No abstract available in English.
Classification ; Clinical Study

Syndactyly is one of most common congenital anomalies of the limb. We reviewed 89 webs of 40 patient with syndactyly which had been treated at Seoul National University Hospital from 1979 to November 1984. It is the purpose of this article to compare the operative methods used in the treatment of syndactyly. In our hands, using the volar interdigital flap in the treatment of syndactyly gives the most excellent postoperative result in both function and cosmesis.
Extremities ; Hand ; Humans ; Seoul ; Syndactyly

Photoplethysmography(PPG) employs an infrared light-emitting diode to transmit light into the skin noninvasively. Light reflected from blood cells is received by a photocell or phototrotransistor which permits recording of the pulsatile cutaneous microcirculation. The use of PPG for vascular measurements in extremities is not new. Since Hertzmann, in 1938, first described the technique to measure skin blood flow, a few investigators have used PPG for clinical application. However, experimental reports on the photoplethysmographic assessment of blood flow after arterial reanastomosis are rare. We assessed the changes of blood flow after reanastomosis of the femoral artery in rabbits using photoplethysmography. We divided 20 rabbits into 3 experimental groups. In Group I, the femoral artery was surgically exposed and clamped for 60 minutes. In Group II, the femoral artery was surgically exposed and clamped, as in Group I, and then severed and anastomosed crudely in order to creat thrombus formation. In Group IU, the femoral artery was prepared as Group II and then anastomosed carefully to ensure patency. Blood flow was measured by photoplethysmography on the anteromedial aspect of the right hind leg, every 15 minutes for the fisrt 2 hours, at the 3rd day, I week, and II weeks post-operatively. The following results were obtained l. After the removal of vascular clamp, the mean time for the pulse wave to return to normal form was 63±24.0 minutes in Group I and 63±18.7 minutes in Group III. There was no statistically significant difference beween the two groups. When the wave form was normalized, it remained so continuously. 2. After the removal of vascular clamp, the mean time for the wave amplitude to return to normal was 108±11.2 minutes in Group I and 102±16.4 minutes in Group III. There was no statistically significant difference between the two groups. 3. The thrombosis which obstructed blood flow was formed within the first 60 minutes(mean time: 49±12.4 minutes) in all the animals in Group II. When the thrombosis was formed, it was readily detected by the change of wave form and by decrease in amplitude. 4. It is concluded from this experiments the changes of blood flow after reanastomosis of the femoral artery in rabbits were accurately assessed by PPG. It is suggested that PPG can be used clinically in monitoring blood flow after arterial reanastomosis.
Animals ; Blood Cells ; Extremities ; Femoral Artery ; Humans ; Leg ; Microcirculation ; Photoplethysmography ; Rabbits ; Research Personnel ; Skin ; Thrombosis

Photodynamic therapy (PDT) is a treatment modality by highly reactive oxygen intermediates generated through the interaction of light with a photosensitizer. We treated actinic keratosis occurred on the face of a 65-year-old woman with topical PDT using 5-aminolevulinic acid (ALA) (MEDAC, Hamburg, Germany) and a 632nm diode laser (Creamoptec, Germany). 20% ALA was applied topically to the lesion sites which were then occluded for 6 hours. Light was administered at a wavelength of 632nm. The light intensity was 100mW/cm2 and the light dose was 100J/cm2. Although the diode laser was expensive, it was easy to handle the laser and the clinical results were excellent with respect to initial complete response and cosmetic outcome. There was only slight pain and a burning sensation during treatment.
Actins* ; Aged ; Burns ; Female ; Humans ; Keratosis, Actinic* ; Lasers, Semiconductor* ; Oxygen ; Photochemotherapy* ; Sensation

PURPOSE: There are many articles about the role of barium esophagography for the diagnosis of gastroesophageal reflux disease. However, there are only rare articles reporting on laryngopharyngeal reflux disease. The purpose of this study is to evaluate the usefulness of performing esophagography with the water-siphon test as an initial screening test for patients with suspected laryngopharyngeal reflux. MATERIALS AND METHODS: From October 2002 to December 2004, barium esophagography with the water-siphon test was performed for 707 patients who had the typical symptoms and telescopic findings of laryngopharyngeal reflux. The results of the 707 esophagograms (the group with laryngopharyngeal reflux) were compared with those of 122 patients who were confirmed as having gastroesophageal reflux upon performing pH-metry (the group with gastroesophageal reflux) and the 324 patients without laryngopharyngeal reflux symptoms (the control group). The results of the water-siphon test were classified into normal, mild, moderate and severe degrees of gastroesophageal reflux. RESULTS: On the water-siphon test for the laryngopharyneal reflux group patients, 71 patients had normal (10.0%), 207 had mild (29.2%), 201 had moderate (28.4%) and 228 had severe (32.2%) degrees of reflux. The positive rates of the water-siphon test were 90.0%, 89.3% and 54.6% for the groups with laryngopharyngeal reflux, gastroesophageal reflux and the control group, respectively. A statistically significant difference was observed between the group with laryngopharyngeal reflux and the control group, and between the group with gastroesophageal reflux and the control group, respectively (p>0.05). CONCLUSION: Esophagography with the water-siphon test is useful as an initial screening test for laryngopharyngeal reflux disease.
Barium ; Diagnosis ; Gastroesophageal Reflux ; Humans ; Laryngopharyngeal Reflux* ; Mass Screening*

No abstract available.
Lasers, Gas* ; Microsurgery*

Recurrent dislocation of the patella is a relatively uncommon disease, which is most commonly seen in females in late adolescence. The condition is usually spontaneous and only rarely fallows traumatic dislocation. Dislocation is nearly always lateral and about one thirdis bilateral. The theoretical rationale of the treatment of the recurrent dislocation and subluxation of the patella is the realignment of the extensor mechanisms. We experienced with recurrent dislocation and subluxation of the patella on 22 knees in 18 patients at Seoul National University Hospital from July 1981 to Oct. 1987 and obtained the following results. 1. The age at operation ranged from 4 to 33 years and its mean was 15.8 years. Among 18 patients thirteen were female and five, male. 2. The most common presenting symiptom was pain (11 knees) and the most common presenting sign was quadriceps muscle atrophy (11 knees). 3. The prominent radiologic finding was patella alta in 6 knees (27.3%), genu valgum in 10 knees (45.3%), and hypoplasia of the lateral condyle of the femur in 2 cases (9%). 4. In two knees supracondylar osteotomy were performed and followed by proximal extensor mechanism realignment. In twelve knees only proximal reconstruction was performed. Four knees were treated by Hauser's technique and three knees with Roux-Gold-thwait technique. And these distal reconstruction procedures were performed with other procedures. 5. Mean follow up period was 1 year and 5 months. And the results are excellent in 8 knees, good in 12 knees and fair in 2 knees.
Adolescent ; Atrophy ; Dislocations ; Female ; Femur ; Follow-Up Studies ; Genu Valgum ; Humans ; Knee ; Male ; Osteotomy ; Patella ; Quadriceps Muscle ; Seoul

During the period from January 1987 to May 1988, arthroscopic partial meniscectomy had been performed in 95 knees of 94 patients. Of the 94 patients, there were 66 males and 28 females ranging in age from 10 to 49 years(mean, 27.4 years). The mean follow up period was 22.1 months (range, 15 to 32 months). Both medial and lateral menisci were affected in 6 knees, so 101 menisci were removed. In the group studied, there were 35 tears of medial, 29 tears of lateral and 37 tears of discoid meniscus. In the 101 tears of meniscus, 22 cases of longitudinal tear, 37 cases of bucket handle tear, 19 cases of flap tear, 13 cases of transverse tear, 5 cases of horizontal tear and 5 cases of complex tear were observed. Most frequently associated lesion was ACL injury (9 cases), and 4 cases of loose body and 4 cases of synovial plica syndrome were also found. The sensitivity of diagnosis with physical examination only was 63.6% and improved with arthrography to 70.4%, and with arthrography and CT to 80.0%. Satisfactory result including excellent and good was 76.6% and no major complication was accompanied.
Arthrography ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Knee ; Male ; Menisci, Tibial ; Physical Examination ; Tears

From March 1988 to August 1989, 51 knees with clinically suspected meniscus injuries were examined by both MRI and arthroscopy and compared their findings prospectively on the basis of arthroscopic findings to determine the accuracy of MRI in detecting meniscus injury of the knee. We used 2.0 tesla superconducting magnet imager(Spectro-20000, GoldStar, Korea) to obtain MR imaging. Our protocol for imaging was producing Tl sagittal images by spinecho technique and T2 coronal images by gradient echo technique, interleaved at 4mm continuously while the patient's knee was in 8–10 degrees of external rotation and surface coil was placed posteriorly to the knee in supine position. We grouped and correlated the findings of MRI with the arthroscopic findings. With this noninvasive MRI, we could obtain multiplanar, high quality images without compliations. Compared with the arthroscopic findings, MRI resulted in a high diagnostic accuracy of 96 and 86 percent for the medial and lateral meniscus, respectively. And it aided in optimal surgical planning for the clinically suspected meniscus injuries.
Arthroscopy ; Knee ; Magnetic Resonance Imaging ; Menisci, Tibial ; Prospective Studies ; Supine Position

The tibiofemoral angle is widely used for the diagnosis and treatment of knee problems, especially in degenerative joint disease of the knee. Among the various methods of measurement of tibiofemoral angle, Bauers method is being used most frequently. But measurement by Bauers method has seemed to show wide individual differences. Therefore we designed a ruler which can be used very easily for the measurement of the tibiofemoral angle with little differences between persons who measure the angle. To testify the advantages of our method, we selected 4 orthopedic surgeons and let them measure the tibiofemoral angles of 60 knees of 30 patients by Bauers method and by our method using the ruler. And 20 orthopedic surgeons measured tibiofemoval angles of 2 left knees by Bauers method and by our method using the ruler. The values of the tibiofemoral angle by two methods were compared and analyzed statistically. There was no significant differences between mean values. But, the tibiofemoral angles by our new method showed little differences among measurers. (P < 0.05)
Diagnosis ; Humans ; Individuality ; Joint Diseases ; Knee ; Linear Energy Transfer ; Methods ; Orthopedics ; Surgeons