OBJECTIVES: A significant number of patients who had a previous surgical treatment in the hip area experience subsequent hip fracture (SHF) on the opposite side. This study aims to analyze the risk factors and the correlation between osteoporosis and SHF on the opposite side by measuring bone mineral density (BMD) and treatment provided by risedronate for the prevention of SHF. MATERIAL & METHODS: We studied 475 patients without treatment who had unilateral hip and included following: death, SHF, alcoholism, living alone, dementia, dizziness, health status, osteoporotic treatment after fracture and BMD from March 1997 to June 2006. We selected 26 patients with SHF and the other 26 patients without SHF who had similar age, sex, BMI, BMD, diagnosis, treatment and follow up. The average follow up was 6.4 years (4~12 years) and 6.2 years (4~12 years).
Alcoholism ; Bone Density ; Dementia ; Dizziness ; Etidronic Acid ; Follow-Up Studies ; Hip ; Humans ; Osteoporosis ; Risk Factors ; Risedronate Sodium

Several suspension biomaterials are available for soft tissue augmentation. Although these gel type implants have been shown to be relatively safe and convenient, their varying degrees of resorption require repeated percutaneous injections. Previous in vivo and in vitro studies have shown that the injection of cultured human adipocytes can produce a sufficient volume effect with extended in vivo stability. This pilot study was undertaken to evaluate the clinical efficacy of this method. Between November 2007 and January 2008, 5 patients were treated with implants of autologous differentiated adipocytes for wrinkle correction and forehead augmentation. The contour changes of the treatment sites were investigated in accordance with the passage of time, as was the occurrence of complications. The degree of patient satisfaction was also evaluated. The injected bioimplants remained in situ. Two weeks after injection, they began to show evidence of a soft tissue augmentation effect. All patients were satisfied with the overall results of this method, and no complications occurred during the follow-up period. The results obtained indicate that differentiated human adipocytes may be successfully injected as living grafts for long-term implants, and that this method is a well tolerated, effective way of performing soft tissue augmentation.
Adipocytes ; Biocompatible Materials ; Follow-Up Studies ; Forehead ; Humans ; Patient Satisfaction ; Pilot Projects ; Skin Aging ; Transplants

This investigation was carried out in healthy twenty-four pregnant women undergoing elective Caesarean section and twelve nonpregnant women of the same age group, The premedication was performed with glycopyrroiate 0.2 mg and hydroxyzine l mg/kg IM respectively in the nonpregnant women, and glycopyrrolate 0.2 mg IM only in the pregnant women. Anesthesia was induced with IV pentothal sodium(4-5 mg/kg), vecuronium(0.08 mg/ kg) and ketamine(0.2 mg/kg) in the nonpregnant(Group I, N =12) or pregnant women(Group II, N=12), and pentothal sodium(4-Smg/kg), vecuronium(reducing dose of 20% from 0.08mg/kg) and ketamine(0.2 mg/kg) in the pregnant women(Group III, N=12). Anesthesia was maintained with 1-2% enflurane, 50% N2O, and O2. The ulnar nerve was stimulated supramaximally at the wrist with train-of-four stimuli every 20 sec. with ABM(Datex Co.) and the electromyographic response of the adductor pollicis muscle was measured. The onset of 50% block of first twitch height(T1) was faster in the group II(1.33+/-0.3min) than in the group I(1.9+/-0.6 min) and group III(1.6+/-0.3 min)(p<0.05). Also, the onset of 95% block of T 1 was faster in the group II(2.5+/-0.5 min) and III(1.6+/-0.3 min) than in the group I(3.8+/-0.9min)(p<0,05). The time of recovery of Tl to 10%, 25% and 50% of control were longer in the group II(34.9+/-5.3, 43.1+/-7.2 and 53.3+/-9.1 min respectively) and III(22.3+/-3.2, 29.5+/-4.5, 38.8+/-8.3 min respectively) than in the group I(21.1+/-4.8, 25.6+/-4.8 and 32.6+/-6.3 min respectively)(p<0.05). The conditions of intubation at 50% block of Tl were adequate in the group I and II but poor in the group III(p<0.05). Apgar score at 1 and 5 minutes after delivery were not significantly different between group II and III. Conclusively, administration of vecuronium dose on body weight basis in the pregnant women resulted in a more rapid onset and prolonged recovery of neuromuscular block than in the nonpregnant women without any adverse effects. Moreover, the conditions of intubation was poor when the dose of vecuronium was reduced by 20% in the pregnant women, Therefore, it is inadequate to reduce the dose of vecuronium concerning about relative overdose in the pregnant women undergoing Caesarean section.
Anesthesia ; Apgar Score ; Body Weight ; Cesarean Section ; Enflurane ; Female ; Glycopyrrolate ; Humans ; Hydroxyzine ; Intubation ; Neuromuscular Blockade* ; Pregnancy ; Pregnant Women ; Premedication ; Thiopental ; Ulnar Nerve ; Vecuronium Bromide* ; Wrist

PURPOSE: Compound tissue defects remain a challenge to reconstructive surgeons. The objective of this study was to introduce examples of successful reconstruction of compound defects of the head and neck and upper and lower limbs, using chimeric flaps based on the subscapular vascular system. METHODS: We report 19 reconstruction cases using chimeric flaps based on the subscapular vascular system. The scapular flap, scapular fascia, scapular bone, parascapular flap, latissimus dorsi, latissimus dorsi perforator flap, latissimus dorsi myocutaneous perforator flap, serratus anterior, serratus anterior fascia, and rib bone were used as components for chimeric flaps. 12 cases had defects of the upper limb, three in the lower limb, three in the head and neck area, and one case had a defect of the thoracoabdominal wall. RESULTS: Defect sizes ranged from 6x8cm to 20x22 cm. The component used most often for skin coverage was the latissimus dorsi perforator flap; for soft tissue bulk, the latissimus dorsi; for fascia coverage, the serratus anterior fascia flap; and for bone reconstruction, the scapular bone flap respectively. In all cases reconstruction was done successfully without additional operative procedures or flap necrosis. CONCLUSION: Because it is fairly easy to employ vascular pedicles of sufficient length and diameter, enabling the use of diverse types of tissue with various shapes and sizes, the use of chimeric flaps based on the subscapular vascular system allows one-stage reconstruction tailored to the characteristics of the defect area.
Fascia ; Head ; Lower Extremity ; Neck ; Perforator Flap ; Ribs ; Skin ; Surgical Procedures, Operative ; Upper Extremity

The result of compensatory sweating after surgical treatment for essential hyperhidrosis had problems in objectivity and validity because it mainly depended on the subjective symptoms of patients. Therefore, we tried to evaluate more precisely and objectively, the distribution and degree of compensatory sweating by D.I.T.I.(Digital Infrared Thermographic Imaging) with subjective symptoms.
Humans ; Hyperhidrosis ; Sweat* ; Sweating*

BACKGROUND: Although variable surgical methods of sympathetic nerve for palmar hyperhidrosis are curative and safe therapeutic options, they have some limitations such as compensatory sweating and anhidrosis of hand in long term satisfaction rate. MATERIAL AND METHOD: Therefore, we tried to decrease severity of compensatory sweating and prevent excessive dryness of hand through selective division of rami communicantes of thoracic sympathetic ganglia distributed to the hands(ramicotomy). RESULT: In postoperative results, about half of the patients maintained humidity of hands and most of them showed no more than mild degree of compensatory sweating. CONCLUSION: Therefore, ramicotomy of thoracic sympathetic ganglia can be recommended as selective and physiologic surgical method for palmar hyperhidrosis.
Ganglia, Sympathetic* ; Hand ; Humans ; Humidity ; Hyperhidrosis* ; Hypohidrosis ; Sweat ; Sweating