No abstract available.
Airway Obstruction* ; Electrocoagulation* ; Tuberculosis*

On the length, strength, free lateral motion, and perfect mobility of the thumb, depends the power of the human hand. The thumb is called pollex because of its strength and that strength is necessary to the power of the hand being equal to that of all the fingers."So stated Sir Chales Bell in the fourth Bridgewater Treatise, first published in 1833. Morrison and O'Brien advocated reconstruction of the thumb with a free wrap around flap from the big toe to recreate a stable, sensate and functional digit including the nail in 1980. From March, 1982 to July, 1988, Twelve thumb reconstructions were performed using the wrap around procedure at Hanyang University Hospital;12 successful thumb reconstructions were reviewed at an average of 16 months after surgery. There were several complications;these included skin necrosis(4), malunion(1), resorption of the bone graft(7). We considered that cosmesis and function were good;pinch grip averaged 68% of normal, sensibility returned in all patients as assessed by two-point discrimination(average 9.5mm). Over all the results are as follows. 1. The wrap around technic provides a good method of reconstruction. 2. The wrap around technic is one stage operation and can be used in the level of metacarpal amputation. 3. The surgeon should be familiar with microsurgical technic.
Amputation ; Hallux ; Hand ; Hand Strength ; Humans ; Methods ; Skin ; Thumb

Vnrus deformity is a common finding in patients who are candidates for toial knee replacement arthropiasty. To obtain excellent clinical results and to maintain well-aligned and stable prosthetic components in patients who have such a deformity, adequate ligament balancing as well as accurate cone.ction of bony alignment is required. But many technical problems are encountered. Especially the bony defect on the medial aspect of the tibia after adequate bone cutting and ligament imbalance with laxity in the lateral side and contracture in the medial side. Total knee replacement arthroplasty with 43 patients(56 cases) to be mcre than 10 degrees of varus of tibio-femoral angle was done by a single surgeon and reviewed retrospectively. The diagnosis was osteoarthritis in 46 cases, rheumatoid arthritis in 9 cases. The average follow up period was average 33 months(l-7 years). Preoperative varus deformity of average 13.5 degree., was corrected to valgus 6.69 degrees at last follow-up. Postoperative range of motion was 122.5 degree. And the mean knee society score improved from 24.8 to 87.2 postoperatively and the function score improved from 23.6 to 83.9 postoperatively. At self-assements, 88.2% of the patients was very satisfied or somewhat satisfied. Total knee replacement ;u1hroplasty in the patients with vaus deformity is effective procedure to corri.ct deformity and improve clini- c;1 and functional status, but long-term follow up period is required for changing alignment.
Arthritis, Rheumatoid ; Arthroplasty* ; Arthroplasty, Replacement, Knee* ; Congenital Abnormalities* ; Contracture ; Diagnosis ; Follow-Up Studies ; Humans ; Knee ; Ligaments ; Osteoarthritis ; Range of Motion, Articular ; Retrospective Studies ; Tibia

The purpose of this study is to confirm the effectiveness of stay-suture which is commonly used in the procedure of end to end anastomosis, to find out general biomechanical properties of peripheral nerve with gradual stretching and to evaluate the histological difference after breakage of the nerve. The sciatic nerves of adult rabbits were excised and they were grouped by I and II. Group I was composed of 14 normal sciatic nerves and group II, 14 sciatic nerves sutured with 5-0 nylon after transection. They were stretched on the "Instron" universal testing machine at a constant rate of 200mm/min until breakage took place and the results were compared. The mean maximal tensile strength was 13.6N in group I and 2.1N in group II, representing about one seventh value. The mean ultimate tensile strength was 4.2MPa in group I and 0.9MPa in group II, representing about one fifth value. In load-elongation curve of group I, viscoelastic property was noted as all other biological tissues have. The mean modulus of elasticity was 19 in normal sciatic nerves, which is somewhat lower value than other tissues, indicating superior elastic property of peripheral nerves. Transverse histologic examination showed that epineurium lost its continuity earlier than perineurium, implying perineurium is a more resistant structure than epineurium. However, to confirm this, it is thought to be necessary to examine the nerves serially during distraction at each different status. In conclusion, stay-suture provided about one fifth of ultimate tensile stress, implying its usefullness of resisting excessive tension in end to end anastomosis of peripheral nerves. Normal sciatic nerves showed viscoelastic property with mean modulus of elasticity of 19.
Adult ; Elastic Modulus ; Humans ; Nylons ; Peripheral Nerves ; Rabbits ; Sciatic Nerve ; Tensile Strength

PURPOSE: To analyze clinical, radiological and pathological features as well as clinical outcome after surgical treatment of patients with secondary chondrosarcoma arising from osteochondroma(tosis). MATERIALS AND METHODS: We retrospectively reviewed clinical records, radiographs, pathologic slides of 14 patients. Nine patients were male and five were female. The mean age was 34 years. The mean follow-up period was 54 months. RESULTS: All patients had a history of previous mass since childhood or puberty. Preexisted osteochondroma was single in 3 patients and multiple in 10. Remaining 1 patient had multiple osteochondromatosis with enchondromatosis. MRI clearly provided thickness of cartilage cap, which was over 2 cm except in 2 cases. Chondrosarcoma was grade 1 in all except 1 case, which was grade 2. Wide excision was performed in 10 patients, marginal excision in 3 and amputation in 1. Twelve patients were doing very well without evidence of disease. Among 3 patients with marginal excision, 1 patient had local recurrence and 1 patient died of disease. CONCLUSION: Comprehensive understanding of clinical, radiological and pathological features of secondary chondrosarcoma is warranted for accurate diagnosis. The best result can be expected with early recognition of malignant change of osteohcondroma(tosis) and wide excision.
Amputation ; Cartilage ; Chondrosarcoma ; Enchondromatosis ; Female ; Follow-Up Studies ; Humans ; Male ; Osteochondroma ; Osteochondromatosis ; Puberty ; Recurrence ; Retrospective Studies

Twenty cases of blepharospasm and thirty five cases of hemifacial spasm were treated by injection with Botulinum Toxin A during a fifteen-month period. A total of 74 treatment sessions were given for 7 months follow-up period and the mean dose of 17.81 units per lid and brow was administered according to Scott's method. The mean ages of blepharospasm and hemifacial spasm patients were 59 years and 49 years, respectively. The mean response time of toxin against blepharospasm and hemifacial spasm were 159.9 days and 167.1 days respectively. The maximum effect of toxin appeared in the first 1 month period following injection. The mean preinjection spasm grade was +3.17 in blepharospasm, and +2.41 in hemifacial spasm, and mean postinjection spasm grade was +0.88 in blepharospasm and +0.52 in hemifacial spasm. The mean preinjection muscle strength was +3.15 in blepharospasm, and +3.07 in hemifacial spasm, and mean postinjection muscle strength was +1.12 in blepharospasm, and +1.24 in hemifacial spasm. The complications attributed to toxin injection were lagophthalmos, and epiphora. These ocular complications were localized, mild and transient, and no systemic side effects were noted.
Blepharospasm* ; Botulinum Toxins* ; Follow-Up Studies ; Hemifacial Spasm ; Humans ; Lacrimal Apparatus Diseases ; Muscle Strength ; Reaction Time ; Spasm

No abstract available.
Cervix Uteri* ; Female

PURPOSE: To report the result of Fresnel prism application and adaptation for visual field relocation and functional vision improvement in homonymous hemianopsia patients. METHODS: Fifteen homonymous hemianopsia patients were prescribed Fresnel prism. To expand the visual field, Fresnel prism was placed base-out toward the defective field and patients were given an adaptation period of 1 month. The effects of the prism on field expansion was evaluated using Goldmann perimetry. In addition, the NEI-VFQ25 questionnaire was utilized asking patients regarding their subjective functional vision and satisfaction in daily life before and after using the Fresnel prism. RESULTS: After 1 month of Fresnel prism prescription, 53% of patients showed objective visual field expansion to the defective field of 12.5 degrees on average. Monocular or macular splitting hemianopsia patients showed more visual field expansion than binocular macular sparing hemianopsia patients. The NEI-VFQ25 score increased significantly and abnormal head position decreased or disappeared after 1 month of using the prism. However, 47% of patients failed to adapt to the prism. CONCLUSIONS: Using Fresnel prism in homonymous hemianopsia patients effectively expands the visual field, corrects abnormal head position, and improves functional vision. However, to improve the success rate, for certain patients the proper choice of prism application method, prism diopters, and constant management are necessary.
Head ; Hemianopsia* ; Humans ; Prescriptions ; Telescopes ; Visual Field Tests ; Visual Fields*

No abstract available.
Mitral Valve Insufficiency*

Two cases of malignant histiocytosis, in which skin involvement was a prominent finding at initial clinical presentation, are reported. 1nteresting histopathologic findings, including Langerhans granule in one case and numerous eosinophils in another, were observed. In one case remission was achieved with BACOP chemotherapy (Bleomycin, Adriamycin, Cyclophosphamide, Vincristine, and Prednisone). In the other case, the patient died nine months after the onset of the disease without any treatment.
Cyclophosphamide ; Doxorubicin ; Drug Therapy ; Eosinophils ; Histiocytic Sarcoma* ; Humans ; Skin ; Vincristine