There have been increasing interests of diabetes in the realm of plastic surgery due to problems like foot ulcer as a complication, delayed wound healing or higher failure rates of flap surgery. Main pathology in diabetes is microvascular compromise as well as metabolic derangements. The disturbance in microvascular circulation results in ischemic environments in the body and acts as a main factor that determines the limit of reconstructive or aesthetic plastic surgery. A useful method to overcome such problems is the use of hyperbaric oxygen therapy, which is known to be effective in the treatment of ischemic skin ulcer or osteoradionecrosis. However, there have been few studies on the survival of diabetic random skin flap or the effects of hyperbaric oxygenation directed to increase survival of such flap. In our study, we supposed that the survival of diabetic random skin flap was diminished owing to compromised microvascular pathology and blood rheology, and metabolic derangements, so we hypothesized that hyperbaric oxygen therapy has both reversible and irreversible effects on the survival of ischemic random skin flap in Streptozotocin-induced diabetic rats. Increase of local transcutaneous oxygen concentration, O2 affinity in blood and dysmorphogenesis of red blood cells are reversible and relatively short-term effects and promotion of neoangiogenesis is irreversible or long-term effects. We intended to confirm that hyperbaric rats and to compare the effects between preoperative and postoperative hyperbaric oxygenation on the survival of such flap. And we expect the additional effects of hyperbaric oxygenation on metabolism in diabetic rat, such as lowering the blood glucose level and solving the arrested weight gain. We divided Streptozotocin-induced diabetic rats into three groups: the first was non-treatment diabetic group, the second was preoperative hyperbaric oxygen treated diabetic group(100% O2, 2 atm, 90min, 15sessions, twice a day), and the third was postoperative hyperbaric oxygen treated group(100% O2, 2atm, 90min, 15sessions, twice a day). After elevation of random skin flap on dorsum of diabetic rats, we evaluated the extent of flap survival by measuring the necrotic areas at 3rd, 7th, 10th, and 13th postoperative days. At that time, we intended to evaluate both effects on flap survival by preoperative and postoperative hyperbaric oxygen therapy. As a result, flap survival of non-treated diabetic group was 41% at 13th postoperative days. In diabetic groups with preoperative and postoperative hyperbaric oxygen therapy, flap survival were increased to 64.6% and 62.4% respectively. Diabetic groups with hyperbaric oxygen therapy have a tendency of meaningful decrement in blood glucose level. However, there were no meaningful differences between preoperative and postoperative hyperbaric oxygen therapy. Hyperbaric oxygen therapy has no effective correlations with body weight changes. We conclude that hyperbaric oxygen therapy has some useful effects on the survival of diabetic random skin flap.
Animals ; Blood Glucose ; Body Weight Changes ; Erythrocytes ; Foot Ulcer ; Hyperbaric Oxygenation* ; Metabolism ; Osteoradionecrosis ; Oxygen ; Pathology ; Rats* ; Rheology ; Skin Ulcer ; Skin* ; Surgery, Plastic ; Weight Gain ; Wound Healing

The soleal line in 115 (left; 61, right; 54) cases of tibiae was studied morphometrically by the method of Mysorekar and Nandedkar. 1. The soleal line showed a uniform character throughout in 26 cases and a mixed characters in 89 cases. The bones showing uniform character were seen generally as a lineal line or wide line. 2. The soleal line having mixed characters divided into three parts. In the upper and middle thirds, the major type of line was wide line. In the lower third, the line was commonly seen as a lineal line. In about 12% of the bones examined the line was seen as a groove, particularly in the middle and lower thirds. 3. The soleal line commenced 1-2cm below the fibular facet In about 61% of cases. 4. The length of the soleal line was 10.5cm, and the ratio to that of the tibia was about 30%. The results of this study provide the characters of the soleal tne of the tibia in Korean. The soleal line, unlike the textbook description, generally shows mixed characters of a line.
Methods ; Tibia*

PURPOSE: Long-term follow-up results of concurrent bilateral or unilateral cementless hip arthroplasty were compared. MATERIALS AND METHODS: Forty eight and 49 patients with concurrent bilateral and unilateral hip artrhoplasties who had more than a 17-year follow-up time were selected. At final follow-up, mean ages were 69.1 and 66.7 years old in the bilateral and unilateral groups, respectively. Mean follow-up times were 21.5 and 22.4 years in the bilateral and unilateral groups, respectively. Clinical results were attained using Harris hip score and standardized anteroposterior and lateral view X-rays. RESULTS: The bilateral group had mean Harris scores of 44.3(standard deviation 3.78) preoperatively, and 81.2 (10.75) at final follow-up. For the unilateral group, the mean scores were 46.5(3.27) preoperatively, and 80.1 (12.05) at final follow-up. At final follow-up, an acetabular cup was securely located in 78.9% and 82.8% of the bilateral and unilateral groups, respectively, and all cases showed firm fixation of the femoral stem in both groups. Osteolysis around the cup and stem were found in 26.3% and 31.4% of the bilateral group and 16.6% and 17.1% of the unilateral group, respectively. Polyethylene wear rate was 0.17 mm/yr and 0.16 mm/yr in the unilateral and bilateral groups, respectively. Using the Kaplan-Meier method, 17-year survival rates for cup and stem were 78% and 89% in the bilateral group, respectively, and 78% and 86% in the unilateral group, respectively. CONCLUSION: In 17-year long-term follow-up, concurrent bilateral hip arthroplasty was insignificantly different clinically and radiologically from the result of unilateral hip arthroplasty.
Arthroplasty ; Follow-Up Studies ; Hip ; Humans ; Osteolysis ; Polyethylene ; Survival Rate

PURPOSE: To assess the spinal canal and neural foraminal stenosis associated with spondylolisthesis on MR imaging. MATERIALS AND METHODS: We retrospectively analysed MR findings of 63 cases of spondylolisthesis(degenerative type:23 cases, isthmic type:40 cases) regarding the type and grade of spondylolisthesis, prensence or absence of associated spinal canal stenosis, and the severity of associated neural foraminal stenosis. RESULTS: Central canal stenosis were more frequent in degenerative type(91%) than isthmic type(33%), and more frequent in grade II spondylolisthesis of degenerative type(100%) and isthmic type(89%) than in grade spondylolisthesis of degenerative type(45%) and isthmic type(20%). There was positive correlation between the severity of neural foraminal stenosis and the grade of spondylolisthesis, whereas there was no significant difference between degenerative and isthmic types. CONCLUSION: Degenerative spondylolisthesis were frequently associated with central canal stenosis more than isthmic type. When the grade of spondylolisthesis was higher, it was more frequently associated with central canal stenosis and severe neural foraminal stenosis.
Constriction, Pathologic* ; Magnetic Resonance Imaging ; Retrospective Studies ; Spinal Canal ; Spondylolisthesis*

We analyzed our experience of orchidopexies performed during last 10 years to evaluate results and to determine the possible approach to the treatment of undescended testes. Between 1988 and 1997, we had treated 420 undescended testes (314 palpable and 106 nonpalpable) in 356 boys. Average patient age at presentation was 4.1 years with 40.2% presenting before the age of 2 years. Of 106 nonpalpable testes, 23 testes were intraabdominal, 32 were preperitoneal and 51 were absent at the surgery. During the period of first 5 years, we had performed the surgery through 31 inguinal and 13 midline transabdominal incisions for 44 patients nonpalpable testes, while during the later 5 years, all 47 patients nonpalpable were treated through inguinal incisions. For the nonpalpable testes, the inguinal approach with or without intraperitoneal extension was successful in defining the location of testes and blind-ending vessels in all patients. Laparoscopy was not helpful in avoiding surgical exploration in all our patients with nonpalpable testes. Of 339 inguinal and midline transabdominal orchidopexies without spermatic vessels ligations, 324 testes were placed in the scrotum, 4 in the upper scrotum and 3 in the inguinal area. Eight were resulted in atrophy. Of 13 Fowler-Stephens orchidopexies, 7 were placed in the scrotum and 6 were resulted in atrophy. Testicular growths were noticed in most patients who underwent orchidopexies and the volume of fixed testes became as large as the contralateral normal testes by the mean duration of 43.3 months postoperatively. In conclusion, orchidopexies were successful in most cases of cryptorchidism in terms of testicular position and growth. However, there were more testicular atrophies in patient in whom spermatic vessels were ligated. In cases of nonpalpable undescended testis, the inguinal approach with or without intraperitoneal extension would be recommended.
Atrophy ; Cryptorchidism ; Humans ; Laparoscopy ; Ligation ; Male ; Orchiopexy* ; Scrotum ; Testis

No abstract available.
Paralysis* ; Tourniquets*

No abstract available.
Gangwon-do* ; Humans

PURPOSE: Epididymal anomalies in boys with an undescended testis have been well documented and most undescended testes are associated with patent processus vaginalis. However, the incidence of epididymal anomalies in descended testes has not well known. We performed a prospective study to determine the relationship between epididymal anomalies and patency of processus vaginalis in boys with hydrocele or cryptorchidism. MATERIALS AND METHODS: From January 1997 to February 1988, epididymal morphologies and the degrees of patency of processus vaginalis(closed, partially closed and open) were examined in 35 boys with hydrocele(37 testes) and 28 boys with cryptorchidism(29 testes) at the surgeries. RESULTS: No epididymal anomaly was found in all 3 hydroceles with closed processus vaginalis. Epididymal anomalies were found in 13 of 22 hydroceles with partially closed processus vaginalis and in 9 of 12 hydroceles with open processus vaginalis. All boys with undescended testes had open processus vagnialis and the epididymal anomalies were found in 27 of 29 undescended testes. The incidence of epididymal anomalies was highest in cryptorchid testes with open processus vaginalis and lowest in descended testes with closed processus vaginalis. Furthermore, epididymal anomalies were found to be more severe in association with more cranially located testes. CONCLUSIONS: The higher incidence of epididymal anomalies were associated with ipsilateral patency of processus vaginalis and testicular position. This finding suggests that the role of the epididymis in testicular descent may not be essential.
Cryptorchidism* ; Epididymis ; Incidence ; Male ; Prospective Studies ; Testis

This study was aimed to elucidate the relationship between combinations of treadmill speed-grade and oxygen consumption(Vo2). Twenty athetic and 20 non-athletic male college students aged 19-24yr were employed to exercise on a treadmill using 4 speeds(4.02, 5.47, 6.76 and 8.05km/h) and 5 grades(0, 8, 12, 16 and 20%). A fixed speed was selected for each session with the grade increased every 3 min. The Vo2, heart rate, stride frequency and stride length were measured during the last min of each 3-min stage. Vo2increased linearly with increasing speed and grade showing significant multiple correlations in nonathletes(Vo2=3.64x+0.831y+0.031xy-7.03, R=0.98, P<0.01) and athletes(Vo2=3.48x+0.324y+0.112xy-5.74, R=0.99, P<0.01). Stride frequency and length tended to increase with increasing speed except for the transition from walking to runnig at 8.05Km/h at which the stride frequency ran up much higher with the stride length getting lower than at 6.76Km/h. Heart rate increased linearly with increasing Vo2. The rate of increase was higher during walking than during running. These results indicate that athletes have higher rate of increase in Vo2than nonathletes at near-maximal exercise and may be used as a guideline in predicting maximum oxygen comsumption and in prescribing exercise intensity.
Athletes* ; Heart Rate ; Humans ; Male ; Oxygen Consumption* ; Oxygen* ; Running ; Walking

No abstract available.