A muscular calf is esthetically unappealing in Asian women. Treatment by liposuction alone has poroven to be difficult due to a small amount of fat. We established a new method of transecting half of the gastrocnemius tendon in order to improve the contour of the calf. Thirty-five patients were operated on during the past 3 years. The medial or lateral half of the gastrocnemius tendon was cut using an endoscopic-guided 3M AGEE blade through a 1cm-sized incision. The portion of the muscle above the site of the transection was elevated from the underlying soleus muscles. We checked the calf circumference and evaluated the clinical results at 6 months postoperatively. An average 10% reduction in calf circumfernce was measured, showing a significant esthetic improvement. There were no significant changes in gait analysis or in the Cybex test. There were no specific complications related to the procedure. Through our clinical experience in 35 cases, we were able to prove that tenotomy is a effective, simple and easy method without severe morbidity.
Asian Continental Ancestry Group ; Female ; Gait ; Humans ; Lipectomy ; Muscles ; Tendons ; Tenotomy*

No abstract available.
Osteoporosis* ; Spondylolisthesis*

The study was performed to measure and compare the peripheral blood T cell and T subsets in normal controls and psoriatic patients. Thirty-two normal controls and fift:en psoriatic patients were subjected to the study and the percentages and the rati vs of peripheral blood T cell and T subsets were measured. The results were as follows: 1. Mean percentages of peripheral blood lymphocytes reactive with OKT3 monoclonal antibody in psoriatic patients were 72. 8+-8. 2%, They decreased significantl) as compared with these in control group(76, 6- i-4. 7%). Mc an percentages of peripheral blood lymphocytes reactive with OKT4 monoclonal antibody in psoriatic patients were 47. 3+6, 7p;. They increased as compared with these in control group(46. 5+-3. 9p;), but the increase was insignificant. 3. Mean percentages of peripheral blood lymphocytes reactive with OKT8 monoclonal antibody in psoriatic patients were 27. 2+5. 5g, They decreased significantly as compared with these in control group(30, 6- l-4. 3%) 4. Mean ratios of lymphocytes reactive with OKT4 monoclonal antibody to these reactive with OKT8 monoclonal antibody in psoriatic patients were 1.8+- 0. 48 They increased significantly as compared with these in control group(1. 6+ 0.34).
Allergy and Immunology ; Humans ; Lymphocytes ; Muromonab-CD3 ; Psoriasis

Arytenoid subluxation or recurrent laryngeal nerve paralysis may result from injury to the larynx following endotracheal intubation or blunt laryngeal trauma. Early diagnosis is important for appropriate treatment and better prognosis. A 62-years-old man was admitted for cholecystectomy. He was intubated without any difficulty and nasogastric tube was inserted with the help of laryngoscope and Magill forcep before surgery. He had a weak voice and hoarseness after atraumatic extubation and those symptoms did not improve even 2 days after. Indirect laryngoscopy, videolaryngotelescopy, electromyography(EMG) and computed tomographic findings revealed anterior, inferior subluxation of left cricoarytenoid cartilage associated with left thyroarytenoid muscle denervation and resultant unilateral vocal cord palsy. Conservative treatment for 40 days after the operation and follow-up examination was done. The voice quality was improved and indirect laryngoscopy examination showed that right vocal cord crossed midline in a attempt to meet its paralyzed counterpart on phonation.
Anesthesia, General* ; Cartilage ; Cholecystectomy ; Denervation ; Early Diagnosis ; Follow-Up Studies ; Hoarseness ; Intubation, Intratracheal ; Laryngeal Muscles ; Laryngoscopes ; Laryngoscopy ; Larynx ; Paralysis* ; Phonation ; Prognosis ; Recurrent Laryngeal Nerve* ; Surgical Instruments ; Vocal Cord Paralysis ; Vocal Cords ; Voice ; Voice Quality

We experienced one case of severe pituitary dwarfism in a 10 years old female girl. Magnetic resonance image (MRI) revealed transection of the pituitary stalk stalk with the formation of high intensity ectopic posterior lobe located at the median eminence and agenesis of an anterior lobe of pituitary gland. The serum growth Hormone (GH) response to clonidine and L-dopa revealed severe GH deficiency. The patient had responses to TRH, normal TSH and partial prolactin response, respectively. There was not response LH and FSH to GnRH. The morning cortisol concentration and serum T4 concentration were decreased below the normal range. These findings and no hyperprolactinemia suggested the presence of a vascular connection between the pituitary gland and hypothalamus, which is not visible on MRI. Sofar, the primary cause of idiopathic pituitary dwarfism in many patients is injury to hypothalamus by perinatal insults. In this patient, there was no history of perinatal insults and postnatal head trauma but transection of the pituitary stalk. We report a case of severe pituitary dwarfism due to agenesis with brief review of related litereature.
Child ; Clonidine ; Craniocerebral Trauma ; Dwarfism, Pituitary* ; Female ; Gonadotropin-Releasing Hormone ; Growth Hormone ; Humans ; Hydrocortisone ; Hyperprolactinemia ; Hypothalamus ; Levodopa ; Magnetic Resonance Imaging ; Median Eminence ; Pituitary Gland* ; Pituitary Gland, Anterior* ; Prolactin ; Reference Values

BACKGROUND: Propofol and ketamine had been used for anesthesia induction and for total intravenous anesthesia. The nature of any hypnotic interactions occurring between propofol and ketamine are unknown. A comparison of maternal and neonatal effects among propofol-ketamine combination, ketamine and propofol were studied when used for anesthesia induction in Cesarean section. METHODS: Forty five patients in ASA class I or II scheduled for Cesarean section randomly assigned to either propofol 2 mg/kg (n=15), ketamine 1 mg/kg (n=15) or propofol 1 mg/kg - ketamine 0.5 mg/kg combination group (n=15) as an induction agent. Maternal systolic and diastolic blood pressure, heart rate, Apgar score and umbilical blood gas analysis were measured. RESULTS: Before intubation, systolic and diastolic pressure were decreased in propofol group but increased in ketamine and propofol-ketamine combination group. Heart rate were increased in all three groups. But there were no significant differences among three groups (p<0.05). After intubation, there were significant increase in systolic, diastolic pressure and heart rate in three groups but no significant differences among three groups (p<0.05). And there was no significant neonatal depression as assessed by Apgar scores and blood gas analyses. CONCLUSIONS: Propofol-ketamine combination was found to be similar to propofol or ketamine only in the effects on the mother and neonate. But propofol-ketamine gained more stable hemodynamic change than propofol or ketamine before intubation. Therefore propofol-ketamine appears to be a suitable alternatives to propofol or ketamine as an induction agent for anesthesia in Cesarean section.
Anesthesia ; Anesthesia, Intravenous ; Apgar Score ; Blood Gas Analysis ; Blood Pressure ; Cesarean Section* ; Depression ; Female ; Heart Rate ; Hemodynamics ; Humans ; Infant, Newborn ; Intubation ; Ketamine* ; Mothers ; Pregnancy ; Propofol*

The frequency of HLA-B27 antigen in 24 patients with psoriasis vulgaris and 11 patients with psoriatic arthritis were examined using the standard micro-lympho- cytotoxicity technique. There was a high frequency of HLA-B27 in psoriatic spondylitis with or without peripheral arthritis (83.3%) compared to controls (4.7%) and the relative risk of HLA-B27 for developing psoriatic spondylitis was 82.5% which indicates a strong association between HLA-B27 and psoriatic spondylitis in Korean populations. However, there was no stastical significance observed in the groups of patients with peripheral arthritis alone or psoriasis vulgaris in regard to the frequency of HLA-B27.
Arthritis ; Arthritis, Psoriatic ; HLA-B27 Antigen ; Humans ; Psoriasis* ; Spondylitis

There have been so many methods described for the correction of the deviated noses but it is difficult to get satisfactory results and recurrence rate is high. There is no exact explanation why the recurrences are so high and no estabished guides for techniques according to the surgical pathology. We found the classical swinging door technique effective in cases where the caudal septum deviated from the midline. However, where the caudal septum and the tip stay in the midline, scoring or submucosal resection do not work well enough to cortet them. We used the reverse swinging door technique of our own. After elevation of mucoperichonodrium, we did sagittal section in the posterior septum and moved the septum to the midline on the pivot point of the caudal septum and. The gap created in the posterior portion of the septum were filed with bone grafts, cartilage grafts or Medopor, which were sutured to the septum, We did this technique with or without osteotmies in 56 deviated noses for last 5 years. The results were very satisfactory and there was no complication.
Cartilage ; Nose* ; Pathology, Surgical ; Recurrence ; Transplants

No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Humans ; Statistics as Topic*

A study was made of the differences in clinical features and immunological aspects between herpes zoster patients with malignancies and those without malignant tumors. The results obtained from the retrospective review of medical records are as follows: Herpes zoster occurred more frequently in younger patients(less than twenty) with malignanciee as compared with the control group of the same ages,' Male was dominant among zoster patients with malignancies as is the contrary to contral group; Tihere were no marked differences in primarilly involved dermatomes between the two groups; Generalized varicelliform eruptiona were more common in zoster pa,tients with malignaneies than in control group, It seemed that zoster patients with malignancies complained of milder degree of pain. Zoeter patienta associated with malignancies were more frequently DNCB-negative and had decreased OKT3+ pan T cells, OKT4+ helper/inducer T cells as compared with control group, which suggest impaired cell mediated immunity in the former.
Herpes Zoster* ; Humans ; Immunity, Cellular ; Male ; Medical Records ; Retrospective Studies ; T-Lymphocytes