No abstract available.
Intestine, Small ; Ischemia ; Urokinase-Type Plasminogen Activator

The finite element method was utilized to find the rigidity of the device in changing the parameters, such as geometrical configuration, material property, and loading condition in an external fixation. In the experimental analysis, a universal testing machine(UTM) was used to evaluate the rigidity of EBI, Monofixator and Hoffmann under the different type of lodings, such as axial compression, bending and torsion in changing the parameters. The result was compared with those of the experimental work. The results were as follows: 1) In standard condition, the yielding loads in axial compression were 85Kg in the EBI, 55Kg in the Hoffmann, and 100Kg in the Monofixator, The rigidity figures were 2930N/cm in the EBI, 764N/cm in the Hoffmann, and 2391M/cm in the Monofixator. Z) The experimental method was adapted to figure out the effect of parametric change on the stiffness of 3 different external fixation apparatus(Monofixator,EBI, Hoffmann). A Monofixator with a parametric change of pin diameter from 6mm to 5mm indicated 40% reduction of stiffness in axial compression and 60% reduction of stiffness in torsion. Also, in the case of the change of pin group separation from 20cm to 15cm it showed 64% increase of stiffness in, AP bending. EBI with the increase of the distance between pin and aluminum bar to 8cm showed 32% decrement of stiffness in axial compression and 38% decrement of stiffness in AP bending. The stiffness of the Hoffmann device was remarkable according to the number of the pin used and the distance between the pin and the aluminum bar. 3) Concerning the difference between the experimental analysis and finite element method in a Monofixator, the results of the experimental analysis were 10% to 37% lower than those of the finite element method. The reason is thought to be caused by complete binding. The obtained data shed light on the future guide-lines and future alterations of the design factors in external fixation device. Approprate use of the obtained information is desirable for the optimal,treatment of the fractured long bone.
Aluminum ; External Fixators ; Methods

Twenty five consecutive patients requiring reoperation due to hemorrhage following surgery for intracranial hematoma removal were identified in a retrospective review of 211 cases of traumatic intracranial lesions treated at our hospital between January 1990 and December 1994. In cases involving head injury, reoperation is nowadays not uncommon. The incidence of cases requiring reoperation was 11.8%, while delayed or recurrent lesions were more common among older patients(mean age=44.39 years). Acute subdural hemorrhage was the most common initial lesion requiring reoperation: in intracerebral and acute subdural hemorrhage, the incidence of reoperation was relatively high(23.1% and 14.7%, respectively): acute epidural hemorrhage was next most common(8.8%). In 88.0% of cases, reoperation was performed within 24 hours. At the time of discharge, good recovery was reported in five cases(20.0%), moderate disability in ten(40.0%), severe disability in two(8.0%), vegetative state in two(8.0%) and death in six(24.0%). The outcome seems to be related to lesions requiring reoperation rather than initial lesions. Furthermore, closed observation and aggressive management can rapidly improve the outcome, even in patients requiring reoperation: it is, in addition, of the utmost importance that CT scans be used early and repeatedly, especially in patients who are at risk of delayed or recurrent lesions.
Craniocerebral Trauma ; Hematoma ; Hematoma, Subdural ; Hemorrhage ; Humans ; Incidence ; Intracranial Hemorrhage, Traumatic* ; Intracranial Hemorrhages* ; Persistent Vegetative State ; Postoperative Hemorrhage ; Reoperation* ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: To present our treatment protocol and surgical outcome for patients with congenital brachymetatarsia in which treatment was decided according to the number of affected rays. MATERIALS AND METHODS: Sixty-nine metatarsals in 44 patients with single or multiple congenital brachymetatarsia were included in the study. When a single ray was affected in a foot, we performed a one-stage lengthening using an intercalary autogenous iliac bone graft. We overcame excessively short rays by the double level lengthening at the metatarsal and proximal phalanx as one stage. When multiple rays were affected in one foot, we performed a one-stage combined shortening and lengthening procedure without an iliac bone graft. RESULTS: All patients were satisfied with the cosmetic and functional results. The average length gain by one-stage lengthening in 56 metatarsals of 38 patients was 14 (6-21) mm. Six patients with a combined shortening and lengthening procedure regained a nearly normal parabola of the involved foot. Neurovascular complication was not identified. CONCLUSION: Satisfactory results were achieved for the treatment of patients with congenital brachymetatarsia, by individualizing the surgical options according to the number of affected rays and general foot appearance.
Clinical Protocols ; Foot ; Humans ; Metatarsal Bones ; Transplants

BACKGROUND: Chronic obstructive lung disease is characterized by smoke-related, gradually progressive, fixed airflow obstructions. However, some studies suggested that a reversible bronchial obstruction is common in chronic obstructive lung disease. Such reversibility persists despite the continued treatment with aerosolized bronchodilators and it appears to be related to the diminution in symptoms. The isolated volume response to a bronchodilator is defined as a remarkable increase in the FVC in response to the administration of a bronchodilator whereas the FEV1 remains unchanged. This has been suggested in patients with severe emphysema. Therefore, the aim of this study was to determine the relationship between the response to a bronchodilator and the severity of an airflow obstruction in COPD patients using the GOLD classification. METHODS: This study examined 124 patients with an airway obstruction. The patients underwent spirometry, and the severity of the airflow obstruction was classified by GOLD. The response groups were categorized by an improvement in the FVC or FEV1 > 12%, and each group was analyzed. RESULTS: Most subjects were men with a mean age of 65.9+/-8.5 years. The mean smoking history was 41.26+/-20.1 pack years. The isolated volume response group had relatively low FEV1 and FVC values compared with the other groups. (p<0.001) CONCLUSION: In this study, an isolated volume response to a bronchodilator is a characteristic of a severe airway obstruction, which is observed in patient with a relatively poorer baseline lung function.
Airway Obstruction ; Bronchodilator Agents ; Classification* ; Emphysema ; Humans ; Lung ; Male ; Pulmonary Disease, Chronic Obstructive* ; Smoke ; Smoking ; Spirometry