No abstract available.
Osteotomy*

No abstract available.
Osteochondritis Dissecans* ; Osteochondritis*

No abstract available.
Carbon Dioxide* ; Carbon* ; Respiratory Rate* ; Tidal Volume*

On the length, strength, free lateral motion, and perfect mobility of the thumb, depends the power of the human hand. The thumb is called pollex because of its strength and that strength is necessary to the power of the hand being equal to that of all the fingers."So stated Sir Chales Bell in the fourth Bridgewater Treatise, first published in 1833. Morrison and O'Brien advocated reconstruction of the thumb with a free wrap around flap from the big toe to recreate a stable, sensate and functional digit including the nail in 1980. From March, 1982 to July, 1988, Twelve thumb reconstructions were performed using the wrap around procedure at Hanyang University Hospital;12 successful thumb reconstructions were reviewed at an average of 16 months after surgery. There were several complications;these included skin necrosis(4), malunion(1), resorption of the bone graft(7). We considered that cosmesis and function were good;pinch grip averaged 68% of normal, sensibility returned in all patients as assessed by two-point discrimination(average 9.5mm). Over all the results are as follows. 1. The wrap around technic provides a good method of reconstruction. 2. The wrap around technic is one stage operation and can be used in the level of metacarpal amputation. 3. The surgeon should be familiar with microsurgical technic.
Amputation ; Hallux ; Hand ; Hand Strength ; Humans ; Methods ; Skin ; Thumb

No abstract available.

Effect of infusion and bolus injection of lidocaine on the pressure response to the increased intracranial pressure(ICP) was investigated in urethane-anesthetized rabbits. 1) Arterial blood pressure(BP) and ICP were significantly raised by infusing saline(0.05ml/min) into an epidural balloon. 2) Infusing of lidocaine(0.5mg/kg/min) into an ear vein minutely inhibited the elevation of BP and ICP when infusing saline into an epidural balloon. However, infusion of lidocaine(1.5mg/kg/min) markedly inhibited the elevation of BP and ICP. 3) Repeating the infusion of saline into the epidural balloon with intervals, the duration reached to the level of 80-10 mmHg ICP was gradually shortened. Each depressor response to the first, second and third injection of lidocaine(3 mg/kg) was similar. The first injection transiently reduced the elevated ICP, but the second and third injection reduced that significantly and the reducing effect was gradually prolonged according to repeating the lidocaine injection. These results show that lidocaine could delay the elevation of ICP and reduce the previously increased ICP by infusing saline into an epidural balloon.
Ear ; Intracranial Hypertension* ; Lidocaine* ; Rabbits* ; Veins

No abstract available.
Prune Belly Syndrome*

PURPOSE: The incidence of clinical nephritis is much higher especially in younger ages and in about one half of the cases, it also shows nephrotic syndrome. Thus, we examine the clinical and pathologic consideration of children with lupus nephritis and their treatment modality to improve the prognosis. MATERIAL AND METHOD: Among 67 cases of children under eighteen who were diagnosed SLE, 50 patients with hematuria and proteinuria from Jan. 1980 to Dec. 1996 were selected for the review. RESULTS: The ratio of the male to female patient was 1:3.5 and the average age at the diagnosis was 11.85+/-3.2 years old. Most common clinical manifestations at the time of the diagnosis were fever and skin rashes and the common laboratory results were proteinuria, hematuria, Out of 50 cases, 33 cases had renal biopsy. The results were 17 cases of Class IV, 7 cases of Class lll, 5 cases of Class lll, 3 cases of Class V and 1 case of Class l. Different treatment modalities were carried out; Corticosteroid only 21 cases, Corticosteroid+Azathioprine 25 cases, Corticosteroid+Cyclophosphamide 3 cases, and Corticosteroid+Cyclosporine A 1 case. However, there were no significant difference in the recurrence and complete remission rate of lupus nephritis in between each treatment groups. Average follow-up period was 37+/-23 months. Of all the follow-ups, 7 patients were dead. CONCLUSION: Early diagnosis should be carried out with renal biopsy, and should be considered for vigorous therapy, which currently includes high doses of corticosteroids and immunosuppressive drugs. Among these immunosuppressive agents, azathioprine has a lower incidence of long-term complications and low costs might be recommended. In addition, regular check-up for anti-DNA antibody, serum complement concentration and appropriate moniroting and management for the adverse effects of the treatment should enable to reach the continuous remission.
Adrenal Cortex Hormones ; Azathioprine* ; Biopsy ; Child* ; Complement System Proteins ; Diagnosis ; Early Diagnosis ; Exanthema ; Female ; Fever ; Follow-Up Studies ; Hematuria ; Humans ; Immunosuppressive Agents ; Incidence ; Lupus Nephritis* ; Male ; Nephritis ; Nephrotic Syndrome ; Prognosis ; Proteinuria ; Recurrence

We report a case of congenital giant pigmented nevus with malignant melanoma of brain in a 14-year-old male patient. He had giant pigmented nevus on the back and neck, and multiple satellite lesions over the whole body since birth. One year prior to visit to our hospital, the patient suffered from various neurologie symptoms including headache, nausea, vomiting, seizure and right side motor weakness. Flistologic findings of skin lesions were benign nevocytic nevi. Computed tomogram of brain demonstrated increased densities in the both fronto-parietal leptameninges and brain parenchyme. Histologic findings of brain parenchyme by stereotaxic long needle biopsy showed the infiltration of melanin containing atypical melanocytes. There was no evidence of malignant melanoma at other organs. All of these findings suggested that origin of malignant melanoma of brain parenchyme was leptomeninges rather than skin.
Adolescent ; Biopsy, Needle ; Brain* ; Headache ; Humans ; Male ; Melanins ; Melanocytes ; Melanoma* ; Nausea ; Neck ; Nevus ; Nevus, Pigmented* ; Parturition ; Seizures ; Skin ; Vomiting

Decerebrate rigidity, in which there is an exaggereted posture with continuous spasm of muscles, especially the extensors, was first produced in 1898 by Sherrington in animals by transection of the brain at a prepontine level. Since it was shown that intact vestibular nuclei were necessary for decerebrate ridigity to persist, the disorder was believed to be caused by release of vestibular nuclei from higher extrapyramidal control. We have experienced 42 cases of the presence of decerebrate ridigity following head injury who were admitted to the Chosun University Hospital from March 1972 to February 1976. Although no one doubts the prognostic gravity of the decerebrate state following cranial trauma, a surpring number of patients in this study survived in a reasonably functional state. The particular factors we have evaluated are the duration of decerebration, the presence or absence of an intracranial hematoma of surgical proportions, the time of surgical intervention in relation to onset of decerebration and the use of corticosteroids. 42 consecutive parients with traumatic decerebration were studied to determine factors that influence the recovery from the decerebrate state. All these cases were diagnosed by clinical findings and cerebral angiography and assessed the prognostic factors on the result of treatment. Although the data did not lend themselves to precise statistical analysis, it is our option that the following conclusions be inferred ; 1. Intracranial hematoma was found in 25 patients (about 60%) from 42 patients who were presence of decerebrate rigidity, among these the sites of intracranial hematoma were as follows ; a) Epidural hematoma was found in 8 patients(32%). b) Subdural hematoma was found in 13 patients(52%). c) Intracerebral hematoma was found in 4 patients(16%). 2. The mortality of decerebrate patients(65%) with direct damage to the brain stem was greater than that of those supratentorial hematoma(52%). However the quality of survival was better in the latter group, indicating the likehood that brain stem compression is often reversible after evacuation of the hematoma even though with residual neurological deflicit. 3. The mortality and morbidity were greater with traumatic intracerebral and subdural hematoma than with epidural hematoma. This correlation was probably related to the amount of associated diffuse brain damage. 4. A progressive increase in the mortality rate in the surgical group could be correlated with the duration of decerebrate rigidity prior to surgical intervention. 5. Patients who recovered from the decerebrate state usually survived even though with residual sequelae. 6. There was an increase in the mortality rate when decerebration persisted for more than on weeks, but there was one survivor after even 35 days of decerebrate state. 7. The mortality rate was highest over 40 years old and was on the contrary under 20 years old. 8. There was no specific effectiveness in the patients with the presence of decerebrate state with the use of parenteral corticosteroid therapy.
Adrenal Cortex Hormones ; Adult ; Animals ; Brain ; Brain Stem ; Cerebral Angiography ; Craniocerebral Trauma ; Decerebrate State ; Gravitation ; Hematoma ; Hematoma, Subdural ; Humans ; Mortality ; Muscles ; Posture ; Spasm ; Survivors ; Vestibular Nuclei ; Young Adult