Microsurgical reconstruction is necessary for children to correct severe trauma and congenital or acuqired deformity. The aim of this study was to evaluate whether or not microsurgical reconstruction is a safe and reliable operation in children and to analyze the differences of microsurgical reconstruction in children compared to adults. The study included 12 children who underwent 13 microsurgical reconstructions among a total of 251 cases of microsurgical reconstruction from May, 1986 to August, 1998. Their ages ranged from 24 months to 14 years and 8 months. There were 7 males and 6 females. The involved sites were 9 legs, 3 hands and 1 face. The causes of microsurgical reconstruction were 9 traumas, 2 congenital anomalies, 1 acquired deformity and 1 cancer. The applied flaps were 4 scapular flaps, 2 rectus abdominis muscle flaps, 1 de-epithelized groin flap, 1 lateral arm flap, 1 forearm tendocutaneous flap, 1 forearm tendocutaneous flap, 1 latissimus dorsi muscle flap, 1 fibula flap, 1 second toe transfer, and 1 wrap-around flap. All patients have had normal growth of the donor and recipient sites without specific complications during an average 2 years follow-up. We concluded that microvascular reconstruction is a very useful and reliable procedure in children if it is performed in consideration of each child's specific characteristics and conditions.
Adult ; Arm ; Child ; Congenital Abnormalities ; Female ; Fibula ; Follow-Up Studies ; Forearm ; Groin ; Hand ; Humans ; Leg ; Male ; Rectus Abdominis ; Superficial Back Muscles ; Tissue Donors ; Toes

OBJECTIVES: Although sonography-guided core needle biopsy is a highly targeted method, there is a possibility of an invasive component after surgical excision of ductal carcinoma in situ (DCIS) of the breast. This study was performed to develop and validate nomograms to predict the postoperative invasive component in DCIS at core needle biopsy. METHODS: Two nomograms were developed using the data of previous meta-analysis and multivariate analysis. Nomograms were validated externally using the data of the authors' affiliation. The accuracy was validated by the expected-to-observed ratio and the Hosmer-Lemeshow goodness-of-fit test. Discrimination was validated by the area under the curve (AUC) of receiver operating characteristic (ROC) curve analysis. RESULTS: The nomogram using the meta-analysis study data was developed at http://dcis-m.surgery.kr.pe/, and the nomogram using the multivariate analysis study data was developed at http://dcis-k.surgery.kr.pe/. The Hosmer-Lemeshow goodness-of-fit test showed that the nomogram using multivariate analysis data (p = 0.131) was better calibrated than that using meta-analysis data (p < 0.001). ROC curve analysis showed statistically significant power of discrimination in both nomograms (AUC = 0.776, 0.751). CONCLUSIONS: Both nomograms showed statistically significant discriminatory power, but the nomogram using the data of multivariate analysis was simpler and more reliable. These would be useful for the prediction of invasive cancer and the need for sentinel node biopsy in DCIS at core needle biopsy.
Biopsy* ; Biopsy, Large-Core Needle ; Breast* ; Carcinoma, Intraductal, Noninfiltrating* ; Discrimination (Psychology) ; Internet ; Multivariate Analysis ; Needles* ; Nomograms* ; ROC Curve

The bone mineral densities of 60 middle school boys were measured with dual photon absorptiometry to define the influence of Taekwon-Do. They were divided into Taekwon-Do and control group, each comprising 30 boys. The bone mineral densities of the head, trunk, pelvis, both upper and lower extremities, and body total were measured. The results were as follows. 1. The BMD of head was 1.668 ± 0.153 in Taekwon-Do and 1.554 ± 0.153 0.167 in control. It was significantly increased in aekwon-Do(p <0.05). 2. The BMD of trunk was 0.378 ± 0.153 0.044 in Taekwon-Do and 0.353 ± 0.153 0.053 in control. There was no significant difference(p >0.05). 3. The BMD of pelvis was 1.648 ± 0.153 0.112 in Taekwon-Do and 1.444 ± 0.153 0.215 in control. It was significantly increased in Taekwon-Do(p <0.005). 4. The BMD of right and left legs were 1.597 ± 0.153 0.118 and 1.579 ± 0.153 0.125 in Taekwon-Do and 1.425 ± 0.153 0.115 and 1.421 ± 0.153 0.113 in control group respectively. They were significantly increased in Taekwon-Do(p <0.005). 5. The BMD of right and left arms were 1.184 ± 0.153 0.090 and 1.178 ± 0.153 0.115 in Taekwon-Do and 1.056 ± 0.153 0.095 and 1.066 ± 0.153 0.097 in control group respectively. They were significantly increased in Taekwon-Do(p.<0.005). 6. The total body BMD was 0.932 ± 0.153 0.068 in Taekwon-Do and 0.846 ± 0.065 in control. It is significantly increased in Taekwon-Do(p<0.005). In conclusion, Taekwon-Do increases the total bone mineral density and the mineral densities of the head, pelvis and extremities but not that of trunk. It is thought that continued practice of Taekwon-Do throughout adult life might prevent the senile osteoporosis
Absorptiometry, Photon ; Adult ; Arm ; Bone Density ; Extremities ; Head ; Humans ; Leg ; Lower Extremity ; Miners ; Osteoporosis ; Pelvis

No abstract available.

No abstract available.
Hernia, Diaphragmatic*

In order to investigate electrolyte changes in serum and urine diuretic therapy, we studied 98 patients with hypertension not optimally controlled by previous treatment. After we divied the patients into three gorups in randomized trial, group A were given Amiloride 10mg/day, group B were given Dihydrochlorothiazide 50mg/day, group C were given Amiloride 5mg/day combined with Dihydrochlorothiazide 25mg/day for 7 days. Blood pressure and electrolyte changes in serum and urine after diuretic theraphy for 7 days were as follows. 1) Serum sodium concentrations were not significantly changed in all three groups(P>0.05). 2) Serum potassium concentrations were increased in group A and C (P<0.05), but there were no significant changes in group B(P<0.05). 3) Urinary sodium exceretions were increased in all three groups(P<0.05). 4) Urinary potassium excretion were decreased in group A and C (P<0.05), but there were increased in group B (P<0.05). 5) Blood pressure were decreased in all three groups(P<0.05).
Amiloride ; Blood Pressure ; Diuretics* ; Electrolytes* ; Humans ; Hydrochlorothiazide ; Hypertension* ; Potassium ; Sodium

PURPOSE: The aim of this study was to introduce a method of obtaining the oscillation graphs of the dental x-ray tube heads relative to time using an accelerometer. MATERIALS AND METHODS: An Accelerometer, Piezotron type 8704B25 (Kistler Instrument Co., Amherst, NY, USA) was utilized to measure the horizontal oscillation of the x-ray tube head immediately after positioning the tube head for an intraoral radiograph. The signal from the sensor was transferred to a dynamic signal analyzer, which displayed the magnitude of the acceleration on the Y-axis and time lapse on the X-axis. The horizontal oscillation of the tube head was measured relative to time, and the settling time was also determined on the basis of the acceleration graphs for 6 wall type, 5 floor-fixed type, and 4 mobile type dental x-ray machines. RESULTS: The oscillation graphs showed that tube head movement decreased rapidly over time. The settling time varied with x-ray machine types. Wall-type x-ray machines had a settling time of up to 6 seconds, 5 seconds for fixed floor-types, and 11 seconds for the mobile-types. CONCLUSION: Using an accelerometer, we obtained the oscillation graphs of the dental x-ray tube head relative to time. The oscillation graph with time can guide the operator to decide upon the optimum exposure moment after xray tube head positioning for better radiographic resolution.
Acceleration ; Head Movements ; Head* ; Radiography

PURPOSE: The aim of this study was to introduce a method of obtaining the oscillation graphs of the dental x-ray tube heads relative to time using an accelerometer. MATERIALS AND METHODS: An Accelerometer, Piezotron type 8704B25 (Kistler Instrument Co., Amherst, NY, USA) was utilized to measure the horizontal oscillation of the x-ray tube head immediately after positioning the tube head for an intraoral radiograph. The signal from the sensor was transferred to a dynamic signal analyzer, which displayed the magnitude of the acceleration on the Y-axis and time lapse on the X-axis. The horizontal oscillation of the tube head was measured relative to time, and the settling time was also determined on the basis of the acceleration graphs for 6 wall type, 5 floor-fixed type, and 4 mobile type dental x-ray machines. RESULTS: The oscillation graphs showed that tube head movement decreased rapidly over time. The settling time varied with x-ray machine types. Wall-type x-ray machines had a settling time of up to 6 seconds, 5 seconds for fixed floor-types, and 11 seconds for the mobile-types. CONCLUSION: Using an accelerometer, we obtained the oscillation graphs of the dental x-ray tube head relative to time. The oscillation graph with time can guide the operator to decide upon the optimum exposure moment after xray tube head positioning for better radiographic resolution.
Acceleration ; Head Movements ; Head* ; Radiography

Current medicine is a living science which is developing rapidly. It seems that coming up with the rapid development of medicine by the conventional educational system has some limitation, since the development is too rapid. Development of internet-based medical educational program(IMEP) would be a kind of solution. To overcome the limitation, we developed an IMEP which could be used either on the File Transfer Protocol(FTP) or World Wide Web(WWW), and tested whether it would meet the requirements of our purpose. The IMEP of ours functioned satisfactorily. IMEP for WWW was accessed by far more frequently than IMEP for FTP by the visitors. Frame-typed HTML files were displayed 2 times faster than plain HTML files. HTML files which hid the graphic data behind were displayed more quickly than conventional HTML files. CGI programs were considered to be necessary tools for bidirectional communications between the host and clients on the IMEP. A small PC server worked properly as well as a large server when the access was confined to a small number of visitors. We concluded that IMEP was an excellent adjuvant method of education to make up the gap between the conventional educational system and the rapid development of medicine.
Education ; Education, Medical ; Internet

Traditionally, evaluation after ACL reconstruction has been focused on physical characteristics and measures of knee stability. Recently, however, reliance on such criteria has been refuted based on the lack of a strong relationship between these measures and both the patient s perception of knee function and return to sports activity. In present study, preoperative and postoperative physical examinations, isokinetic dynamometer, arthrometer test and functional tests were performed on 17 patients with chronic anterior cruciate ligament tears treated by arthroscopic reconstruction using autogenous bone-patellar tendon-bone graft with at least 1 year of follow-up. Muscle power, joint stability and functional recovery were checked for functional evaluation by specific methods. Lysholm score rating scale and functional tests (single leg hop test, vertical jump test, timed single jump test) were performed preoperatively and 6, 12 months postoperatively. Pivot-shift test, Lachman test, anterior drawer test, thigh circumference index and Cybex II+ isokinetic dynamometer test were done preoperatively and at 3, 6, 12 months postoperatively. KT-2000 arthrometer test was done at last follow-up. Lysholm score has showed increasing tendency at 6, 12 months postoperatively (p < 0.01). In Cybex study, deficit percentage of peak torque and total work of the quadriceps and hamstrings was same or slightly decreased at 3, 6 months, but have decreased at 1 year follow-up (p < 0.01). Functional tests and physical examinations have also showed improving tendency at 12 months (p < 0.01). Arthrometer test revealed no significant laxity of the knee joint at last follow-up. In conclusion, muscle strengh and functional capacity in ACL reconstructed knee showed significant improvement at postoperative one year compared with preoperative status. It was considered that arthroscopic reconstruction using autogenous bone-patellar tendon-bone graft is one of the useful method for chronic anterior cruciate ligament injury.
Anterior Cruciate Ligament ; Autografts* ; Bone-Patellar Tendon-Bone Grafts ; Follow-Up Studies ; Humans ; Humulus ; Joints ; Knee ; Knee Joint ; Leg ; Muscle Strength* ; Patellar Ligament* ; Physical Examination ; Sports ; Thigh ; Torque