No abstract avaiable.
Glucose* ; Homeostasis*

There is much controversy concerning the method of treatment on the tibial fracture because of frequent complications, such as non-union, delayed union and infection. Authors reviewed and analyzed 110 tibial fractures which had been treated at the Department of Orthopedic Surgery, Sung Ae General Hospital from June 1983 to March 1987 by the groups, conservative treatment, open reduction and internal fixation with compression plate and closed flexible intramedullary nailing. The results were as follows :1. In regard to the fracture location, there was no difference in the healing time among the treatment methods. The I.M. nailing group healed 1.5 weeks earlier than other groups in each location. 2. In minor and moderate severity by Ellis, the I.M. nailing group revealed better result, and in major one, the compression plate group showed better result. More complications occured in major severity. 3. Union time among the trestment methods was not affected by the fibular fractures, but most of the complications occured in the concomitant fibular fracture case. 4. In open fracture, the healing time showed no difference among the groups, and was prolonged about 2 weeks than closed fracture. In closed case, the I.M. nailing group showed good result. 5. The cases, which were reduced earlier in the conservative group, and treated within 3 days in the I.M. nailing group revesled better result. 6. The radiological union time from the definite treatment was 15.80 weeks in the conservative treatment group, 15.18 weeks in the compression plate group and 13.92 weeks in the I.M. nailing group.
Clinical Study ; Fracture Fixation, Intramedullary ; Fractures, Closed ; Fractures, Open ; Hospitals, General ; Methods ; Orthopedics ; Tibia ; Tibial Fractures

Congenital dislocation of the knee is very rare deformity and presents with anterior displacement of the tibia in relation to the femur. Early gentle manipulation and serial splintage or plaster cast is recommended for treatment and successful in the majority except the case of quadriceps contracture or late correction. We experienced two cases of bilateral congenital dislocation of the knee who had been treated with early gentle manipularion, immobilization with serial corrective dual splint, passive stretching and night splint. Our results are good in both cases.
Casts, Surgical ; Congenital Abnormalities ; Contracture ; Dislocations ; Femur ; Immobilization ; Knee ; Muscle Stretching Exercises ; Splints ; Tibia

No abstract available.
Humans ; Kidney Transplantation*

To delineate the coronary anatomy and left ventricular function during early myocardial infarction, coronary arteriography and left ventriculogrphy were performed, prospectively in 23(22%) of 105 patients who were admitted to the coronary care unit at Masan Koryo Hospital from June 1986 to June 1988 within 4 weeks after the onset of symptoms(medium:21 days, range:18 days to 25 days). 1) Among 23 patients, male is 20 patients and female is 3 patients. The ratio of male to female was 6.6:1. The mean age was 55.4+/-10.3 years(range:34-77 years). 2) Coronary artery narrowing state which related to myocardial infarction was as follows; 2 patients(7%) had normal, 1 patients(4%) had insignificant narrowing(below 50%) 5 patients(22%) had moderate narrowing(50-75%), 10 patients(43%) had severe narrowing(75-99%), 5 patients(22%) had complete occlusion(100%). 3) The range of coronary artery disease was as follows; 9 patients had one vessel disease, 10 patients had two vessel disease, 1 patients had three vessel disease, and ejection fraction had no significant difference among 3 groups but lowest in three vessel disease. Among 23 patients, 13 patients had anterior infarction, 10 patients had inferior infarction. 4) Left ventricular ejection fraction and multiple vessel disease had no significant difference between i) the young(under 45 years old) and the old(over 45 years old) age groups, ii) presence or non presence of previous angina, iii) Killip classification I, II and III, IV) anterior infarction and inferior infarction. 5) In left ventriculography, akinesis and dyskinesis were shown at similar ratio in anterior infarction and inferior infaraction. Dyskinesis was shown in 27% of patients who have 0-1 vessel disease, 50% of patients who have 2-3 vessel disease, 62% of patients who have collateral circulation, 26% of patients who dose not have collateral circulation. 6) Collateral circulation was found in 8 patients(35%). Age and left ventricular ejection fraction were high in patients without collateral circulation than with collateral circulation, but there is no significant difference and collateral circulation exists regardless of infarction site and range of coronary artery disease. 7) As for the complication of angiocardiography in this study, there was ventricular tachycardia in 3 patients(13%) without mortality. It is concluded that coronary arteriography can be safely performed in early stage after acute myocardial infarction. Also good prognosis is anticipated since three vessel disease and complete occlusion were low in acute myocardiaol infarction of Korean People. Since these are not much case performed study, however more study on this area is required.
Angiocardiography ; Angiography* ; Classification ; Collateral Circulation ; Coronary Angiography ; Coronary Artery Disease ; Coronary Care Units ; Coronary Vessels ; Female ; Humans ; Infarction ; Male ; Mortality ; Myocardial Infarction* ; Prognosis ; Prospective Studies ; Stroke Volume ; Tachycardia, Ventricular ; Ventricular Function, Left

We investigated the electrophysiological changes in the cerebral cortical evoked potentials(CEP's) and subsequent changes in the regional cerebral blood flow(rCBF) following increased intracranial pressure(ICP) in cats. A small balloon connected to a fine polyethylene tube was placed on the epidural space of the left parietal region through a small burr hole and inflated with saline in increment of 0.2 ml to simulate the expanding mass. The ICP was maintained at 150 mmH2O and 250 mmH2O levels during the experimental period. The study was conducted with 30 adult cats, weighing between 2.7 and 4.5kg. The animals were anesthetized with pentobarbital (50mg/kg) intraperitonially and tracheostomy was performed to maintain self respiration. Two small burr holes were made on both frontal regions for rCBF measurement and a small burr hole was made on the right primary sensorimotor cortex for a cerebral cortical stimulating electrode. A recording electrode for CEP's was placed on the dura of the left cerebellar hemisphere. For experiments, animals were divided into 3 groups. Group I:Animals(n=10) with 80mmH2O of ICP, Group II:Animals(n=10) with 150 mmH2O of ICP, Group III:Animals(n=10) with 250mmH2O of ICP. The CEP's and rCBF measurements were carried out in each animal before and immediately after increased ICP(IICP), at the 30th min, 60th min, 90th min, 120th min, 150th min and 180th min after IICP. The rCBF was measured by hydrogen clearance method. The results were as follows ; 1. A significant elevation of the systolic blood pressure was observed after the 60th min in both IICP groups. 2. 1) Group II animals showed a significant reduction of rCBF by 10.5% and 39.5% in the right frontal lobe at the 60th min and 180th min after IICP, and by 19.8% and 57.7% in the left frontal lobe at the 60th min and 180th min after IICP, respectively. 2) Group III animals showed also a significant reduction of rCBF by 18.2% and 54.4% in the right frontal lobe at the 60th min and 180th min after IICP, and by 62.9% and 84.7% in the left frontal lobe at the 60th min and 180th min after IICP, respectively. 3) Reductions of the rCBF of the left frontal lobe in the Group III animals were greater than those of the Group II animals. 3. 1) Changes of amplitude and latency in the CEP's were more prominent in the Group III animals than those of the Group II animals. 2) Changes of the late components of CEP's(N2) might represent derangements of the neural activity of the descending reticular formation in brainstem. 4. A close correlation was found between CEP's and rCBF changes, which suggested being a threshold relationship. In conclusion, it is assumed that the detection of CEP's in the cerebellum is a quite valuable prognostic tool to evaluate the neural activity of the non-specific reticular formation and specific somatosensory pathways in the acute intracranial hypertension. The prolongated latencies and suppressed amplitude in the CEP's indicate the presence of damages in brainstem multisynaptic pathways.
Adult ; Animals ; Blood Pressure ; Brain Stem ; Cats ; Cerebellum ; Electrodes ; Epidural Space ; Frontal Lobe ; Humans ; Hydrogen ; Intracranial Hypertension ; Intracranial Pressure* ; Pentobarbital ; Polyethylene ; Rabeprazole ; Respiration ; Reticular Formation ; Tracheostomy

Mesenchymal chondrosarcoma is a rare tumor occurring in both bone and soft tissues and exhibits characteristics of a highly malignant tumor. The authors experienced a case of mesenchymal chondrosarcoma ocurring in a 33-year-old man, which had invaded the soft tissues of the chest wall and had been incompletely removed, and recurred in the adjacent T10 vertebra 4 years later. The patient presented with severe back pain and paraparesis at admission. Radiographic studies of the vertebra showed an aggressive osteolysis of the vertebral body, pedicle, lamina, compression of the spinal cord, and soft tissue invasion. The tumor was totally removed by an anterior and posterior combined approach. The removed vertebral body was replaced with a titanium mesh cage, and the thoracic spine was stabilized by both anterior and posterior fixations with instruments. The pathological and the clinical characteristics of mesenchymal chondrosarcoma are discussed.
Adult ; Back Pain ; Chondrosarcoma, Mesenchymal* ; Humans ; Osteolysis ; Paraparesis ; Spinal Cord ; Spine* ; Thoracic Wall ; Titanium

Although evolution and time course of ischemic brain infarct should be a matter of interest to investigators in the research of brain ischemia as well as traumatic brain injury, few papers have ever been reported. Authors observed quantitatively sequential changes of infarct size and regional cerebral blood flow(rCBF) to assess the evolution of focal ischemic brain infarct in the rat following left MCAO. Fifteen rats, weighting 250 g to 370 g, were used in this experiment. The experiment animals were divided into three groups: 6, 24 and 48 hours groups(HG) after MCAO. The rCBF of bilateral caudate nuclei was measured by hydrogen clearance methods. Areas of brain infarction were delineated by tripheny-tetrazolium chloride(TTC) at the preselected 8 coronal levels of forebrain. The areas of brain damage were drawn on scale diagrams(x4 actual size) of forebrain and measured by a plannimeter. In the experimental groups, just after MCAO, rCBF of the ipsilateral caudate nucleus was reduced to 29.4+/-6.5 to 24.5+/-7.9 ml/100 g/min from the basal value of around 117 to 121 ml/100 g/min and showed a tendency of getting more reduced to 19.4+/-7.6 ml/100 g/min by 48 hours. The rCBF of the contralateral caudate nucleus was maintained in the basal value throughout the experiment. Comparing the total amounts of ischemic damage of 48 HG to those of 5 and 24 HG, the infarction size was significantly increased in cerebral hemisphere as well as cerebral cortex and caudate nucleus(p<0.05). But there was not any significant difference between 6 and 24 HG. The experiment provides evidence for the evolution of focal ischemic brain infarct without any further change of decreased rCBF. The data suggest that it is desirable to observe the change of pathologic findings by not less then 48 hours following the arterial occlusion in the study of ischemic brain infarction in the rat, particularly as long as ischemic damage is delineated by TTC.
Animals ; Brain ; Brain Infarction ; Brain Injuries ; Brain Ischemia ; Caudate Nucleus ; Cerebral Cortex ; Cerebrum ; Humans ; Hydrogen ; Infarction* ; Infarction, Middle Cerebral Artery* ; Middle Cerebral Artery* ; Prosencephalon ; Rats* ; Research Personnel

Spinal hemangioma is the uncommon, slowly growing benign tumor that arises from the blood vessels and commonly located in thoracic spine. We have recently experienced a caseof capillary Hemangioma in intradural extramedullary space of thoracic spine level. The patient presented with a slowly progressive weakness of both lower extremities and hypesthesia below T6 dermatome. The plain X-ray films, thoracic spine myelography and CT scan disclosed an intradural mass at T5 level. The mass was surgically removed and conformed by histological examination.
Blood Vessels ; Capillaries* ; Hemangioma ; Hemangioma, Capillary* ; Humans ; Hypesthesia ; Lower Extremity ; Myelography ; Spine ; Tomography, X-Ray Computed ; X-Ray Film

OBJECTIVE: To evaluate the pregnancy outcomes of women with congenital uterine anomaly exceeding 20 weeks of gestation. METHODS: We reviewed retrospectively the birth records of the Seoul National University Hospital between January 1, 1990, and December 31, 2005. We grouped congenital uterine anomalies into five classes, namely bicornuate, didelphys, septate, arcuate, and unicornuate uterus. We compared the pregnancy outcomes with each anomaly. RESULTS: We found 106 cases of congenital uterine anomaly within a given period of time. There were 63 cases of bicornuate uterus, 19 cases of didelphys, 16 cases of septate uterus, 5 cases of arcuate uterus, and 3 cases of unicornuate uterus. The overall preterm delivery rate was 22.6% (24/106) and cesarean section rate was 74.5% (79/106). A high cesarean section rate was due to metroplasty, abnormal fetal presentation, and uterine anomaly itself. The preterm delivery rate and cesarean section rate of each uterine anomaly did not differ statistically from one another. Five fetuses were stillborn, and one fetus died after birth because of a placenta abruption. The overall take-home baby rate was 94.3% (100/106). There was no maternal mortality and only one case was suffered from postpartum bleeding. CONCLUSION: Our results suggest that the most of women with uterine anomaly exceeding 20 weeks of gestation may take their baby home.
Birth Certificates ; Cesarean Section ; Female ; Fetus ; Hemorrhage ; Humans ; Labor Presentation ; Maternal Mortality ; Obstetric Labor, Premature ; Parturition ; Placenta ; Postpartum Period ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Retrospective Studies ; Seoul ; Uterus