A2 D time, a time interval from aortic second heart sound to the D point of mitral valve echogram, was reported as a valuable index of the left ventricular relaxation in its early diastole. It was suggested, however, that A2D time is influenced by variable factors rather than single factor. This study was performed to evaluate the influences of several on the A2D time and to extend our understandings in A2D time. For this purpose, A2D time was measured in 4 groups whose hemodynamic states were different, i.e.31 normal subjects (group A), 32 patients with essential hypertension without decompensation (group B), 10 normotensive patients with clinically full blown congestive heart failure (group C), and 11 patients with hypertensive heart failure (group D), and the mean values of each group were compared between the groups. Concordantly systolic hemodynamic parameters were observed and the relationship of A2D time and each of these parameters were observed. A2D time was consistently influenced by the level of left ventricle impedance and it is well correlated with parameters representing left ventricular systolic performances. In hypertensive subiects, A2D time was increased before the deterioration of the left ventricular systolic function but shortened after clinical heart failure. These findings suggest that A2D time may be of value in longitudinal follow-up of the left ventricular function in the hypertensive patients even before the development of clinical heart failure.
Diastole ; Electric Impedance ; Heart Failure ; Heart Sounds ; Heart Ventricles* ; Hemodynamics ; Humans ; Hypertension ; Mitral Valve ; Relaxation ; Ventricular Function, Left

A clinical study of the tibial fracture was made on patients, total 234 tibias, who were treated at the Department of Orthopedic Surgery, Paik Hospital, Inje Medical College from 1974 to 1979. The results were as follows: 1. The ratio between male and female was 5. 5: 1 and majority was found between 3rd decade and 5th decade. 2. In the shape of fracture, commiuted fracture, transverse fracrure were common in order. 3. The most common cause of these fractures was traffic accident and the ratio between open and closed fracture was 1:2. 4. The most common associated injury was the fibular fracture. 5. More complications ensued in open reduction and internal fixation than in closed reduction. of 50 cases, which were treated by open reduction and internal fixation, delayed union in 32 cases (64%) and infection in 11 cases (22%) resulted. 6. In the treatment of open comminuted tibial fractures with skin and soft tissue loss or marked displacement, Hoffmans external fixation method and pin and resin external fixation method bad good results, Early motion of adjacent joint, easy care of wound and rigid fixation were obtained by it.
Accidents, Traffic ; Clinical Study ; Female ; Fractures, Closed ; Humans ; Joints ; Male ; Methods ; Orthopedics ; Skin ; Tibia ; Tibial Fractures ; Wounds and Injuries

Changes of power spectrum of R-R interval variabilty during recovery from N2O-O2 - halothane anesthesia have been studied in 20 patients. Power spectral analysis of R-R intervals during awake period and recovery period have been performed with newly developed R-R interval variability, we compared the power of each frequency range(low: 0.04-0.08 Hz, middle 0.10-0.15 Hz, high: above 0.3 Hz) between awake period and recovery period. There was no difference between awake period and recovery period in the power of low and high frequency ranges, but there was remarkable difference in power of midfrequency range. During awake period the power of midfrequency range changed with cyclic pattern, but there was no cyclic change during recovery period even after the regain of consciounss(30+/-3.2 min.). The power of midfrequency range during recovery period began to change with cyclic pattern only after 45 minutes. It is concluded that the power of midfrequency range is useful index of recovery from N2O-O2 -halothane anesthesia.
Anesthesia* ; Halothane ; Humans

Analysis of R-R interal variability is a useful method of obtaining many information about cardiovascular control mechanisms. Among the many methods of analyzing R-R variability, power spectral analysis(PSA) is said to be the most powerful and acurate tool. Although application of computer techniques in analysing R-R interval variability were introduced, as most of the studies on the R-R interval variability have been off-line and invasively, they were not suitable for practical use. So we prepared a program for non-invasive on-line perioperative assessment of R-R interval variability. We used Turbo C++(ver 1.0, Borland International, USA) and Turbo Assembler(ver 2.0, Borland International, USA) for programing. Data were collected by A/D converter(PCL 718,, Taiwan) by interrupt mode and transferred to TBM386 compatibie computer with VGA color monitor. By applying PSA to R-R interval variation, we can get an almost as confident information about the cardiovascular system as analysis of arterial waveform, In addition to this we can get data that requires very reduced momory size, and get them non-invasively. So analysing R- R interval variability may be the most suitable method for on-line continuous assessment of cardiac parameters.
Cardiovascular System

OBJECTIVE: To evaluate the role of C-reactive protein and fetal fibronectin for patients with preterm labor and intact mxmbranes. STUDY DESIGN: The study group was comprised of sixty patients who presented to the Taegu Fatima Hospital between 24-36 gestational weeks who had a diagnosis of preterm labor. The study group underwent assay of C-reactive protein in the matemal serum, and fetal fibronectin from the external os and posterior fomix of the vagina by means of polyester fiber swabs. The study group was categorized to four groups according to the results of CRP and fetal fibronectin, that is 28 cases of CRP(-)/fetal fibronectin(-); group I, 12 cases of CRP(+)/fetal fibronectin (-); groupII, 9 cases of CRP(-)/fetal fibronectin(+); groupIII, 11 cases of CRP(+)/fetal fibronectin(+): grouplV, and the controls were 12 women without preterm labor. Outcome measures were occurrence of preterm delivery, the admission-to-delivery interval, matemal age and parity, fetal body weight, 1min/5min Apgar score, perinatal morbidity and mortality etc. Statistical analyses were performed by means of ANOVA test and Dunnett's t-test. RESULTS: The prevalence of study group were group I 46.7%, group II 20%, group III 15% and group IV 18.3%. There were no significant difference of matemal age, parity and gestational weeks at admission between study group and control group, but in all study group the admission to delivery interval was significantly shorter than that of control group. Analysis indicated also no significant difference of maternal hemoglobin between study group and conuol group but white blood cell count of group II and IV were significantly higher than that of control group. In perinatal outcomes, the mean birth weight and 1 minute Apgar score of study group except group I were significantly lower than those of control group but 5minutes Apgar score was lower only in group IV compared with control group. Perinatal morbidity and mortality of study group were higher than those of control group except group I. This study group was designed to compare the diagnostic performance of cervical fibronectin and of the serum CRP levels. The sensitivity and specificity of fetal fibronectin as a test to predict of preterm labor were 80% and 90%, which were slightly higher than those of CRP(70%, 78%). CONCLUSION: Both positive cervicovaginal fetal fibronectin and positive C-reactive protein in women with preterm uterine contraction can help identify the pregnancies at risk and to select proper management protocol.
Apgar Score ; Birth Weight ; C-Reactive Protein ; Daegu ; Diagnosis ; Female ; Fetal Weight ; Fibronectins ; Humans ; Leukocyte Count ; Membranes* ; Mortality ; Obstetric Labor, Premature* ; Outcome Assessment (Health Care) ; Parity ; Polyesters ; Pregnancy ; Prevalence ; Sensitivity and Specificity ; Uterine Contraction ; Vagina

No abstract available.
Pregnancy*

No abstract available.
Dislocations* ; Tendons*

Giant cell tumor of the spine is a rare and potentially malignant condition which presents rather difficult clinical problems in treatment because of their localization and unpredictable clinical course. Authors experienced a case of giant cell tumor involving third lumbar vertebra which was successfully treated by ea bloc resection and anterior interbody fusion of the adjoining vertebrae with iliac bone graft. At eighteen months follow up, there is no evidence of recurrence and solid union of the bone graft was noted.
Follow-Up Studies ; Giant Cell Tumors ; Giant Cells ; Recurrence ; Spine ; Transplants

Purpose: A giant macular hole with retinal detachment occurred in a patient who had undergone several surgical treatments for retinal detachment, macular hole, and complicated cataracts. Here we report a case of successful retinal attachment and macular hole closure for this patient after autologous retinal flap transplantation.Case summary: Recently, an 18-year-old female presented with a newly developed visual field disturbance in her left eye. She had been on medication for severe atopic dermatitis in the past and seven years ago underwent scleral buckling, pars plana vitrectomy, and complicated cataract surgery due to rhegmatogenous retinal detachment of the left eye. Five years ago, extensive internal limiting membrane peeling, intravitreal gas tamponade, and aftercataract removal were performed due to the development of a macular hole with retinal detachment of the left eye. Thereafter, although the retina was reattached, closure of the macular hole was not successful. Recently, a giant macular hole with a retinal detachment was detected in this patient accompanied by symptoms of visual disturbance. Autologous retinal flap transplantation and intravitreal silicone oil tamponade were performed. Two months after the operation, she underwent silicone oil removal. Successful closure of the macular hole and retinal reattachment were confirmed. Conclusions In a patient with a refractory giant macular hole with retinal detachment, the closure of the hole and retinal reattachment were successfully achieved after retinal flap transplantation, without viscoelastics or perfluorocarbon liquid.

PURPOSE: The residual intrahepatic stones with biliary strictures are difficult to remove percutaneously via T-tube tract after surgery in patients with recurrent pyogenic cholangitis. We evaluated the effectiveness of percutaneous balloon dilatation of benign biliary strictures. MATERIALS AND METHODS: The balloon dilatations with 6-12mm angioplasty balloon catheter and stone extractions were performed via a T-tube tract after surgical treatment in 15 patients with recurrent pyogenic cholangitis. The balloons were inflated for 3-4minutes under 5 atm. until disappearance of waist of the stricture site, from one to seven session. After balloon dilatation, residual stones were extracted with saline irrigation or stone basket. RESULTS: Among total 42 strictures, the balloon dilatation was succesful in 27 strictures(64.3%), partially successful in 12 strictures(28.6%), and failed in three strictures(7.1%). Single or central biliary strictures were dilated easily rather than multiple ductal strictures. Of 26 sites with residual intrahepatic stones, stone extraction was complete in 17 sites(65.4%), incomplete in seven sites(26.9%) due to impacted or large stone and acute ductal angulation, and failed in two sites(7.7%). CONCLUSION: Percutaneous balloon dilatation of benign biliary strictures is an effective procedure for extraction of residual intrahepatic stones associated with recurrent pyogenic cholangitis.
Angioplasty ; Catheters ; Cholangitis ; Constriction, Pathologic* ; Dilatation* ; Humans