Between sept. 1982 and June 1985, the authors have performed arthroscopic debridement on 32 knees of 30 patients with primary osteoarthritis of the knee. Operative procedures including lavage, partial meniscectomy, excision of shelf, partial or total synovectomy of the anterior compartment, debridement of the articular cartilage, removal of loose bodies and multiple drilling of the articular cartilage were variously combined case by case. The follow-up period was between 18 and 52 months, with on average of 30.6 months. Clinical results were evaluated with the modified method of Sprague, III and were classified “Excellent”. “Good”, “Fair” and “Poor”. The data were analyzed by Fishers exact test to clarify the relationship between clinical results and various preoperative factors. The results were as follows: l. Of the total 32 knees, results were “excellent” in 17(53.1%), “good” in 9(28.1%), “fair” in 3 (9.4%) and “poor” in 3(9.4%) knees respectively. Satisfactory results, including “excellent” and good, were achieved in more than 3/4 cases(81.2%) . 2. Of the 3 “poor” cases, 2 cases seemed to be affected by major depression and the other one case had no specific cause to be considered. 3. The unsatisfactory cases, including “fair” and “poor” cases, commonly had degenerative changes of patellofemoral joint arthroscopically although the correlation between it and the results were not significantly proved statistically(P>0.05). 4. The correlation between amount of effusion, degree of degeneration of articular cartilage and amount of fibrinoid debris were not significantly proved statistically(P>0.05). 5. The correlation between clinical results and amout of effusion. degreq or site of degeneration of articular cartilage, degree of flexion contracture, meniscal tear, synovectomy, debridement of articular cartilage and number of operative procedures could not be significanly proved statistically. In conclusion, arthroscopic treatment of the primary osteoarthritis of the knee shows relatively satisfactory results in most cases with fewcomplications and a short rehabilitation period, and the procedure could be recommended as a process inbetween conservative treatment and definitive treatment such as total knee replacement. But any specific relationship between clinical results and various preoperative factors could not be proved statistically. The clinical results seemed to be attected by individual unknown factors and further precise analysis and long term follow-up will be necessary to clarify them.
Arthroplasty, Replacement, Knee ; Arthroscopy ; Cartilage, Articular ; Contracture ; Debridement ; Depression ; Follow-Up Studies ; Humans ; Knee ; Methods ; Osteoarthritis ; Patellofemoral Joint ; Rehabilitation ; Surgical Procedures, Operative ; Tears ; Therapeutic Irrigation

Broncho-gastric fistula caused by benign gastric ulcer perforation after esophagectomy is very rare. In general anesthesia of a patient with broncho-gastric fistula, in spite of hyperventilation, leakage of the anesthetic gases through fistula may make the patient hypercapneic, and positive pressure ventilation may increase the risk of the pulmanary aspiration by the regurgitation of gastric fluid by stomach distension. For that reason, in this patient, denitrogenation was performed during patient's voluntary respiration with 100% oxygen for 5 minutes, and induction was performed without positive pressure ventilation, and one lung ventilation was carried out. Hypoxemia was followed by one lung ventilation because his pulmonary function was moderate obstructive type and his lung was damaged by aspiration of gastric fluid via broncho-gastric fistula. A low level of continuous positive airway pressure (CPAP) has no significant hemodynamic effect and can maintain the patency of nonventilated lung, so hypoxemia induced by one lung ventilation may be reduced. Thus we carried out one lung ventilation with CPAP (10 cmH2O) in nonventilated lung and blocked broncho-gastric fistula with a bronchial blocker for prevention of both regurgitation of gastric fluid and leakage of anesthetic gases. One lung anesthesia was performed without any problem in this case.
Anesthesia ; Anesthesia, General* ; Anesthetics, Inhalation ; Anoxia ; Continuous Positive Airway Pressure ; Esophagectomy ; Fistula* ; Hemodynamics ; Humans ; Hyperventilation ; Lung ; One-Lung Ventilation ; Oxygen ; Positive-Pressure Respiration ; Respiration ; Stomach ; Stomach Ulcer

No abstract available.
Biopsy, Fine-Needle* ; Breast*

A total of 110 computed tomographic scans of the brain in pediatric population were reviewed. They wereretrospectively analyzed focusing on the ventricular dilatation, widening of subdural space in frontal region andprominence of cerebral sulci in hemisphere. The results were compared with clinical recored. In the measurementbicaudate ventricular index waas above 0.18, which ws considered ventricular dilatation. The subdural space in thefrontal region and teh prominent cerbral sulci in the hemisphere were visualized among the cases aged over twoyears with clinical evidence of cerbral problem is pediatric population. The diagnostic application of CT to thecases of cerebral disorder in pediatric population is highly recommended.
Brain ; Dilatation ; Subdural Space

No abstract available.
alpha-Fetoproteins* ; Birth Weight* ; Immunoglobulins* ; Parturition*

No abstract available.
Catecholamines* ; Female ; Labor Stage, Second* ; Parturition* ; Plasma* ; Pregnancy ; Supine Position*

PURPOSE: It is well known that a high proportion of patients with cerebral palsy have neurogenic bladder. However, cystometry performed to determine the presence and type of neurogenic bladder is an invasive procedure. We evaluated the validity of uroflowmetry and postvoid residual urine volume as a screening tool for neurogenic bladder in children with cerebral palsy. MATERIALS AND METHODS: 34 children with cerebral palsy (range 6-13 years) were randomly selected for this study. Uroflowmetry and residual urine volume were deter mined at least twice in 22 children. Uroflow curve pattern was classified into normal, tower, plateau and staccato type. All patients underwent cystometry with sphincter elec tromyography. We analyzed relationship between the results of uroflowmetry and cystometry. RESULTS: Of the 34 patients, 23 (67.6%) children displayed upper motor neuron lesion of bladder. 11 (32.4%) had uninhibited contraction, 9 (26.5%) small capacity and con comitant detrusor-external sphincter dyssnergia was found in 3 (8.8%). Of 22 children who performed uroflowmetry, 13 showed abnormality. Staccato, tower, and plateau type of pattern was seen 11 (84.6%), 1 (7.7%), and 1 (7.7%) patient, respectively. The re maining 9 (40.9%) children were normal. Eleven of the 13 children with abnormal uroflow curve on uroflowmetry showed upper motor neuron lesion of bladder. Among 13 children with abnormal cystometric results, 11 reveal abnormal uroflow curves. 2 children (22.2%) displayed upper motor neuron lesion of bladder among the 9 children with normal uroflow curve. So, uroflowmetry reveal sensitivity 84.6%, specificity 77.8% for neurogenic bladder in cerebral palsied children. CONCLUSIONS: These results show a high rate of neurogenic bladder in children with cerebral palsy as in previous reports. Abnormalities on uroflow curve correlated well with abnormal cystometry findings. We believe that uroflowmetry is a viable noninvasive screening tool for the detection of neurogenic bladder in children with cerebral palsy.
Cerebral Palsy* ; Child* ; Humans ; Mass Screening* ; Motor Neurons ; Sensitivity and Specificity ; Urinary Bladder ; Urinary Bladder, Neurogenic* ; Urodynamics

No abstract available.
Leiomyosarcoma* ; Uterine Inversion*

No abstract available.
Fibronectins* ; Granulation Tissue* ; Wound Healing* ; Wounds and Injuries*

The Sertoil-Leydig cell tumor (SLCT) is gonadal tumor of sex-cord type, similar to that seen in the various phase of testicular development in the male. It is the most common type of all virilizing ovarian tumors and account for less than 0.5% of all ovarian tumors. A 26-year-old woman had an ovarian SLCT associated with an elevated level of serum AFP. The tumor had a heterologous element of intestinal-type mucinous epithelium, retiform and intermediately differentiated tubules of the Sertoli cell, and AFP-producing Leydig cells. After surgery, the serum AFP level of the patient fell to the normal range. We experienced a case of AFP producing SLCT, so we present it with a brief review of literature.
Adult ; alpha-Fetoproteins* ; Epithelium ; Female ; Gonads ; Humans ; Leydig Cells ; Male ; Mucins ; Ovarian Neoplasms ; Reference Values ; Sertoli-Leydig Cell Tumor*