We studied the historical changes of intervertebral disc displacement using magnetic resonance imaging. The phenomenon of the spontaneous regression of herniated discs is well known. The case of a 40-years-old male presenting with a large disc herniation at L5-S1, experiencing severe sciatic pain, and having the straight leg raising test positive at 25 degrees is presented. The extruded disc was documented by clinical examination. He was treated conservatively with epidural steroid injection (ESI), medication, physical therapy and self-exercise and reevaluated in 10 weeks later, 30 and 1 year. Large extruded disc can be treated successfully by physical therapy with ESI. However, the degeneration and the dehydration of disc result in decrease of disc height. Consequently, the regression of extruded disc might have been due to the resorption and the dehydration.
Dehydration ; Humans ; Intervertebral Disc ; Intervertebral Disc Displacement ; Leg ; Magnetic Resonance Imaging ; Male

BACKGROUND: Traction has often been utilized to treat patients with a herniated lumbar disc. Currently, the most advanced type of traction therapy is non-surgical spinal decompression. Therefore, this study was conducted to evaluate the effectiveness of decompression therapy in patients with a herniated lumbar disc based on clinical findings and symptoms. METHODS: Sixty patients with herniated lumbar discs were included in this study. The patients were randomly divided into two groups, a decompression group (n = 30) and a traction group (n = 30). To evaluate the impact of decompression and traction therapy on the herniated disc, the clinical symptoms for each group were evaluated prior to and after treatment using the visual analogue scale (VAS), straight leg raising (SLR), the herniation index, and the disc height. RESULTS: The VAS score was significantly lower in the decompression group (2.0 +/- 0.2) than the traction group (3.9 +/- 0.2) following treatment. In addition, the SLR angle was significantly higher in the decompression group (79 +/- 1.5) than the traction group (63.3 +/- 1.9). The herniation index was significantly lower in the decompression group (217.6 +/- 19.1) than the traction group (259.5 +/- 16.4). Finally, the disc height was not significant differences between pre-treatment and follow-up in two groups. CONCLUSIONS: The results of this study suggest that decompression therapy for the treatment of patients suffering from a herniated lumbar disc has an effect on the pain, SLR, and herniation indices, not disc heights.
Decompression ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; Leg ; Stress, Psychological ; Traction

Fractures involving joints and about the joints provide complex problems with small comminuted fractures, surrounding soft tissue injuries and articular cartilage damage. Various problems are also encountered on the weight bearing surface, especially on the convex side of the distal Femur. Even though many auther had recommended kinds of management upto now, operative methods are more suggested in order to get good results regarding with the accurate anatomical reduction, rigid internal fixation and early joint motion. The clinical analysis of rnanagements of 20 cases of distai femoral fracture demonstrate that seperate dual incision-bilateral or right angle plane-to originate fracture site, and anatomical reduction & rigid internal fixation, early non-weight bearing ROM exercise of joint were sometimes mandatory to treat the displaced, comminuted fracture.
Cartilage, Articular ; Femoral Fractures ; Femur ; Fractures, Comminuted ; Joints ; Soft Tissue Injuries ; Weight-Bearing

The most common fracture about the elbow joint in chilren is a supracondylar fracture. The displaced fracture is difficult to manage due to the potential danger of Volkmann's ischemia, nerve injury, and malunion, During the period of 6 years from June, 1979 to June, 1985, 63 children with supracondylar fractures of the humerus were treated at Pusan Paik Hospital, Inje Medical College, and analyzed. The results are summarized as follows: 1. The average age was 7.1 years, ranged from 1 year to 14 years, and the male and female ratio was 2.5: l. 2. In type of fracture, extension type was 92% and flexion type was 8%. In displacement of fracture, Grade I was only 2 cases, Grade III and IV were 87.3%. Posteromedial displacement was 42.8% (27 cases). 3. At the time of admission, 15cases(23.8%) accompanied nerve injury, of these median nerve injury (9 cases) was most common. All the patient with nerve injury were completely recovered within 14 months after reduction. 4. Severe cubitus varus was 14.2%, and severe limitation of elbow motion was 1.6%. 5. Of 61 displaced fractures, 37 patients were treated with closed reduction and percutaneous pin fixation. By Flynn's criteria, satisfactory results were obtained in 36 of the 37 patients(97.3%) treated with percutaneous pinning. 6. In the displaced fractures, closed reduction and percutaneous pinning is a satisfactory method for obtaining and maintaining reduction while preserving vascular function, if acute flexion is necessary for stable reduction.
Busan ; Child ; Clinical Study ; Elbow ; Elbow Joint ; Female ; Fractures, Closed ; Humans ; Humerus ; Ischemia ; Male ; Median Nerve ; Methods

Esmolol is rapid ultrashort-acting, cardioselective beta1-adrenergic blocker and that is used for attenuation of acute hypertension associated with rapid sequence induction of general anesthesia. A 35-year-old severe preeclamptic patient was scheduled for elective cesarean section. After preoxygenation, anesthesia induced with using penthotal sodium 250 mg, esmolol 25 mg, and succinylcholine 62.5 mg for endotrachial intubation. We detected to increase airway resistance during manual ventilation. Breathing sound was auscultated wheezing and ronchi. And then cyanosis was developed and oxygen saturation was decreased to below 75%. After 20 min, patient's color was returned to pink and patient's self-respiratory function was good. Bronchospasm occured because that beta-adrencergic blockade with esmolol, by leaving the parasympathetic and alpha-adrencrgic influence relatively unopposed. We report bronchospasm after esmolol 25 mg was injeected for attenuation of acute hypertensive response for cesarean section of preeclamptic patient with rapid sequence induction of general anesthesia.
Adult ; Airway Resistance ; Anesthesia ; Anesthesia, General ; Bronchial Spasm* ; Cesarean Section ; Cyanosis ; Female ; Humans ; Hypertension ; Intubation ; Oxygen ; Pregnancy ; Respiratory Sounds ; Sodium ; Succinylcholine ; Ventilation

Esmolol is rapid ultrashort-acting, cardioselective beta1-adrenergic blocker and that is used for attenuation of acute hypertension associated with rapid sequence induction of general anesthesia. A 35-year-old severe preeclamptic patient was scheduled for elective cesarean section. After preoxygenation, anesthesia induced with using penthotal sodium 250 mg, esmolol 25 mg, and succinylcholine 62.5 mg for endotrachial intubation. We detected to increase airway resistance during manual ventilation. Breathing sound was auscultated wheezing and ronchi. And then cyanosis was developed and oxygen saturation was decreased to below 75%. After 20 min, patient's color was returned to pink and patient's self-respiratory function was good. Bronchospasm occured because that beta-adrencergic blockade with esmolol, by leaving the parasympathetic and alpha-adrencrgic influence relatively unopposed. We report bronchospasm after esmolol 25 mg was injeected for attenuation of acute hypertensive response for cesarean section of preeclamptic patient with rapid sequence induction of general anesthesia.
Adult ; Airway Resistance ; Anesthesia ; Anesthesia, General ; Bronchial Spasm* ; Cesarean Section ; Cyanosis ; Female ; Humans ; Hypertension ; Intubation ; Oxygen ; Pregnancy ; Respiratory Sounds ; Sodium ; Succinylcholine ; Ventilation

The extracardiac conduit Fontan procedure is the last surgical step in the treatment of patients with a functional single ventricle. An acquired pulmonary arteriovenous malformation may appear perioperatively or postoperatively due to an uneven hepatic flow distribution. Here we report a case of a bifurcated Y-graft Fontan operation in a 15-year-old male patient with a unilateral pulmonary arteriovenous malformation after an extracardiac conduit Fontan operation.
Adolescent ; Arteriovenous Malformations* ; Fontan Procedure ; Heart Defects, Congenital ; Humans ; Male ; Vascular Diseases

Loeys-Dietz syndrome (LDS) is an autosomal dominant connective tissue disorder that is characterized by aggressive arterial and aortic disease, often involving the formation of aortic aneurysms. We describe the cases of two children with LDS who were diagnosed with aortic root aneurysms and successfully treated by valve-sparing aortic root replacement (VSRR) with a Valsalva graft. VSRR is a safe and suitable operation for children that avoids prosthetic valve replacement.
Aneurysm ; Aorta ; Aortic Aneurysm ; Aortic Diseases ; Child* ; Connective Tissue ; Humans ; Loeys-Dietz Syndrome* ; Transplants

Purpose: Regular moderate-intensity aerobic exercise confers immense vascular benefits, yet the lack of time remains the most common barrier to a regular exercise routine. A Tabata exercise is a type of high-intensity interval training exercise that is time efficient and has recently been demonstrated to improve cardiorespiratory fitness and metabolic profiles, but its benefits on vascular function still remain unclear. We tested the hypothesis that the Tabata-styled exercise would be as effective as moderate-intensity continuous exercise (MICE) in improving vascular function in young healthy adults. Methods: Using a randomized, cross-over design, fourteen healthy men (age, 23.8±2.3 years; body mass index, 23.7±2.2 kg/m2 ) performed two acute exercise trials, separated at least by 72 hours: a modified Tabata-styled exercise (eight sets of 20-second exercise at 120% of maximal power output using a bike and 10-second rest, total 4 minutes) or a MICE for 30 minutes at a heart rate reserve of 40%–60%. Vascular function was assessed via brachial artery flow-mediated dilation and arterial stiffness (pulse wave velocity and augmentation index) at baseline and again at 60 minutes and 120 minutes after exercise. Results: Compared with MICE, a Tabata-styled exercise increased heart rate at 60 minutes (p＜ 0.05). Both exercises improved vascular function to a similar extent, as evidenced by an increase in flow-mediated dilation and a reduction in arterial stiffness at 60 minutes and 120 minutes (p＜ 0.05). Conclusion These findings demonstrate that the Tabata-styled exercise is a time-efficient exercise strategy that is as effective as MICE in enhancing vascular function in healthy young men.

BACKGROUND: Biochemical bone markers have been suggested to reflect postmenopausal high bone turnover. These markers could be useful in following response to hormone replacement therapy (HRT). But we have few studies about the sequential changes of biochemical bone markers and bone mass after HRT in Korean women, and it is unclear whether women with early menopause have different response to HRT from women with normal menopause. The aims of the present study were to see the sequential changes of biochemical bone markers and bone mass after HRT in Korean women, to examine whether a single baseline biochemical bone marker or a change in biochemical bone marker could predict subsequent bone mass, and to determine the difference of response to HRT between women with early menopause and women with normal menopause. METHODS: Postmenopausal women (n=21) were divided with into three groups according to their age at menopause (AAM): the first group with AAM < or = 43 years (early menopause group, n=7), the second group with 43 years < or = AAM < or = 50 years (n=4), and the third group with AAM > or = 50 years (normal menopause group, n=10). For the HRT, conjugated estrogen (0.625mg per day) and continuous or cyclic medroxyprogesterone (2.5-10mg per day) were administered. Bone mineral density (BMD) was measured at baseline and 12 months and biochemical bone markers were measured at baseline and 3, 6, and 12 months during HRT. RESULTS: Deoxypyridinoline, type 1 collagen N-telopeptide, bone alkaline phosphatase, and osteocalcin were significantly decreased at 3 months, and mean percent changes from baseline of bone resorption markers were larger than those of bone formation markers. At 12 months, BMD was significantly increased at lumbar spine and Ward's triangle. But BMD was not significantly increased at femur neck and femur trochanter. Two baseline bone markers (bone alkaline phosphatase and type 1 collagen N-telopeptide) correlated with changes of BMD but any changes of bone markers at 3, 6 months didn't correlate with changes of BMD. In early menopause group, changes of bone markers and BMD were larger than those in normal menopause group, but the difference between the two groups was not significant. CONCLUSION: All four bone markers showed significant reduction at 3 months, but bone resorption markers were decreased more markedly and rapidly, and some baseline bone markers can predict the change of BMD after HRT. The difference of response to HRT between early menopause group and normal menopause group was not significant.
Alkaline Phosphatase ; Bone Density* ; Bone Resorption ; Collagen Type I ; Estrogens ; Female ; Femur ; Femur Neck ; Hormone Replacement Therapy* ; Humans ; Medroxyprogesterone ; Menopause ; Osteocalcin ; Osteogenesis ; Spine