No abstract available.
Cholecystectomy, Laparoscopic*

A primary infection of the intervertebral disc in adult is an uncommon entity. Usually these patients are not actually ill and their symptoms have been present for some months. Pyogenic infection of the intervertebral disc in children was well documented by a number of authors,but this condition was less well recognized in the adult. We analysed 12 cases of discitis in adults which were treated at the Department of Orthopedic Surgery of Severance Hospital for 10 years from January 1975 to March 1984 by curettage and autogenous iliac bone graft through anterior approach. The results obtained from this study were as follows: 1. The average duration of symptoms before diagnosis was 9.6 months. 2. The lumbar spine was involved in 83% and next in thoracic spine. 3. The most prominent symptoms and signs are backache and local tenderness at the site of the lesion. 4. Ten patients had the preceding disease or definile past history of previous back surgery, myelogram, abscess, urinary tract infection, heavy lifting and back trauma. 5. The white cell count was of little value in the initial investigation, but the E.S.R. was raised in 67%. 6. Positive cultures from the intervertebral disc were obtained in 8 cases(67%). The causative organisms were 5 Staphylococcus, 2 E-coli, and 1 Pseudomonas aeruginosa. 7. The most common radiological finding on admission was narrowing of the intervertebral disc space, and the tomogram showed the most reliable finding for the preoperative diagnosis. 8. In the treatment, focal curettage or diskectomy and anterior fusion with autogenous iliac bone graft was done in all cases. Antibiotics were administrated for 4 to 10 weeks (average 5.5 weeks) after operation and the cast or brace was applied for immobilization. 9. Over-all clinical result were as follows; eight patients (67%) excellent, 3 patients good, 1 patient fair, and no recurrence.
Abscess ; Adult ; Anti-Bacterial Agents ; Back Pain ; Braces ; Cell Count ; Child ; Clinical Study ; Curettage ; Diagnosis ; Discitis ; Diskectomy ; Humans ; Immobilization ; Intervertebral Disc ; Lifting ; Orthopedics ; Pseudomonas aeruginosa ; Recurrence ; Spine ; Staphylococcus ; Transplants ; Urinary Tract Infections

PURPOSE: To evaluate the necessity for repair of associated deltoid ligament rupture in lateral malleolar fracture. MATERIALS AND METHODS: Twenty of twenty-five patients were evaluated. Each received surgical treatment without repair of the ruptured deltoid ligament. We found that the medial clear space was widened more than 5 mm in intraoperative stress tests which had been done between May 2003 and June 2008. We did follow-up on these patients for more than 1 year after surgery. At the final follow-up, radiologic and clinical assessment were evaluated on plain X-ray and according to Olerud Molander ankle scores. RESULTS: Open reduction and internal fixation of the lateral malleolar was done in all cases and an additional transfixation screw was needed in 17 patients who had concurrent syndesmotic disruption. Average medial clear space widening before surgery was 9.28 mm (7.0-17.14 mm), at final follow-up time it was 3.43 mm (2.9-5.28 mm). And there were 8 (40%) good, 10 (50%) fair and 2 (10%) poor ratings on radiologic evaluation, but the mean clinical score was 93.75, with 17 (85%) being excellent, 2 (10%) good and 1 (5%) fair on clinical evaluation. CONCLUSION: In the treatment of lateral malleolus fracture associated with disruption of the deltoid ligament, satisfactory clinical results could be obtained including lateral joint stability, with accurate anatomical reduction and internal fixation of the lateral malleolus and distal tibio-fibular joints. Medial joint stability could be obtained without deltoid ligament repair.
Animals ; Ankle ; Exercise Test ; Follow-Up Studies ; Humans ; Joints ; Ligaments ; Rupture

We recently observed an unusual case of visual loss after periocular injection of silicone oil. A 31-year-old woman immediately experienced total loss of vision in the left eye with ipsilateral headache and ocular pain, dyspnea, abdominal pain, general weakness, and transient coma after subcutaneous injection of silicone oil on the glabellar area to reduce the facial wrinkles. We believe that the cause of blindness was multiple embolization in the central retinal artery and posterior ciliary branches of the ophthalmic artery.
Abdominal Pain ; Adult ; Blindness* ; Coma ; Dyspnea ; Female ; Headache ; Humans ; Injections, Intraocular ; Injections, Subcutaneous* ; Ophthalmic Artery ; Retinal Artery ; Silicone Oils*

Since coronary arteriovenous fistula(CAVF) was first reported by Krause in 1865, more than 400 cases have been reported. It is relatively rare disease and originates more commonly in the right than in the left coronary artery. We report a case of CAVF between right coronary artery and right ventricular inflow tract with significant left to right shunt in a 34-year old female who was admitted for the cardiomegaly on routine chest X-Ray. It was detected by transthoracic and transesophageal echocardiography, and confirmed by cardiac catheterization and coronary angiography. The opening of the fistula draining into the right ventricle was obliterated with sutures. There was no significant shunt in postoperative cardiac catheterization and coronary angiography.
Adult ; Arteriovenous Fistula* ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomegaly ; Coronary Angiography ; Coronary Vessels ; Echocardiography ; Echocardiography, Transesophageal* ; Female ; Fistula ; Heart Ventricles ; Humans ; Rare Diseases ; Sutures ; Thorax

The authors analyzed 52 patients with traumatic cervical fracture and dislocation admitted to the department of neurosurgery, Gyeongsang National University Hospital between July, 1989 and December, 1993. The most common age group was 21-30 years old, and 46 were male. The most frequent cause of injury was motor vehicle accident. High cervical injuries were 11 cases and mid-low cervical injuries were 41 cases. 34 cases had surgical intervention by anterior approach with bone graft only(5), anterior approach with bone graft and instrumentation(9), posterior approach with wiring and bone graft(18) and total laminectomy(2). The others had conservative treatment and immobilized by traction(9), Halo-vest(8) or neck collar(1). The average post of immobilization of conservatively treated patients was 9.7weeks, anterior approach without instrumentation was 9 weeks and posterior approach was 5.4 weeks, but patients who treated by anterior approach with instrumentation keep soft collar only. At final follow-up, no significant differences were noted between surgically and conservatively treated group but initial neurologic state correlates with prognosis, independent of modality of treatment. Thus the surgical intervention does not significantly influence the prognosis of the patient but shortens the duration of postoperative immobilization.
Dislocations* ; Follow-Up Studies ; Humans ; Immobilization ; Male ; Motor Vehicles ; Neck ; Neurosurgery ; Prognosis ; Transplants

PURPOSE: This study investigated the incidence of adverse events (AEs) and risk factors associated with sedation using chloral hydrate (CH) for brain magnetic resonance imaging (MRI) in the neonatal intensive care unit (NICU). METHODS: This was a retrospective study of infants who received CH for brain MRI in the NICU. Among the enrolled infants (n=143), 12.6% (n=18) were included in the AE group and 87.4% (n=125) were in the non-adverse event group (NAE). RESULTS: Gestational age (GA) at birth and corrected GA at sedation were 35+0±7+2 and 39+5±3+1 respectively. The rate of AEs was 12.6%, included oxygen desaturation (5.6%), aspiration (4.9%), paradoxical agitation (0.7%), tachycardia or bradycardia (0.7%), and arrest (0.7%). In univariate analysis, the AE group was younger in corrected GA at sedation than the NAE group (37+2 [range, 36+0 to 40+0] vs. 40+1 [range, 38+2 to 41+4], P=0.015). There was no significant difference in CH dosage (50.0 [range, 50.0 to 50.0] vs. 50.0 [range, 50.0 to 50.0], P=0.092), cardiopulmonary (33.3% [n=6] vs. 17.6% [n= 22], P=0.209) and central nervous system (61.1% [n=11] vs. 65.6% [n=82], P=0.054) morbidity. In multivariate analysis, CH dosage was the only significant risk factor for AEs associated with sedation (odds ratio, 1.04; 95% confidence interval, 1.01 to 1.07; P=0.0186). CONCLUSION: AEs associated with sedation using CH are not uncommon and should be considered when using high dose CH for diagnostic testing in the NICU.
Bradycardia ; Brain ; Central Nervous System ; Chloral Hydrate ; Diagnostic Tests, Routine ; Dihydroergotamine ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Magnetic Resonance Imaging ; Multivariate Analysis ; Oxygen ; Parturition ; Retrospective Studies ; Risk Factors ; Tachycardia

A study carried out to evaluate the bleeding control and prophylactic effect of rebleeding using emergency endoseopic sclerotherapy in patients with hleeding gastric varices. 42 patients with gastric variceal bleeding were admitted to the Yeungnam University Hospital from May, 1983 to August, 1992. Patients were randomly classified into control group, 20 patients treated with conservative management, and sclerotherapy group, 22 patients treated with emergency endoscopic sclerotherapy. The two group were analysed with age, sex, etiology of liver cirrhosis, nature of bleeding episode, hematocrit on admitting day, amount of sclercsants used, rebleeding episodes, complications, and mortality. There were no significant differences in the severity of underlying liver disease and hematocrit on admission between two groups. Blood transfusion were performed in 19 cases of control group and 21 cases in sclerotherapy group(p>0.05). The amounts of transfusion were 7. 7units in control group and 6.1 units in sclerotherapy group(p<0,05). Rebleeding were developed in 65% and 18% of the patiehts with control and sclerotherapy group, respectively(p<0.05). Chest pain and mild fever were observed after endoscopic sclerotherapy. These results suggest that the endoscopic sclerotherapy is effective method in hemostasis of bleeding gastric varices and short-term prevention of rebleeding, but mortality rate was not decreased compared to control group. Development of more effective methods to treat gastric variceal bleeding is required.
Blood Transfusion ; Chest Pain ; Emergencies ; Esophageal and Gastric Varices* ; Fever ; Hematocrit ; Hemorrhage* ; Hemostasis ; Humans ; Liver Cirrhosis ; Liver Diseases ; Mortality ; Sclerotherapy*

OBJECTIVE: To determine the heating characteristics of needle-shaped duplex stainless steel thermoseeds, and to evaluate their effectiveness in the induction of hyperthermia in rabbit liver. MATERIALS AND METHODS: Thermoseeds of the two different shapes, L-shaped for single doses of hyperthermia and I-shaped for in-vitro study and repeated hyperthermic induction, were prepared. For the in-vitro study, an I-shaped thermoseed 0.23 mm in diameter and 25 mm long was placed inside a plastic tube filled with water. Heat was applied for 30 minutes within an induction magnetic field, and during this time changes in temperature were recorded using three thermocouples. For the in-vivo study, fifteen New Zealand white rabbits were divided into five equal groups. An I-shaped or L-shaped thermoseed was inserted in each rabbit's liver, and then placed within the center of the magnetic induction coil during a 30-minute period of hyperthermia. The rabbits in the first group were sacrificed immediately after hyperthermia was induced once, while those in the other groups were sacrificed at 1, 3, and 7 days, respectively, also after one induction. The remaining three rabbits were sacrificed 4 days after three consecutive daily treatment sessions. The resected segments of liver were subsequently evaluated histopathologically for the extent of coagulation necrosis caused by heating of the thermoseed. RESULTS: The in-vitro study demonstrated that the temperature in the thermoseed, which was 25.9 degree C before heating and 54.8 degree C after heating, rose rapidly at first but progressively less rapidly as time elapsed. Light microscopic examination of the rabbits' livers revealed coagulation necrosis and infiltration by inflammatory cells around the insertion site of the thermoseed. The maximum diameter of coagulation necrosis was 2.81+/-1.68 mm, and this occurred in the rabbits that were sacrificed 7 days after heat induction. CONCLUSION: Needle-shaped duplex stainless steel thermoseeds show temperature-dependent-type heating characteristics, and in rabbit liver, induced coagulation necrosis of surrounding tissues after heat is applied for 30 minutes. These thermoseeds may thus be useful for the induction of interstitial hyperthermia.
Animal ; *Body Temperature ; Hyperthermia, Induced/*instrumentation ; Liver/pathology/*physiology ; Necrosis ; Rabbits ; Stainless Steel ; Support, Non-U.S. Gov't

PURPOSE: Transurethral resection of the prostate (TURP) is the gold standard for the surgical treatment for benign prostatic hyperplasia (BPH), but the procedure's limitations are its invasiveness and the high prevalence of complications. Photoselective vaporization of the prostate (PVP) using an 80w high power potassium-titanyl-phosphate (KTP) laser has recently been developed as a less invasive treatment. We assessed the efficacy of PVP as an alternative to TURP for the treatment of BPH. MATERIALS AND METHODS: The medical records of 324 patients who were surgically treated for BPH from July 2005 to December 2007 were retrospectively reviewed. Among the 324 patients, 190 patients of Group I were treated by TURP and 134 patients of Group II were treated by PVP. Before treatment, assessing the serum PSA level transrectal ultrasound and urodynamic study were done. The primary efficacy parameters were the postoperative international prostatic symptom score and the uroflow parametersat 6 months after the operation. The secondary efficacy parameters were perioperative factors such as the duration of the hospital stay, the operative time and the catheter-indwelling period. Any adverse reactions were monitored. RESULTS: There was no significant difference in the basal characteristics of the study subjects between both the groups. The primary efficacy parameters, the IPSS, the Qmax and thepostvoid residual urine volume were significantly improved in both groups, but there were no significant differences between both the groups. In group II, the perioperative parameters such as the operation time, the hospitalization day and the catheter-indwelling periodwere significantly shorter than those of group I (p<0.05). But the urethral complications such as urethral stricture, dysuria and bladder neck contracture were more common in group II. CONCLUSIONS: These results suggest that PVP using an 80w high power KTP could be an alternative for TURP in terms of efficacy. For the general, safe use of PVP, PVP should be carefully done until the causes of the urethral complications of PVP are determined.
Contracture ; Dysuria ; Hospitalization ; Humans ; Laser Therapy ; Length of Stay ; Medical Records ; Neck ; Operative Time ; Prevalence ; Prostate ; Prostatic Hyperplasia ; Retrospective Studies ; Transurethral Resection of Prostate ; Urethral Stricture ; Urinary Bladder ; Urodynamics ; Volatilization