No abstract available.
Heart Septal Defects, Ventricular* ; Tricuspid Valve Insufficiency*

No abstract available.

Major concerns in cleft palate repair are improved speech results and adequate maxillary growth. In these respects, Furlow's double reversing Z-plasty which requires minimal hard palatal dissection and redirects palatal muscles to produce an overlapping muscle sling is theoretically optimal method to close the cleft palate. However, it often requires backcut around the maxillary tubercle even dissection around the pedicle on oral mucosal Z-plasty flap. Raw surface heals secondarily but leads to scarring within the soft palate. In the current study, IIpatients all had incomplete cleft palate and were operated double reversing Z-palatoplasty using intraoperative rapid mucosal expansion (IRME), from November, 1996 till July, 1997. With the IRME, we reduced the incidence of backcut or dissection on the oral mucosal flap. Only three patients need small backcut incision and two of these were closed primarily with V-Y fashion. To examine the histologic changes and expansion rate with the IRME, same procedures were performed to palatal mucosa of three cats. Expanded mucosal size was increased to 33.3% and histologically, change of mucosal architecture was not found except capillary dilatation. As a result, intraoperative mucosal expansion offers sufficient mucosal size, reduce incidence of backcut, therefore minimizes palatal scar formation. Balanced maxillofacial growth and normal occlusion are expected with this procedure.
Animals ; Capillaries ; Cats ; Cicatrix ; Cleft Palate ; Dilatation ; Humans ; Incidence ; Mucous Membrane ; Palatal Muscles ; Palate, Soft

The purpose of this study is the present the short rerm result of arthroscopic reconstruction for PCL injury. Since January l990, authors have implanted the synthetic polyester ligament (ABC ligament, Surgicraft, U.K) into the substance of ruptured PCL proper under arthroscopic control. The follow up period ranged from 24 months to 61 months (average,35months). The main cause of injuries were traffic accidents in 38. Thirtyfive of patient were men and three were women, range in age from 18 to 70 years (average, 37 years). 18 were acute injury and operated at average 12 days after injury and 20 knee were chronic injury and operated at average 9 months after injury. There were 25 case that had combined ligament injuries (l2 ACL injury, ]0 MCL injury, 8 LCL injury elc). In 15 knees, the tear was in the mid substance area and in 13 it was near femoral attach site and in lO it was near tibial attach site. Postoperative result were evaluated by roentgenographic evaluation of posterior sagging, KT-20 (0 arthrometer and Lysholm knee score. Difference were improved from 12.5 mm (mean: pre.op) to 3.8m (mean: post.op) on posterior drawer test. Both knee showedminimal difference on KT-20N) study (2.l mm on 201b) at the time of follow up. The average Lysholm knee score were 84.7. By Clancy criteria, the result were exceflent 9 case (24%), good in 20 case (53%), fair in 7 case (18'Po) and failui e in 2 case (5%). On based of this study, arthroscopic augmentation with ABC ligament in PCL injury is very effective treatment but more longer follow-up and more case must he needed to accept this method.
Accidents, Traffic ; Female ; Follow-Up Studies ; Humans ; Knee ; Ligaments* ; Male ; Polyesters* ; Posterior Cruciate Ligament*

This study examined the relation between anger-coping types and hypertension in employed men aged 40-60 who consented to participate during the biannual physical checkup in the department of health management in 1988. The subjects analyzed were five hundred thirteen excluding those having hypertension history and/or current antihypertensive medications. Anger-coping types were constructed from the Harburg's model with two hypothetical anger-provoking situations involving wife and boss. Hypertensives were defined more than 140mmHg systolic blood pressure and/or 90mmHg diastolic blood pressure. Hypertensives were one hundred fifty two(29.6%) and those who suppressed their anger were 61.6%0 and 62.8% in wife and boss situations respectively. Items of anger, guilt, protest, and suppressed anger in wife situation showed odds ratios of 0.78-0.94 without statistical significance. But four items in boss situation showed odds ratios more than 1, especially anger-in types of anger item had 1.58 times the prevalence of hypertension of anger-out types(95% confidence intervals(CI) 1.06~2.35) and subjects who indicated that suppressed their anger had 1.55 times the prevalence of hypertension of those who expressed their anger(95% CI l.03~2.32). For anger suppressed vs. expressed types of total suppressed anger index, prevalence of hypertension was 1.31(95% CI 0.83~2.08). After adjusting for age, body mass index, smoking and drinking, the odds ratios were slightly increased in both situations except guilt items compared with univariate analysis. These results suggest that the relation between Harburg's anger-coping model and hypertension is replicated partially in this subjects.
Anger ; Blood Pressure ; Body Mass Index ; Drinking ; Guilt ; Humans ; Hypertension* ; Male ; Odds Ratio ; Prevalence ; Smoke ; Smoking ; Spouses

The authors reviewed both the clinical and radiographic results of 36 bipolar hemiarthroplasty using the porous-coated Harris-Galante uncemented femoral stem performed for avascular necrosis in 30 patients from January 1985 to June 1992. The average age was about 45.6 years and the average follow-up was fifty-four months. Clinical results by the Harris evaluation method were excellent in 33 cases, good in 2 cases, and fair in 1 case. The radiographic fixation of the femoral stem at final follow-up was bony ingrowth fixation in 31 cases, fibrous ingrowth fixation in 4 cases, and unstable fixation in 1 case. There was neither medial nor superior migration of the bipolar cup of more than two millimeters.
Follow-Up Studies ; Head* ; Hemiarthroplasty* ; Humans ; Necrosis*

The purpose of this study was to investigate the gaps of bone-acetabular component interface, the initial mechanical stability and the effects of adjuvant screw fixation in the press-fitted two different shaped porous-coated acetabular components. Semi-hemispherical Harris-Galante II cup and full hemispherical Trilogy cup were press-fitted with or without adjuvant screw fixation in 40 bovine femur. The gaps of bone-implant interface were measured in each radiography of all specimen and axial compression tests and rotational stability tests were performed using servohydraulic tension-compression machine. There was significantly smaller gap at polar 1/3 region in the specimen implanted with Trilogy cup. But the adjuvant screw fixation did not affect the amount of gap. There was no significant statistical difference in axial load and rotational stability test in each situations of fixation. This study demonstrates that the initial mechanical stability is not influenced by the shape of semi-hemispherical Harris-Galante II cup and full hemispherical Trilogy cup and also independent of adjuvant screw fixation. But smaller gap of Trilogy cup at the polar 1/3 region indicates the possibility that less amout of wear debris of polyethylene or metal will be deposited and therefore less osteolysis or cup loosening will occur, but this hypothesis should be confirmed by the long-term clinical follow-up.
Acetabulum* ; Arthroplasty, Replacement, Hip* ; Femur ; Follow-Up Studies ; Osteolysis ; Polyethylene ; Radiography

We studied the natural history of asymptomatic early avascular necrosis of the femoral head in forty-three patients(forty-three hips) who had been treated with arthroplasty due to progressed avascular necrosis of femoral head but had no symptoms in the other side. All initial lesions were classified with Ficat staging and International classification(ARCO). The duration until symptom onset and radiologic evidence of disease progression were evaluated. The average follow up period was over 37 months. Among forty-three hips, twenty-nine cases(67.4%) remained asymptomatic until last follow up but fourteen cases(32.6%) were symptomatic during the follow up, and twenty-six cases(60.5%) did not progress on the radiography but seventeen cases(39.5%) progressed to Ficat stage 3 or 4. Fifteen cases of IA, IIA, IB-cental and II B-central without lateral lesion did not occur symptom and didnt progress to Ficat stage 3 or 4 over a period of average 47 months(24-71 months). But fourteen cases of IB, IC, g B and II C progressed to Ficat stage 3 or 4 and they were all lateral lesion. These results suggest careful observation only can be done in the case of small involvement(less than 15%) and medial or central lesion relatively over a long period of time but for the large involvement(more than 30%) and especially lateral lesion, aggressive surgical treatment may be considered even though the early stage of disease for the prevention of progression. However it will need more period of time to accurately compare the results of various methods of treatment.
Arthroplasty ; Disease Progression ; Follow-Up Studies ; Head* ; Hip ; Natural History* ; Necrosis* ; Radiography

No abstract available.
Facial Bones* ; Humans

Hypertensive encephalopathy is characterized by an acute, severe rise in blood pressure associated with headache, nausea, vomiting, altered mental status, and focal neurologic deficits, and rapid improvement after control of blood pressure. An eight-year old boy had been admitted with symptoms of red urine, fever, headache, convulsion, and visual blurring of vision. Blood pressure was 140/90mmHg, and CSF exam revealed WBC 8/mm3, glucose 83mg/dL, protein 106mg/dL. Serum C3 was 8mg/dL, C4 17mg/dL, ASO 1,024 Todd units. Brain CT showed non specific findings, however, MRI revealed symmetric high signal intensity lesions on T2WI over the parieto-occipital areas bilaterally. These lesions had been completely resolved on the following MRI 4 weeks later.
Blood Pressure ; Brain* ; Fever ; Glomerulonephritis* ; Glucose ; Headache ; Humans ; Hypertensive Encephalopathy* ; Magnetic Resonance Imaging* ; Male ; Nausea ; Neurologic Manifestations ; Seizures ; Vomiting