The normal vascularization of peripheral nervesand the vascular factor in peripheral nerve les ons have regained increasing interest among surgeons. So, several attempts have been made to assess the relative importance of the vasa nervorum and intrinsic longitudinal vascular plexuses of nerve in maintaining the blood supply.of a segment of nerve trunk. The purpose of our experiment was to determine in laboratory animals the maximum extent to which a nerve can be mobilized without impairing its vascular supply so much that nerve function is jeopardized. All our studies were carried out on both sides of the sciatic-tibial nerve of thirty-two rabbit which were anesthetized intraperitoneally with urethane. The experimental procedure differed in three groups, Group I in which the sciatic nerve was mobilized 3 cm in length, Group II was mob lized 7 cm length and Group III was mobilized 10cm long. The tibialis post. muscles of each group were analyzed at intervals ot 1,2,4,6 and 8 weeks after neurolysis. Each muscles were examined grossly and histologically after hematoxylin and eosin staining. Experimental studies showed that a peripheral nerve is a well vascularized structure with a considerable reserve capacity in its microirculation. The intrinsic collateral system is well developeed and experimental deta supported the view that peripheral nerves may be mobilized over a cons derable length with or the only minium interference with their microvascular flow. The results were as follows: 1. The first evidence of histologic change in the muscle fibers was in the sarcolemmal neclei. 2. Localized atrophy of muscle fibers were observed at the six weeks after neurolysis. 3. With increasing length of neurolysis, abnormal finding were developed in early stage. 4. Massive atrophy of muscle fibers were noted in the muscle fibers which neurolysed more 7cm.
Animals, Laboratory ; Atrophy ; DEET ; Eosine Yellowish-(YS) ; Hematoxylin ; Muscles ; Peripheral Nerves ; Sciatic Nerve ; Surgeons ; Urethane ; Vasa Nervorum

To fill the large bone defect after bone and soft tissue tumor resection, there are several options such as tumor prosthesis, bone cement with intramedullary nail, autogenous bone graft and allograft. We had used isotrophic autogenous bone graft by using the heat-treated bone removed from tumor site. We analyzed the periods for junctional union and regeneration of autoclaved or low-heat treated groups, and compared these two methods to know which method is better for reconstruction of the bone defect after tumor resection. From Jan. 1987 to Sept. 1993, twelve patients took heat-treated autogenous bone graft: 6 auto- claved, and 6 low heat-treated. Each group had 10 places of junction sites between host and grafted bone. The tumors were 2 cases of osteosarcoma, 3 parosteal osteosarcoma, 2 Ewing's sarcoma, 2 malignant soft tissue tumors, 1 giant cell tumor, and 2 metastases from thyroid cancer and synovial sarcoma. The graft sites were 4 in humerus, 4 pelvis and 4 femur. Two cases showed marginal surgical margin and others wide surgical margin. Here we compare4 the difference between autoclaved group(120℃, 2 atm., 20 min) and low heat-treated group(65℃, 30 min. in water) on the aspect of complications and period to achieve junctional union to host bone. Average follow-up period was 25.3(11 to 88) months. Graft related complications in autoclaved group were bone resorption(2 sites), fracture of grafted bone(2). For low heat-treated group there was no such complication. Nonunion occurred in 3 sites for autoclaved group and 1 for low heat-treated group. Average period for junctional union was 7.3 months(5 to 10 months) for autoclaved group and 6.1 months(5 to 9 months) for low heat-treated group. With these results, heat treated bone autograft may have several advantages such as easy accessi- bility, low cost and anatomical reconstruction of the bone defect. The low heat-treated autogenous bone graft may have more advantages than that of the autoclaved one, and this method may be ratio- nalized to fill the large bone defect made by tumor resection.
Allografts ; Autografts ; Femur ; Follow-Up Studies ; Giant Cell Tumors ; Hot Temperature ; Humans ; Humerus ; Methods ; Neoplasm Metastasis ; Osteosarcoma ; Pelvis ; Prostheses and Implants ; Regeneration ; Sarcoma, Ewing ; Sarcoma, Synovial ; Thyroid Neoplasms ; Transplants

No abstract available.
Interleukin-2* ; Interleukins* ; Killer Cells, Natural*

From Mar. 1985 to Dec. 1992, 170 cases of osteosarcoma, which were proved histologically were admitted in our department at least one time. Among them we analysed 89 cases of Ennekings stage IIB who took limb-salvage(54) or amputation(35) and followed our protocol, with non-randomized retrospective study. The average age of the 89 patiens was 17.0 years(7 to 57). Fifty-four cases of salvage group took neoadjuvant chemotherapy, 35 cases of amputation group took neoadjuvant or adjuvant chemotherapy. The result revealed prevalences of 2/54, 0/35 as to local recurrence; 15 of 54, 17 of 35 as to metastasis; 14 of 54, 15 of 35 as to death. Of the 2 patients who had a local recurrence, one died of metastasis and the other was lost follow up. According to Kaplan-Meier's plot 5-year continuously disease free survival rate for whole 89 cases of stage IIB was 43.1%, for salvage group 56.4%, for amputation group 34.0%. There were no signifcant difference in survival rate between salvage and amputation groups(p>0.05, by log-rank test). This result means the limb-salvage operation for Enneking's stage IIB osteosarcoma does not hinder patients survival.
Amputation ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Osteosarcoma ; Prevalence ; Recurrence ; Retrospective Studies ; Survival Rate

So far with the advancement in treatment modalities for malignant bone and soft tissue sarcomas the survival rate become higher. Till now there are some questions who can survive. Temporary procedure not affecting the treatment schedule would have more advantages than primary permanent one. When there is higher possibility of survival, this can be switched to permanent one. From Dec. 1986 to Jan. 1994, we had performed 40 cases of temporary arthrodesis after segmental resection of malignant bone and soft tissure tumors around the knee by using intramedullary nail andbone cement. Thirty eight cases of bone tumors[osteosarcoma(33), malignant fibrous histiocytoma(MFH)(3), chondrosarcoma(1), Ewing's sarcoma(1)] and 2 cases of soft tissue sarcomas[MFH(1), squamous cell carcinoma(1)] were analysed. Types of intramedullary nail used were rigid(Huckstep, 23 cases) or flexible(Ender, 17 cases). Six cases(15%) showed mechanical implant failure due to fracture (Huckstep;5, Ender;1) between 2 to 20 months after operation. Rearthrodesis using Ender nail and bone cement(5) or arthroplasty using Kotz prosthesis(1) were done for fractured cases. The other complicaitons were deep infection(2), peroneal nerve palsy(2), or transfixing screw fracture(2). Second reconstruction procedure was carried out in 2 cases with arthroplasty using Kotz prothesis. For IM nail, multiple Ender nailing seems to be superior to the Huckstep in mechanical strength. Contrary to the primary permanent reconsturction of the bone defect, this procedure has several advantages: 1) simple and does not hinder postoperative chemotherapy, 2) even in the extensively involved cases, can save the limb if the neurovascular structures are spared, 3) in Stage III, can save the salvagable limb, 4) economic and immediate stability can be helpful in the patient's quality of life, 5) two years later, when the survival approaches plateau, we can switch to another kinds of salvage operation, 6) Ender nail was superior to Huckstep in mechanical stability, 7) can be used for children expecting leg lengthening near puberty. It is useful for sarcoma patients around knee who require prolonged chemotherapy anbd whose life expectancy is relatively unexpectable.
Adolescent ; Appointments and Schedules ; Arthrodesis ; Arthroplasty ; Child ; Drug Therapy ; Epithelial Cells ; Extremities ; Humans ; Knee ; Leg ; Life Expectancy ; Peroneal Nerve ; Puberty ; Quality of Life ; Sarcoma ; Survival Rate

The antihypertensive effect of Doxazocin were evaluated in 20 patients with essential hypertension. Two to eight mg of Doxazocin per day were administered continuously for two or eight weeks. The results were as follows : 1) Doxazocin were effective in 18 out of 20 patients(90%) at the end of 8 weeks treatment. 2) The systolic blood pressure was signigicantly decreased(173+/-20mmHg VS 144+/-33mmHg, P+/-0.001), and the diastolic blood pressure was also decreased(110+/-10mmHg VS 93+/-19mmHg, P<0.01) after treatment. 3) Triglyceride showed a decreasing tendency but statistically significance was not observed. Total cholesteral, HDL-cholesterol, BUN, creatinine, and uric acid did not change significantly before and after treatment with Doxazocin. 4) The side effects were headache in one case and dizziness in to cases. These results suggest that Doxazocin is an effective antihypertensive agent and concerning lipid profile, further long term observation is needed.
Blood Pressure ; Creatinine ; Dizziness ; Headache ; Humans ; Hypertension* ; Triglycerides ; Uric Acid

One hundred patients with hyperventilation syndrome presenting to emergency department(ED) were studied. Those were diagnosed on clinical basis by emergency medical physician. The male to female ratio was 15 : 85. In monthly distribution, the numbers of patients were increased during the two months, June and July. The 41% of patients visited the emergency center from 9:00 p.m. to 3:00 a.m.. The most common predisposing factors were the domestic problems, especially those between husband and wife(37%). Presenting complaints were dyspnea(34), paresthesia(30), muscle spasm(24), dizziness(6) and palpitation(6 patients). The initial examination of the patients in the ED were as follows, systolic blood pressure(134+/-7.15mmHg), heart rate(87.67+/-14.34/minute), respiratory rate(22.21+/-3.34/minute) and body temperature(36.61+/-0.31 degrees C, n=98). Arterial blood gas analysis showed alkalemia(pH 7.51+/-0.09) and hypocapnia(PCO2 26.67+/-8.30mmHg). After emergency cares, including carbone dioxide re-breathing and antianxietics, most of the symptoms were disappeared. The mean duration of stay in ED was 3.27+/-0.23 hours. The most important considerations in diagnosis of hyperventilation syndrome was the patients's history and the effective management was carbon dioxide rebreathing for a few minutes and antianxietics.
Blood Gas Analysis ; Carbon ; Carbon Dioxide ; Causality ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Female ; Heart ; Humans ; Hyperventilation* ; Male ; Spouses

BACKGROUND: Due to its anatomical location and vague symptom, early diagnosis of traumatic pacreatic injury is difficult. Furthermore it is very difficult to carry out appropriate management for the injury, so morbidity and mortality rates of traumatic pancreatic injuries remain high. Patients and METHODS: We reviewed medical records of 35 cases of patients who had been diagnosed as pancreatic injury and operated at Department of Surgery, Busan National University College of Medicine between January 1995 and December 2000. RESULT: 1) The male to female ratio was 2.5:1 and the highest incidence occurred in the 4th decade(31.3%). 2) Thirty two cases(91.4%) were injured by blunt trauma and 3 cases(8.6%) were injured by penetrating trauma. 3) The most common clinical manifestation was abdominal pain. 4) Twenty two patients(62.9%) were operated within 24hours after injury, and the mean time interval between injury and operation was 26.4 hours. 5) The serum amylase levels higher than 150 somogi unit were recorded in 20 cases(57.1%) of the patients. 6) Twenty seven patients(77.1%) had another associated injury with an average of 2 associated intraabdominal injuries. The most frequently injured intraabdominal organ was mesentery. 7) Complications occurred in 20 of 35 patients(57.1%) and the most common complication was pancreas-related complications, such as fistula, pseudocyst, abscess, pancreatitis. 8) Six patients(17.1%) were died due to hypovolemic shock, sepsis, respiratory failure and renal failure. CONCLUSION: Early diagnosis and appropriate operative methods may reduce morbidity and mortality from traumatic pancreatic injury
Abdominal Pain ; Abscess ; Amylases ; Busan ; Early Diagnosis ; Female ; Fistula ; Humans ; Incidence ; Male ; Medical Records ; Mesentery ; Mortality ; Pancreatitis ; Renal Insufficiency ; Respiratory Insufficiency ; Sepsis ; Shock

Time intervals and indices of left ventricular diastolic filling were studied by M-mode and pulsed Doppler Echocardiography in 18 dilated cardiomyopathy patients. After one two hours captopril(capril(R)) 25mg medication. 1)Systolic blood pressure, Diastolic blood pressure, Heart rate were significantly decreased. 2) Dimensions of LVSD, LVDD, LA, Aorta and EF were not changed measured by M-mode echocardiography. 3) IRT measured by M-mode and Pulsed Doppler echocardiography were significantly increased(45+/-33msec VS 74+/-35msec. 84+/-32msec VS 100+/-22msec P<0.05). 4) A2-E measured by M-mode and Pulsed Doppler echocardiography were significantly increased(114+/-45msec VS 134+/-46msec, 156+/-46msec VS 194+/-48msec, P<0.05). 5) Deceleration time was significantly increased(137+/-36msec VS 205+/-40msec P<0.05). 6) Transmitral peak flow velocities were not changed significantly. In summary captopril influences early diastolic time intervals with dilated cardiomyopathy patients and we interpreted these effects be beneficial on diastolic filling pattern.
Aorta ; Blood Pressure ; Captopril ; Cardiomyopathy, Dilated* ; Deceleration ; Echocardiography ; Echocardiography, Doppler, Pulsed ; Heart Rate ; Humans

The fruits showing brown rot symptom on dwarf flowering almond were found in Gongju, Chungchungnam-Do in Korea in July 2005. Small water-soaked lesions on the fruits were initiated, and gradually developed to soft rot covered with gray conidia. Then the diseased fruits were shrunk and became grayish-black mummies. A fungus was isolated from the diseased fruit and its morphological, cultural and molecular genetic characteristics were investigated. Typical blastospores of Monilinia spp. were observed under a light microscope both from tissues of the diseased fruits and from PDA-grown cultures. The fungus grew well at 25degrees C and on PDA. The ITS ribosomal DNA region (650 bp) of the fungus was amplified by PCR and analyzed. Comparative data on ITS sequence homology among Monilinia spp., ITS sequence-based phylogram and morphological characteristics showed that the fungus is Monilinia fructicola. This is the first report on Monilinia fructicola causing brown rot on fruits of dwarf flowering almond in Korea.
Chungcheongnam-do ; DNA, Ribosomal ; Flowers* ; Fruit ; Fungi* ; Korea* ; Molecular Biology ; Mummies ; Polymerase Chain Reaction ; Prunus dulcis* ; Sequence Homology ; Spores, Fungal