No abstract available.
Diuretics*

Achilles tendon is the most powerful and the biggest tendon of the body and its rupture is frequently sports-related. Many authors reported the effects of mobilization, electricity, ultrasound and various drugs as factors influencing the injured tendon. We studied the effects of early passive mobilization after firm suture using plantaris tendon as tension suture material and reinforcing membrane on the repair of a ruptured Achilles tendon. From March 1992 to December 1995, twenty-two operations on the Achilles tendon were carried out in our hospital. 1. Fourteen patients were male and eight patients were female. The mean patient age was 38 years, ranging from 13 to 68 years. Average follow-up periods was 2 years and 7 months, ranging from 12 months to 3 years and 8 months. 2. The rupture site was 4.7cm proximal to the tendon insertion into the calcaneus on average. 3. We performed the operations with end to end suture technique. After approximation of the ruptured ends of the tendon with a No. 5 Ethibond tension suture using a modified Kessler stitch, placed plantaris tendon in a fascial needle and pass it circumferentially and distal plantaris tendon is fanned out and tacked over the repair. 4. Postoperative treatment was done as following protocol Short leg cast was done with equinus position for initial 3 weeks, and then cast was removed, hydrotherapy and passive exercises was employed. About 6 weeks after operation when the foot can be brought to right angle, a reverse 90degrees ankle stop short leg brace was applied for additional 6 weeks and partial weight bearing was aUowed. 5. Follow-up results were classified according to the Arner-Lindholm scale. We had 16 excellent results and 6 satisfactory results. After rigid suture it may be possible to introduce a regimen of progressive isometric stimulation and protected loading and streching combined with removable orthosis. Such early exercises are likely to improve the rate of rehabilitation over plaster immobilization.
Achilles Tendon* ; Ankle ; Braces ; Calcaneus ; Electricity ; Exercise ; Female ; Follow-Up Studies ; Foot ; Humans ; Hydrotherapy ; Immobilization ; Leg ; Male ; Membranes ; Needles ; Orthotic Devices ; Rehabilitation ; Rupture* ; Suture Techniques ; Sutures ; Tendons ; Ultrasonography ; Weight-Bearing

BACKGROUND: During clinical practice we found that left ventricular systolic function(LVSF) has been normalized in some patients with cardiomyopathy. We investigated the echocardiographic and clinical factors affecting normalization of LVSF in these patients. METHOD: The patients with LV systolic dysfunction(EF<40%) were evaluated with echocardiography, coronary angiography and/or 201-Thallium SPECT and follow-up echocardiography(FUE) one year later. They had no coronary, valvular, congenital heart diseases. Consecutive 50 patients with improved LVSF(EF> or =55%) in FUE were defined to Group 1(mean age 57+/-16, male 21, female 29, mean follow-up 18+/-6 month) and another consecutive 50 patients with sustained decreased LVSF(EF<40%) and no increment of EF over 10% in FUE were defined to Group 2(mean age 56+/-14, male 32, female 18, mean follow-up 20+/-6 month). RESULTS: By univariate analysis, significant factors affecting normalization of LVSF were female sex, non-smoker, first experience of dyspnea, absence of bundle branch block in ECG, end-diastolic dimension of LV(LVEDD), end-diastolic volume of LV(LVEDV), LA size, less sphericity, presence of pericardial effusion, peak and end systolic wall stress. By multivariate analysis, LVEDD(Group 1: 61+/-7, Group 2: 71+/-7mm, p<0.001), LVEDV(Group 1: 139+/-59, Group 2: 190+/-51ml, p<0.01), absence of bundle branch block in ECG and 1st attack of symptom were significant. By Receiver operating characteristics curve analysis, area under curve of LVEDD and LVEDV were 0.859(95%CI: 0.775-0.920) and 0.805(95%CI: 0.681-0.896), respectively. LVEDD< or =64mm predicted normalization of LVSF with a sensitivity 76% and a specificity 86%. CONCLUSION: Determination of cardiac dimension and volume by echocardiography is very important to predicting normalization of LV systolic function in primary myocardial disease. And this results suggest that myocardial structural integrity may be important for recovery of LV function in clinical setting.
Bundle-Branch Block ; Cardiomyopathies* ; Coronary Angiography ; Dyspnea ; Echocardiography* ; Electrocardiography ; Female ; Follow-Up Studies ; Heart Diseases ; Humans ; Male ; Multivariate Analysis ; Pericardial Effusion ; ROC Curve ; Sensitivity and Specificity ; Statistics as Topic ; Tomography, Emission-Computed, Single-Photon

Profound reduction of anterograde coronary flow with concomitant ischemia is seen occasionally during percutaneous coronary intervention despite technically successful procedure. We found interesting coronary flow pattern in a patient with acute myocardial infarction, showing angiographic no reflow phenomenon after direct PTCA. The coronary blood flow pattern of the angiographic no-reflow phenomenon in this case was characterized by minimal systolic flow and sharp deceleration of diastolic flow. Coronary flow reserve calculated by the ratio of adenosine induced maximal hyperemic velocity and basal velocity was reduced. The Dopplertipped guide wire was useful for observation of phasic coronary flow pattern of angiographic no-reflow phenomenon.
Adenosine ; Deceleration ; Humans ; Ischemia ; Myocardial Infarction* ; No-Reflow Phenomenon ; Percutaneous Coronary Intervention

No abstract available.
Catheters* ; Renal Dialysis*

No abstract available.
Androgen-Insensitivity Syndrome* ; Male

No abstract available.
Androgen-Insensitivity Syndrome* ; Male

We report a case of primary cutaneous mucinous adenocarcinotna in a 64-year-old female. The tumor was about 2cm in size, forminga round dome-shaped alopecic scalp mass which had gradually increased in size over about 5 years, Histalogic examination revealed that the tumor was divided into numerous compartments by strands of fibrous tissue. In each compartment, abundant amounts of pale-staining mucin surrounded nests or cords of moderately anaplastic epithelial cells. We couldn't find any evidence of internal neoplasms as a source of metastasis. We resected the tumor with approximately a 1 cm margin and then performed a split thickness skin graft.
Adenocarcinoma, Mucinous* ; Betazole ; Epithelial Cells ; Female ; Humans ; Middle Aged ; Mucins* ; Neoplasm Metastasis ; Scalp ; Skin ; Transplants

BACKGROUND: Today, patients with fatty liver have increased by several factors. Some patients with fatty liver have abnormal liver function tests, by the way they have interpreted unwisely and made wrong therapeutic approach about abnoimal liver function tests. So we conducted this study to evaluate the factors related to patients with fatty liver and make basic concept for management. METHODS: We selected 96 patients(71 men, 25 women) who were diagnosed as fatty liver by ultrasound in Asan Medical Health Examination Center, also selected 91 controls(68 men, 23 women) who had similar sex and age distribution from January to December, 1993. We excluded toxic and viral hepatitis cases or patients. We surveyed by questionnaires that composed of 3 day-dietary diary and life style. Nutrient and alcohol intakes were analyzed by nutrient-analysis program that was derivated from Food Composition Table, and we analyzed several biochemical variables. RESULTS: There were 71 men and 25 women with fatty liver, 68 men and 23 women in controls. In cases of men, the mean age was 47 years-old in patient group, 44 years-old in control group. The obesity index was 112.7% in patients, 102.6% in controls, the mean level of triglyceride was 205mg/dl in patients, 150mg/dl in controls. The mean level of serum HDL-C was 46mg/dl in patients, 50mg/dl in controls(p<0.05). The frequency of obesity was 66.2% in patients, 27.9% in controls, hypertriglyceridemia was 42.3% in patients, 22.1% in controls(p<0.05). The frequency of patients who had increased AST was 26.8% in patients, 11.8% in controls, and the frequency of patients or cases who had increased ALT was 26.8%, in patients, 7.4% in controls(p<0.05). There were no significant statistical differences in the nutrient intakes, alcohol drinking and exercise between the male patients and controls. In cases of women, the mean age was 53 years in patient gr oup or among patients, 51 years in controls. The obesity index was 112.2% in patients, 102.1% in controls, and the mean level of serum triglyceride was 198.3mg/dl in patients, 136.4mg/dl in controls(p<0.05). The frequency of obesity was 76.0% in patients, 30.4% in controls, and the frequency of hypertriglyceridemia was 36.0% in patients, 13.0% in controls. There were statistically significant differences in the frequency of obesity and hypertriglyceridemia between patients and controls(p<0,05). There were no statistically significant differences in the frequency of increased AST and ALT, nutrient intakes, alcohol drinking, and excercise between patients and controls. CONCLUSIONS: The fatty liver disease was attributed either to obesity or hypertriglyceridemia. Therefore, it is very important to control of weight and hypertriglyceridemia in the management of patients with fatty liver.
Adult ; Age Distribution ; Alcohol Drinking ; Chungcheongnam-do ; Fatty Liver* ; Female ; Hepatitis ; Humans ; Hypertriglyceridemia ; Life Style ; Liver Function Tests ; Male ; Middle Aged ; Obesity ; Triglycerides ; Ultrasonography ; Surveys and Questionnaires

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