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

OBJECTIVE: The purpose of this study was to determine the usefulness of brainstem evoked potential (BAEP) in the diagnosis of cerebellopontine angle (CPA) tumors. METHOD: Sixteen subjects in which BAEP study was compatible with CPA tumors were retrospectively reviewed and analyzed the results of BAEP, findings of CT and MRI, and clinical signs. RESULT: Thirteen subjects were reviewed and three were lost in follow-up. 1) CPA tumors were confirmed with CT/MRI in 10 subjects and the other 3 patients had other lesions which could be differentiated from CPA tumors clinically. The positive hit rate of BAEP was 76.9% in 13 patients whose findings were compatible with CPA lesion. 2) Of 10 patients with CPA tumor, the tumors were bilateral in 4 patients and unilateral in 6 patients, and the diagnosis of the tumors were vestibular schwannoma in 9 patients and meningioma in 1 patient. 3) The major symptoms of the patients with CPA tumors were hearing loss, tinnitus, dizziness, facial nerve palsy, headache, cerebellar dysfunction, nystagmus, and vertigo. 4) The most common abnormal findings of BAEP in the patients with CPA tumors were increase in the interpeak latency I-III and I-V on the affected side and interpeak latency III-V on the unaffected side. CONCLUSION: The BAEP considering clinical correlation is a useful study as a screening test in the diagnosis of CPA tumors because of its high positive hit rate and cost-effectiveness compared with CT/MRI.
Brain Stem* ; Cerebellar Diseases ; Cerebellopontine Angle* ; Diagnosis* ; Dizziness ; Evoked Potentials ; Evoked Potentials, Auditory, Brain Stem* ; Facial Nerve ; Follow-Up Studies ; Headache ; Hearing Loss ; Humans ; Magnetic Resonance Imaging ; Mass Screening ; Meningioma ; Neuroma, Acoustic* ; Paralysis ; Retrospective Studies ; Tinnitus ; Vertigo

Erythema nodosum has been known to be frequently associated with some kind of drug, infections with streptococci, mycobacteria, lymphogranuloma venerum and certain unknown pathogenic processes such as sarcoidosis, iilcerative colitis and regional enteritis. However, the association of erythema nodosum with leukemia has rarely been reported. Erythema nodosum with leukemia has been divided into leukemia cutis with specific infiltration of atypical leukemic cells and leukemid with non specific infiltration of normal infilammatory cells. We report herein a case of the very rare but typical erythema nodesum showing nonspecific infiltrative panniculitis as an initial manifestation of chronic myelocytic leukemia.
Colitis ; Crohn Disease ; Erythema Nodosum* ; Erythema* ; Leukemia ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Panniculitis ; Sarcoidosis

PURPOSE:The incidence of glucose intolerance is increased in patients with Turner syndrome. Both noninsulin dependent diabetes mellitus and insulin dependent diabetes mellitus are increased. The purpose of this study was to investigate the impaired rate of carbohydrate metabolism in Turner syndrome after growth hormone treatment. METHODS:We investigated the incidence of carbohydrate intolerance and diabetes mellitus in 94 patients with Turner syndrome with NDDG and WHO criteria. The oral glucose tolerance test was performed in 78 patients. In 12 patients treated with growth hormone, the glucose tolerance test was performed before and after treatment. The insulin tolerance test was done in 20 patients. RESULTS:Only one patient had random plasma glucose level of more than 200 mg/dl. In results of the glucose tolerance test(n=78), 2 patients had glucose tolerance by NDDG criteria and 7 patients had it by WHO criteria. There was no change in glucose tolerance test results during growth hormone treatment. According to the results of the insulin tolerance test, we couldn't find any difference in insulin resistance between the growth hormone treatment group and the other treatments(oxandrolone, estrogen) group. CONCLUSION: The impaired rate of carbohydrate metabolism in Turner syndrome was much lower than in other reports. We observed that the impaired rate of carbohydrate metabolism did not increase after growth hormone treatment. However, the long-term effects in patients treated with growth hormone will be elucidated.
Blood Glucose ; Carbohydrate Metabolism* ; Diabetes Mellitus ; Glucose ; Glucose Intolerance ; Glucose Tolerance Test ; Growth Hormone* ; Humans ; Incidence ; Insulin ; Insulin Resistance ; Turner Syndrome*

OBJECTIVE: In a pregnant rabbit model using hysteroscopy-guided inoculation of E. coli, we investigated pregnancy outcome according to elapsing time with immediate antibiotic treatment after E. coli inoculation, and in turn determined which of the maintenance of pregnancy with antibiotic and tocolytic administration or prompt delivery in the management of preterm labor complicated with intrauterine infection offered the improvement of pregnancy outcome. METHODS: Timed-pregnant rabbits underwent hysteroscopy at 20-21 days of gestation(70%). Animals were inoculated with either E. coli(0.2 ml containing 10' cfu/ml) or saline, and administered ampicillin-sulbactam(100 mg/kg/day; Unasyn; Pfizer) in divided doses every 8 hours beginning 30 minutes after microbial inoculation until euthanasia with one of the following; 3 days(n 10), 5 days(n 8), or 7 days(n-8) after hysteroscopy. In the first study, which performed in animals with inoculation of E. coli, pregnancy outcome including fetal survival rate and results of microbial studies and placental pathology were compared among three groups. In second study, which performed in animals with inoculation with saline, pregnancy outcome were compared among three groups for the purpose of elucidating effects of antibiotic administration during inoculation-to-euthanasia interval on pregnancy outcome. RESULTS: Of rabbits inoculated with E. coli and receiving antibiotics immediately, the rate of fetal survival and positive intrauterine cultures in total and live fetuses decreased significantly, and the rate of placental inflammation in total and live fetuses increased significantly with time from intracervical inoculation with E. coli to euthanasia(p<0.05, respectively). Of rabbits inoculated with saline and receiving antibiotics immediately, the rates of fetal survival, positive intrauterine cultures in total and live fetuses, and placental inflammation in total and live fetuses have no difference with time from intracervical inoculation with saline to euthanasia. CONCLUSION: Fetal complications including fetal death could be induced in utero if persistent subclinical intrauterine infection was present in spite of earlier antibiotics administration initiated after inoculation of E, coli. Therefore, when treating with antibiotics in intrauterine infection, it is needed to observe and monitor the presence of persistent intrauterine infection, and if it is persistent, prompt delivery may be better than maintenance of pregnancy with antibiotic and tocolytic administration for the improvement of pregnancy outcome.
Animals ; Anti-Bacterial Agents* ; Euthanasia ; Female ; Fetal Death ; Fetus ; Hysteroscopy ; Inflammation ; Obstetric Labor, Premature ; Pathology ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Rabbits ; Survival Rate

It has been proven that the newborn screening programs for congenital hypothyroidism are very important for its early detection and the early treatment of congenital It has been proven that the newborn screening programs for congenital hypothyroidism are very important for its early detection and the early treatment of congenital hypothyroidism can ameliorate and possibly reverse its consequences. Treatment with L-thyroxine is started in case of suspicious hypothyroidism at the first visit. Serum concentration of total and free thyroxine become normal within 1week after start of therapy but TSH values become normal from 2 months to 6 months after L-thyroxine therapy. The possible explanations for prolonged TSH elevation in congenital hypothyroidism are poor compliance for therapy, an inadequate dose of L-thyroxine, elevated threshold for thyrotropin suppression and two novel mutations in the thyrotropin (TSH) receptor gene in a child with resistance to TSH. Authors have experienced two cases of prolonged TSH elevation with normal T3 and T4 levels till 18months and 27 months of age after optimal L-thyroxine therapy and literature were reviewed.
Child ; Compliance ; Congenital Hypothyroidism* ; Humans ; Hypothyroidism ; Infant, Newborn ; Mass Screening ; Thyrotropin ; Thyroxine

No abstract available.
Diagnosis* ; Leptospirosis*

No abstract available.
Diagnosis* ; Leptospirosis*

In air leak syndrome, a significant portion of the volume delivered during a positive pressure breath can be lost through the leak. HFOV can achieve adequate ventilation at lower peak and/or mean intrapulmonary pressure than conventional mechanical ventilation (CMV) and has been an effective treatment of already established air leak syndrome. We report a 1-day-old male infant with severe respiratory failure from pneumothorax and pneumomediastinum, who was refractory to CMV with chest tube drainage. HFOV was applied to this patient for 114 hours, and improvement of oxygenation and ventilation as well as significant reduction of pneumothorax followed.
Chest Tubes ; Drainage ; Humans ; Infant ; Male ; Mediastinal Emphysema ; Oxygen ; Pneumothorax ; Respiration, Artificial ; Respiratory Insufficiency ; Ventilation*

PURPOSE: This study was to identify the meaning of the experience of 'well-being' of female college students in Korea and provide fundamental materials to improve nursing interventions. METHODS: The participants were six female students who gave consent to participate in this study. This study was conducted between August 2006 and November 2006. Each interview took one to three hours. The contents of the interviews were recorded and dictated afterwards. In addition, the interviews were carried out such a way that the gathered information was sufficiently saturated. The data was analyzed with the phenomenological analytic method suggested by Giorgi (1985). RESULTS: As a result of analysis, the following have been identified.: proper dietary treatment, proper physical treatment, harmonized psychological treatment, environmental- friendly treatment, and hypersensitivity to the mass media. CONCLUSIONS: The finding of this study offers profound information on the 'well-being' of female college students in Korea and provides fundamental materials to improve the quality of nursing interventions.
Female ; Humans ; Hypersensitivity ; Korea ; Mass Media