The treatment of Achilles tendon rupture is controversial between surgical repair and conservative cast treatment. This study was attempted to compare the biomechanical and morphological results between operative and nonoperative treatments of experimentally tenotomized rabbit Achilles tendon with the lapse of time. A total of 72 adult rabbits were used. After tenotomizing the Achilles tendons, the subjects were divided into 3 groups according to the time of the initiation of the treatment and each group was subdivided into 2 further subgroups according to the method of treatment; immediate operation and nonoperation, 1 week delayed operation and nonoperation, and 2 weeks delayed operation and nonoperation subgroups. Ten animals from each subgroup were sacrificed after four weeks of cast immobilization and the Achilles tendons were prepared for the gross, biomechanical and histological examinations. At the same time, two animals from each subgroup were examined by Microfil perfusion for microvascular changes in the healed tendons. On biomechanical examination, maximal loads were decreased with the lapse of time in each treatment method, and there were statistical significances between the immediate and 2 weeks delayed operation subgroups, 1 week and 2 weeks delayed operation subgroups, and immediate and 2 weeks delayed nonoperation subgroups. A maximal loads were higher in the operative treatment of each group but there was no statistical significances between operative and nonoperative treatment of each group. The results of absorption energy and stiffness were similar to those of maximal load. In conclusion, these results suggest that a rupture of the Achilles tendon should be treated as early as possible preferably within 1 week, in order to achieve a high tensile strength irrespective of the treatment method. In terms of rerupture, nonoperative treatment is comparable with surgical treatment if a rupture of Achilles tendon is managed within 2 weeks of injury.
Absorption ; Achilles Tendon ; Adult ; Animals ; Humans ; Immobilization ; Methods ; Perfusion ; Rabbits ; Rupture ; Silicone Elastomers ; Tendons ; Tensile Strength

Ankylosing spondylitis is a chronic inflammatory disease which most frequently affects the sacro-iliac joints of young men, and also the synovial joints of the whole spine. Bony fusion of these joints and ossification along the longitudinal ligaments lead to total immobility of the vertebrae. Sixty-two cases of ankylosing spondylitis treated at the Severance Hospital from June 1980 to June 1986 were analysed clinically and the followings were obtained. 1. The average age was 38 years and the sex ratio between the male and the female was 58: 4(Male=94%). 2. The most frequent location of pain was low back (32%), and the pain was usually bilateral (81%). 3. The main stiff regions were the hip joint (35%) and the lumbar spine (27%). 4. The most frequent joint affected was the hip (44%), and the extraarticular manifestations were pleuropulmonary disease (29%), gastrointestinal disorder (15%), iritis (10%), etc. 5. The characteristic X-ray findings were sacro-iliac changes (72%), facet joint blurring (53%), and syndesmophyte (37%). 6. Laborstory findings showed increased ESR (85%), positive HLA B-27 (97%), negative rheumatoid factor (94%), and the serum immunoglobulins snd complements were not decreased.
Clinical Study ; Complement System Proteins ; Female ; Hip ; Hip Joint ; Humans ; Immunoglobulins ; Iritis ; Joints ; Longitudinal Ligaments ; Male ; Rheumatoid Factor ; Sex Ratio ; Spine ; Spondylitis, Ankylosing ; Zygapophyseal Joint

The echocardiographic results obtained from normal group(910 cases), borderline hypertention group(78 cases), define hypertension group(182 cases) and hypertensive heart disease group(55 cases) in Heart Center, Paik Hospital, Inje Medical College, Pusan, Korea between September 1985, were as followings; 1) LVDeD, 5.94+/-1.07cm in hypertensive heart disease group was significantly increased compared with 4.93+/-0.64cm in normal group, 4.92+/-0.73cm in borderline hypertension group and 4.90+/-0.64cm in define hypertension group. LVSeD, 4.86+/-0.98cm in hypertensive heart disease group was significantly increased compared with 3.24+/-0.58cm in normal group, 3.21+/-0.52cm in definite hypertension group. 2) LVDeV/s, 180.26+/-84.76ml/m2 in hypertensive heart disease group was significantly increased compared with 86.13+/-37.34ml/m2 in normal group, 86.26+/-41.02ml/m2 in borderline hypertension group and 83.78+/-30.86ml/m2 in definite hypertension group, and LVSeV/S, 97.51+/-55.67ml/m2 in hypertensive heart disease group was significantly increased compared with 25.28+/-13.25ml/m2 in normal group, 23.68+/-14.62ml/m2 in borderline hypertension group and 24.02+/-14.36ml/m2 in definite hypertension group. 3) There was no significant differance of SV/S, between 61.50+/-26.02ml/m2 in normal, 63.98+/-30.86ml/m2 in borderline, 63.06+/-22.96ml/m2 in definite hypertension group and 61.82+/-30.67ml/m2 in hypertesive heart disease group. E.F. 44.06+/-9.94% in hypertensive heart disease group was significantly reduced comparing with 71.08+/-8.89% in normal group, while 74.35+/-8.26% in borderline and 73.28+/-8.49% in definite hypertensive was significantly increased. F.S., 17.02+/-5.18% in hypertensive heart disease group was significantly reduced comparing with 34.44+/-6.81% in normal, while 35.64+/-7.62% in borderline and 36.87+/-7.26% in definite hypertension group was significantly increased. 4) VSTh, 1.24+/-0.32cm in hypertensive heart disease group, 1.17+/-0.12cm in definite hypertension group and 1.16+/-0.41cm in borderline hypertension group are significantly increased comparing with 0.99+/-0.21cm in normal group. LVPWTh, 1.01+/-0.27cm in hypertensive heart disease group and 0.90+/-0.21cm in definite hypertension group was significantly increased comparing with 0.79+/-0.16cm in normal group. 5) VSTh was increased in 13.3% of borderline hypertension group, 32.8% of definite hypertension group and 31.6% of hypertensive heart disease group. LVPWTh was increased in 4.4% of borderline hypertensive group, 26.9% of definite hypertension group and 30.2% of hypertensive heart disease group. Symmetrical septal hypertrophy was noted in 5.1% of borderline hypertension group, 20.1% of definite hypertension group and 32.1% of hypertensive heart disease group. Total septal or left ventricular posteior wall hypertrophy was noted in 17(21.8%) of 78 borderline hypertension group, 154(89.8%) of definite hypertension group and 51(93.9%) of 55 hypertensive heart disease group.
Busan ; Echocardiography* ; Heart ; Heart Diseases ; Humans ; Hypertension ; Hypertrophy ; Korea ; Ventricular Function, Left*

BACKGROUND: Transradial coronary intervention was introduced recently. It has less bleeding and vascular complications and advantage of early ambulation. METHODS: We compared 142 transradial coronary interventions (101 stents, 56 balloon angioplasty and 18 rotablation) with 120 transfemoral interventions in 230 patients from January to August 1998. RESULTS: Overall success rate was not different between two approaches (92% vs 89%), but smaller sized sheath and less amount of contrast agent were required in transradial interventions compared to transfemoral interventions. Conventional guiding catheters which are used in transfemoral approach were used in most cases (94%) of transradial interventions. Judkins left 3.5 (in stead of JL4.0 in femoral approach) and Judkins right 4.0 were the most frequently used guiding catheters in transradial approach. Stent implantation was successfully done in 99 out of 101 lesions (98%) in transradial intervention and 76 out of 78 lesions (97%) in transfemoral intervention. Rotational atherectomy and primary balloon angioplasty or stenting were done successfully in 10 - 20% of the patients in both groups. All procedures were done successfully without any major procedure-related complications (myocardial infarction, death, bypass surgery) or major vascular complications in both groups. During the clinical follow-up of transradial group, punctured arteries showed 10% incidence of radial artery pulse weakness with 3% of pulse loss. CONCLUSION: Transradial approach is useful another feasible route for coronary interventions. The feasibility of primary balloon angioplasty or stenting and rotational atherectomy by transradial approach should be evaluated in the future.
Angioplasty, Balloon ; Arteries ; Atherectomy, Coronary ; Catheters ; Coronary Artery Disease* ; Coronary Vessels* ; Early Ambulation ; Follow-Up Studies ; Hemorrhage ; Humans ; Incidence ; Infarction ; Radial Artery ; Stents

BACKGROUND: Carotid artery stenosis is not infrequently associated with coronary artery disease. However, the technique performing selective carotid angiography is not established during right transradial coronary angiography. We investigated the reliability and safety of selective carotid angiography from the right transradial approach. MATERIALS AND METHODS: Following right transradial coronary angiography, selective carotid angio-graphy was performed using a 5 Fr Simmons-2 catheter in 103 patients (59+/-8 years [range, 18-80], 78 males). Ninety five (92%) patients had significant coronary artery disease. Subclavian and innominate arteries were moderately tortuous in 25 (24%) patients and aortic arch was elongated, more vertically oriented in 20 (19%). After forming a loop in ascending (n=65, 63%) or descending (n=38, 37%) aorta, the catheter was withdrawn and rotated counterclockwise to engage its tip in left carotid artery and innominate artery subsequently. After the catheter tip was adjusted at each ostia of carotid arteries, contrast material was delivered. In 63 (61%) patients, the procedures were performed on outpatient basis. RESULTS: Bilateral selective carotid angiography was successfully performed in 101 (98%) patients. In two patients with severely tortuous subclavian artery, the catheter was not engaged selectively in left carotid artery. The image quality of the angiograms performed by manual injection was determined satisfactory. Significant carotid stenosis was found in 17 (17%) patients. There were no complications, including thromboembolism and arterial dissection. CONCLUSION: Selective carotid angiography can be performed reliably and safely using a 5 Fr Simmons catheter from the right transradial approach. This technique is useful for evaluation of isolated or associated carotid artery stenosis from the right transradial approach.
Angiography* ; Aorta ; Aorta, Thoracic ; Brachiocephalic Trunk ; Carotid Arteries ; Carotid Stenosis ; Catheters ; Coronary Angiography ; Coronary Artery Disease ; Humans ; Outpatients ; Radial Artery ; Subclavian Artery ; Thromboembolism

No abstract available.
Adult* ; Child* ; Humans ; Tuberculosis, Spinal*

Liquid crystal thermography is a new diagnostic imaging method detecting the temperature change by the physiologic disturbance as compared with the radilogic method detecting the anatomical distortion. We have used liquid crystal thermography in 54 patients with complaining low back pain during the period form 2nd. March 1989 to 30th. April 1989. Of these 54 patients, 35 had myelography and C-T scan, 23 had EMG, and 13 were operated upon. 1. There were 35 clinically positive patients on whom concomitant myelography and C-T scan was performed; 32 patients(91%) had a positive myelography and C-T scan, and 30 patients (86%) had a positive thermography. Of these 35 patients, 23 had EMG concomitantly; 17 patients(74%) had a positive EMG and 18 patients(78%) had a positive thermography. 2. Liquid crystal thermography correlated with myelography and C-T scan in 31 patients(89%), EMG in 18 patients(78%). 3. Concomitant thermography, myelography and C-T scan, and surgery were performed on 13 patients among them EMG was added on 5 patients; Myelography and C-T scan had 100% accuracy, thermography had 92% accuracy, and EMG had 80 % accuracy. 4. Liquid crystal thermography is non-invasive method, dose not involve the use of ionizing radiation, and correlates well with clinical and surgical findings and other diagnostic methods, and costs relatively low. So, liquid crystal thermography is useful and reliable diagnostic method in patients with low back pain.
Diagnostic Imaging ; Humans ; Liquid Crystals ; Low Back Pain ; Methods ; Myelography ; Radiation, Ionizing ; Thermography

BACKGROUND: Epinephrine used in surgery to provide hemostasis may elicit ventricular arrhythmias. A desirable anesthetic would not sensitize the myocardium to exogenously administered epinephrine. So the effect of sevoflurane, which was introduced to clinical anesthesia recently, on cardiac arrhythmias induced by the infusion of epinephrine was compared with those of halothane which was already known to epinephrine-induced arrhythmia in the 14 mongrel dogs. METHODS: The authors compared the arrhythmogenicity (three or more premature ventricular contractions, PVCs)of intravenously administered epinephrine in 14 mongrel dogs who were randomly assigned to receive sevoflurane (1.7 vol%) or halothane (0.75 vol%) anesthesia equipotently. The arrhythmogenic doses of epinephrine determined in this comparative study were expressed by both infusion rates of epinephrine during sevoflurane and halothane anesthesia. RESULTS: The mean values of the arrythmogenic infusion rates of epinephrine were 27.1 7.6 g/kg for sevoflurane and 2.7 0.8 g/kg for halothane. CONCLUSIONS: We concluded that the arrythmogenic doses of epinephrine during sevoflurane were significantly higher than those during halothane anesthesia.
Anesthesia* ; Animals ; Arrhythmias, Cardiac ; Dogs* ; Epinephrine* ; Halothane* ; Hemostasis ; Myocardium ; Ventricular Premature Complexes

No abstract available.
Humans

No abstract available.
Arthritis, Rheumatoid* ; Humans ; Scleroderma, Localized*