No abstract available.
Brain Injuries* ; Brain* ; Disability Evaluation* ; Humans ; Perfusion* ; Technetium Tc 99m Exametazime* ; Tomography, Emission-Computed, Single-Photon*

Supracondylar fracture of the humerus in children is the most common fracture of the elbow in contrast with infant or adult, and there are also many problem in treatment and accompanying complication. These injuries are difficult to manage in case of a delayed initial treatment or repeated close manipulation. We analysed 32 cases which failed and delayed initial management, at department of orthopedic surgery, Chung Nam University Hospital from Jan. 1977 to Dec. 1981. The results obtained were as follows: 1. The cases admitted after unsatisfactory treatment at other hospital among all cases are most common (59.4%). 2. The average duration after trauma are 5.3 days. The average duration until successful reduction after initial trauma are 7.3 days, 3. In types of fracture, there are all displaced supracondylar fracture (Type II, III, IV). 4. In treatments, initial sucessful close reduction are 5 cases (15.6%). The others require other managements, ie, final successful tractions are 5 cases, final sucessful percutaneous pinnings are 5 cases and final open reductions are 16 cases. 5. Cubitus varus deformity was more common in manual reduction and traction groups than in open reduction and percutaneous pinning groups, but limitation of elbow motion was more common in open reduction and percutaneous pinning groups. 6. In complications, there were 5 nerve palsies (4 radial nerves, 1 median nerve), 3 pin tract infections, 1 myositis ossificans, 9 severe cubitus varus and 5 severe limitation of motion.
Adult ; Child ; Clinical Study ; Congenital Abnormalities ; Elbow ; Humans ; Humerus ; Infant ; Myositis Ossificans ; Orthopedics ; Paralysis ; Radial Nerve ; Traction

No abstract available.
Epidermal Cyst*

No abstract available.
Trichothiodystrophy Syndromes*

Fournier's gangrene is an infective necrotizing fasciitis of the perineal, genital or perianal regions. Management of this disease has involved prompt surgical debridement with initiation of broad spectrum antibiotics and intensive supportive care. Multiple debridements orchiectomy, urinary deversion, and fecal diversion should be performed as clinically indicated. Hyperbaric oxygen therapy and topical application of unprocessed honey may prove to be useful adjuncts as new therapies. After excision of all necrotic tissue, the tissue losses have been managed by primary repair. split-thickness skin grafts, rotational or free myocutaneous flaps and omental flaps. Skin graft did not take on bare testis lacking the tunica vaginalis, and gracilis myocutanous flap was too bulky to cover the scrotal area. The progress of necrosis ceased by using intravenous PGE1 injection in the aspect of characteristic obliterative endarteritis causing cutaneous and subcutaneous vascular thrombosis and necrosis of tissue in Fournier's gangrene. We have reconstructed large scrotal defects with bilateral superomedial thigh flap in three Fournier's gangrene patients after stopping tissue necrosis with PEG1 treatment and several surgical debridements of the wounds. The use of this flap ensures a virtually normal sensation, which is important for the erotic propensity of the scrotum. Easy flap design and dissection, as well as primary closure of the donor site, are another benefits of this method.
Alprostadil* ; Anti-Bacterial Agents ; Debridement ; Endarteritis ; Fasciitis, Necrotizing ; Fournier Gangrene* ; Honey ; Humans ; Hyperbaric Oxygenation ; Myocutaneous Flap ; Necrosis ; Orchiectomy ; Scrotum ; Sensation ; Skin ; Testis ; Thigh* ; Thrombosis ; Tissue Donors ; Transplants ; Wounds and Injuries

This retrospective study evaluated possible rupture of silicone gel breast implants in 92 patients. the series included patients undergone augmentation mammoplasty(n=59), and reconstructive mammoplasty(n=23) from Sep. 1993 to Aug. 1996. the age of implants ranged from 4 months to 8 years(mean:23.1months). of these, 19 cases displayed Ultrasonographic sings of rupture. of 13 implants removed, 7 were intact and 6 were ruptured. Implant contour deformities and radial folds are often seen in both ruptured and intact silicone implants and therefore cannot serve as reliable signs of rupture. A stepladder sign in intact implant is believed to be the result of reverberation artifacts within the interior of the implant. Due to these false-positive ultrasonographic findings, ultrasonographiy is not as absolutely reliable tool for the diagnosis of implant rupture. Alternative imaging methods(CT, MRI) are required to establish an accurate preoperative diagnosis.
Artifacts ; Breast Implants* ; Breast* ; Congenital Abnormalities ; Diagnosis ; Humans ; Retrospective Studies ; Rupture* ; Silicone Gels*

BACKGROUND: The concept of myocardial injury after coronary occlusion is changing in recent years. Brief episode of ischemial induces reversible myocardial injury and repeated brief ischemic insults might cause myocardial necrosis due to cummulative damages. Recent observations showed that brief episodes of ischemia have protective effects on the myocardium increasing the myocardial tolerance to a subsequent sustained ischemic insult. This phenomenon is termed ischemic preconditioning and can be noticed after a variety of protocols in multiple species of experimental animals. This study was planned to 1) measure the changes of hemodynamic parameters and the ischemic damage of insulted myocardium during ischemic preconditioning, and 2) compare the infarct sizes with or without preconditioning. METHODS: Using canine model of a single 90 minutes' occlusion of left anterior descending coronary artery and 240 minutes' reperfusion, 14 mongrel dogs were randomized to with(n=7) or without(n=7) ischemic preconditioning such as four 5 minutes' occlusion and 5 minutes' reperfusion, Changes of hemodynamic parameters and extents of the ischemic myocardial damages during preconditioning were observed. And using in vitro myocardial staining with monastral blue and triphenyl tetrazolium chloride, we compared the infarct sizes and risk areas in two groups of occlusion and reperfusion canine model with and without preconditioning. RESULTS: 1) Heart rate was significantly decreased after first 5 minutes' occlusion compared with those of basal control(151+/-27 VS 163+/-25 BPM, p<0.05) without further changes in subsequent ischemic insults. Left ventricular systolic pressure was significantly decreased after first 5 minutes' occlusion(109.0+/-19.9 VS 130.6+/-23.3mmHg, p<0.005), and after first 5 minutes' reperfusion and second 5 minutes' occlusion compared with those of basal control(111.3+/-29.8, 109.9+/-17.2 VS 130.6+/-23.3mmHg respectively, p<0.05), without further changes during remaining ischemia. Left ventricular end diastolic pressure and maximum +dp/dt were not changed. Peak -dp/dt was decreased significantly after first and second 5 min occlusion(943.7+/-294.4, and 962.1+/-281.5) from basal control level(1168.2+/-358.8mmHg, p<0.05). Thereafter no change was noted during remaining preconditioning. The changes in rate-pressure product were same as those of left ventricular systolic pressure(first 5 minutes occlusion ; 17.3+/-3.7 VS 21.2+/-3.5, p<0.005, second 5 minutes' occlusion ; 17.9+/-5.3, 18.1+/-3.4 VS 21.2+/-3.5, p<0.05). 2)Transmyocardial lactate extraction ratio was significantly decreased in early phase of ischemic preconditioning(17.5+/-11.3 VS 25.2+/-9.9%, p<0.05). 3) Hemodynamic parameters such as heart rate, left ventricular systolic pressure, left ventricular end-diastolic pressure, maximum +dp/dt, peak -dp/dt and rate-pressure product were changed similarly in both control and precontioned groups. 4) There was no significant difference of mean myocardial blood flows in infarct zones, which represent collateral blood flow, after 5 minutes' brief occlusion and 60 minutes of sustained occlusion in preconditioned group. 5) The infarct area/risk area ratio was significantly reduced in preconditioned group(27.0+/-9.6 VS 5.6+/-3.1%, p<0.005), but the risk area/left ventricular area ratio showed no difference in the two groups. CONCLUSIONS: These findings suggest that, in the early phase of brief repeated occlusion and reperfusion, myocardial ischemic damage accompaning systolic and diastolic myocardial dysfuctions develops and myocardial protective effect of ischemic preconditioning was obtained at the same time. Ischemic preconditioning group demonstrated reduced infarct sizes compared to those of control group after 90 minutes' sustained ischemia and reperfusion in canine acute myocardial infarction model.
Animals ; Blood Pressure ; Coronary Occlusion ; Coronary Vessels* ; Dogs ; Heart Rate ; Hemodynamics ; Ischemia ; Ischemic Preconditioning* ; Lactic Acid ; Myocardial Infarction ; Myocardial Reperfusion ; Myocardium ; Necrosis ; Reperfusion

PURPOSE: This study was conducted to perform a comparative analysis of the efficacy and safety of conventional transurethral resection of the prostate (TUR-P), transurethral resection in saline (TURIS), and TURIS-plasma vaporization (TURIS-V) when performed by a single surgeon for benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: The clinical data of 73 consecutive men who underwent conventional TUR-P (39), TURIS (19), or TURIS-V (15) for BPH were retrospectively analyzed. All procedures were carried out by a single surgeon between October 2007 and April 2010. The patients were assessed preoperatively and perioperatively and were followed at 1, 3, and 6 months postoperatively. Patient baseline characteristics, perioperative data, and postoperative outcomes were compared, and major complications were recorded. RESULTS: In all groups, significant improvements in subjective and objective voiding parameters were achieved and were sustained throughout follow-up. TURIS-V had the shortest operation time compared with conventional TUR-P and TURIS (p=0.211). TURIS-V significantly decreased procedural irrigation fluid volume, postoperative irrigation duration, catheter duration, and hospital stay compared with conventional TUR-P and TURIS. There were no significant differences between the groups in hemoglobin levels or serum sodium levels before and after the operations. There were three transfusions and four clot retentions in the TUR-P group, and one transfusion and one clot retention in the TURIS group. The TURIS-V group had no complications. CONCLUSIONS: TURIS and TURIS-V were effective for the surgical treatment of BPH in addition to conventional TUR-P. TURIS-V was not inferior to conventional TUR-P or TURIS in terms of safety.
Catheters ; Follow-Up Studies ; Hemoglobins ; Humans ; Length of Stay ; Male ; Pilot Projects ; Prostate ; Prostatectomy ; Prostatic Hyperplasia ; Retention (Psychology) ; Retrospective Studies ; Sodium ; Transurethral Resection of Prostate ; Urologic Surgical Procedures ; Volatilization

Percuaneous mitral valvuloplasty(PMV) is an alternative to surgical mitral commissurotomy for patients with mitral stenosis. To assess the immediate and follow-up results of PMV and to identify factors in fluencing the outcome and coplications of PMV, we analyzed the clinical, echocardiographic and hemodynamic data of 108 patients who underwent PMV. 1) Good hemodynamic results were obtained in 86 patients(79.6%). The factors predicting immediate outcome of PMV were mitral valve mobility, total echoscore, and EBDA/BSA. 2) Predictors of the increase in mitral valve area by PMV were age, sex, rhythm, and NYHA functional class before PMV. The independant predictors were rhythm(p=0.008) and functional class(p=0.002). 3) The degree of mitral regurgitation increased in 26 patients(24%), did not changed in 79 patients(73%) and decreased in 3 patients(3%). The increase of MR could not predicted from any features of the clinical, echocardiographic or hemodynamic daa. The severity of MR decreased by one grade in 15% of patients and did not change in 66% of patients during follow-up. 4) Left-to-right shunt was detected in 19 patients(18%). The predictors were valve mobility, pulmonary artery pressure and pulmonary vascular resistance. 5) Follow-up catheterization(mean 14 months) identified restenosis in six of 16 patients. The predictors of restenosis were sex, total echosecore, and left atrial volume. 6) The hemodynamic data at follow-up were good compared with prePMV data(p<0.01), but follow-up miral valve area decreased than that of postPMV(p<0.05). Immediate decrease in pulmonary vascular resistance followed by progressive improvement during follow-up. 7) Immediate complications of PMV were peripheral arterial embolism in one patient(1%), pericardial effusion in two(2%), transient arrhythmia in four(4%), left-to-right shunt in nineteen(18%) and increase in the grade of MR in twenty-six(24%). This study suggests, that PMV produces excellent immediate and follow-up results and is a safe and effective procedure in the nonsurgical treatment of mitral stenosis.
Arrhythmias, Cardiac ; Echocardiography ; Embolism ; Follow-Up Studies* ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis* ; Pericardial Effusion ; Pulmonary Artery ; Vascular Resistance

Percuaneous mitral valvuloplasty(PMV) is an alternative to surgical mitral commissurotomy for patients with mitral stenosis. To assess the immediate and follow-up results of PMV and to identify factors in fluencing the outcome and coplications of PMV, we analyzed the clinical, echocardiographic and hemodynamic data of 108 patients who underwent PMV. 1) Good hemodynamic results were obtained in 86 patients(79.6%). The factors predicting immediate outcome of PMV were mitral valve mobility, total echoscore, and EBDA/BSA. 2) Predictors of the increase in mitral valve area by PMV were age, sex, rhythm, and NYHA functional class before PMV. The independant predictors were rhythm(p=0.008) and functional class(p=0.002). 3) The degree of mitral regurgitation increased in 26 patients(24%), did not changed in 79 patients(73%) and decreased in 3 patients(3%). The increase of MR could not predicted from any features of the clinical, echocardiographic or hemodynamic daa. The severity of MR decreased by one grade in 15% of patients and did not change in 66% of patients during follow-up. 4) Left-to-right shunt was detected in 19 patients(18%). The predictors were valve mobility, pulmonary artery pressure and pulmonary vascular resistance. 5) Follow-up catheterization(mean 14 months) identified restenosis in six of 16 patients. The predictors of restenosis were sex, total echosecore, and left atrial volume. 6) The hemodynamic data at follow-up were good compared with prePMV data(p<0.01), but follow-up miral valve area decreased than that of postPMV(p<0.05). Immediate decrease in pulmonary vascular resistance followed by progressive improvement during follow-up. 7) Immediate complications of PMV were peripheral arterial embolism in one patient(1%), pericardial effusion in two(2%), transient arrhythmia in four(4%), left-to-right shunt in nineteen(18%) and increase in the grade of MR in twenty-six(24%). This study suggests, that PMV produces excellent immediate and follow-up results and is a safe and effective procedure in the nonsurgical treatment of mitral stenosis.
Arrhythmias, Cardiac ; Echocardiography ; Embolism ; Follow-Up Studies* ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis* ; Pericardial Effusion ; Pulmonary Artery ; Vascular Resistance