Pain snd disability often fractures of the cslcaneus even though the original injury was skillfully treated. The causes are traumstic arthritis of the subtalar joint, abnormalities of the peroneal tendons or weakness of Gastrocnemius, etc. We have experienced the resection of lateral prominence of calcaneus in 7 patients who complained of pain by entrapment of peroneal tendons between lateral malleolus and lateral prominence of malunited calcaneus. The follow up time after operation was 3 years and 4 months to 12 months. In all patients the pain was markedly improved between postoperative 5 weeks and 10 weeks. When the last follow up, 6 patients among 7 patients except one case of subtalar arthritis were astisfaetory.
Arthritis ; Calcaneus ; Follow-Up Studies ; Humans ; Subtalar Joint ; Tendons

No abstract available.
Embryonic Structures ; Fetus ; Humans* ; Kidney*

Most studies of limb lengthening have concentrated on the osteotomy. In the present study, the response of soft tissue (muscle, artery, nerve) to different length, rates or rhythms of distraction have been investigated to define the nature of any damage and to see whether new muscle is created. The purposes of the this study are to evaluate the optimum condition for soft tissue during limb lengthening and to study the effect of different rates & rhythms of tibial lengthening on the soft tissue in rabbits hy observing the changes of muscle, artery and nerve. We lengthened the right tihiae of fifty-four growing New Zealand white rabbits by callotasis. The left tibiae were used as control. The rabbits were divided into three different rates & rhythms groups: Group 1 (increments of 0.5mm /day, divided 2 times/day), Group II (increments of 0.5mm/day, divided 3 times/day), Group III (increments of 10mm/day, divided 2 times/day). Each Group was subdivided into three lengthening groups: 1 ( 10% lengthening), 2 (20% lengthening), 3 (30% lengthening). At the end of lengthening, histopathologic & histomorphometric studies were done on the medial heads of gastrocnemius muscles, the posterior tibial artery and the posterior tibial nerve. In the histopathological study, these were stained by hematoxylin eosin, PAS and observed by light microscopy. Electron microscopic examination was done in all samples. In light microscopic findings, the sum of scores of the following five suhjects, each counted from 0 to 3, were analysed for individual groups between the experimental side and the control by the Mann-Whitney test and the kruskal-Wallis test. The following conclusions were made hased on the above observations; 1. There was no significant difference between groups I, II and III, but there was a significant dif-ference between the 10%, 20% and 30% lengthening groups by histopathologic study. And the predominant responses of muscle to the lengthening were atrophy and endomysial fibrosis. 2. There was no change in the proportion of the muscle fiber types by histomophomeric study. 3.ln the initial phase, the muscle adaptation to the gradual lengthening was attained by sliding in Jess than 20% distraction but finally the muscle was regenerated by new muscle formation. 4. Major soft tissue complication to the gradual lengthening was induced by muscle. But arteries & nerves were well adapted to the gradual lengthening up to 30% Iengthening.
Arteries ; Atrophy ; Eosine Yellowish-(YS) ; Extremities ; Fibrosis ; Head ; Hematoxylin ; Microscopy ; Muscles ; Osteogenesis, Distraction ; Osteotomy ; Rabbits* ; Tibia ; Tibial Arteries ; Tibial Nerve

No abstract available.
Varicose Veins

We report a case of fibroma of tendon sheath developed in a 22-year-old woman. The tumor of about 5 years duration was protruding on the volar surface of her 4th finger tip. It was well-demarcated rubbery-hard, and immovable on palpation. The surface on the tumor was smooth and had some telangiectasias. It was asymptomatic and non-tender. The histopathologic findings of excised specimen revealed well-demarcated lobulated mass with widely-spacd: fibroblasts in a hyalinized collagenous matrix. The characteristic slit-like spaces were found in hypoellular and fasciitis-like region. After excision, local recurrence has not been observed for about one and a half years of follow-up period.
Collagen ; Female ; Fibroblasts ; Fibroma* ; Fingers ; Follow-Up Studies ; Humans ; Hyalin ; Palpation ; Recurrence ; Telangiectasis ; Tendons ; Young Adult

We report a case of fibroma of tendon sheath developed in a 22-year-old woman. The tumor of about 5 years duration was protruding on the volar surface of her 4th finger tip. It was well-demarcated rubbery-hard, and immovable on palpation. The surface on the tumor was smooth and had some telangiectasias. It was asymptomatic and non-tender. The histopathologic findings of excised specimen revealed well-demarcated lobulated mass with widely-spacd: fibroblasts in a hyalinized collagenous matrix. The characteristic slit-like spaces were found in hypoellular and fasciitis-like region. After excision, local recurrence has not been observed for about one and a half years of follow-up period.
Collagen ; Female ; Fibroblasts ; Fibroma* ; Fingers ; Follow-Up Studies ; Humans ; Hyalin ; Palpation ; Recurrence ; Telangiectasis ; Tendons ; Young Adult

BACKGROUND: Laryngomicrosurgery has some special characteristics. It is stressful due to intubation and direct laryngoscopy during a short operation time. Therefore both adequate anesthesia and quick recovery for the slience therapy after the operation are needed. This study compared the cardiovascular responses and recovery pattern between propofol and Thiopental-Enflurane anesthesia. METHODS: Sixty outpatients of ASA class 1 or 2 for microlaryngoscopy were randomly assigned to receive either anesthesia with propofol (Group P, n = 30) and thiopental-enflurane (Group E, n = 30). Group P was induced with propofol 2 mg/kg and succinylcholine 1 mg/kg and maintained with vecuronium 0.04 mg/kg, propofol 10 - 6 mg/kg/h, and N2:O2/3 L/min:2 L/min. Group E was induced with thiopental 5 mg/kg and succinylcholine 1 mg/kg and maintained with vecuronium 0.04 mg/kg, enflurane 1 3 vol%, and N2O:O2/3 L/min:2 L/min. Ketorolac (30 mg) and hydrocortisone (100 mg) were added for postoperative pain in both groups. The changes in blood pressure and heart rate, pre and post induction, were compared in both groups. In addition, we compared energence time and the state of recovery (Steward's score) 5 minutes and 15 minutes after extubation and the frequencies of other complications. RESULTS: No significant differences in age, wt, sex and anesthesia time of the two groups were observed. Mean arterial pressures were significantly different after anesthesia and after intubation between the two groups. However the heart rates were not different among the groups. The extubation time was significantly shorter in Group P. The recovery score at 5 min and 15 min after extubation was significantly higher in Group P. CONCLUSIONS: We conclude that propofol with nitrous oxide may be useful in laryngeal microsurgery, especially, when silence therapy is needed.
Anesthesia* ; Arterial Pressure ; Blood Pressure ; Enflurane ; Heart Rate ; Humans ; Hydrocortisone ; Intubation ; Ketorolac ; Laryngoscopy ; Microsurgery ; Nitrous Oxide ; Outpatients ; Pain, Postoperative ; Propofol* ; Succinylcholine ; Thiopental ; Vecuronium Bromide

A case of mucocele of the sphenoid sinus with blurred vision and headache is presented. Mucocele of the sphenoid sinus is relatively rare and benign. Accurate diagnosis is possible through Brain CT scan and MRI. But it should be included in the differential diagnosis of malignancy or pituitary tumor, and unnecessary treatment such as radiotherapy or craniotomy should not be performed. In this case, mucocele is extended into sella turcica which is markedly destroyed and eroded. We removed it by sublabial transseptal sphenoidal sinusotomy and drainage without difficulties and postoperative complications.
Brain ; Craniotomy ; Cytochrome P-450 CYP1A1 ; Diagnosis ; Diagnosis, Differential ; Drainage ; Headache ; Magnetic Resonance Imaging ; Mucocele* ; Pituitary Neoplasms ; Postoperative Complications ; Radiotherapy ; Sella Turcica ; Sphenoid Sinus* ; Tomography, X-Ray Computed

In order to evaluate the effecacy of 2D-Doppler echocardiography for the measurement of pulmonary flow(Qp), systolic flow(Qs), the ratio of pulmonary flow and systemic flow and systemic flow(Qp/Qs), 19 membranous ventricular septal defect patients were examined in the period from July, 1986 to October, 1987 at Ewha Women's university hospital. The measurement of Qp, Qs, Qp/Qs by 2D-Doppler echocardiography were compared with the results by the Fick's method of cardiac catheterization.The following results were obtained. 1) The total of the 19 patients consisted of 15 males and 4 females. The mean age of the patients was 8.2 years. 2) It was found that the Fick's method and 2D-Doppler measurements of Qp (n=19, r=0.67), Qs (n=19, r=0.88), and Qp/Qs ratio(n=19, r=0.62) were highly correlated(p<0.01). 3) It is understood that the measurement of Qp, Qs, Qp/Qs ratio by 2D-Doppler echocardiography were quite useful to the noninvative diagnosis of ventricular septal defect.
Cardiac Catheterization* ; Cardiac Catheters* ; Diagnosis ; Echocardiography* ; Echocardiography, Doppler ; Female ; Heart Septal Defects, Ventricular* ; Humans ; Male

Malignant rhabdoid tumor (MRT) is a rare and highly aggressive neoplasm of infancy and childhood. Although it was originally described and most frequently reported in the kidney, it may occur in various extra-renal sites such as the liver, thymus, and soft tissue. In the last decade primary central nervous system (CNS) MRTs have been reported in both the supra- and infratentorial compartments. Patients with CNS MRT were generally below the age of two and reports in adults are extremely rare. This is a case of primary cerebellar MRT in a 24-year-old woman, who had presented with intermittent headache, vocal cord palsy, and cerebellar dysfunctions such as abnormal finger to nose test and tandem gait. By magnetic resonance imaging scan, a well-enhancing solid mass was demonstrated at the posterior fossa filling the 4th ventricle, which extended into the medulla and cervical cord via the foramen of Magendie. Histologically, the monotonous polygonal tumor cells were arranged in diffuse sheet with occasional hemorrhagic necrosis. The nuclei were vesicular and eccentrically located due to eosinophilic, PAS-positive, intracytoplasmic inclusions with prominent nucleoli. They were diffusely or focally immunoreactive for vimentin, neurofilament, cytokeratin, GFAP, synaptophysin, and smooth muscle actin, while epithelial membrane antigen and desmin were negative. Ultrastructurally, the polyhedral tumor cells were densely packed with primitive intercellular junctions. Scanty fibrillar intermediate filaments were intermingled with cellular organelles. Postoperatively, craniospinal irradiation and systemic chemotherapy have been done and she has been free of tumor recurrence during the 13 months' follow-up periods.
Actins ; Adult* ; Central Nervous System ; Cerebellar Diseases ; Cerebellum* ; Craniospinal Irradiation ; Desmin ; Drug Therapy ; Eosinophils ; Female ; Fingers ; Follow-Up Studies ; Gait ; Headache ; Humans ; Intercellular Junctions ; Intermediate Filaments ; Keratins ; Kidney ; Liver ; Magnetic Resonance Imaging ; Mucin-1 ; Muscle, Smooth ; Necrosis ; Nose ; Organelles ; Recurrence ; Rhabdoid Tumor* ; Synaptophysin ; Thymus Gland ; Vimentin ; Vocal Cord Paralysis ; Young Adult