Since 1856, Mayer13) coined the term “osteotomy” for a tibial resection for an angular deformity, various shapes and designs of osteotomies in long bone or pelvis have been popularized to treat the malunion, osteoarthritis of hip and knee, bow leg, L.C.P., or C.D.H. etc. The purpose of corrective osteotomy for tibia is so different from that of upper extremity because it must be restored the weight bearing alignment, and equalize or minimize the leg length discrepancy. We respectively reviewed 14 cases with various angular deformities on tibia who were treated at Dept. of Orthopaedic Surgery, Catholic Medical College from Jan. 1976 to Dec. 1984. The results obtained were as follows: 1. Causes of angular or rotational deformities of tibia were malunion in 11, bow leg in 2 and partial closure of distal tibial epiphysis in l. 2. Ten cases of tibial deformities exceeded over the 10° of medial or lateral angulation and 15° of anterior or posterior bowing were corrected for normal weight-bearing alignment in lower leg. And a rotational deformity may be so disabling to walk as to require surgery. So four cases of tibial angular deformities combined with more than 20° of external rotation and 5° of internal rotation were corrected for normal good looking walks. 3. The maximum length that can be gained by an opening wedge osteotomy was near the point of maximum angluation, but it could be changed by the cause of deformity and patient's age. We've done 4 cases of opening and 10 cases of closing wedge osteotomy. 4. Angular deformity in one plane due to fracture in children under 10 years of age may be corrected spontaneously by growth, but deformities due to bow leg or epiphyseal injury cann't be expected any spontaneous correction of deformity by growth. So three cases of tibial deformities due to bow leg or epiphyseal injury in children were corrected in earlier after recognition of that deformities because of possible damage to articular cartilage and the combined rotational deformities. 5. A slight deformity if the angulation involves near a joint, knee or ankle could be seriously disabling and so must be correctcd earlier. 6. Functional results of the corrective wedge osteotomy in angular and rotational deformities of tibia were excellent, good, fair in 4, 7 and 3, respectively.
Ankle ; Cartilage, Articular ; Child ; Congenital Abnormalities ; Epiphyses ; Genu Varum ; Humans ; Knee ; Knee Joint ; Leg ; Numismatics ; Osteoarthritis, Hip ; Osteotomy ; Pelvis ; Tibia ; Upper Extremity ; Weight-Bearing

No abstract available.
Humans ; Mothers*

Autologous Transfusion, storage of one's own blood for subsequent infusion if needed, is safe and effective in a variety of scheduled operative procedures. Obstetric involvement in such programs in very limited, however, because of concern over the possibility of inducing premature labor or causing fetal distress by blood volume change or vasovagal reactions. We describe our experience with pregnant women in this program. The incidence of vagovagal reactions of autologous donation was 9.5% (2.21). After entry into this program, 17pastients received a total 37pints, which consist of 19 Autologous and 18 Homologous. Homologous transfusion was avoided in 30% of patients receiving blood. The values of the mean hematocrits before and after hpebotomy were 34.1% and 31.8% respectively. It was stastically significant (p<0.01). We recommended that autologous blood donation by pregnant women in third trimester is safe for mothers or infants and it should be strongly encouraged for patient with placenta previa and repeated cesarean section.
Blood Donors ; Blood Volume ; Cesarean Section ; Female ; Fetal Distress ; Hematocrit ; Hemorrhage* ; Humans ; Incidence ; Infant ; Mothers ; Obstetric Labor, Premature ; Placenta Previa ; Pregnancy ; Pregnancy Trimester, Third ; Pregnant Women* ; Surgical Procedures, Operative

Female ; Pregnancy ; Pregnancy, Ectopic*

Median nerve somatosensory evoked potentials (SSEPs) were studied in 98 cases of cerebrovascular disease(CVD), and compared with the SSEPs of 100 healthy subjects. According to the clinical and radiological (brain CT and/or MRI) findings, the patients were divided into four groups; 21 cases with brainstem lesion, 33 with thalamic lesion, 32 with subcortical lesion, and 12 with cortical lesion. Comparing with the results of SSEPs obtained from 100 cases of normal subjects, abnorrnal SSEPs were found 7 of 21 patients in brainstem lesion, 17 of 33 in thalamic lesion, 15 of 32 in subcortical lesion, and 9 of 12 in cortical lesion. There are no statistical significance betueen the lesion site and rate of abnormal SSEPs findings. The 48 patients of CVD exihibited abnormal findings with the patterns of(1) absence ol conical responses in 32 cases(32.7%), (2)decreasing the ratio of amplitude between non-affected and affected cortex in 21 cases (21.4%), (3) prolonged inter-peak latency (IPL) between P/Nl3-N19 in 10 cases(10.2%), (4)distorted shapes in 8 cases(8.7%), and (5) low amplitudes of affected cortical potentials in 6 cases (61%). There were 9 cases who revealed abnormally high amplitude of cortical potentials over the non-affected hemisphere. These findings are suggesting that alteration of amplitude are more prominent than prolonged IPL between P/Nl3-Nl9 in SSEPs of CVD. The changes of SSEPs look more related to the deficit position and vibration sense rather than the pin-prick.
Brain Stem ; Evoked Potentials, Somatosensory* ; Humans ; Median Nerve ; Vibration

Thoracic outlet syndrome (TOS) is an uncommon condition which is caused by compression of subclavian artery, vein or brachial plexus in the region of thoracic outlet area, which is composed by the first rib, clavicle, anterior and middle scalene muscles and other connective tissue. In arterial TOS, chronic arterial compression causes arterial stenosis, poststenotic dilatation, aneurysm formation, intramural thrombus and peripheral arterial embolism. We present herein a case of arterial TOS patient with multiple distal embolization. The patient was 43-year old male with crutch ambulation because of sequelae of polioviral infection in his youth. His chief complaint was discoloration and gangrenous change of five right digits for 1 month. A rudimentary first right rib was found in simple chest X-ray. Angiographic findings were stenosis and poststenotic dilatation of right subclavian artery, multiple peripheral arterial embolic obstructions and numerous collateral vessel formation. Right thoracoscopic sympathectomy (T2), resection of the abnormal first rib and the abnormal axillary arterial segment was performed through the supraclavicular and transaxillary incision, then interpositional graft with saphenous vein was done for arterial reconstruction. A minor lymphatic fluid collection around the area of operation occurred, but it was easily controlled by percutaneous drainage. The gangrenous wounds of digits were improved after restoration of blood circulation.
Adolescent ; Adult ; Aneurysm ; Blood Circulation ; Brachial Plexus ; Clavicle ; Connective Tissue ; Constriction, Pathologic ; Dilatation ; Drainage ; Embolism ; Humans ; Male ; Muscles ; Ribs ; Saphenous Vein ; Subclavian Artery ; Sympathectomy ; Thoracic Outlet Syndrome* ; Thorax ; Thrombosis ; Transplants ; Veins ; Walking ; Wounds and Injuries

BACKGROUND: This study was conducted to find out the relationship between autonomous function and fatigue rating. The subjects were patients with complaints of fatigue who visited the department of family medicine in a general hospital. METHODS: We conducted this study from April to December 2002 in patients complaining of fatigue. The subjects were categorized into low, intermediate, and high fatigue groups. Heart rate variability was measured for five minutes at rest, followed by a five minute mental arithmetic test. We analyzed the relationship between fatigue ratings and autonomous function with SPSS 10.0. RESULTS: There was a statistically significant increase in the mean heart rate variability in the all three groups at rest and with stress. There was a statistically significant increase in LF norm increase in the low and high fatigue groups. HF norm showed a statistically significant decrease in the intermediate and high fatigue group. The variation in LF norms was highest in the low fatigue group and lowest. With the mental arithmetic test, the low fatigue group showed decreased rMSSD, HF and HF norm values compared to the intermediate group. The above values showed decrease in the high fatigue group compared to the low group. CONCLUSIONS: Overactivity of the sympathetic nervous system was observed as fatigue ratings increased. The cadiovascular autonomic response tended to decrease as fatigue ratings increased.
Autonomic Nervous System ; Fatigue* ; Heart Rate ; Hospitals, General ; Humans ; Sympathetic Nervous System

OBJECT: Pelvic actinomycosis is a relatively rare chronic suppurative and granulomatous infectious disease, caused by a gram-positive anaerobic bacteria. Actinomyces israelli is the most common subtype in human disease commonly associated with intrauterine device (IUD). This study was designed to analyze clinical and laboratory characteristics of patients with pelvic actinomycosis. METHODS: We reviewed medical records of 12 patients with pelvic actinomycosis who were admitted between January 1, 1995 and December 31, 2005. The clinical characteristics, diagnostic evaluation and surgical treatment results were retrospectively analyzed. RESULTS: The ages of the cases varied between 30 and 53 years old. Of the 12 patients, 11 patients had been using an IUD. Two cases had hydronephrosis due to infection. All our cases involved ovary and/or uterus and had predisposing factors of disease progression, including IUD, dilatation and curretage. Most common presenting symptom of patients were abdominal pain (75%). Preoperatively, 5 cases were diagnosed as actinomycosis, but 7 cases misconceived as a pelvic malignancy, secondary degenerated myoma and tuboovarian abscess. Exploration were performed in all patients. All cases were cured following surgery with subsequent antibiotics. CONCLUSION: Actinomycosis should be considered preoperatively, especially in long-term IUD usage, fever and laboratory findings that indicate the presence of pelvic infection. Radiologic findings (CT) can assist in making the diagnosis of pelvic actinomycosis. Appropriate antibiotics, as well as surgery, are important in the treatment of pelvic actinomycosis.
Abdominal Pain ; Abscess ; Actinomyces ; Actinomycosis* ; Anti-Bacterial Agents ; Bacteria, Anaerobic ; Causality ; Communicable Diseases ; Diagnosis ; Dilatation ; Disease Progression ; Female ; Fever ; Humans ; Hydronephrosis ; Intrauterine Devices ; Medical Records ; Middle Aged ; Myoma ; Ovary ; Pelvic Infection ; Retrospective Studies ; Uterus

PURPOSE: It is known that DNA methylation is associated with histone acetylation status in regulation of gene expression. In this study, we investigate the effect of demethylating agents and histone deacetylase (HDAC) inhibitor on the tumor suppression and the combined effect of two agents according to methylation status in human colon and breast cancer cell lines. METHODS: In this study, the RKO colorectal cancer cell line, MCF-7 breast cancer cell lines were considered. For each cell line, we used HDAC inhibitor sodium butyrate (SB), demethylating agent 5-aza-2'-deoxycytidine (5-aza-DC) and a combination of both agents. We estimated the percentage of cell survival using the XTT method and experimented with the augmentative effects of both agents. RESULTS: In RKO cell line in which most of the genes are methylated, 74% of cell survival was shown for 5-aza-DC treatment and 83% of cell survival for SB treatment. In MCF-7 cell line that approximately half of the genes are methylated, 82% cell survival was shown for 5-aza-DC treatment and 63% cell survival for SB treatment. We observed that the survival fraction is lower after the combined treatment of 5-aza-DC and SB than that of 5-aza-DC or SB alone in both RKO (53%) and MCF-7 (49%) cell lines (P<0.001). CONCLUSION: For highly methylated genes, 5-aza-DC is more effective on the tumor suppression than SB. On the other hand, if the methylation of the promoter region is at low density, SB is noted to be more effective than 5-aza-DC. Furthermore, the combined treatment of 5-aza-DC and SB is more effective than using each agent alone.
Acetylation ; Azacitidine ; Breast ; Breast Neoplasms ; Butyrates ; Cell Line ; Cell Survival ; Colon ; Colorectal Neoplasms ; DNA Methylation ; Epigenomics ; Gene Expression Regulation ; Hand ; Histone Deacetylase Inhibitors ; Histone Deacetylases ; Histones ; Humans ; MCF-7 Cells ; Methylation ; Promoter Regions, Genetic ; Sodium

PURPOSE: Diagnosis of a hemodynamically significant patent ductus arteriosus(PDA) that should be treated is difficult to determine by clinical and echocardiographic examinations. The aim of this study was to clarify the interrelationship of plasma atrial natriuretic peptide(ANP) concentrations and clinical signs or echocardiographic signs of PDA in preterm infants and use plasma ANP concentrations as a diagnostic indicator of a hemodynamically significant PDA. METHODS: Twenty-four preterm infants who were born at Guro Hospital, Korea Medical Center were evaluated on the 3rd day after birth. Clinical signs(cardiovascular dysfunction score 3) and echocardiographic signs[magnitude of left-to-right shunt across a PDA and left atrium(LA): Ao ratio] of a PDA and plasma ANP concentrations were measured. RESULTS: Plasma ANP concentrations and LA/Ao ratios of preterm infants with hemodynamically significant PDA were significantly higher than those of preterm infants without hemodynamically significant PDA. Plasma ANP concentrations were related to the magnitude of the left- to-right shunt across a PDA and LA: Ao ratio. Plasma ANP concentrations of LA/Ao of more than 1.3 were significantly higher than that of LA/Ao of less than 1.3. CONCLUSION: In preterm infants, high plasma ANP concentration may be a useful predictive indicator of a hemodynarnically significant PDA. Measurement of plasma ANP concentration may play a role in deciding the need for and timing of medical or surgical management of preterm infants with PDA.
Atrial Natriuretic Factor ; Diagnosis* ; Ductus Arteriosus, Patent* ; Echocardiography ; Humans ; Infant, Newborn ; Infant, Premature* ; Korea ; Parturition ; Plasma