No abstract available.
Aeromonas*

Rigid posterior fixation of the atlas to the third and fourth cervical spine was achieved in a patient in whom axis pedicle fracture and dislocation of axis on the third cervical spine. Althouth there was no evidence of neurologic disorder, marked instability of axis on the third cervical spine should inevitably be fused in any procedures. An anatomically contoured loop was secured to the posterior arch of the atlas and the laminae of the third and the fourth cervical spine by sublaminar wirings. The technique has the advantage over bone graft, either alone or with cement, in that it affords rigid stabilization, allows early mobilization and some flexion movement of atlanto-occipital joint.
Atlanto-Occipital Joint ; Dislocations ; Early Ambulation ; Humans ; Nervous System Diseases ; Spine ; Spondylolisthesis ; Transplants

The primary aims of fracture treatment include the restoration of normal anatomy and a return of function to the injuried as early as possible. In pilon fracture, various methods of treatment were developed to accomplish this purpose. Fibular fixstion is a rarely accepted mehtod in the treatment of pilon fractures because it can't provide rigid internal fixation, But it might be indicated when an open wound was : present medially over the distal tibia, the ligamentous attachments of distal fibula and medial malleolus to talus and calcaneus and of the distal tibiofibular syndesmosis are largely intict. Utilizing these attachment, Fibular fixation can stabilize comminuted fractures of distal tibia affecting ankle joint. This procedure is so effective and simple The author has used this technique in three instances for two years with excellent results. This is not an original method, but worthy of being remindful of the literature.
Ankle Joint ; Ankle ; Calcaneus ; Fibula ; Fractures, Comminuted ; Ligaments ; Methods ; Talus ; Tibia ; Tibial Fractures ; Wounds and Injuries

The precise diagnosis of internal derangement of the knee is difficult, since the signs and symptoms are frequently obscure. For this reason, diagnostic aids have long been sought, and arthrogrphy has been widely used as a means to improve diagnostic accuracy. Recently, post-arthrographic high resolution computed tomogrphy has been added to the diagnostic techniques for the evaluation of the knee. Arthrography and post-arthrographic high resolution computed tomography were carried out in 97 cases of clinically suspicious meniscal tear from January 1986 to October 1987. Among them, 40 cases were confirmed by arthroscopic surgery and following results were obtained. l. Arthorgraphy resulted in a diagnostic accuracy of 92.5% and 72.5% for medial and lateral meniscal lesion. Post-arthrographic high resolution computed tomography resulted in that of 95.0% and 90.0% for each meniscal lesion. 2. 16 cases of them were discoid meniscus. 13 cases(92.5%) were detected by arthrography and 16 cases(100%) by post-arthrographic high resolution computed tomography. 3. The sensitivity of arthrography was proved to be 100% and 65.4% for medial and lateral meniscal lesion, and thst of post-arthrographic high resolution computed tomography to be 100% snd 88.5% for each meniscal lesion. The specificity of arthrography was 90.0 and 85.7% in each meniscal lesion and that of post-arthrographic high resolution computed tomography was 93.3% and 92.9% in each meniscal lesion. 4. Post-arthrogrsphic high resolution computed tomography was proved to show better diagnostic accuracy, and good visualization of the relationship and extent of torn meniscal lesions. The meniscal anatomy that was displayed by high resolution computed tomography more accurately depicted the anatomical findings that were seen at arthroscopy. With this additional information, arthroscopists could plan more appropriate surgical approach.
Arthrography ; Arthroscopy ; Diagnosis ; Knee ; Sensitivity and Specificity ; Tears

Noninvasive prediction of pulmonary arterial pressure is of paramount importance in heart disease. To estimate pulmonary arterial pressure, several echocardiographic techniques, including abnormal pulmonary valve motion, prolongation of RV preejection period/RV ejection time ratio and contrast echocardiography have been proposed. Recently Doppler echocardiography has been known to detect intracardiac blood quantitatively. For assessment of the benefit of several indices by Pulsed Doppler echocardiography for mean pulmonary arterial pressure, 22 patients(mean pulmonary pressure> or =20mmHg; 11, <20mmHg; 11) were compared with the mean pulmonary arterial pressure by cardiac catheterization. In comparison of mean pulmonary arterial pressure(MPAP); 1) Right preejection period / RV ejection time RPEP/RVET;r=0.278 2) Right preejection period / Acceleration time RPEP/AT : r=0.654 3) Acceleration time(AT) AT=-1.55(MPAP)+154.37(r=-0.763) AT=-92.99(log MPAP)+239.41(r=-0.752) AT is less than 105 msec in 9 or 11 pulmonary hypertension and one of 11 normal individual. 4) Acceleration time/ RV ejection time AT/RVET=-136.36(MPAP)+83.31(r=-0.817) AT/RVET=-0.29(log MPAP)+0.81(r=-0.803) 5) (Right preejection period+Decceleration time) / AT (RPEP+DT)/AT=9.6(MPAP)-0.16(r=0.806) (RPEP+DT)/AT=3.86(log MPAP)-2.46(r=0.789) In conclusion AT/RVET, (RPEP+DT)/AT and Acceleration time of 105 msec are valuable indices to estimate mean pulmonary arterial pressure by Pulsed Doppler echocardiogram.
Acceleration ; Arterial Pressure* ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography ; Echocardiography, Doppler ; Echocardiography, Doppler, Pulsed* ; Heart Diseases ; Hypertension, Pulmonary ; Pulmonary Valve

BACKGROUND: Nonrheumatic atrial fibrillation is common in elderly and associated with an increased risk for thromboembolism. Left atrial spontaneous echo contrast(SEC) and thrombus. which are easily detected by transesophageal echocardiography(TEE) in patients with rheumatic mitral valve disease and atrial fibrillation, have been known as markers of thromboembolism. However, most of the previous studies on left atrial SEC and thrombus were performed in rheumatic mitral valve disease or various conditions including rheumatic mitral valve disease. Therefore this study was underaken in order to investigatd 1) the prevalence of left atrial SEC and thrombus, and 2) clinical and echocardiographic variables related to left atrial SEC and thrombus in nonrheumatic atrial fibrillation. METHODS: In patients with estabished atrial fibrillation over 7 days, we examined the clinical gistory and performed transthoracic echocardiography(TTE) and TEE simultaneously. Enlisted patients were those without rheumatic mitral valve disease, prosthetic valves, previous thromboembolism, and recent anticoagulant therapy. RESULTS: 1) Left atrial SEC was detected in 32(62.7%) of 51 patients and left atrial thrombus in 10(19.6%). All thrombi were located in the left atrial appendage. 2) In univariate analysis, SEC positive group showed higher prevalence of congestive heart failure(CHF)(56.3% vs 0%, p<0.001), lower ejection fraction(42.2+/-14.1% vs 50.8+/-9.7%, p<0.05), lower left atrial appendage blood flow velocity(peak positive flow velocity ; 18.7+/-11.1cm/sec vs 32+/-12.4cm/sec, p<0.01, and peak negative flow velocity ; 21.4+/-12.4cm/sec vs 31.9+/-12.8cm/sec, p<0.01) than SEC negative group. Multivariate analysis identifed CHF as an independent variable related to left atrial SEC(p=0.02, Odds ratio ; 2.38, 95% CI ; 1.18-4.82). 3) In univariate analysis. left atrial thrombus positive group showed higher prevalence of CHF(70% vs 26.8%, p<0.05), larger left atrial demension(34+/-3.4mm/m2 vs 30.6+/-4.6mm/m2, p<0.05) than thrombus negative group. Multivariate analysis identifed CHF as an independent variable related to left atrial thrombus(p=0.04, Odds ratio ; 4.30, 95% CI ; 1.11-16.68). 4) Left atrial thrombus is more frequent in SEC positive group than in SEC negative group(28.1% vs 5.3%), however, there was no statistical significance(p=0.07). CONCLUSION: 1) Left atrial SEC is common in nonrheumatic atrial fibrillation and significantly related to CHF. 2) Left atrial thrombus is frequently detected in SEC positive patients, however, it is more realted to CHF than left atrial SEC itself.
Aged ; Atrial Appendage ; Atrial Fibrillation* ; Echocardiography ; Estrogens, Conjugated (USP) ; Heart ; Humans ; Mitral Valve ; Multivariate Analysis ; Odds Ratio ; Prevalence ; Thromboembolism ; Thrombosis*

BACKGROUND: Twenty-four-hour ambulatory blood pressure(ABP) monitoring has become increasingly popular for diagnosing and treating hypertension. Therefore the reference value of normotensive subjects was necessary for interpretation of hypertensive subjects. Several studies were reported on reference values in normotensive subjects. The purpose of this study was to determine 24-hour ABP in normotensive Korean adults stratified for sex and five age groups. This study also assessed ABP in relation to a family history of hypertension, smoking and body mass index(BMI). METHODS: ABP monitoring was performed in 200 healthy normotensive volunteers(ranged in age from 20 to 69 years, five decades, 20 men and 20 women per each decade), over 24 hours, taking measurement at 30-min intervals. The 24-hour interval was divided into day-time(6am-10pm) and night-time(100pm-6am) periods. Mean ABP and pressure loads(percentage of systolic readings>140mmHg, diastolic readings>90mmHg) were obtained. RESULTS: The mean ABP in 200 subjects was 113+/-8.6/72+/-6.9mmHg over 24 hours, 117+/-9.7/75+/-7.0mmHg during day-time, and 106+/-9.8/67+/-8.3mmHg at night-time, and pressure loadd averaged 5.1+/-7.4/7.9+/-8.9% over 24 hours. The +2 standard deviation(SD) as the upper limit of normal was 130/86mmHg over 24 hours in 200 subjects. The mean ABP and pressure load were 116+/-7.6/74+/-7.6mmHg and 6.4+/-8.3/10.1+/-10.2% in 100 subjects of men, and 110+/-8.3+/-70+/-6.6mmHg, 3.7+/-6.0/5.7+/-6.8% in women. Mean ABP and pressure load showed significant difference in relation to age group and sex, however, no significant difference in relation to a family history of hypertension or smoking. In relation to BMI group, diastolic blood pressure and diastolic pressure load were significantly different.
Adult* ; Blood Pressure* ; Female ; Humans ; Hypertension ; Male ; Reference Values ; Smoke ; Smoking

PURPOSE: Cyclin E is essential for the transition from the G1 to S-phase of the cell cycle, and plays important roles in carcinogenesis in many cancers. Especially, low molecular weight cyclin E is overexpressed in breast cancer and its level of expression correlates well with the progression and prognosis. Although the cyclin E level is amplified, and overexpressed, in many cancers, including colorectal cancer, the role of low molecular weight cyclin E in colorectal cancer remains to be studied. Therefore, the expression of low molecular weight cyclin E in various stages of colorectal tumors was studied. MATERIALS AND METHODS: The expression of low molecular weight cyclin E was analyzed in 45 tumors, and compared with paired normal mucosa from the same patients (6 adenomas, 11 stage A, 14 stage B and 14 stage C colorectal cancers) by Western blot analysis. The expres sion of low molecular weight cyclin E was also analyzed in normal colon mucosa from 12 healthy normal controls. RESULTS: The low molecular weight cyclin E was expressed exclusively in all stages of colon tumors, but not in the normal mucosa from the same patients or in the normal controls. However, there was no correlation between tumor progression and the degree of expression of low molecular weight cyclin E. CONCLUSION: The expression of low molecular weight cyclin E is suggested to be an early event in colorectal carcinogenesis.
Adenoma ; Blotting, Western ; Breast Neoplasms ; Carcinogenesis* ; Cell Cycle ; Colon ; Colorectal Neoplasms ; Cyclin E* ; Cyclins* ; Humans ; Molecular Weight* ; Mucous Membrane ; Prognosis

No abstract available.
Anesthesiology* ; Education* ; Publications*

Although it is evident that even a very short below knee stump is superior to the lengest above knee stump, short below knee stumps present difficult pmblems in fitting prostheses. To solve these problems, twenty-nine short below knee amputees, those could not be fitted prostheses because of stump complications, had been treated by fibulectomy and resection of the peroneal nerve from March 1978 to March 1983. All the cases were followed up average 2 years and 3 months and the following results were obtained: 1. The complications of short below knee stumps decreased significantly after fibulectomy and res ection of the peroneal nerve. 2. After fibulectomy, weight bearing areas under the lateral tibial condyle increased considerably. 3. In group of below knee stumps between 5cm and 7.4cm long, P.T.B. prostheses with metal joints and thigh corsets should be fitted without difficulties. 4. In group of short below knee stumps between 7.5cm and 9.9cm long, P.T.B. prostheses with steel joints and thigh corsets, P.T.B. prostheses with knee cuff only, or supracondylar P.T.B. prostheses (K. B. M.) could be fitted selectively without any difficulty. 5. In group of short below knee stumps between 10cm and 12cm long, P. T.B. prostheses with knee cuff only or supracondylar P. T.B. prostheses could be fitted selectively without any difficulty. 6. After fibulectomy and resection of the peroneal nerve, all the short below knee amputees except for one case of very short stump (4.5cm long) could walk with their prostheses satisfactorily.
Amputees ; Humans ; Joints ; Knee ; Peroneal Nerve ; Prostheses and Implants ; Steel ; Thigh ; Weight-Bearing