No abstract available.
Dreams*

We studied the technical problems of step-cut osteotomy and a method to improve the problem. When a bony fragment is removed from distal humerus in step cut osteotomy, we obtain a bony defect of the shape of a right triangle. The distal part of this defect is right angled(90 degrees) but the proximal part inserted in it is less 2than 90 degrees, they do not correspond to each other. There is, however, no explanation on this in the original article. By personal communication with DeRosa, he said he would remove a part of the small bony spike of the lateral side after osteotomy. However, it is technically difficult to remove a part of the distal bony spike because it is tiny and it can cause a fracture on the bony spike. Even in a successful 1case, there arises a problem of fixing with a cortical screw. To solve this problem, we instead removed a part of the lateral cortex of proximal part so that we made possible the contact of medullary canal at the osteotomy site without removing the lateral spike of distal bony spike. This way, a more stable fixation and a faster bony union were made possible. This modified method was performed on 17 cases, in which the average age of the patients was 13 years old(9 to 18). For 4-6 weeks after the operation, they were immobilized the upper extremity in a cast, and after that, then were allowed to do exercises. We obtained the complete bony union between the 10th and 16th week after the operation. In the follow-up cases of minimum 1 year, 12 cases were proven excellent, 3 cases were good, and 2 cases were poor by Oppenheim's criteria. There was one case of radial nerve transient paresis and one case of metal failure. There was no nonunion on osteotomy site. By using the modified method, we made possible the mechanically stable and technically easier fixation to obtain satisfactory results.
Exercise ; Follow-Up Studies ; Humans ; Humerus ; Methods ; Osteotomy ; Paresis ; Radial Nerve ; Upper Extremity

In order to compare mechanical stability of the Ilizarov external fixation methods for treatment of pilon fracture of the tibia, six human amputed tibiae were utilized to simulate Ruedi type I, II, and III fractures anatomically and non-anatomically reduced. Six fracture models which were either anatomically(3) or non-anatomically(3) reduced were first stailized by the Ilizarov construct composed of two tibial rings and foot assembly with connecting rods and ankle hinges and underwent axial load compression test using Instron. And then same tests were repeated on the models in which ankle hinges between the tibial rings and foot assembly were removed to examine biomechanical effect of the ankle hinges on the fracture stability. When the fracture model was fixed by the construct without ankle hinges, 720 N-780 N were required to disrupt fracture stability. When the fracture was non-anatomically reduced and was fixed by the construct without ankle hinges, 420 N-520 N were required to disrupt the fracture stability. The current study suggests that Ilizarov fixation system should have the construct composed of two tibial rings and foot assembly with connection rods and ankle hinges to prevent fracture destabilization during early ankle motion and weight-bearing in the tibial pilon fracture.
Ankle ; Foot ; Humans ; Methods ; Tibia ; Weight-Bearing

No abstract available.
Asthma* ; Humans ; Pneumocytes* ; Superoxides*

Portable gamma radiography for nondestructive testing with 192Ir is commonly used in various industrial fields to defect possible internal defects of metals in pipelines, tanks, bridges, ships and so forth in Korea. Compared to the numerous researches about biologic effects and potential risks of radiation, only a Jew papers were reported about radiodermatitis from occupational exposure to 192Ir. In this study, we investigated six patients with occupational radiodermatitis with developed during portable gamma radiography for nondestructive testing with 192Ir. All six patients had developed radiodermatitis on their hands and fingers. They noticed painful swelling, erythema, and bullae on their fingers or palms 1 to 2weeks after exposure. Three patients suffered from chronic fibrosis and recurrent ulcerations. We also discussed about the working situation of our patients and reviewed the literatures about the radiodermatitis from occupational exposure to 192Ir. In conclusion, we think ionizing radiation, though it is a useful tool in industry, must be carried out in accordance with radiation protection rules and regulations.
Erythema ; Fibrosis ; Fingers ; Hand ; Humans ; Jews ; Korea ; Metals ; Occupational Exposure* ; Radiation Protection ; Radiation, Ionizing ; Radiodermatitis* ; Radiography ; Ships ; Social Control, Formal ; Ulcer

BACKGROUND: The use of anesthesia during assisted reproductive technology (ART) such as TEST (Tubal Embryo Stage Transfer) may expose early embryo to anesthetics in tubal fluid. The effects of anesthetic agents on the development of early embryo in ART are yet unclear. The purpose of this study was to evaluate the effects of narcotics on mouse two-cell embryo development using in vitro growth model of mouse embryo. METHODS: Mouse two-cell embryos were exposed to narcotics, fentanyl (6.0 nM; 30.0 nM) and meperidine (1.0 M; 3.6 M) respectively. Mouse two-cell embryos unexposed to any drugs were served as controls. In vitro developmental patterns were observed on the third and fifth day of culture. RESULTS: There were no significant differences in the rates of embryos arrested at 2~8 cell stage on the third day after culture and blastocysts development and their hatching on the fifth day after culture among three groups. CONCLUSION: We conclude that fentanyl and meperidine in clinical therapeutic concentration have no detrimental effects on the in vitro two-cell mouse embryo development. But further investigations are required to determine whether narcotics have any adverse toxic effects in human reproductive medicine.
Anesthesia ; Anesthetics ; Animals ; Blastocyst ; Embryonic Development* ; Embryonic Structures* ; Female ; Fentanyl ; Humans ; Meperidine ; Mice* ; Narcotics* ; Pregnancy ; Reproductive Medicine ; Reproductive Techniques, Assisted

No abstract available.
Vascular System Injuries*

PURPOSE: To draw attention to the radiological findings of a benign variant of cerebral astrocytoma in a young patient. MATERIALS AND METHODS: A 24-year-old man with generalized tonic-clonic seizure of 7 years' duration and normal neurological examination was examined with plain skull series, brain CT and MRI, and cerebral angiography. MR imaging was performed with a 0.5 Tesla Toshiba MRT-50A scanner (TIWI, PDWI, T2WI, 0.1 mmol/kg of Gd- DTPA, SE). RESULTS: 1 ) Plain skull series: A radiolucent lesion with a partial radiopaque rim of about 2.5 x 3 cm size in the right anterior parietal bone.2) B rain CT scan: A cystic mass in the right frontoparietal cortex of midconvexity with pressure erosion on the adjacent skull and partial enhancement at outer and anterior portion.3) Brain MRI:A hypointense mass containing a small, intensely enhancing isointensity anterolaterally on Tl-weighted images, which was hyperintense with better delineation of bulging cortical-based appearance on T2-weithted images. No peritumoral edema.4) Cerebral anglography: An avascular mass. CONCLUSION: The diagnosis of pleomorphic xanthoastrocytoma(PXA) should be entertained in patients in whom a superticially placed enhancing intracerebral tumor containing cystic portion that seems to be in contact with the meninges develops during juvenile years.
Astrocytoma ; Brain ; Cerebral Angiography ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Meninges ; Neurologic Examination ; Pentetic Acid ; Rabeprazole ; Rain ; Seizures ; Skull ; Tomography, X-Ray Computed ; Young Adult

In the whole arm type of brachial plexus injury, the nerve grafting method give the best result. As it is impossible, however to operate the preganglionic whole arm type by interfascicular nerve graft, the treatment of this type of injury is difficult. In this lesion, neurotization may be the only useful method. To evaluate it's efficacy, 38 cases of multiple neurotization have been reviewed. The follow up period was on average 45 months(24 months to 76 months). The results are as follows: 1. Motor or sensory improvement of good or better results was observed in 27 nerves(29%) and that of better-than-fair results in 54 nerves(57%). 2. The best results were obtained in patients less than thirty year old and in the patients where the operation was performed within the first six months after injury(19 cases, 42%). 3. The use of spinal accessory, phrenic, intercostal and supraclavicular nerves, as a source of neurotization produced similar results. Phrenic nerve neurotization was performed without any significant respiratory difficulty. 4. The results of neurotization were analysed by Kim's method. Functional recovery of the upper extremity showed relatively poor results. 5. Out of the 25 patients who had developed a painful syndrome before neurotization, 19 cases(60%) showed improvement of the symptom. Multiple neurotization in preganglionic whole arm type of brachial plexus injury is of a little value in improving upper extremity function. Nerve neurotization can not always make a paralysed upper limb useful, because it is impossible to control the digits and intrinsic muscles in the hand and to restorate fine sensation by it. Nevertheless, functional recovery of the paralyzed upper limb, compared with no previous muscle contraction, encourages patients who have suffered serious brachial plexus injuries to start an active their life again.
Arm ; Brachial Plexus ; Follow-Up Studies ; Hand ; Humans ; Methods ; Muscle Contraction ; Muscles ; Nerve Transfer ; Phrenic Nerve ; Sensation ; Transplants ; Upper Extremity

BACKGROUND: To study the prognosis of patients with lung cancer, many investigators have reported the methods to detect cell proliferation in tissues including PCNA, thymidine autoradiography, flow cytometry and Ki-67. PCNA, also known as cyclin, is a cell related nuclear protein with 36KD intranuclear polypeptide that is maximally elevated in S phase of proliferating cells. In this study, PCNA was identified by paraffin-embedding tissue using immunohistochemistry which has an advantage of simplicity and maintenance of tissue architecture. The variation of PCNA expression is known to be related with proliferating fraction, histologic type, anatomic(TNM) stage, degree of cell differentiation, S-phase fraction and survival rate. We analyzed the correlation between PCNA expression and S-phase fraction, survival. METHODS: To investigate expression of PCNA in primary lung cancer, we used immunohistochemical stain to paraffin-embedded sections of 57 resected primary non-small cell lung cancer specimen and the results were analyzed according to the cell type, cell differentiation, TNM stage, S-phase fraction and survival. RESULTS: PCNA expression was dMded into five group according to degree of staging(-, +, ++, +++,++++). Squamous cell type showed high positivity than in adenocarcinoma. Nonsignificant difference related to TNM stage was noticed. Nonsignificant difference related to degree of cell differentiation was noticed. S-phase fraction was increased wit advance of PCNA positivity, but t could not reach the statistic significance. The 2 year survival rate and median survival time were -50% 13 months, +75% 41.3 months, ++73% 33.6 months, +++67% 29.0 months, ++++25% 9 months with statistic significance (P<0.05, Kaplan-Meier, generalized Wilcox). CONCLUSION: From this study. PCNA expression was high positive n squamous cell cancer. And, there was no relationship between PCNA positivity and TNM stage, cellular differentiation or S-phase fraction. But, the patients with high positive PCNA staining showed poor survival rate than the patients with lower positive PCNA. It was concluded that PCNA immunostaining is a simple and useful method for survival prediction in paraffin embedded tissue of non-small cell lung cancer.
Adenocarcinoma ; Autoradiography ; Carcinoma, Non-Small-Cell Lung* ; Cell Differentiation ; Cell Proliferation ; Cyclins ; Flow Cytometry ; Humans ; Immunohistochemistry ; Lung Neoplasms ; Neoplasms, Squamous Cell ; Nuclear Proteins ; Paraffin ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Research Personnel ; S Phase ; Survival Rate* ; Thymidine