No abstract available.
Free Tissue Flaps*

No abstract available.
Fistula*

No abstract available.
Humans ; Rectus Abdominis* ; Tissue Donors*

No abstract available.
Adenoma*

Cerebral palsy is the most common motor disorder in childhood. In cerebral palsy, spasticity can be a very disabling feature: limited locomotor abilities, contracture and gait difficulty. We present two cases of cerebral palsy patients who had treated with oral medication and chemodenervation with the Botulinum toxin A or alcohol but could not walk independently. We performed percutaneous selective radiofrequency thermocoagulation in the tibial motor nerve branch under the general anesthesia. The degree of spasticity, which was measured with modified Ashworth scale and modified Tardieu scale, was reduced and recurrence of the spasticity wasn't seen untill 6 months. Percutaneous selective radiofrequency thermocoagulation could be a treatment option for spasticity of cerebral palsy with little adverse effect.
Anesthesia, General ; Botulinum Toxins ; Cerebral Palsy ; Contracture ; Electrocoagulation ; Gait ; Humans ; Muscle Spasticity ; Nerve Block ; Recurrence

The prevalence of PPNG among pretreatment isolates at a VD Clinic in Seoul has been studied and reported annually since 1981. In 1987, 649 strains of N. gonorrhoeae were isolated, among which 339(52.2%) were PPNGs. The prevalence of PPNG in Seoul is still increasing.
Korea* ; Prevalence* ; Seoul*

From January 1988 to December 1995, 27 patients, 11 men and 16 women, underwent surgical intervention at our institution for prosthetic valve dysfunctions. The mean age was 43.5+/-12.2 years. Seventeen (63.0%) patients had the mitral valve replacement, 8 (29.6%) the aortic valve, 1 (3.7%) the aortic composite graft, and 1 (3.7%) the tricuspid valve. Mean follow-up period was 49.5+/-30.9 months. In 12 bioprostheses, mean interval between the previous valve replacement and the reoperation was 104.9+/-34.9 months. The causes of redo surgery were structural deterioration of the prosthetic valve (12/12, 100%), paravalvular leak (2/12, 16.7%), and prosthetic valve endocarditis (1/12, 8.3%). In 15 mechanical prostheses, the mean interval was 55.2+/-43.7 months. The causes of redo surgery were pannus formation (8/15, 53.3%), paravalvular leak (4/15, 26.7%), and valve thrombosis (3/15, 20.0%). Posto-perative complications occurred in 7 patients (25.9%). There was no intraoperative death. But one patient, who received mechanical aortic valve replacement died on the 3rd postoperative day due to low cardiac output and multiorgan failure.
Aortic Valve ; Bioprosthesis ; Cardiac Output, Low ; Endocarditis ; Female ; Follow-Up Studies ; Heart Valve Prosthesis* ; Heart Valves* ; Humans ; Male ; Mitral Valve ; Prostheses and Implants ; Reoperation* ; Thrombosis ; Transplants ; Tricuspid Valve

BACKGROUND: Mesenteric infarction is a significant cause of death in elderly patients, and is being reported with increasing frequency. The diagnosis seldom is made prior to the onset of gangrene, despite an increased awareness of the lethality of mesenteric ischemia. The outcome for patients with mesenteric ischemia depends on the age of the patient, the extent and the severity of the ischemia and the effectiveness of the collateral blood supply. METHODS: We retrospectively reviewed the cases of 23 patient with mesenteric infarction who had been treated at the Department of Surgery, Hallym University, Chunchon Sacred Heart Hospital, between September 1988 and August 1977. RESULTS: The mean age was 52.3 years and the ratio of males to females was 1:1.6. The most frequent underlying diseases were hypertension, congestive heart failure, atrial fibrillation, and myocardial infarction. The radiologic study of a simple plain abdomen revealed a paralytic ileus in 87% of the cases; a partial vascular occlusion was shown under angiogram. The mean time lapse from onset of symptom to operation was 38.3 hours. Eight (34.8%) patients died when renal failure, ARDS or peritonitis developed. CONCLUSIONS: The cause of the persistently high mortality in patients with mesenteric in farction and to define a more effective form of management based on our results and recent clinical or laboratory findings. This study was concluded that early detection of the mesenteric infarction was reduced postoperative complications.
Abdomen ; Aged ; Atrial Fibrillation ; Cause of Death ; Diagnosis ; Female ; Gangrene ; Gangwon-do ; Heart ; Heart Failure ; Humans ; Hypertension ; Infarction* ; Intestinal Pseudo-Obstruction ; Ischemia ; Male ; Mortality ; Myocardial Infarction ; Peritonitis ; Postoperative Complications ; Renal Insufficiency ; Retrospective Studies

BACKGROUND: Cerebrovascular accidents after coronary bypass surgery(CBS) are serious and responsible about 10% for postoperative mortality. Recently, the rate of cerebrovascular complication after CBS has increased with increasing number of the operations for high risk patients with old age, hypertension, diabetics and etc. This study was intended to identify the risk factors of cerebrovascular accident after CBS by reviewing the medical records of the patients who underwent CBS. MATERIALS AND METHOD: We reviewed the medical records and statistically analyzed the data of 185 patients who underwent CBS between March 1991 and July 1999. RESULT: The rate of cerebrovascular complication was 7.5%(14 patients) of which there were 5 deaths. Total number of postoperative death was 11 during the same period, and 45.5% of postoperative deaths were associated with cerebrovascular complication. Postoperative arrhythmia(p=0.0064), history of previous CVA(p=0.0090), bypass time(p= 0.0181), atherosclerosis of aorta(p=0.03575) and diabetics(p=0.0452) were statistically related with the development of postoperative cerebrovascular complication. Two patients underwent carotid endarterectomy concomitantly with CBS, neither of them developed cerebrovascular complications. The 3 patients over 75 years did not develop cerebrovascular complication after CBS. CONCLUSION: Risk factors associated with the development of postoperative cerebrovascular complication after CBS were postoperative arrhythmia, history of previous stroke, bypass time, atherosclerosis of aorta and diabetics.
Aorta ; Arrhythmias, Cardiac ; Atherosclerosis ; Cerebrovascular Disorders ; Coronary Artery Bypass ; Endarterectomy, Carotid ; Humans ; Hypertension ; Medical Records ; Mortality ; Postoperative Complications ; Risk Factors ; Stroke

Hyperglycemia has been reported to worsen the tolerance of the brain to ischemia, and it has therefore been recommended that patient undergoing neurosurgical procedures not receive glucose-containing solutions. Since ischemic events lead to increased lactate production and accumulation and hence neuronal damage, the present study was designed to test the effect of insulin-induced hypoglycemia and decreased lactate by 2-Deoxyglucose and Dichloroacetate on focal cerebral ischemia in rats. Although the pre and post-ischemic blood glucose levels of control group and Dichloroacetate group showed no change, the blood glucose level of 2-Deoxyglucose group showed a significant increase(p=0.001), and insulim group a significant decrease(p=0.004). The reducing effects on the infarct zone in these three treated groups were found with statistical significance. As compared with control group, the tissue lactate levels of treated groups were decreased in both infarct zone and border zone but these data did not show statistical significance. From these observations, it is suggested that reduction of lactate production and accumulation could be beneficial by affording neuronal protection in ischemic tissues.
Animals ; Blood Glucose ; Brain ; Brain Ischemia* ; Cerebral Infarction ; Deoxyglucose* ; Dichloroacetic Acid* ; Humans ; Hyperglycemia ; Hypoglycemia ; Insulin* ; Ischemia ; Lactic Acid ; Neurons ; Neurosurgical Procedures ; Rats*