No abstract available.

No abstract available.
Genu Varum*

No abstract available.
Hemorrhage* ; Hemorrhoids* ; Ligation* ; Rubber*

No abstract available.
Rectal Prolapse*

Vascular grafts are often required in clinical stiuations to bridge arterial or venous grafts. Numerous studies exist in the literature concerning the results of such arterial and venous graft of relatively large vessels. There are only a few reports dealing with experimental microvascular grafts. Histopathological features of the grafted vessels were studied after autogenous venous grafts,autogenous arterial grafts and venous allografts using microsurgical techniques. The results were summerized as follow. 1. The patency rate of grafted vessels by microsurgical techniques was 86.8%. 2. In autogenous venous grafts histopathological changes occur later, and to a less pronounced degree, than that in autogenous arterial grafts. 3. Venous allografts showed severe acute inflammatory reaction throughout the layer at 3~7 days postoperatively, but histopathological features of grafted vessels of autografts and venous allografts' did not differ each other in later results. 4. Autogenous venous grafts, autogenous arterial gtafts and venous allografts persist as living sucture but undergo certain histological changes consisting of fibrous reinforcement. 5. It may be said that histological examination of the specimen led general conclusion that the most useful microvascular graft to reestablish circulation of damaged vessels is the autogenous venous graft, but autogenous arterial graft and venous allograft are also applicable when autogenous venous tissue is not available.
Allografts ; Autografts ; Transplants

Interlocking nailing technique has many advantages in the fracture treatment. Such as the prevention of infection and devitalization by closed technique, stable intramedullary osteosynthesis, bone grafting effect of reaming debris, and early restoration of loading and function, comparing to the conventional intramedullary nailing. However, we met many problems during the operative procedure due to deficient concept and technique. We have checked the possible problems during and after the procedure of interlocking nailing for the tibia or femur fractures in 69 cases. 1. Sixty nine cases were consisted by 26 cases of femur fractures and 43 cases of tibia fractures. 2. The inadequate implant length was the most common error in the implant selection (4 cases in femur, 6 cases in tibia). 3. A new fragment was made in 12 patients(17%) during surgery, more commonly in the femur (9 cases), especially medial side and distal to the fracture line. 4. Bone shortening, angulation deformity or rotational deformity, caused by incomplete reduction, were developed more commonly in the tibia than in the femur. 5. Post-operative deep infection were developed in 2 cases(3%). 6. Delayed or non-union were developed in 18 cases(28%), who were followed for more than 3 months. 7. Circumferential wiring or bone grafting using semiclosed technique is thought to be useful to prevent delayed or nonunion when there is a wide gap between fractured fragments pre-operatively.
Bone Transplantation ; Congenital Abnormalities ; Femur ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Surgical Procedures, Operative ; Tibia

BACKGROUND: Irbersatan, an orally active antihypertensive agent, effectively reduce blood pressure by directly blocking angiotensin II receptors without any significant adverse effects. The purpose of this study is to evaluate the efficacy and safety of irbesartan in patients with mild to moderate hypertension. METHODS: This study enrolled 83 patients who had diastolic pressure above 95 mmHg and below 110 mmHg on two measurements. Sixty eight patients were administered 150mg of irbesartan, an angiotensin II receptor blocker, daily for four weeks as an initial dosage. If the sitting diastolic pressure was equal to or greater than 90 mmHg after a 4 week treatment period, the dosage was doubled until the end of 8 weeks. Baseline pressures, antihypertensive effect, side effects, laboratory findings were compared before and after treatment. RESULTS: Fourty two patients out of 53 patients having completed this study showed decreased blood pressure equal to or more than 5 mmHg of the sitting diastolic pressure (response rate=79%). Twenty one patients out of 53 patients showed normalized blood pressure below 90 mmHg of the sitting diastolic pressure (normalization rate=40%). The extent of decrease in diastolic and systolic blood pressure after eight week treatment was an average 11.7+/-10.1 mmHg and 16.3+/-18.9 mmHg, respectively (p<0.05). Nineteen ontoward side effects was observed in 17 patients out of 68 patients with medication (frequency of ontoward effects=25%). Only one case with headache was considered to be related to the medication. Abnormal laboratory findings were observed in eight patients, and only one case with elevation of bilirubin and ALT levels was considered to be related to the medication. CONCLUSION: In conclusion, irbesartan is a safe and effective antihypertensive drug in patients with mild to moderate hypertension with tolerable side effects.
Bilirubin ; Blood Pressure ; Headache ; Humans ; Hypertension* ; Receptors, Angiotensin

Most anal fistulas are either intersphincteric or low transsphincteric and are treated by fistulotomy with a few recurrence and minimal risk of incontinence. In high and complicated fistulas, fistulotomy should not be used because of a high chance of incontinence. High transsphincteric or suprasphincteric fistulas, anterior fistulas in female, patients with coexisting inflammatory bowel disease, elderly patients with poor sphincter function, multiple simultaneous fistulas, or patients with multiple prior sphincter injuries need alternative technique to minimize the incidence of incontinence. The alternative techniques include seton placement, advancement flap closure, muscle filling procedure, fibrin glue, etc. depending on the status of fistula and patients. The various sphincter sparing techniques used widely are reviewed.
Aged ; Female ; Fibrin Tissue Adhesive ; Fistula ; Humans ; Incidence ; Inflammatory Bowel Diseases ; Rectal Fistula* ; Recurrence

The diagnosis of a Battered Child Syndrome is made by the pediatrician, surgeon and the radiologist because almost parents deny the diagnosis or refuse to answer the doctor's questions. The imaging modalities play a key role in the investigation and documentation of the battered child syndrome, because of the high frequency of the typical skeletal lesion. Although physical abuse is denied by parents, the recognition of this entity is possible by the primary diagnostic imaging study in the suspected child abuse. The imaging studies are either a bone scan and x-ray series or a complete radiolographic skeletal survey by X-ray series. In an expected intracranial injury, a CT scan of the head is mandatory We experienced a case of Battered Child Syndrome in a 6 month-old male infant who had subdural hemorrhage and fractures of skull and ribs in different stages of healing and repair. The brief review of the literature was made.
Battered Child Syndrome* ; Child ; Child Abuse ; Diagnosis ; Diagnostic Imaging ; Head ; Hematoma, Subdural* ; Humans ; Infant ; Male ; Parents ; Ribs ; Skull ; Tomography, X-Ray Computed

Glutathione has a key role in several detoxification reactions and in the protection against injury caused by reactive oxygens. Pregnancy-induced hypertension(PIH) is associated with endothelial cell dysfunction. Such dysfunction could be caused by oxidative stress. There is evidence of increased activity of free radicals in PIH, but little is known about the part played by changes in specific antioxidants. In this study, the changes of glutathione levels were investigated in blood of patients with PIH, and cord blood of these patients was also investigated. The glutathione levels in cord blood of neonates from hypertensive pregnant women were significantly higher than in cord blood from normotensive pregnant women. The changes of gamma-glutamuylcysteine synthetase and of glutathione s-transferase in placenta were not significant, but gamma-glutamyl transpeptidase activity increased significantly in placenta of hypertensive pregnant women. These results suggest that the increased glutathione in cord blood of patients with PIH may be due to increased glutathione interorgan transport resulting from incerased activity of the placenta gamma-glutamyl transpeptidase.
Antioxidants ; Endothelial Cells ; Female ; Fetal Blood ; Free Radicals ; gamma-Glutamyltransferase ; Glutathione Transferase ; Glutathione* ; Humans ; Hypertension, Pregnancy-Induced* ; Infant, Newborn ; Ligases ; Oxidative Stress ; Oxygen ; Placenta* ; Pregnancy ; Pregnant Women