No abstract available.
Muscular Atrophy*

Potentially, some donor site complications are associated with the harvesting of autogenous tricortical iliac bone grafts for anterior spinal fusion. The purpose of this study was to evaluate the reliability of the anterior iliac crest reconstruction after harvesting autogenous iliac grafts for anterior spinal fusion. We devided into two groups : the study group were the anterior iliac crest reconstruction in 57 patients with minimal twelve months follow up period, the control group were not the anterior iliac crest reconstruction in 21 patients who could not obtain the rib from retroperitoneal approach. The average follow up was obtained at 43.3 months(12 to 72 months) in study group, at 41.6 months(12 to 60 months) in control group. The study group had a tendency to improve the donor site pain after incorporation of the rib graft and the control group tend to remain the donor site pain till late especially in the thinner group and combined disease group. In residual deformity of the donor site, the study group was superior to the control group. Residual deformity of the study group was associated with the complications such as displacement and resorption of the grafts. Cosmetic residual deformity tends to be higher in the thinner group. Radiographically all rib gragts incorporated in situ in 51 patients despite of some cases of migration(Average 11 weeks and 4 days) and clinical results did not affect by biological behavior of rib grafts on the follow up radiogram. The authors attempted anterior iliac crest reconstruction using the implants (Mennen plate in 3 patients, threaded pin in 3 patients) after large harvesting of autogenous tricortical graft in 6 patients who could not obtain the rib from retroperitoneal approach or could not fit the rib too the defect. In those cases the results were satisfactory clinically. These results suggest anterior iliac crest reconstruction can minimize painful deformity after the harvesting of autogenous tricortical iliac grafts for anterior spinal fusion.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Ribs ; Spinal Fusion ; Tissue Donors ; Transplants

PURPOSE: It has been known for a long time that infants of insulin dependent diabetic mothers are prone to develop macrosornia, organomegaly, hyperbilirubinemia, respiratory distress syndrome, hypoglycemia, hypocalcemia, septicemia and congenital anomalies in the neonatal period. And echocardiographic asymmetrical- ventricular septal hyper- trophy(ASH) has been observed in the newborn infants of diabetic mothers. The etiology of the ASH remains unknown, although fetal hyperglycemia and subsequent glycogen deposits have been postulated as contributing factors. Therefore, we have studied whether large for gestational age(LGA) has played an important role of developing ASH. METHODS: We compared echocardiographic findings in neonates of LGA and appro- priate for gestational age(AGA), who were admitted to the Department of Pediatrics, Chung Ang University Hospital from April 1994 to March 1997. RESULTS: 1) Mean LVED in LGA and AGA were 1.96+0.06cm and 1.94+0.04cm, respectively. 2) Mean LVPW in LGA and AGA were 0.37+0.05cm and 0.370.05cm, respectively. 3) Mean IVS in LGA and AGA were 0.400.09cm and 0.380.09cm, respectively. 4) Mean IVS/ LVPW in LGA and AGA were 1.09+0.12 and 1.040.17, respectively. There was no statistical significance between two groups in echocardiographic findings. CONCLUSION: There is no relation between LGA and ASH in the neonate. According- ly, we may not need to perform echocardiography LGA routinely.
Echocardiography ; Gestational Age* ; Glycogen ; Humans ; Hyperbilirubinemia ; Hyperglycemia ; Hypertrophy* ; Hypocalcemia ; Hypoglycemia ; Infant ; Infant, Newborn* ; Insulin ; Mothers ; Pediatrics ; Sepsis

Synthetic hydroxyapatite is a safe, nontoxic, biocompatible, and osteoconductive material. Hydroxyapatite-coated implants have the property of achieving a very strong bond with living bone in a relatively short period. From March 1992 to June 1994, 140 hydroxyapatite-coated primary total hip prostheses were implanted. This study included 60 cases that could follow up minimum 3 years. At the time of mean follow up, 45 months after operation, the mean Harris hip score was 92 points. Only two patients complained of thigh pain at last follow up. On radiographic evaluation, radiolucent lines were seen around the uncoated distal part of the stem in 46 percents of the implants. No radiolucent line was observed around the coated area of the prosthesis. Cancellous condensation was seen in 95 per cents of the implants at the Gruen zone 2 and 6 area. Cortical hypertrophy was present in 32 percents. Fourteen cases had the gaps at the bone to acetabular cup interface in the immediate postoperative period. The gaps disappeared in 12 months after operation. Five implants were revised because of polyethylene wear, cup migration and periprosthetic fracture. The clinical outcome was excellent. But this result was obtained in the relatively short-term follow up. Longer-term data will be the only true test of the value of hydroxyapatite coated implant.
Acetabulum ; Arthroplasty, Replacement, Hip ; Durapatite* ; Follow-Up Studies ; Hip Prosthesis* ; Hip* ; Humans ; Hypertrophy ; Periprosthetic Fractures ; Polyethylene ; Postoperative Period ; Prostheses and Implants ; Thigh

No abstract available.
Aspergillosis ; Diabetes Mellitus ; Humans ; Liver Cirrhosis ; Liver ; Lung ; Maxillary Sinus

Zonisamide was administered to 20 patients with refractory epileptic seizures. The mean duration of the administration was 6 months, and the mean dosage was 7.2 mg/kg/day. The efficacy of zonisamide was rated remarkable in 15% of the cases, improvement in 40%, and no change in 45%. The response rates of zonisamide were 62.5% for myoclonic seizures, 50% for tonic-clonic seizures, 80% for atonic seizures and 33.3% for atypical absence seizures. There was no correlation between the clinical response and dose or serum concentration of the drug. The adverse effects were observed in 35% of the cases which were drowsiness, dizziness, ataxia, nausea, and vomiting. In all cases, however, the administration of zonisamide could be continued.
Ataxia ; Child* ; Dizziness ; Epilepsy* ; Epilepsy, Absence ; Humans ; Nausea ; Seizures ; Sleep Stages ; Vomiting

Thirty one free vascularized fibula bone grafts were performed for treatment of osteonecrosis of the femoral head in 26 patients, 24 men and 2 women aged from 16 to 48(mean:32 years). Twenty one patients had unilateral disease. Five patients had bilateral disease underwent staged bilateral free vascularized fibula grafts three months apart. Associated etiological factors included alcohol(9 patients), steroid(7 patients), and trauma(one patient). The condition was considered idiopathic in the remaining 9 patients. Radiologic staging by Ficat included stage 1 in one hip, stage II in 15 hips, stage III in 14 hips, and stage IV in one hip. A skin island flap was used for monitoring purpose for the grafted fibula. One monitoring, flap was necrotized due to vascular occlusion but the fibula bone graft was left in place to use as a nonvascularized bone graft. Average follow-up period was 21 months in 31 hips. Pain was relieved in 28 hips(93.3 percent) and aggravated in 2 hips(6.7 per cent). On radiographic evaluation, 26 hips(86.7 per cent) demonstrated excellent preservation of the femoral head contour. Progressive collapse of the femoral head (greater than 1-2 mm) occurred in 2 hips, i mm depression in one hip with stage III and 2 mm collapse in one hip with stage IV. In conclusion, the free vascularized fibula bone graft is an excellent treatment modality for preserving the femoral head and relieving symptoms in cases of the osteonecrosis of the femoral head.
Depression ; Female ; Fibula* ; Follow-Up Studies ; Head* ; Hip ; Humans ; Male ; Osteonecrosis* ; Skin ; Transplants

The number of cancers in the head and neck areas has been increasing due to the increasing life span of the patients and a free flap is a common procedure to reconstruct defect in the head and neck area. From March 1990 to February 1998, 105 patients underwent 110 free flap operations after head and neck cancer ablation and they were reviewed retrospectively. Among 110 free flaps, 93 are forearm flaps, 6 jejunal flaps, 5 vascularized fibular osteocutaneous flaps, 2 lateral arm flaps, 2 rectus abdominis myocutaneous flaps and 1 latissimus dorsi muscle flap and 1 latissimus dorsi myocutaneous flap. Sixty-five radial forearm flaps and 4 ulnar forearm flaps were utilized in patched type and 24 radial forearm flaps in tubed type mainly for the reconstruction of intraoral and hypopharyngeal defects. Sis jejunal flaps were utilized for the esophageal reconstruction and 5 vascularized fibular osteocutaneous flaps for the mandibular reconstruction. The remaining flaps were for the reconstruction of other areas of head and neck.Overall survival rate of the flap was 95.5%. Immediate complications were fistula formation(3 cases), total flap loss (4 cases) or partial flap loss(3 cases) and donor site problems(10 cases). Superior thyrodial artery was the most commonly used recipient artery(89 cases) which was followed by facial artery, lingual artery and transverse cervical artery. Size discrepancy was not remarkable between the donor and recipient arteries. However, there was usually a marked size discrepancy between donor and recipient veins. More than two venous anastomoses were performed to increase the success rate of the flap surgery. An average follow-up period was 38 months ranging from 3 months to 6 years. There was no patient who died during or right after the operations, but 23 patients died due to recurrence of tumors or underlying heart disease during the follow-up period. Remaining patients lived well excluding 6 late postoperative complications such as 4 cases of esophageal stenosis and 2 cases of osteoradionecrosis. We conclude that free flap reconstruction after head and neck cancer ablation improves the quality of life and minimizes the loss of function.
Arm ; Arteries ; Esophageal Stenosis ; Fistula ; Follow-Up Studies ; Forearm ; Free Tissue Flaps* ; Head and Neck Neoplasms* ; Head* ; Heart Diseases ; Humans ; Mandibular Reconstruction ; Myocutaneous Flap ; Neck ; Osteoradionecrosis ; Postoperative Complications ; Quality of Life ; Rectus Abdominis ; Recurrence ; Retrospective Studies ; Superficial Back Muscles ; Survival Rate ; Tissue Donors ; Veins

BACKGROUND: The effects of a newly synthesized potassium channel opener, KR-30816((-)(nitro-2-hydroxymethyl-2-methy-2H-1-benzopyran-4-y1)pyridine oxide) on the action potential of papillary muscles of guinea pigs and the ATP-sensitive potassium channel current(IKATP) of single ventricular muscle cells of rats were examined to make clear its action mechanism of the KATPchannel. METHODS: We used the conventional microelectrode and the excised inside-out patch configuration. RESULTS: KR-30816 caused a shortening of the action potential duration in dose-dependent manner, which was inhibited by glibenclamide(3microM). Before run-down of the K+channel, KR-30816 activated the cardiac ATP-sensitive K+ channel only in the presence of ATP and shifted the dose-response relation curve between [ATP]i and the channel activity to the right in parallel. After run-down of the KATP channel, KR-30816 did not after the channel opening either in the absence or in the presence of UDP. CONCLUSION: These results suggest that KR-30816 antagonizes the inhibitory effect of ATP on the KATPchannel in a competitive manner, thereby enhancing the channel openings.
Action Potentials ; Adenosine Triphosphate ; Animals ; Guinea Pigs ; Heart ; Microelectrodes ; Muscle Cells ; Papillary Muscles ; Potassium Channels* ; Potassium* ; Rats ; Uridine Diphosphate

The changes of electroencephalogram(EEG) in patients with dementia are most commonly studied by analyzing power or magnitude in certain traditionally defined frequency bands. However because of the absence of on identified metric which quantifies the complex amount of information, there are many limitations in using such a linear method. According to chaos theory, irregular signals of EEG cal also result from low dimensional deterministic chaos. Chaotic nonlinear dynamics in the EEG can be studied by calculating the correlation dimension. The authors have analyzed EEG epochs from three patients with dementia of Alzheimer type and three matched control subject. The result showed that patients with dementia of Alzheimer type had significantly lower correlation dimension than non-demented controls on 12 channels. Topographic analysis showed that the correlation dimensions were significantly lower in patients with Alzheimer's disease on frontal, temporal, central, and occipital head regions. These results show that brains of patients with dementia with dementia of Alzheimer type have a decreased complexity of electrophysiological behavior. We conclude that the nonlinear analysis such as calculating correlation dimension can be a promising tool for detecting changes in the complexity of brain dynamics.
Alzheimer Disease ; Brain ; Dementia* ; Electroencephalography* ; Head ; Humans ; Nonlinear Dynamics*