The recent trend in method of long bone fracture had been toward bracing or closed medullary nailing except for certain fractures that fall within well-established surigcal criteria. Functional bracing is gaining widespread acceptance in management of tibial, femoral, and forearm fractures and is well suited to humeral shaft fractures. Twenty four cases of humeral shaft fractures were treated with functional brace and early mobiliza tion from October 19S2 to June 1984 at Busan National University Hospital and the results were as follows. 1. The fracture sites were composed of middle third in 15 cases, distal third in 6 cases, and proximal third in 3 cases and the fracture shapes were transverse in 10 cases, oblique and spiral in 5 cases respectively, and comminuted in 4 cases. 2. The average time from injury to functional bracing was 13.0 days and to discontinuance of the functional brace was 9.0 weeks. 3. Nonunions have not been encountered in all cases. The residual angulation was under 20degrees in all but one and the most common deformity was varus in 20 cases. Minimum limitation of motion, mostly a loss of the last few degrees of external rotation, was detected after follow-up of 2 months but did not present any clinical problem. 4. The achievement of rapid and uninterrupted osteogenesis without undesirable functional or cos- metic deficit could be listed as the advantage.
Braces ; Busan ; Congenital Abnormalities ; Follow-Up Studies ; Forearm ; Fractures, Bone ; Humerus ; Methods ; Osteogenesis

This is a report of 13 cases of surgically corrected ruptured aneurysm of the aortic sinus of Valsaha. The simultaneous trans-venous and trans-arterial catheterization and cineangiogram are the best diagnostic procedures. In 12 cases, the aneurysm originated from the right coronary sinus and only one from the noncoronary sinus. Eleven aneurysms ruptured into the right ventricle and 2 into the right atrium. Eight cases were associated with ventricular septa1 defect and 5 with aortic regurgitation. In three cases the Hancock porcine valve replacement was done. There was no surgical mortality.
Adolescent ; Adult ; Aortic Aneurysm/surgery* ; Aortic Rupture/diagnosis ; Aortic Rupture/surgery* ; Child ; Female ; Heart Catheterization ; Human ; Male ; Sinus of Valsalva/surgery*

BACKGROUND: Clonidine is an alpha2-adrenergic drug used for analgesic effect, reducing sympathetic stimulation and anesthetic requirement. We examined the analgesic effect of clonidine on incisional pain after its intrathecal administration using a rat postincisional model. METHODS: After an intrathecal (IT) catheter insertion in 20 Spraw Dawley rats, they were divided into two groups; one group (Group S, n = 10) received a saline 20microl injection through an IT catheter, and another (Group C, n = 10) received clonidine 20microgram in 10microl volume followed by another 10microl of saline for washing the catheter. The measurements of the threshold of tactile allodynia (TTA) were performed at 20, 40, 60, 80, 120, 180 and 240 mins after the IT injection. Additionally, 1, 2 and 3 days after the first IT injection, IT injection and the measurements of TTA of pre- and post-injection were repeated. The measurements of TTA were performed in both areas, 5 mm (N-area) and 10 mm (R-area) away from incision by using von Frey hair and up-down method. RESULTS: TTA (N-area) and TTA (R-area) during 4 hours after IT injection in Group C were greater than those in Group S (P< 0.05). TTA (N-area) of post-injection 2 and 3 days after the first IT injection were greater than those of pre-injection in Group C (P< 0.05), and TTA (R-area) after the IT injection 1, 2 and 3 days after the first IT injection were greater than those of pre-injection in Group C (P< 0.05). CONCLUSIONS: A single IT injection of clonidine 20microgram had analgesic effects lasting more than 4 hours in the rat postincisional model. Additional IT clonidine could show antiallodynic effects during three days after the first IT clonidine.
Animals ; Catheters ; Clonidine* ; Hair ; Hyperalgesia ; Rats*

No abstract available.
Angiography ; Arterial Occlusive Diseases ; Lower Extremity

OBJECTIVE: The purpose of this study was to investigate the risk factors of adhesive capsulitis and the effect of intra-articular steroid injection in spinal cord injured patients. METHOD: Fifty spinal cord injured patients participated in this study. The risk factors of adhesive capsulitis were compared between fourteen patients with adhesive capsulitis and thirty-six patients without one. Methylprednisolone acetate 40 mg mixed with 0.5% lidocaine 2 ml was given into glenohumeral joint space in adhesive capsulitis group and their pain and range of motion (ROM) were analyzed. RESULTS: 1) The incidence of adhesive capsulitis was higher in patients with higher injury level, older age and delayed start of rehabilitation therapy. 2) 10 cm visual analogue scale scores were significantly decreased after intra-articular steroid injection (p<0.01). 3) The shoulder ROM was increased after intra-articular steroid injection. The shoulder ROM at pre-injection was 126o in flexion, 113o in abduction, 64o in external rotation and 51o in internal rotation. The shoulder ROM at 4 weeks after injection was 138o in flexion, 131o in abduction, 74o in external rotation and 77o in internal rotation. CONCLUSION: There was a trend that the incidence of adhesive capsulitis was higher in patients with higher injury level, older age and delayed start of rehabilitation therapy. Further, it was suggested that intra-articular steroid injection was effective for reducing pain and improving ROM.
Adhesives* ; Bursitis* ; Humans ; Incidence ; Lidocaine ; Methylprednisolone ; Range of Motion, Articular ; Rehabilitation ; Risk Factors ; Shoulder ; Shoulder Joint ; Spinal Cord Injuries ; Spinal Cord*

Liver lacerations are the most common intra-abdominal injury that leads to death, and control of hemorrhage remains the primary problem in lowering mortality. The perihehatic packing is a important technique for selected patients with major liver injuries. A major problem associated with perihepatic packing has been the adherence of the laparotomy pads to the raw surface or the omentum, which leads to recurrent bleeding related to clot disruption and avulsion of the hepatic parenchyma when the packs are removed. We had the opportunity to prevent renewed bleeding using Steri-Drapes in patients with hepatic laceration. Reported here are the effectiveness of Steri-Drepes in perihepatic gauge packing.
Hemorrhage ; Humans ; Lacerations ; Laparotomy ; Liver ; Mortality ; Omentum

Surgical revascularization is very effective for the relief of chest pain, improvement of exercise tolerance and ventricular performance in certain ischemic heart diseases. Bypass graft angiography and native coronary angiography after coronary artery bypass graft(CABG) were required for the evaluation of graft patency, progression of the native coronary artery disease and to predict the prognosis of the patients after CABG. The cases included in this study involved 15 patients who underwent selective bypass graft angiography among 102 CABG cases. Thirty eight sites were bypassed by saphenous vein and two sites by internal mammary artery. The results were as follows: 1) The overall patency rate of the saphenous vein bypass graft was 76.3% and the two sites of the internal mammary artery bypass graft were both patent. 2) The patency rate of direct anastomosis was 86.2% and of sequential anastomosis, 44.4%. 3) In eight patients who underwent native coronary angiography, five patients showed progression of grafted coronary artery disease. Among them, two patients had accompanying progression of coronary artery disease in non-grafted vessels. 4) Follow up treadmill test performed in six patients showed improvement of exercise tolerance in all patients. 5) There was some increase in the ejection fraction of the left ventricle after CABG in six patients who received follow up left ventriculography.
Angiography* ; Chest Pain ; Coronary Angiography ; Coronary Artery Bypass* ; Coronary Artery Disease ; Coronary Vessels* ; Exercise Test ; Exercise Tolerance ; Follow-Up Studies ; Heart Ventricles ; Humans ; Mammary Arteries ; Myocardial Ischemia ; Prognosis ; Saphenous Vein ; Transplants*

The increasing use of the laparoscopic surgery in the management of gynecologic disease resulted in an increasing incidence of complication and the development of new complications. Incisional hernia through laparoscopic trocar site is an unusual complication of laparoscopy. A rare form of port-associated complication is omental herniation. This report describes a case of omental herniation through a 10-mm subumbilical incision following uneventful laparoscopic surgery.
Female ; Genital Diseases, Female ; Hernia ; Incidence ; Laparoscopy* ; Surgical Instruments

Dermoid cysts are the most common type of ovarian neoplasms occurring during a woman's reproductive life and account for 25% of all premenopausal ovarian neoplasms. Intraoperative spillage of dermoid cyst materials may lead to febrile morbidity, ileus, peritonitis, adhesion or fistula formation. Rarely, malignant element spillage, if present, may also lead to cancer dissemination. The management of dermoid cyst is controversal. Recently, laparoscopic surgery for ovarian cysts has been increasingly accepted. But, in view of the high risk of intraperitoneal rupture of large sized cysts, many surgeon still prefer the laparotomic approach. Recently, we did laparoscopic salphingo-oophorectomy to the patient having 20cm sized dermoid cyst. Intraoperative spillage of cyst material occurred, but patient recovered without any postoperative complication. So, we present this case with brief review of the literatures.
Dermoid Cyst* ; Female ; Fistula ; Humans ; Ileus ; Laparoscopy* ; Ovarian Cysts ; Ovarian Neoplasms ; Peritonitis ; Postoperative Complications ; Rupture ; Teratoma

PURPOSE: Under the proper program, day-case laparoscopic cholecystectomy is feasible in the aspect of postoperative recovery consisting of patient's satisfaction and postoperative complication. In this study, we plan a new protocol for laparoscopic cholecystectomy by analyzing factors that can reduce hospital days. METHODS: A total of 175 patients who underwent three-day laparoscopic cholecystectomy were initially selected. Out of 175 patients, secondary selection was executed using inclusion criteria. The selected patients were scheduled for new two-day laparoscopic cholecystectomy, and 89 patients were included in the data analysis. This study elucidated the comparative analysis between the discharged in the postoperative day 0 group and the postoperative day 1 group. RESULTS: The clinical characteristics were not significantly different between discharged in the postoperative day 0 group and the postoperative day 1 group. The combined diseases were not significantly different between the two groups. Post-operative complications in both groups were analyzed on the seventh day after the operation. No significant difference was observed between the two groups. Members of the patient group who were discharged on postoperative day 0 were given a survey regarding post-operative pain, desirability of discharge, and the level of satisfaction with patient education. The average score was 8.3 out of 10 points. In comparison of the total hospital cost between the two groups, the group discharged on postoperative day 0 had lower cost in all factors. CONCLUSION: We conclude that day-case laparoscopic cholecystectomy is as safe and effective as routine clinical pathway applied laparoscopic cholecystectomy in stable cardiovascular disease, uncomplicated pulmonary disease, and controlled DM patients.
Cardiovascular Diseases ; Cholecystectomy, Laparoscopic* ; Critical Pathways ; Hospital Costs ; Humans ; Lung Diseases ; Patient Education as Topic ; Postoperative Complications ; Statistics as Topic