30); anesthesia with enflurane and N2O, and the group GC (n = 30); anesthesia with combined caudal block using 1% lidocaine 1 ml/kg and enflurane. Systolic (SBP), diastolic (DBP), mean blood pressure (MBP), and heart rate (HR) were measured at the 6 different time periods; at before induction (T1), just before skin incision (T2), just after skin incision (T3), 5 min (T4), 10 min (T5), and 30 min (T6) after skin incision. RESULTS: There were no significant differences in variables of hemodynamics between both group. Compared with the values at T1, those of SBP, DBP, and MBP at T2, T3, T4, T5, and T6 were decreased in both groups. However, there were no difference in those values at the same time periods between the two groups. The values of SBP, DBP, and MAP at T3, T4, T5, T6 in group G were higher compared with those at T2. CONCLUSIONS: From these results, we concluded that there were no significant changes in hemodynamics by combined general and caudal anesthesia in pediatric patients.
Anesthesia ; Anesthesia, Caudal* ; Blood Pressure ; Child* ; Enflurane ; Heart Rate ; Hemodynamics* ; Humans ; Lidocaine ; Pain, Postoperative ; Pediatrics ; Skin ; Umbilicus

BACKGROUND & METHODS: Approximately 10% of the essential hypertensive patient have overt proteinuria due to renal target organ damage, which indicates poor prognosis. Recently microalbuminuria has been prove to be a good early predictor for renal damage in patients with diabetes or hypertension. Some authors reported that near 40% of the essential hypertensives have microalbuminuria. To determinate prevalence of microalbuminuria in Korea essential hypertensives, 24-hr ambulatory blood pressure monitoring and radioimmunoassay to detect BP and UAER were performed after 4 weeks wash-out period in 137(78 hypertensive and 54 normotensive) consecutive cases. RESULTS: Among 78 hypertensives, overt proteinuria was seen in 8.97%(7/78). And prevalence of microalbuminuria were 29.4%(23/78) in hypertensives and 16.7%(9/54) in normotensives. Urine microalbumin excretion rate(UAER) was significantly correlated with mean arterial pressure(MAP) in total subjects(r=0.286, p=0.0012), but not in total hypertensives(r=0.135, p=NS) or in hypertensives with UAER(r=-0.098, p=NS).UAER of female hypertensives was increase than that of male hypertensives(13.17+/-16.28microg/min vs 22.87microg/min, p=0.027). CONCLUSION: Prevalence of microalbuminuria in Korean hypertensives was relatively lower then other reports. Overt proteinuria was noted in 8.97% of the hypertensives which is same prevalence as other countries. Moreover MAP was well correlated with UAER in total subjects. Further evaluation should be done to detect exact role of UAER in hypertensives as an early predictor for renal target organ damage.
Blood Pressure Monitoring, Ambulatory* ; Blood Pressure* ; Female ; Humans ; Hypertension ; Korea ; Male ; Prevalence* ; Prognosis ; Proteinuria ; Radioimmunoassay

BACKGROUND & METHODS: Approximately 10% of the essential hypertensive patient have overt proteinuria due to renal target organ damage, which indicates poor prognosis. Recently microalbuminuria has been prove to be a good early predictor for renal damage in patients with diabetes or hypertension. Some authors reported that near 40% of the essential hypertensives have microalbuminuria. To determinate prevalence of microalbuminuria in Korea essential hypertensives, 24-hr ambulatory blood pressure monitoring and radioimmunoassay to detect BP and UAER were performed after 4 weeks wash-out period in 137(78 hypertensive and 54 normotensive) consecutive cases. RESULTS: Among 78 hypertensives, overt proteinuria was seen in 8.97%(7/78). And prevalence of microalbuminuria were 29.4%(23/78) in hypertensives and 16.7%(9/54) in normotensives. Urine microalbumin excretion rate(UAER) was significantly correlated with mean arterial pressure(MAP) in total subjects(r=0.286, p=0.0012), but not in total hypertensives(r=0.135, p=NS) or in hypertensives with UAER(r=-0.098, p=NS).UAER of female hypertensives was increase than that of male hypertensives(13.17+/-16.28microg/min vs 22.87microg/min, p=0.027). CONCLUSION: Prevalence of microalbuminuria in Korean hypertensives was relatively lower then other reports. Overt proteinuria was noted in 8.97% of the hypertensives which is same prevalence as other countries. Moreover MAP was well correlated with UAER in total subjects. Further evaluation should be done to detect exact role of UAER in hypertensives as an early predictor for renal target organ damage.
Blood Pressure Monitoring, Ambulatory* ; Blood Pressure* ; Female ; Humans ; Hypertension ; Korea ; Male ; Prevalence* ; Prognosis ; Proteinuria ; Radioimmunoassay

Mucopolysaccharidoses are a group of inherited disorders of metabolism resulting in the deposition of mucopolysaccharide in various tissues. This leads to organ dysfunction and anatomical abnormalities which can be important to the anesthetist. These abnormalities result in airway difficulty and difficult intubation. We successfully performed endotracheal intubation in a case of mucopolysaccharidoses in a 9-year-old female patient using fiberoptic laryngoscopy.
Child* ; Female ; Humans ; Intubation ; Intubation, Intratracheal* ; Laryngoscopy* ; Metabolism ; Mucopolysaccharidoses

BACKGROUND: Although radiofrequency catheter ablation (RFCA) is useful in the treatment of idiopathic ventricular tachycardia, especially right ventricular outflow tract tachycardia (RVOTT), some tachycardias remain resistant despite several attempts. This study was focused to search of electrocardiographic characteristics suggestive of successful radiofrequency ablation of idiopathic ventricular tahycardia showing LBBB and inferior axis. MATERIALS AND METHODS: The study subjects were 19 patients (mean age 4415, male 5, female 14) those we tried RFCA under the diagnosis of RVOTVT. The study subjects were grouped into success group (N=14) and failed group (N=5). We analyzed the morphologic characteristics of QRS complex during ventricular tachycardias or ventricular premature beats in both groups. RESULTS: Acute success was obtained in 14 of 19 patients. For RFCA of RVOTT, pace mapping and/or activation mapping were used to select an ablation site as described previously(1). Activation mapping was possible only for 5 patients. All patients except one patient of success group showed inferior axis of QRS during VT. We didn't find significant difference in QRS axis, QRS morphologies in lead 1 and aVL, and QRS width in lead II and V2 between success (N=14) and failed group (N=5). However, in analysis of morphologic comparison of precordial leads, 12 out of 14 patients in success group showed initial r wave in V1 (p=0.017) and 11 patients had precordial transition >V3 (p=0.038). Whereas, in failed group, 4 patients had precordial transition V3 and only one patient showed precordial transition >V3. Initial r of V1 was seen in one patient and remaining 4 patients showed QS pattern in V1. CONCLUSION: Analysis of QRS morphology in V1 and precordial transition site may identify patients with high and low success rate during RFCA of idiopathic RVOTT
Axis, Cervical Vertebra* ; Bundle-Branch Block* ; Cardiac Complexes, Premature ; Catheter Ablation* ; Diagnosis ; Electrocardiography* ; Female ; Humans ; Male ; Tachycardia ; Tachycardia, Ventricular*

BACKGROUND: Persistent facial telangiectasia, erythema and flushing are the major cosmetic problems in patients with rosacea. However various therapeutic treatments for rosacea papules and pustules are not effective in reducing telangiectasia and flushing reactions. Matrix-centered theory that dermal matrix degradation can cause telangiectasis, erythema and flushing, is one of the various theories of rosacea pathogenesis. Shark cartilage extracts are collagenase inhibitors and can inhibit dermal matrix degradation. OBJECTIVE: The purpose of this study was to evaluate the clinical effects of shark catilage extracts (Venatrix(R)) for erythematotelangiectatic rosacea patients. METHODS: Twenty three patients with erythematotelangiectatic rosacea applied shark cartilage extracts twice daily for up to 8 weeks. Efficacy was evaluated by erythema index using mexameter (MPA 5, CK, Germany) and clinical photography. RESULTS: Erythema index decreased from 525.7+/-114 to 413.9+/-101.7 (mean reduction: 21.3%) (p<0.1) after 8 weeks treatment. 16 patients (69%) showed excellent or good results by clinical photography. Transient stinging sensation was the most common adverse effect and these symptoms improved after the first few days. There were no other significant side effects. CONCLUSION: Shark cartilage extracts may be an effective treatment for mild erythematotelangiectatic rosacea.
Bites and Stings ; Cartilage* ; Erythema ; Flushing ; Humans ; Matrix Metalloproteinase Inhibitors ; Photography ; Rosacea* ; Sensation ; Sharks* ; Telangiectasis

BACKGROUND: The hemodynamic effects of an episode of ventricular tachycardia (VT) may vary from mild decrease in blood pressure to sustained hypotension, collapse, and death. Little is known about the factors responsible for these diverse effects. Ventricular function, vasomotor tone, and tachycardia cycle length could be major determinants of variable hemodynamic responses to VT. The site of origin was found to be a factor affecting pulse pressure even in an isolated ventricular premature contraction. However, the role of origin site in hemodynamics of VT is not yet elucidated. The purposes of this study were to evaluate the effects of VT origin site and VT cycle length to their hemodynamic changes. And we also have assessed the role of cardiac autonomic receptor activation in hemodynamic recovery during and immediate after VT. METHODS: In 18 open chest dogs anesthetized with chloralose, bipolar ventricular pacing (VP) was performed using sutured epicardial electrodes at 3 different sites ; left ventricular apex (LVA), right ventricular outflow tract (RVOT), and right ventricular apex (RVA). At each site, VP was repeated for 60 seconds at 3 different rates; 1.75X, 2X, and 2.25X of baseline heart rate (BHR). Mean arterial pressure (MAP), mean left atrial pressure (MLAP) and mean pulmonary artery pressure (MPAP) were monitored during VP. deltaMAP was defined as the difference between the baseline MAP and lowest MAP during VP. deltaMLAP was defined as the difference between highest MLAP during VP and baseline MLAP. Cardiac vagal and beta-adrenoreceptor blockades were achieved by intravenous bolus administration of propranolol (1 mg/kg and then 1 mg/kg/hr) and atropine (0.5 mg/kg and then 0.5 mg/kg/hr). After cardiac autonomic blockade, VP was repeated at 2X of baseline heart rate for 60 seconds at each site. RESULTS: Baseline MAP, MLAP, and MPAP were 101+/-8.1 mmHg, 0.3+/-0.41 mmHg, and 10+/-2.4 mmHg, respectively. At the same pacing site of VP, MAP was decreased significantly with VP and deltaMAP was increased significantly as VP cycle length shortened (all P<0.001). At the same pacing cycle length of VP, deltaMAP was significantly greater at RVA or RVOT than LVA: LVA vs RVOT ; all P<0.001 at 3 different rates, LVA vs RVA ; P<0.05 (1.75X & 2X of BHR), P<0.001 (2.25X of BHR). But there was no significant difference in deltaMAP between RVA and RVOT. At the same pacing site of VP, MLAP and deltaMLAP were increased significantly as VP cycle length shortened (all P<0.01), but at the same cycle length of VP, there was no significant differences in deltaMLAP at 3 different VP sites. Ventricular pacing after autonomic blockade induced a greater increase in deltaMAP and deltaMLAP compared to controls (all P<0.01 at 3 pacing sites). And cardiac autonomic blockade also resulted in significant blunting of recovery of MAP during VP compared to controls. CONCLUSION: Above results showed that pacing cycle length plays a major role in determining the hemodynamic outcomes during ventricular pacing, and that the site of origin could be an independent factor of ventricular tachycardia hemodynamics. And also modulation of tone of the adrenergic nervous system is essentially required for the hemodynamic recovery during ventricular tachycardia.
Animals ; Arterial Pressure ; Atrial Pressure ; Atropine ; Blood Pressure ; Chloralose ; Dogs* ; Electrodes ; Heart Rate ; Hemodynamics* ; Hypotension ; Nervous System ; Propranolol ; Pulmonary Artery ; Tachycardia ; Tachycardia, Ventricular ; Thorax ; Ventricular Function