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

PURPOSE: The prevalence and severity of childhood obesity are increasing rapidly worldwide. Spontaneous and stimulated growth hormone (GH) secretion are impaired in obesity. However, despite the low GH levels, normal or increased insulin-like growth factor-I (IGF-I) levels have been observed in obese subjects. Growth velocity is commonly normal or increased in obese children. As for the possible mechanisms underlying these observations, overnutrition, chronic hyperinsulinemia and increased free IGF-I have been suggested. To explain the possible mechanisms by which obese children are taller than normal weight children, we have compared height, leptin, insulin, IGF-I and IGF binding protein-3 (IGFBP-3) with body mass index and studied the relationship among these parameters in obese and control group. METHODS: Auxological and endocrine evaluation were performed in 33 obese children (18 boys and 15 girls) and 47 non-obese children (24 boys and 23 girls) at Hanyang University Hospital from Jan. 1999 to Dec. 2000. Obesity was defined as a body mass index (BMI) greater than the 95th percentile for age and sex. Fasing blood samples were taken for the measurement of serum leptin, insulin, IGF-I and IGFBP-3 by radioimmunoassay. RESULTS: The serum concentrations of leptin, insulin, IGF-I and IGFBP-3 were significantly higher in obese children than those in non-obese children. The serum concentrations of leptin (r=0.751, P=0.000), insulin (r=0.746, P=0.000) and IGF-I (SDS) (r=0.747, P=0.000) showed positive correlation to BMI. And the serum concentrations of IGFBP-3 showed positive correlation to BMI with low correlation coefficient respectively (r=0.275, P=0.015). The serum concentration of insulin correlated to that of IGF-I (SDS) positively (r=0.585, P=0.000). CONCLUSION: This study suggest that increased sensitivity of GHR modulated by chronic hyperinsulinemia and increased circulating IGF-I produced by accumulated adipose tissue may enhance the growth in obese children.
Adipose Tissue ; Body Mass Index ; Child* ; Growth Hormone ; Humans ; Hyperinsulinism ; Insulin* ; Insulin-Like Growth Factor Binding Protein 3* ; Insulin-Like Growth Factor I* ; Leptin* ; Obesity ; Overnutrition ; Pediatric Obesity ; Prevalence ; Radioimmunoassay

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

No abstract available.
Leukemia, Myeloid, Acute* ; Sarcoma, Myeloid*