No abstract available in English.
Clinical Study ; Humans ; Upper Extremity

We found that the packing of a rolled tensor fascia lata flap after the excision of avascular lunate was reasonably effective in relieving symptoms in 4 patients with advanced Kienbock's disease, even though there was still some residual postoperative loss of wrist motion and grip strength, and the slightly progressive tendencies of earpal collapse and translation as well as rotational deformities of scaphoid. Pre-operatively all patients had pain and limited motion of the wrist as well as weakness of grip. Roentgenographically all had sclerosis, fragmentation and collapse of the lunate. They were analysed each two cases in advanced stage II and III according to the classification by Lichtman. Most had symptoms for longer than two and half years. After removal of the avascular lunate through a dorsal incision, a rolled tensor fascia lata flap was packed to fit the defect. Patients were followed for an average of sixteen months. All were improved clinically but there were somewhat postoperative progress in carpal collapse, translation and rotational deformities of scaphoid roentgenographically.
Classification ; Congenital Abnormalities ; Fascia Lata ; Fascia ; Hand Strength ; Humans ; Osteonecrosis ; Sclerosis ; Wrist

BACKGROUND: Normal humans meet the increased ventilatory need during exercise initially by the increase of tidal volume (TV) and later by the increase of respiratory frequency (Rf). And the inspiratory duty cycle (Ti/Ttot) is also increased more than 50% for the compensation of the decrease of respiratory cycle provoked by the increase of respiratory frequency. The patients with chronic airflow obstruction show rapid and shallow breathing pattern during exorcise because of the degreased ventilatory capacity and the increased dead space ventilation. However, the studies about the change of inspiratory duty cycle are only a few and there is no literature about the relationship between the change of inspiratory duty cycle and the degree of airflow obstruction. METHODS: The subjects were the twelve patients with chronic airflow obstruction (CAO) and ten normal people. The incremental exercise test was done. The increase of work load was 10 Win CAO group and 25 Win normal control group. The analysis of the results was done by the comparison of the parameters such as minute ventilation (VE), TV, Rf, physiologic dead space (Vd/vt), and inspiratory duty cycle between the two groups. Each parameters were compared after transformation into % control duration base that means dividing the total exercise time into five fractons and % control duration data were obtained at rest, 20%, 40%, 60%, 80%, and max. Statistical analysis was done by repeated measure ANOVA using SAS program. RESULTS: The changes of VE and TV were significantly different between two groups while the change of Rf was not significant. The decrease of Vd/vt was significantly low in CAO group. Ti/Ttot was markedly increased from 38.4+3.0% at rest to 48.6+4.5% at max in normal control group while Ti/Ttot showed little change from 40.5+2.2% at rest to 42.6+3.5% at max. And the change of inspiratory duty cycle showed highly good correlation with the degree of airflow obstruction (FEVl%). (r=0.8151, p<0.05) CONCLUSIONS: The increase of Ti/Ttot during exercise observed in normal humans is absent in the patients with CAO and the change of Ti/TtDt is well correlated with the degree of airflow obstruction.
Compensation and Redress ; Exercise Test* ; Humans ; Pulmonary Disease, Chronic Obstructive* ; Respiration* ; Tidal Volume ; Ventilation

BACKGROUND: There are many suggested methods for the indirect determination of anaerobic threshold(AT) using the changes of ventilatory parameters in respones to ventilatory load accompanying the increase of blood lactic acid level during exercise and the threshold derived from them is called ventilatory threshold( VT). They include ventilatory equivalent method(VEM), End-tidal PO2 method(PETO2), V-slope method(VSM), and respiratory quotient method(RQ). But in the patients with chronic airway ohstruction(CAO), the AT determined by ventilatory methods may not reflect true AT because the patients with GAO show inadequate ventilatory response to the increase of blood lactic acid level during excercise. METHODS: For the investigation of detection rate and reliability of above four VT determination methods in the patients with GAO, we performed the symptom-limited and maximal incremental exercise test in 17 patients with GAO and 12 normal controls. The incremental workload was 10 W/min in GAO group and 25 W/min in control group. The reliability of VT in each group was investigated by the calculation of Spearman correlation coefficient. RESULTS: The detection rates of VT were 100% by RQ, 91.7% by both VEM and POETO2, and 83.3% by VSM in normal control group, while 94.1% by RQ, 64.7% by VEM and PETO2, and 83.3% by VSM in GAO group. Good correlations were noted among VEM, PETO2, and VSM except RQ in normal control group. But there was no significant correlation except between VEM and PETO2 in GAO group. CONCLUSIONS: RQ is very sensitive but crude and VEM is near similar to PETO2. The clinical usefulness of VT determined by ventilatory method might be limited in patients with severe GAO.
Airway Obstruction* ; Exercise Test ; Humans ; Lactic Acid

No abstract available.

Indirect fluorescent antibody tests were performed with sera of paragonimiasis patients and skin test positive sera against Paragonimus antigen. Paragonimus antigen was prepared from lyophilized adult worms of P. westermani by defatting with ethyl-ether before extracting with barbital buffered saline. Preparation of Paragonimus antigen for the indirect fluorescent antibody test was based upon Sato's method used for sero-diagnosis of anisakiasis, with Sephadex G-25 instead of Sepharose 4B. The results were as follows: The indirect fluorescent antibody titers of paragonimiasis patient's sera ranged from 1:64 to 1:512, whereas the control sera showed titers of less than 1:16. As controls, Clonorchis patient's sera and parasite-free healthy human sera were used. In indirect fluorescent antibody tests, the skin test positive human sera against Paragonimus antigen showed a positive rate of 41.5 per cent in the case of titers more than 1:40. On the other hand, complement fixation tests on the same sera showed a positive rate of 32.5 per cent in the case of titers more than 1:20.
parasitology-helminth-trematoda ; paragonimiasis ; Paragonimus westermani ; diagnosis ; indirect fluorescent antibody tests ; serum ; ethyl-ether

No abstract available.
Adolescent* ; Humans ; Korea*

Gorham's syndrome (Gorham's disease, Massive osteolysis, Disappearing bone disease, phantom bone) is a rare disorder characterized by histologically benign proliferation of thin-walled vascular channels originating in bone associated with extensive lysis of regional bone matrix. It starts in bone, but it may secondarily involve soft tissues and adjacent bones. Although the osteolysis usually arrests spontaneously, its biologic behavior is unpredictable. The etiolgy is still in dispute and the treatment presents many problems. The author's case was a 20-year old girl, who had pathologic fracture in neck and supracondylar area of left femur with osteolysis of left pelvis, femur, and proximal fibula and tibia. She also had lymphangioma involving bones and adjacent soft tissues. To our knowledge, there is no report on Gorham's syndrome in Korea. The authors report a case of Gorham's syndrome with review of literatures.
Bone Matrix ; Dissent and Disputes ; Female ; Femur ; Fibula ; Fractures, Spontaneous ; Humans ; Korea ; Lymphangioma ; Neck ; Osteolysis ; Osteolysis, Essential ; Pelvis ; Tibia

Eighty long bone open fractures were treated with immediate internal fixation within an average of 7.4 hours after trauma from June, 1984 to September, 1989. Mean follow-up was 17 months ranging from 1 year to 3 years and 4 months. Fifty-four tibia, 11 femur, 9 forearm, and 6 humerus open fractures were encountered. According to Gustilo and Anderson's wound classification, there were 19 Type I, 26 Type II, and 35 Type III open fractures. Internal fixation was facilitated with plate and screws in 58 cases, Ender nails in 13 cases, Kuntscher nails in 3 cases, and screws only in 5cases. Bone grafting was performed in 47 cases. Uncomplicated union was achieved in 16cases (84 %) in type I, 23 cases (88%) in Type II, and 18 cases (51%) in Type III. Transient soft tissue infection was noted in 3 cases(16%) in Type I, 3 cases(8%) in Type II, and 5 cases(14%) in Type III. Transient osteomyelitis was present in 1 caes(4%) in Type II, and 4 cases(11%) in Type III, and all were resolved within 1 month. Three cases of Type III open fractures where mutilated injury was associated with severe vascular injuries were ended up with amputation. Five unions (14%) in Type III were complicated with chronic osteomyelitis. Overall uncomplicated union was achieved in 38 cases (87%) in Type I & II, and 18 cases (51%) in Type III. Soft tissue coverage especially with viable muscle and stable fixation with good cortical contact seemed to be important prognostic factors. While there exists potential disadvantages of higher minor and major complication rates and more sophisticated management of the patient, this one-stage open reduction and internal fixation with bone graft which converts open fracture into stable closed fracture might be of some value especially in Type I & II open fractures in terms of simultaneous management of fracture and open wound, prevention of secondary infection, anatomical reduction including joint congruity, stable maintenance of reduction, elimination of deformity, and early joint motion.
Amputation ; Bone Transplantation ; Classification ; Coinfection ; Congenital Abnormalities ; Femur ; Follow-Up Studies ; Forearm ; Fractures, Closed ; Fractures, Open ; Humans ; Humerus ; Joints ; Osteomyelitis ; Soft Tissue Infections ; Tibia ; Transplants ; Vascular System Injuries ; Wounds and Injuries