No abstract available.

No abstract available.
Gonadotropins* ; Oocytes*

A tibial plateau fracture was first described in the literature by Thamhayn, in 1852. It is a fracture of the proximal end of the tibia, usually involving an articular surface. The fracture is regarded as serious as it involves a major weight bearing joint and loss of function results in a high percentage disability of the extremity. Of the tibial plateau fractures treated at Hanyang University Hospital between June 1972 and August 1979, the 44 cases that could be followed for three months to two years have been analysed according to its cause, classification, treatment and result. Open reduction is indicated in anyone of or a combination of the following deformities as shown by roentgenograms: 1. a vertical depression in the plateau of greater than eight milimeters; 2. a horizontal displacement of the lateral or medial condyle of greater than four milimeters; 3. valgus or varus instability of the knee one or more milimeters in excess of that of the uninjured knee. Manipulation under anesthesia with skeletal traction is indicated in severe comminuted fracture that it is difficult to reduce with internal fixation, and open fracture that it is inevitable to delay operation. Plaster immobilization is indicated in the remaining situations except those of open reduction and skeletal traction. Anatomical considerations and a clinical end-result study of the 44 fractures emphasize the vulner-ability of the lateral tibial plateau to a valgus force on the extended knee. Among the 44 cases twenty-two (50 percent) were treated by plaster immobilization, 2 (4.5 percent) by skeletal traction, and 20 (45.5 percent) by operation. Thirty-nine cases (88.6 percent) out of 44 revealed the rating of “ACCEPTABLE” according to Hohl and Luck criteria.
Anesthesia ; Classification ; Clinical Study ; Congenital Abnormalities ; Depression ; Extremities ; Fractures, Comminuted ; Fractures, Open ; Immobilization ; Joints ; Knee ; Tibia ; Traction ; Weight-Bearing

OBJECTIVE: This study is aimed to evaluate the various clinical characteristics, prognostic factors, and the treatment results in epidural hematomas on posterior cranial fossa. METHODS: Thirty-two patients with posterior fossa epidural hematomas(PFEDH) were managed in our institute from 1992 to 2001. In the same period, 414 patients with traumatic epidural hematomas were surgically treated and among these, 28 cases(6.8%) were PFEDH. Neurological state, findings of computed topography scans, and results of the treatment were evaluated in this study. RESULTS: The patients' ages ranged from 4 to 60 years, with predominance in adolescents. The male to female ratio was 3: 1. Twenty-nine patients presented with occipital trauma and twenty-eight cases had fracture in occipital bone. Fourteen patients suffered immediate unconsciousness and 6 patients with initial alert mentality experienced delayed progressive loss of consciousness. However, there were no changes on mentality in 12 cases. In 14 cases, the hematoma was localized exclusively within the posterior cranial fossa. In remaining 18 cases, the hematoma extended beyond the sinuses to the occipital area. In 13 cases, the amount of hematoma was increased in follow-up computed tomographic scan. All patients, managed with surgery or conservative treatment(4 cases), survived with a good recovery. CONCLUSION: The most important prognostic factor is prompt surgical evacuation of hematomas. For attaining good result, earlier diagnosis with consecutive computed tomographic scans are much important.
Adolescent ; Cranial Fossa, Posterior* ; Craniocerebral Trauma ; Diagnosis ; Female ; Fibrinogen ; Follow-Up Studies ; Hematoma* ; Humans ; Male ; Occipital Bone ; Prognosis ; Unconsciousness

BACKGROUND AND OBJECTIVES: Stroke onset is known to vary by several factors. Although it has been known that stroke may develop most frequently in the morning, its association with the type of activity has quite rarely been described. METHODS: We prospectively investigated by interview the time of and the activity during or before the onset of stroke in patients with acute cerebral infarction from Aug. 1995 to Mar. 1996. The activities were subdivided into basal metabolic rate state, sedentary, light, moderate, and heavy movements based on the caloric expenditure. RESULTS: One hundred-twenty five patients were enrolled. The time of day when ischemic stroke most frequently occurred was from 8:00 AM to noon. The type of activity was significantly associated with stroke onset in that it developed most commonly during and just after sleep or resting. The relationship between the onset of stroke and such patterns of onset time and the activity was found only in the atherothrombotic infarction, but not in the other stroke types. CONCLUSION: We demonstrated that stroke has clear diurnal variation. Our observations also suggested that the activity may be significantly associated with stroke onset. These findings may be useful for better understanding of the pathogenesis and prevention of ischemic stroke.
Basal Metabolism ; Cerebral Infarction* ; Health Expenditures ; Humans ; Infarction ; Prospective Studies ; Stroke

Septic arthritis of the shoulder joint in a neonate is very rare. Damage to the growth plate and ossification center of the proximal humerus may lead to disability of the shoulder joint. Therefore, early diagnosis and proper treatment are very important. We treated septic arthritis of the shoulder joint in a 9-day old newborn baby by arthroscopic irrigation and debridement using a 2.4 mm wrist arthroscope instrument. We could achieve a satisfactory result by inspecting the inside condition of the joint directly, removing granulation tissues and debris and washing out the joint by arthroscopy.
Arthritis, Infectious ; Arthroscopes ; Arthroscopy ; Debridement ; Early Diagnosis ; Granulation Tissue ; Growth Plate ; Humans ; Humerus ; Infant, Newborn ; Joints ; Shoulder ; Shoulder Joint ; Wrist

No abstract available.
Heart Neoplasms*

No abstract available.
Tetracycline* ; Thyroid Gland* ; Thyroid Nodule*

A patient, 59 years old male, with paroxysmal AV reentrant tachycardia utilizing a concealed left lateral accessory pathway with long VA conduction time is presented. During tachycardia P waves were negative in leads I, aVL, and V6 and positive in leads aVR and V1. The R-P/P-R ratio was 1.6. Radiofrequency catheter ablation was successful to interrupt the VA conduction through the accessory pathway.
Catheter Ablation ; Humans ; Male ; Middle Aged ; Tachycardia*

BACKGROUND AND OBJECTIVES: Behcet's disease (BD) may develop variable neuro logic manifestations. We herein report patients with neuroBD with special reference to clinical, cerebrospinal fluid (CSF), and radiological findings. METHODS: Twenty-six patients, who fulfilled international BD criteria, were enrolled. Twenty-four of them fulfilled the criteriae at the time of, and another two at a three and four month follow up after presenting neurological manifestations. Twenty-two patients had CSF examination. All but three patients had imaging studies (CT scan in 7 and MRI in 16). RESULTS: Most patients with neuroBD presented with focal neurologic deficits, followed by meningitic symptoms and behavioral changes or cognitive dysfunctions. The common initial neurological symptoms or signs were hypereflexia, headache, dysarthria, and disturbances of eye movement in order of frequency. One or more parameters of CSF examinations were abnormal in all but two patients. Mean WBC count was 165+/-279/mm3 (9-1320). Nine of them were neutrophilic (polys >50%). Protein was mildly ele vated up to 155 mg/dI. Neuroimaging studies showed abnormal findings in 18 patients (75 %). Increased signal intensity on T2 weighted image was the most common finding. Basal ganglia, midbrain, pons and thalamus were the common sites of involvement in that of frequency. Although most patients had a lesion in the brain parenchyme or meninges, one patient had venous sinus thrombosis and another one had myelitis. Clinical outcomes were good in that all but three patients improved. However, 10 of them (38 %) recurred during their follow-up period of average 36 months. CONCLUSIONS: Our findings suggest that neuroBD may present with variable neurologic manifestations and show characteristic neutrophilic CSF findings and multifocal brainstem or diencephalon involvements. The frequent recurrence, despite their good clinical outcomes, points up the need for careful long-term neuologic observations.
Basal Ganglia ; Brain ; Brain Stem ; Cerebrospinal Fluid* ; Diencephalon ; Dysarthria ; Eye Movements ; Follow-Up Studies ; Headache ; Humans ; Logic ; Magnetic Resonance Imaging ; Meninges ; Mesencephalon ; Myelitis ; Neuroimaging ; Neurologic Manifestations ; Neutrophils ; Pons ; Recurrence ; Sinus Thrombosis, Intracranial ; Thalamus