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

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

Female ; Pregnancy ; Pregnancy, Ectopic*

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

PURPOSE: Insulinomas are a rare disease, which can be cured by surgical management if diagnosed early. However, diagnosis and localization are difficult, due to their small size and varied clinical manifestations. We analyzed the clinicopathological features, diagnosis and surgical management of insulinomas. METHODS: We retrospectively analyzed 12 insulinoma patients who had undergone pancreatic surgery, between 1988 and 2001, at the Department of Surgery, College of Medicine, The Catholic University of Korea. RESULTS: The male to female ratio of the insulinoma patients was 1: 1 with a mean age of 37.9 years, ranging from 20 to 65. The clinical manifestations were loss of consciousness, weakness, confusion and dizziness, and all the patients had findings compatible with Whipple's triad. The median duration of symptoms before surgery was 16.8 months, ranging from 1 to 48 months. Hyperinsulinemic hypoglycemia was confirmed, during prolonged fasting, when the concomitant fasting blood sugar level was 42.4mg/dl and insulin level was 25.2 microU/ml (8.1~61.8 microU/ml). The insulinoma can be localized in 11 patients (91.7%) preoperatively. For the preoperative localization, a transhepatic portal vein sample (THPVS), selective angiography and a CT scan were good diagnostic methods. Intraoperative ultrasonography was the most useful localization tool during the operation. For treating the insulinoma, an enucleation, a distal pancreatectomy, and a pylorus preserving pancreaticoduodenectomy were performed in 5, 6 and 1 patients, respectively. An enucleation case was diagnosed as nesidioblastosis after surgery, thus needing a near total pancreatectomy. One patient with a multiple endocrine neoplasia (MEN), subtype I, needed a thyroidectomy and an adrenalectomy. All cases were single, benign tumors within the pancreas. The symptoms of hypoglycemia and the laboratory values were normal in all patients after surgery. CONCLUSION: We experienced 12 insulinoma patients, where preoperative suspicions, proper utilization of diagnostic tools, and prudent intraoperative diagnostic procedures enhanced the diagnostic accuracy of the insulinoma, and led to better treatment strategies.
Insulinoma* ; Pancreas*

BACKGROUND: This study was conducted to find out the difference of heart rate variability between practicing Tai Chi and walking at 6 km/hr. METHODS: Twelve healthy volunteers aged 25 to 35 were recruited through advertisement. All the subjects gave their informed consent, and the study was approved by the Institutional Review Board of the Catholic Medical Center Research Foundation. The subjects either practised Tai Chi or walked at 6 km/ hr on a treadmill machine, maintaining 5-minute rest, 20-minute exercise, and 30-minute rest. After 1 week, they switched and performed the other form of exercise. During the exercise, beat-to-beat HRV data was recorded by Polar S-810. We calculated HRV indices using Matlab software program and analyzed the mean value of HRV indices. RESULTS: The differences of the mean value of HRV indices of pre-exercise resting period were not significant. However, repeated ANOVA revealed that there were significant differences of change in the mean of SDNN (-14.27+/-13.03 ms, -33.67+/-20.23 ms; P=0.023), RMSSD (-10.17+/-9.59 ms, -21.90+/-12.60 ms; P=0.087), and STIDX (171.60+/-196.84, 1003.49+/-812.56; P=0.003) between practising Tai Chi and walking. The differences of change in mean heat rate, LF/HF ratio, LF, HF and TP were not significant. The differences of the mean value of HRV indices of the post-exercise resting period were not significant compared to the pre- exercise period. CONCLUSION: The result of this study suggest that exertional intensity of practising Tai Chi is similar to that of walking. Moreover, practising Tai Chi may be more profitable than walking in the aspect of HRV.
Ethics Committees, Research ; Exercise* ; Healthy Volunteers ; Heart Rate* ; Heart* ; Hot Temperature ; Informed Consent ; Tai Ji ; Walking

Hemin blocked lipid peroxidations induced by either ascorbate/FeSO4, a metal-catalyzed oxidation system, or 2,2'-azobis-2-amidino-propane hydrochloride (ABAP) which produces peroxy radicals at constant rates. Hemin at very low micromolar concentrations strongly inhibited the ascorbate/FeSO4-induced peroxidation of rat liver phopholipids, soybean phosphatidylcholine and arachidonic acid, and this inhibition was also evident with the use of ABAP, although much higher concentrations of hemin were required than those for the inhibition of ascorbate/FeSO4-induced lipid peroxidation. However, hemoproteins such as hemoglobin, myoglobin and cytochrome C did not show any significant effect on this lipid peroxidation. Hemopexin and albumin abolished the inhibitory action of hemin. During incubation with ascorbate/FeSO4 or ABAP, hemin underwent a change in its absorption spectrum, resulting in a progressive decrease in the peak height of the characteristic absorption band at 385 nm. The above results suggest that hemin may act as an important antioxidant in vivo, protecting lipids from the peroxidative damage.
Absorption ; Animals ; Arachidonic Acid ; Cytochromes c ; Hemin* ; Hemopexin ; Lipid Peroxidation* ; Liver ; Myoglobin ; Phosphatidylcholines ; Rats ; Soybeans