No abstract available.

Arthroscopic synovectomy has some limitations for adequate posterior visualization, and it is difficult to establish the posterior portal because of potential damage to neurovascular structures. The purpose of this study is to introduce a newly designed arthroscopic technique passing through posterior septum and to review the arthroscopic synovectomy using transposterior septal portal in the knee. Routine arthroscopic examination of the knee joint is performed using standard anterolateral and anteromedial portals. Posterior arthroscopic technique is divided into four steps. The first step is to make a posteromedial portal. The second step is to make a posterolateral portal. The third step is to make a hole at the posterior septum and to examine the posterolateral compartment. The fourth step is to examine the posteromedial compartment by switching the arthroscope to the posterolateral portal in the same manner. This technique provides complete visualization of the posterior compartment of the knee joint including the posterior aspect of the medial and lateral femoral condyles, posterior horn of both menisci, the posterior cruciate ligament(PCL), the meniscofemoral ligament, posterior aspect of the popliteal tendon, and the posterior capsule. We reviewed 47 cases(of 43 patients) of arthroscopic synovectomy using anterolateral, anteromedial and transposterior septal portal. The results were assessed with follow up of at least 1 year using the criteria of pain, synovitis, effusion, and range of motion. In 15 case rheumatoid arthritis, we had good result in 14 cases, but 1 case of recurrence was noted at 2 months after surgery. Non specific synovitis, 11 cases, had the similar result of rheumatoid arthritis. In 9 cases with hemophilic arthritis, pain and effusion were improved, but range of motion was improved minimally. In 2 cases with gouty arthritis, 2 cases with tuberculous arthritis, and I case with pigmented villonodular synovitis(PVNS), range of motion was rather reduced. It is considered that arthroscopic technique using transposterior septal portal is safe procedure without damaging the PCL, posterior capsule, neurovascular structures, and very efficient method in removing hypertrophied synovium or debris of persistent synovitis or arthritis of the knee joint and helpful in removing encapsulated loose bodies located behind the PCL.
Animals ; Arthritis ; Arthritis, Gouty ; Arthritis, Rheumatoid ; Arthroscopes ; Arthroscopy ; Follow-Up Studies ; Horns ; Knee ; Knee Joint ; Ligaments ; Range of Motion, Articular ; Recurrence ; Synovial Membrane ; Synovitis ; Tendons

We have employed the external akeletal fixation devices, that is Hoffmann apparatus and Pin and Resin fixation method, for the treatment of 44 cases of long bone fractures from Dec. 1978 to Dec. 1981. The following are our impressins. 1. Hoffmann apparatus and Pin and Resin fixation method proved to be effective and useful measure for the management of fractures of long bones, particulary in cases of the open tibial fractures. 2. Employing the Hoffmann apparatus to the tibial model, the possible limit of correction of the fracture alignment was calculated. It was found that the average angle of correction of deformity can be managed up to 20 degrees in varus and valgus deformity, 70 degrees in anterior angulation, 40 degrees in posterior angulation and 70 degrees in rotation. 3. Pin and Resin fixation method is one of effective means in immobilization of long bones. It is simple to apply, easy to manipulate and inexpensive while offering fair fixation without much complications and therefore we recommend the method as the best alternative to expensive Hoffmann apparatus. 4. The complications of Hoffmann apparatus and Pin and Resin fixation method were pin tract infections and ankle stiffness which were generally minor and prevented by more careful aseptic technique and encouraging early joint motion.
Ankle ; Congenital Abnormalities ; Fracture Fixation ; Fractures, Bone ; Immobilization ; Joints ; Methods ; Tibial Fractures

No abstract available.
Humans ; Nephritis, Interstitial* ; Nephrotic Syndrome*

OBJECTIVE: To determine whether the somatostain analogue, octreotide, pretreatment before ovulation induction with human menopausal gonadotropin (hMG) affects ovarian response, and ovulation induction outcome in infertile patients with polycystic ovarian syndrome (PCOS) resistant to clomiphene citrate (CC) METHODS: From November 1998 to June 1999, 30 infertile patients with PCOS unresponsive to CC were randomly allocated either octreotide pretreatment (treatment group) (n = 15) or hMG alone (control group) (n = 15) groups. In the treatment group, 100 g of octreotide were administered daily for 7 days after progesterone injection for withdrawal bleeding, and then hMG was administered for ovulation induction. RESULTS: There were no differences in the total number of hMG ampules required and the duration of hMG administration between the two groups. The number of follicles of 10-14 mm diameter on the day of hCG injection was significantly less in the treatment group than that in the control group (4.3 +/- 2.5 vs. 9.6 +/- 4.4, p < 0.001). The serum estradiol (E2) level on the day of hCG injection was significantly lower in the treatment group, with 1579.2 +/- 421.0 pg/ml compared with 2120.3 +/- 512.7 pg/ml in the control group (p < 0.001). The hematocrit level on the day of hCG injection was also significantly lower in the treatment group than that in the control group (36.9 +/- 2.1% vs. 40.8 +/- 2.9%, p < 0.05). The incidence of severe ovarian hyperstimulation syndrome (OHSS) seemed to be lower in the treatment group, but the difference did not achieve significance (6.7% vs 20.0%). CONCLUSION: This study suggests that octreotide pretreatment before ovulation induction could improve hormonal milieu compared to hMG alone, and therefore may be effective in ovulation induction for patients with PCOS resistant to CC.
Clomiphene ; Estradiol ; Female ; Gonadotropins ; Hematocrit ; Hemorrhage ; Humans ; Incidence ; Octreotide ; Ovarian Hyperstimulation Syndrome ; Ovulation Induction* ; Ovulation* ; Polycystic Ovary Syndrome* ; Progesterone ; Somatostatin*

No abstract available.
Cisplatin* ; Hearing*

Investigations into the development of new therapeutic agents for lung inflammatory disorders have led to the discovery of plant-based alternatives. The rhizomes of Anemarrhena asphodeloides have a long history of use against lung inflammatory disorders in traditional herbal medicine. However, the therapeutic potential of this plant material in animal models of lung inflammation has yet to be evaluated. In the present study, we prepared the alcoholic extract and derived the saponin-enriched fraction from the rhizomes of A. asphodeloides and isolated timosaponin A-III, a major constituent. Lung inflammation was induced by intranasal administration of lipopolysaccharide (LPS) to mice, representing an animal model of acute lung injury (ALI). The alcoholic extract (50–200 mg/kg) inhibited the development of ALI. Especially, the oral administration of the saponin-enriched fraction (10–50 mg/kg) potently inhibited the lung inflammatory index. It reduced the total number of inflammatory cells in the bronchoalveolar lavage fluid (BALF). Histological changes in alveolar wall thickness and the number of infiltrated cells of the lung tissue also indicated that the saponin-enriched fraction strongly inhibited lung inflammation. Most importantly, the oral administration of timosaponin A-III at 25–50 mg/kg significantly inhibited the inflammatory markers observed in LPS-induced ALI mice. All these findings, for the first time, provide evidence supporting the effectiveness of A. asphodeloides and its major constituent, timosaponin A-III, in alleviating lung inflammation.
Acute Lung Injury ; Administration, Intranasal ; Administration, Oral ; Alcoholics ; Anemarrhena* ; Animals* ; Bronchoalveolar Lavage Fluid ; Herbal Medicine ; Humans ; Lung* ; Mice ; Models, Animal* ; Plants ; Pneumonia* ; Rhizome*

METHOD: 34 patients with a solitary pulmonary nodule less than 6 cm of its diameter who visited Samsung Medical Center from Semptember, 1994 to Semptember, 1995 were evaluated prospectively. Simple chest roentgenography, chest computer tomography, FDG-PET scan were performed for all patients. The results of FDG-PET were evaluated comparing with the results of final diagnosis confirmed by sputum study, PCNA, fiberoptic bronchoscopy, or thoracotomy. Results: (1) There was no significant difference in nodule size between malignant (3.1 1.5cm) and benign nodule(2.81.0cm)(P>0.05). (2) Peak SUV (standardized uptake value) of malignant nodules (6.93.7) was significantly higher than peak SUV of benign nodules(2.71.7) and time-activity curves showed continuous increase in malignant nodules. (3) Three false negative cases were found among eighteen malignant nodule by the FDG-PET imaging study and all three cases were nonmucinous bronchioloalveolar carcinoma less than 2 cm diameter. (4) FDG-PET imaging resulted in 83% sensitivity, 100% specificity, 100% positive predictive value and 84% negative predictive value. Conclusion: FDG-PET imaging is a new noninvasive diagnostic method of solitary pulmonary nodule that has a high accuracy of differential diagnosis between malignant and benign nodule. FDG-PET imaging could be used for the differential diagnosis of SPN which is not properly diagnosed with conventional methods before thoracotomy. Considering the high accuracy of FDG-PET imaging, this procedure may play an important role in making the dicision to perform thoracotomy in diffcult cases.
Adenocarcinoma, Bronchiolo-Alveolar ; Bronchoscopy ; Diagnosis ; Diagnosis, Differential ; Humans ; Proliferating Cell Nuclear Antigen ; Prospective Studies ; Radiography ; Sensitivity and Specificity ; Solitary Pulmonary Nodule* ; Sputum ; Thoracotomy ; Thorax

PURPOSE: To evaluate the usefulness of CT for determining the causes of intestinal obstruction followingsurgery for abdominal cancer. MATERIALS AND METHODS: CT scans were performed in 54 patients with benign (n = 25)or malignant (n = 29) bowel obstruction after surgery for abdominal malignancies ; the causes of obstruction wereconfirmed pathologically (n = 34) or clinically (n = 20). Three radiologists interpreted the CT scans andevaluated their accuracy, sensitivity, and specificity. Through analysis of CT findings, malignant and benignobstruction was compared with regard to the presence of mass or lymphadenopathy, bowel change, mesenteric change,ascites, and other ancillary findings. RESULTS: In distinguishing malignant from benign obstruction, thediagnostic accuracy achieved by three radiologists was 67%, 74%, and 78%. When there was a mass at the obstructedor prior surgical site, lymphadenopathy, an abrupt transitional zone, or irregular wall thickening at anobstructed site, malignant obstruction was suspected (P < .05) ; in the absence of a mass, CT findings ofmesenteric vascular engorgement, extensive ascites, a smooth transition zone and normal or smooth wall thickeningat the obstructed site suggested benign obstruction (P < .05). The presence of omental infiltration, mesentericinfiltration and metastatic lesions at other sites did not always indicate malignant obstruction. In addition,bowel wall thckness, luminal diameter and the interval between surgery and bowel obstruction were notstatistically significant. CONCLUSION: CT is useful for determining the causes of obstruction following surgeryfor abdominal cancer, though particularly when definite peritoneal mass is not demonstrated this usefulness inlimited.
Ascites ; Humans ; Intestinal Obstruction ; Lymphatic Diseases ; Phenobarbital ; Sensitivity and Specificity ; Tomography, X-Ray Computed

Splenic pseudocyst is a rare complication of abdominal trauma. Although it is rare, splenic pseudocyst is well-documented in the literature. According to the current classification, approximately 30% of all splenic cysts or pseudocysts result from direct abdominal trauma. In addition, chronic pancreatitis leads to change of nearby organs with possible acute and chronic complications including splenic lesions. This unusual complication can occur in both emergent and nonemergent conditions. The useful diagnostic procedures to assess intrasplenic pseudocyst are sonogram, CT scan, splenic scan, and occasionally angiography. However, definite diagnosis of pseudocyst is possible only after splenectomy when the absence of epithelial lining is confirmed histologically. Splenic pseudocyst requires surgical resection. We experienced a 31-year-old man who confirmed of warmness in the left side of back with left upper quadrant abdominal pain for several months. First impression was splenic lymphangioma based on CT scan and sonogram finding. Splenectomy was performed. Microscopic examination revealed splenic pseudocyst with fibrous capsule without epithelial lining.
Adult ; Cysts/*diagnosis/radiography/ultrasonography ; Diagnosis, Differential ; Humans ; Lymphangioma/diagnosis ; Male ; Splenectomy ; Splenic Diseases/*diagnosis/radiography/ultrasonography ; Splenic Neoplasms/diagnosis ; Tomography, X-Ray Computed