In the treatment of flexor tendon injury of the hand, re-rupture after primary tendon repair is one of complications which occurs occasionally and so impose burden on both the patient and the surgeon. Authors experienced twelve cases of re-rupture after primary flexor tendon repair of 274 patients from Mar. 1989 to Mar.1996. The incidence of re-rupture after primary flexor tendon repair was 4.4% in author's series. One case happened with slip down injury, and in six cases re-rupture occurred during physical therapy with snapping click sound. However in five cases, the patients conldnt recognize any related causes. In majority of cases, re-ruptures were identified between three and five weeks after primary repair by the surgeon and the patient, so it could be suggested that the attention should be paid for the high possiblity of re-rupture during this period. Operative findings were the resorption and friability of repaired end with insecure suture fixation in two cases, rupture of suture material in four cases and loosening of the knot in six cases. From this study, the authors suggest the importance of knot, and recommend to make more than four knots on suture tie with attention to the tie direction, and advise careful physical therapy according to each patients' different situation. In the treatment of re-rupture, end-to-end re-anastomosis was available in seven cases (59%). In five cases (41%), tendon graft was needed. The clinical result of the re-rupture cases was evaluated by the Stickland evaluation method, and it was satisfactory in 67% of the patients who had the complication of re-rupture.
Hand* ; Humans ; Incidence ; Rupture ; Sutures ; Tendon Injuries ; Tendons* ; Transplants

We evaluate the effects of diltiazem in 19 patients with ischemic heart disease (15 patients) of classical anginal pectoris & 4 patients of variant angina) by means of clinical status & electrocardiographic changes and obtain the results as follows: 1. The pulse rate & blood pressure were decreased by diltiazem slightly but these decreases were not significant in statistical meaning. 2. Diltiazem administration of 4 weeks duration normalized EKG completely in 4 patients & partially in 3 patients among the 13 patients who showed abnormal resting EKG initially. 3. All 19 patients who received diltiazem showed clinical improvement; 9 patients had excellent responses, 7 patients good responses & 3 patients fair responses. 4. Diltiazem had side effects in 3 patients, drowsiness, mild euphoria & possibly tolerance respectively in each patients.
Angina Pectoris* ; Blood Pressure ; Diltiazem ; Electrocardiography ; Euphoria ; Heart Rate ; Humans ; Myocardial Ischemia ; Sleep Stages

BACKGROUND: The insulin resistance is common in the patients with essential hypertension, even in the absence of non-insulin-dependent diabetes mellitus(NIDDM) or hyperlipidemia. It is well known that the offspring of patients with NIDDM have shown less insulin sensitivity compared with that of normal parents. But it is not yet known whether the insulin resistance is common in the offspring of patients with essential hypertension in Korea, who have no hypertension, NIDDM and hyperlipidemia. The aims of this study were to find out whether the insulin resistance exist in the middle aged normal offspring of the patients with essential hypertension and whether the insulin resistance is dependent on the metabolic abnormalities such as the body mass index(BMI), obesity and hyperlipidemia. METHODS: The serum lipid profiles and oral glucose tolerance test were performed. The anthropometrical measurement was done. The abdominal CT scan at umbilicus level and thigh CT was performed in the 11 offspring of parents with essential hypertension(group I;male : 7, female : 4)and 24 offspring of parents without essential hypertension, NIDDM, ischemic heart disease and hyperlipidemia(group II; male : 9, female : 15). RESULTS: The average age of group I was 44.1+/-6.9 years, and that of the group II was 47.5+/-9.5 years. There were no significant differences in the blood pressure, weight, BMI, waist to hip ratio, waist to thigh ratio. And there were no significant differences in the serum cholesterol, triglyceride, HDL-cholesterol, serum Na, and plasma renin activities between both groups. Fasting plasma insulin and 2 hour insulin after 75gm glucose ingestion were significantly higher in group I than in group II(8.5+/-3.0mU/mL versus 5.0+/-1.8mU/mL, 61.6+/-31.7mU/mL versus 33.3+/-16.8mU/mL, p<0.05). The insulin sensitivity index was significantly lower in group I than in group II(355.1+/-92.6 versus 451.8+/-88.1, p<0.05). The visceral fat area was wider in group I than in group II(102.0+/-30.7cm2 versus 64.5+/-28.5cm2, p<0.05). The multiple regression analysis with the fasting plasma insulin and insulin sensitivity index as the dependent variables and family history of essential hypertension, visceral fat area and BMI as the predictor variables revealed that only the family history was associated with the fasting plasma insulin and insulin sensitivity index. CONCLUSIONS: The offspring of the parents with essential hypertension showed the insulin resistance with increased visceral fat area in comparison with the offspring of the parents without essential hypertension.
Blood Pressure ; Cholesterol ; Diabetes Mellitus, Type 2 ; Eating ; Fasting ; Female ; Glucose ; Glucose Tolerance Test ; Humans ; Hyperlipidemias ; Hypertension ; Insulin Resistance* ; Insulin* ; Intra-Abdominal Fat ; Korea* ; Male ; Middle Aged* ; Myocardial Ischemia ; Obesity ; Parents* ; Plasma ; Renin ; Thigh ; Tomography, X-Ray Computed ; Triglycerides ; Umbilicus ; Waist-Hip Ratio

No abstract available.
Fever ; Histiocytic Necrotizing Lymphadenitis*

No abstract available.
Thanatophoric Dysplasia*

No abstract available.
Thanatophoric Dysplasia*

PURPOSE AND BACKGROUND: Recently several clinical studies suggested that maternal treatment with magnesium sulfate had protective effects against cerebral palsy in premature infants. But previous studies with differing perinatal animal models resulted in inconclusive results with regard to magnesium neuroprotection. Our purpose was to study the neuroprotective effect of magnesium sulfate and optimal dosage on hypoxicischemic brain damage in the newborn rat. METHOD: Seven-day-old rats(n=68) underwent right carotid ligation, followed by 3 hours of hypoxia(8% oxygen in 92% nitrogen). Rats received magnesium sulfate immediately before and again after hypoxia(two doses, 150mg-600mg/kg/dose, n=39), or saline solution(n=29). Severity of injury was assessed 5 days later, by visual evaluation of ipsilateral hemisphere infarction and by measurement of bilateral hemispheric cross sectional areas. RESULTS: Magnesium sulfate pre-treatment reduced the incidence of liquefactive cerebral infarction and atrophy from 80.8% in controls to 22.2% with magnesium sulfate(450 mg/kg/dose, P<0.05). Quantitation of hemispheric areas confirmed these findings. Percent protection based on inter-hemisphere area differences by pre-treatment with magnesium sulfate 450mg/kg/dose ranged from 71.1%(hippocampus) to 90.8%(striatum). However higher dose of magnesium(600mg/kg/dose) did not attenuate hypoxic-ischemic brain injury in the newborn rat but increased mortality. CONCLUSION: Pretreatment of magnesium sulfate has neuroprotective effects against hypoxia-ischemia in the newborn rat and adequate dose of magnesium sufate is important to protect the brain. Magnesium pretreatment may be an effective strategy to decrease the severity of neonatal hypoxic-ischemic brain injury in the adequate dose.
Animals ; Atrophy ; Brain ; Brain Injuries ; Cerebral Infarction ; Cerebral Palsy ; Humans ; Incidence ; Infant, Newborn* ; Infant, Premature ; Infarction ; Ligation ; Magnesium Sulfate* ; Magnesium* ; Models, Animal ; Mortality ; Neuroprotective Agents* ; Oxygen ; Rats*

STUDY DESIGN: The authors retrospectively analysed the difference of clinical natures in contained vs. ruptured HIVD. OBJECTIVE: To compare contained HIVD with ruptured HIVD in respect of clinical symptoms, signs and the result after surgery. SUMMARY OF LITERATURE REVIEW: In contained disc herniation, the disc material remains beneath tile intact outer annulus. But, once disc material penetrates through the limit of posterior annulus, it is a ruptured herniation or disc extrusion/sequestration. There is few report concerning the clinical characteristics related to type of herniation. MATERIALS AND METHODS: Forty-six patients, treated by open discectomy from March 1990 to December 1994, were followed up for minimum two years. The clinical symptoms and signs including SLR, motor deficit, sensory deficit, change of DTR, and severity of radiating pain were periodically followed up on the predesigned protocol. Result: Twenty patients had contained disc and remaining 26 had ruptured disc. The mean age of contained disc was 31.4 years and that of ruptured disc was 43.3 years. In preoperative examination, 18/26 cases of patients with ruptured discs, developed pain in less than 3 months, compared with 7/20 cases of does with contained ones. Motor deficit was positive in 25/26 cases (96.2%) of ruptured discs and 12/20 cases (60%) of contained ones. 23/26 cases (80.8%) of patients with ruptured discs, had sensory deficit compared with 12/20 cases (60%) of those with contained ones. There was no significant difference in SLR and DTR change between ruptured and contained disc. CONCLUSIONS: Factors such as age, motor and sensory deficits and duration of symptoms had correlation with the type of herniation, but SLR and DTR change showed no statistical difference in this study. Clinical outcome showed no significant difference between two groups, but in ruptured group, the results were getting worse with the time goes. On the basis of this study, we concluded that the clinical symptoms and signs were different between the two groups, but surgical results showed no statistical difference.
Diskectomy ; Humans ; Retrospective Studies

Intradural lipomatosis is a rare clinical entity characterized by excessive fat deposition in the intradural space. And they occur slightly more frequently in males. It may lead compression of the spinl cord or lumbargo, radiating pain, paresthesia, intermittent claudication and if they involve the cervical and thoracic region, the patients with tumours in these regions most frequently present with a slow ascending monoparesis or paraparesis, cutaneous sensory loss and defective deep sensation. Only 3% of tumours have been reported in the thoraco-lumbar region. The diagnosis should be based on a combination of clinical, imaging, surgical, and histological findings, and especially the diagnostic procedure of choice in patients with progressive myelopathy is MRI scan as it produces accurate imaging without exposure to ionizing radiation. He was treated surgically-removal of excessive fat tissue and decompressive laminectomy. We report a case of intradural lipomatosis that we had removed by surgically.
Diagnosis ; Humans ; Intermittent Claudication ; Laminectomy ; Lipomatosis* ; Magnetic Resonance Imaging ; Male ; Paraparesis ; Paresis ; Paresthesia ; Radiation, Ionizing ; Sensation ; Spinal Cord Diseases

The present study was designed to estimate the seroprevalence of NLVs among diarrheagenic children and in healthy adults in Seoul and its vicinity with the use of an EIA and an Western blot (WB) based on recombinant Norwalk virus capsid protein (rNV) and crude virus preparations as antigen. Seroconversion was observed in 34 (83%) of 41 tested using the EIA and in 21 (54%) of 39 using the WB, suggesting that the NLVs with epitopes common to rNV are prevalent in Seoul area. Diarrheal children who were known to have been infected with several other strains of the NLVs showed no significant antibody response to the rNV. Infection with rNV occurred earlier in life: primary infections with rNV were common before the age of 6 months and over 91% of children had evidence of infection by that age by the EIA. Since the amount of the NLV antigens available for seroepidemiologic surveys is limited, we tried to detect NLV antibody by using crude virus preparations as antigen. One crude virus preparation of a child whose stool yielded genetically distinct NLV revealed the presence of the plural number of bands upon SDS-PAGE, but precipitated only one band (62 kDa) after the WB with a serum (collected 10 days after the onset of symptoms) of another diarrheal child. The WB assay we present in this report revealed that the NLVs are prevalent among Korean population and that the sera contained antibody to a single major structural protein, with molecular sizes of 58 to 62 kDa, compatible with the sizes reported for the Norwalk virus and Snow Mountain agent proteins, respectively. When the results of the WB were compared with those obtained by the EIA, the EIA antibody assay was sensitive enough to detect an antibody rise of as much as 4096-fold but not as specific as the WB. The WB assay presented in this paper will provide a powerful tool to elucidate not only antigenic structures of the NLVs but also seroepidemiology of the NLV infection. The availability of an unlimited source of antigen will enable a large scale serologic studies that will greatly increase our understanding of the role of NLVs in human enteric illness.
Adult ; Antibody Formation ; Blotting, Western ; Capsid Proteins ; Capsid* ; Child ; Electrophoresis, Polyacrylamide Gel ; Epitopes ; Humans ; Norovirus* ; Norwalk virus* ; Seoul* ; Seroepidemiologic Studies* ; Snow