Calcaneus is the largest tarsal bone and serves weight bearing of the body. The calcaneus has a pattern of cancellous bone enclosed with a very thin cortical shell. It is difficult to reduce the bony fragments accurately when there are comminution and displacement on the calcaneal fractures. Retrospective study was carried out of 18 patients(21 feet) of calcaneus fractures after axial fixation in Soonchunhyang University Hospital from July, 1982 to July, 1988. Minimum follow up period was 8 months(average 2 years 6 months). The clinical analysis of them are reported with a review of the literature and the results are follows:l. According to the Rowe's unit system, the results of treatment were excellent or good in 9 cases of 13 tongue types and 5 cases of 8 joint depression types. 2. The results were satisfactory in the calcaneal fractures of well reestablished Bohler angle to 21-30 degrees. 3. The results were excellent or good in 5 cases operated within post-trauma 1 week and in 9 cases operated from 1 week to 2 weeks. 4. The results were poor in the 2 joint depression type with severe comminution. And subtalar joint fusion was performed on the previous 2 cases. Then pain on the lateral malleolar area was subsided.
Calcaneus ; Depression ; Follow-Up Studies ; Joints ; Retrospective Studies ; Subtalar Joint ; Tarsal Bones ; Tongue ; Weight-Bearing

No abstract available.
Animals ; Evoked Potentials, Motor* ; Rats*

The 4,725 cattle in the enzootic region, 6 counties of southern Korea, were surveyed for besnoitiosis epidemiologically by examining the scleral conjunctiva for the cysts and the following results were obtained. The survey showed that 285 cattle, representing 6 per cent of a total of 4,725 cattle examined had S.C. cysts. Only 49 (14 per cent) of them showed clinical sclerodermatitis and the ratio between clinical and inapparent cases was 1:5.8. On age distribution of the S.C. positive cases the highest incidence(10-12 per cent) was seen in amimals that were from 5 to 8 years of age, but clinically apparent cases occurred much more in younger age of animal. In local incidence of S.C. cysts positive cases the prevalence was higher in the secluded districts such as Koheung and Sancheoung counties(9 per cent).
parasitology-besnoitiosis ; epidemiology ; prevalence rate ; scleral conjunctiva cyst

BACKGROUND: Ambulatory blood pressure monitoring is widely available in clinical practice. To evaluate the pattern of normal 24 hour variation of blood pressure and the problems in analysis of data which was obtained with use of automatic blood pressure recorder, 24 hour ambulatory blood pressure was measured. METHODS: Ambulatory blood pressure was recorded for 24 hours with automatic blood pressure monitor in 22 normotensive young adolescents. RESULTS: 1) Average 24-hour BP was 109mmHg in systolic(115+/-30 for male, 102+/-30 for female), 66mmHg in diastolic(69+/-18 for male, 63+/-19 for female) and pulse rate was 72 beats per minute(70+/-23 for male, 75+/-26 for female). 2) Data obtained from ambulatory blood pressure monitor should be analyzed after deletion of unacceptable data with use of conventional criteria. Blood pressure increase which is not accompanied by increase in pulse rate increase can be used as another criteria to rule out unacceptable blood pressure data. 3) Blood pressure was low from mid-night to 6 A.M. and began to rise slowly till mid-day and then maintained steadily through the remainder of the day. And 24 hour variation of blood pressure was more adequately assessed after application of Fourier analysis. CONCLUSIONS: These results suggest that certain deletion criteria was inevitable during analysis of the data which were obtained from ambulatory blood pressure recorder and Fourier analysis can be used as valuable smoothing technique to assess the 24-hour blood pressure profiles.
Adolescent* ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory* ; Blood Pressure Monitors ; Fourier Analysis ; Heart Rate ; Humans ; Male

Fentanyl is a potent, synthetic opioid analgesic with a rapid onset and short duration of action. Recently, there have been many case reports that overuse or misuse of fentanyl patch resulted in fatal intoxication. Delayed hypoxic leukoencephalopathy typically manifests 2 to 40 days after apparent recovery from hypoxic event, and patients suffer from cognitive impairment, upper motor neuron signs, gait disturbance, or psychosis. We report first case of delayed encephalopathy with psychotic symptoms after overuse of fentanyl patch. Patient was found to have respiratory failure and mental change due to transdermal fentanyl overdose. She made a complete recovery in 2 weeks. After 4 weeks of the event, she readmitted with declining mental status. At 30 weeks after overdose, she complained of auditory and visual hallucination and showed paranoid delusion and odd behavior. Since admission into psychiatric unit, her psychotic symptoms have improved with antipsychotics. In conclusion, fentanyl patch should be used in order to prevent psychotic symptoms as well as medical complications.
Antipsychotic Agents ; Delusions ; Fentanyl* ; Gait ; Hallucinations ; Humans ; Leukoencephalopathies ; Motor Neurons ; Psychotic Disorders* ; Respiratory Insufficiency

BACKGROUND: Maintenance of normal arterial carbon dioxide tension (PaCO2) is not generally a problem if the same tidal volume can be maintained when changing from two-lung(TLV) to one-lung ventilation(OLV). However, there have been a few studies on the use of capnography in monitoring the adequacy of ventilation during one-lung anesthesia. We have therefore studied how closely end-tidal PCO2 (PETCO2) values reflect changes in PaCO2 in patients undergoing thoracoscopic sympathectomy during TLV and after transition to OLV. METHODS: We have measured arterial oxygen tension(PaO2), PaCO2, PETCO2, and (PaCO2-PETCO2) in 24 adult, either sex, patients by infra-red spectrometry. They were measured after induction of anesthesia, in supine position(TLVsup), after a lateral decubitus position(TLVlat), at 15 minutes after left OLV(OLVLt), after right OLV(OLVRt), and at 10 minutes in the supine position re-positioned at the end of the operation(TLVrep). Data were analyzed with a one-way analysis of variance with repeated measures followed by multiple comparision. The correlation between PaCO2 and PETCO2 were tested using linear regression. RESULTS: PaCO2 did not significantly change, whereas PETCO2 significantly decreased at OLVLt, OLVRt compared with TLVsup value (OLVLt, 29.7 mmHg OLVRt, 30.5 mmHg and TLVsup, 33.6 mmHg; P< 0.05). Compared with TLVsup(0.2 mmHg), (PaCO2-PETCO2) significantly increased at OLVLt, OLVRt, TLVrep(3.7 mmHg, 2.3 mmHg, 3.5 mmHg). The correlation between PaCO2 and PETCO2 in these series is consistent. (r>0.65, P<0.0006) CONCLUSIONS: In the patients undergoing thoracoscopic sympathectomy with TLV or OLV in the lateral decubitus position, PETCO2 is a reliable estimate of the PaCO2. However, when the operative time is prolonged the arterial PCO2 may be more reliable than PETCO2.
Adult ; Anesthesia ; Capnography ; Carbon Dioxide ; Humans ; Linear Models ; One-Lung Ventilation* ; Operative Time ; Oxygen ; Spectrum Analysis ; Supine Position ; Sympathectomy ; Thoracoscopy* ; Tidal Volume ; Ventilation

BACKGROUND: The effect of arterial carbon dioxide tension (PaCO2) during ischemia and reperfusion has been a controversial issue. In this study, the effect of PaCO2 during ischemia and reperfusion was evaluated by 31P magnetic resonance spectroscopy (MRS). METHODS: Incomplete global cerebral ischemia was induced by ligation of carotid artery under lowered mean blood pressure (mean blood pressure= 40 mmHg) for 30 minutes followed by 2 hours of reperfusion. Eighteen cats were divided into 3 groups: For group 1 (n=6) (control group), animals were subjected to normocarbia (PaCO2=28~33 mmHg) during ischemia and reperfusion, for group 2 (n=6), animals were subjected to hypocarbia (PaCO2=18~23 mmHg) during ischemia and reperfusion, and for group 3 (n=6), animals were subjected to normocarbia during ischemia and hypocarbia during reperfusion. RESULTS: For group 1, the energy metabolism measured by [PCr/Pi] was recovered about 74.7 6.4%. For group 2, the energy metabolism failed to be completely recovered by 120 minutes of reperfusion (69.3 7.3%), whereas for group 3, the energy matabolism was completely recovered by 120 minutes of reperfusion (97.6 2.4%). There were statistically significant differences between group 1 and group 3 (p<0.05). The changes in pH were not significantly different among the groups. CONCLUSION: In this study, a condition of hypocarbia during reperfusion seems better for the energy metabolism after incomplete global ischemia of cats.
Animals ; Blood Pressure ; Brain Ischemia ; Brain* ; Carbon Dioxide ; Carotid Arteries ; Cats* ; Energy Metabolism* ; Hydrogen-Ion Concentration ; Ischemia ; Ligation ; Magnetic Resonance Spectroscopy ; Reperfusion

BACKGROUND: Flow interruption technique has been used to measure respiratory system mechanics, and its prominent advantage is to partitionate the respiratory system resistance into airway and tissue component. In this study, we investigated the effects of varing concentrations of enflurane on respiratory system mechanics using flow interruption technique. METHODS: Six cats, weighing 3.0~3.6 kg were used. Pentobarbital sodium was injected intraperitonially and endotracheal intubation was followed. Intermittent mandatory ventilation was applied with Siemens Servo 900C ventilator. The inspiratory flow rate, tidal volume, and respiratory rate were fixed, and normocarbia (PaCO2; 30~35 mmHg) was maintained throughout the experiment. The changes in the pressure and volume were recorded with Bicore CP100 pulmonary monitor at control, 0.5, 1, 1.5, and 2 MAC of enflurane. The data were transfered to a PC and analyzed by Anadat processing software. Respiratory system, airway and tissue viscoelastic resistances, and dynamic and static compliances were calculated. RESULTS: Respiratory system resistances decreased up to 1 MAC of enflurane compared to the control value (p<0.05), but there were no significant differences in the values of resistance among 1, 1.5, 2 MAC of enflurane. There were no significant differences in tissue viscoelastic resistances, and dynamic and static compliances with varying concentrations of enflurane. CONCLUSIONS: Enflurane significantly reduces the respiratory system resistance mainly by decreasing airway resistance. Tissue viscoelastic resistance and respiratory system compliances are not influenced by changes in concentration of enflurane.
Airway Resistance ; Animals ; Cats* ; Enflurane* ; Intubation, Intratracheal ; Mechanics* ; Pentobarbital ; Respiratory Rate ; Respiratory System* ; Tidal Volume ; Ventilation ; Ventilators, Mechanical

In order to ascertain the status of health damage among Korean farmers who spray pesticides regularly in summer, blood and urine samples were collected for 88 volunteers during July to Septembei in 1990. Serum cholinesterase activity, parent compounds of pesticides in blood and urine, SGOT, SGPT, blood pressure, pulse rate were measured. The results were as follows ; 1. Mean cholinesterase activity after spraying pesticides was significantly lower than that before splaying. While proportion of abnormal cholinesterase activity (<1900U/L) group was 2.3% before spraying pesticides, tHe proportion of the group after spraying was 22.8% 2. Cholinesterase activity were decreased over 50% in 14.7% of the suhjects who can be classified into poisoning group 3. While pulse rate and blood pressure were slightly increased in poisoning group, those were significantly decreased in non-poisoning group. 4. Consecutive splaying of pesticide caused further reduction of cholinesterase activity, 5. Five parent compounds of pesticides frequently used during summer farming were analyzed using 106 blood samples. IBP in one sample and Isoprothiolane in four samples were detected. No parent compounds were detected in urine samples.
Alanine Transaminase ; Aspartate Aminotransferases ; Blood Pressure ; Cholinesterases* ; Heart Rate ; Humans ; Parents ; Pesticides ; Poisoning ; Volunteers

BACKGROUND: We examined whether increases of intra-abdominal pressure would decrease compliance (C) of both lung and chest wall. METHODS: We measured airway and esophageal pressure in 10 anesthetized/paralyzed tracheally intubated patients during mechanical ventilation at the respiratory rate of 10 freq/min and the tidal volume of 10 ml/kg undergoing laparoscopic cholecystectomy. Measurements were made at 0 mmHg intra- abdominal pressure the (Pab) in supine position and at 15 mmHg Pab in 10 head-up (reverse Trendelenburg) position at 0, 5, 10 and 15 min. after CO2 insufflation. RESULTS: We found that abdominal carbon dioxide insufflation caused a marked increase in peak airway pressure, plateau pressure and esophageal pressure (p<0.05); a reduction in compliance of respiratory system and chest wall (p<0.05). CONCLUSION: These changes should be considered in patients such as those with pulmonary disease, undergoing laparoscopic cholecystectomy where increase in impendance may be critical.
Carbon Dioxide ; Cholecystectomy, Laparoscopic* ; Compliance* ; Humans ; Insufflation ; Lung ; Lung Diseases ; Respiration, Artificial ; Respiratory Rate ; Respiratory System* ; Supine Position ; Thoracic Wall ; Tidal Volume