For the management of adult dysplastic hips with early degenerative arthritis, we can prevent further progress of secondary degenerative changes of the hip by a Rotational Acetabular Osteotomy, which effectively corrects the preoperatively inadequate acetabular coverage of the femoral head. Biomechanical advantages of this procedure are, l. An adequate coverage of tl; femoral head then enlarges the actual weight-bearing surface area, and so diminishes the resultant force per unit area of the acetabular weight-bearing surface and femoral head. 2. The resultant forces are also diminished by a medial shift of the femoral head. 3. The shearing force is decreased by the reduction of roof obliquity. 4. Because of the rotation of the original articular surface, remodeling the post-operative acetabular articular surface as Chiari operation is not necessary, and so can be performed even on elderly patients.
Acetabulum ; Adult ; Aged ; Head ; Hip ; Humans ; Osteoarthritis ; Osteotomy ; Weight-Bearing

The fibromatosis is a rare timorous with local invasion, but is not metastasized distantly. This term should not be applied to nonspecific reactive fibrous proliferations that are part of an inflammatory process of are secondary to injury of hemorrhage and have no tendency toward growth or recurrence. It arises principally from the connective tissue of muscle and overlying fascia or aponeurosis (musculoaponeurotic fibromatosis), and chiefly affects the muscle of shoulder, pelvic girdle, and extremity. The term 'aggressive fibromatosis' is also employed to describe this disease, but it is impossible to predict the clinical course in the individual case. The fibromatosis arising in the mediastinum is very rare, and the report about it is nearly absent. The plain radiography shows merely mass with soft tissue density. The CT demonstrates a poorly defined homogenous or heterogeneous mass, isodense with skeletal muscle on precontrast-images, and slightly hyperdense to muscle on postcontrast-scan. Accurate delineation between the tumor & surrounding tissue is vague or frequently impossible. The authors experienced one case of the mediastinal fibromatosis recently and report the case with review of concerned literature.
Connective Tissue ; Extremities ; Fascia ; Fibroma* ; Hemorrhage ; Indonesia ; Mediastinum ; Muscle, Skeletal ; Radiography ; Recurrence ; Shoulder

Percutaneous needle biopsy of pulmonary lesion with use of fluoroscopic guidance is well estabilished as a diagnostic tool but limited by the small size and inaccessibility of certain lesions. However, percutaneous needle biopsy'has been used increasingly in relation to advance and the salty of smaller biopsy needle and new imaging modalities such as ultrasound and CT. CT, because of its characteristics of high resolution, allows tissue sampling with considerable safty from area that heretofore could not be visualized under fluoroscopy. The authors summarized 44 pulmonary lesions that underwent CT-guided transthoracic biopsy with fine-needle over a 14 month period and analyzed the sensitivity of PTNB. -CT-guided PTNB was done with 20 gauge or 22 gauge Westcott biopoy needle (Mann medical products, USA). A diagnosis was made in 27 of 44 cases (61%) including malignany in 19 of 24 cases and benignancy in 8 of 20 cases. The pulmonary mass lesions were located at the peripheral zone of the lung field in 33 cases and at the central zone in 11 cases. Complications were observed in 2 cases which were pneumothorax and hemoptysis each but specific therapy was not required The sensitivity of PTNB by one session was 61% (27/44). The sensitivity of malignancy was 79% (19/24) and benignancy was 40% (8/20). These results suggest the usefulness of PTNB using fine needles be increased in eariler diagnosis and improved staging of pulmonary nodular lesions without significant complications.
Biopsy ; Biopsy, Needle* ; Diagnosis ; Fluoroscopy ; Hemoptysis ; Lung* ; Needles* ; Pneumothorax ; Ultrasonography

To keep the patent airway during a general anesthetic procedure or when handling an unconscious patient is the most important concern as well as responsibility and/or duty of the anesthesiologist. Many delicate operations could and can be performed because of the development of anesthetic techniques aad methods, especially through the introduction of endotracheal intubations. However, at times, an endotracheal tube can unfortunately be a hazardous instrument-lethal instead of lifesaving. The authors experienced a case of left main bronchial obstruction with a thick mucus plug immediately following the completion of oro-endotracheal intubation. This was successfully remedied by direct bronchoscopic aspiration under transtracheal spray. In such a circumstance as this, the newly designed instrument, namely; a bronchofiberscope, is a real necessity.
Humans ; Intubation ; Intubation, Intratracheal* ; Mucus*

Contusions ; Facial Bones ; Facial Nerve ; Facial Nerve Injuries ; Facial Paralysis ; Humans ; Incidence ; Lacerations ; Orbit ; Salivary Glands ; Skin ; Soft Tissue Injuries ; Wounds and Injuries

Intradural lipomatosis is a rare clinical entity characterized by excessive fat deposition in the intradural space. And they occur slightly more frequently in males. It may lead compression of the spinl cord or lumbargo, radiating pain, paresthesia, intermittent claudication and if they involve the cervical and thoracic region, the patients with tumours in these regions most frequently present with a slow ascending monoparesis or paraparesis, cutaneous sensory loss and defective deep sensation. Only 3% of tumours have been reported in the thoraco-lumbar region. The diagnosis should be based on a combination of clinical, imaging, surgical, and histological findings, and especially the diagnostic procedure of choice in patients with progressive myelopathy is MRI scan as it produces accurate imaging without exposure to ionizing radiation. He was treated surgically-removal of excessive fat tissue and decompressive laminectomy. We report a case of intradural lipomatosis that we had removed by surgically.
Diagnosis ; Humans ; Intermittent Claudication ; Laminectomy ; Lipomatosis* ; Magnetic Resonance Imaging ; Male ; Paraparesis ; Paresis ; Paresthesia ; Radiation, Ionizing ; Sensation ; Spinal Cord Diseases

In order to observe the development of ventricular arrhythmia during regional myocardial ischemia and reperfusion, especially under the presence or absence of ST-T electrical alternans on epicardial EKG. The proximal left descending coronary artery(LAD) was ligated for 20 minutes and then reperfused suddenly in twenty-three cats. Standard lead EKG(Lead??, chest lead EKG and epicardial lead EKG were recorded simultaneously during the occlusion and reperfusion respectively. During the ligation of LAD, STEA was observed in thirteen cats(56.5%). In occlusion period, the incidence of ventricular tachycardia in STEA positive group was significantly higher than in the negative group(p<0.01) and arrhythmic score was significantly higher(p<0.005) also In the reperfusion period the incidence of vefntricular fibrillation in STEA positive group was significantly higher than in the negative group(p<0.025). But there was the tendency to be higher in arrhythmic score of STEA positive group. There were no differences in heart rate, systolic left ventricular pressure, ST elevation and ST width in both groups. Most forms of ST-T of sinus rhythm before and after development of ventricular premature beat was low form(L). It was concluded that at the presence of STEA on EKG, the incidence of ventricular arrhythmia was more prevalent. So, STEA can be available as a marker of ventricular arrhythmia and prognostic factor.
Animals ; Arrhythmias, Cardiac* ; Cardiac Complexes, Premature ; Cats ; Electrocardiography* ; Heart Rate ; Incidence ; Ligation ; Myocardial Ischemia ; Reperfusion ; Tachycardia, Ventricular ; Thorax ; Ventricular Pressure

No abstract available.

A study on changes of serum HDL-cholesterol level in various diseased states was performed. Diseased groups were nephrotic syndrome, liver cirrhosis, hyperthyroidism, hypothyroidism and chronic alcoholism. Following results were obtained. 1) Compared to normal control group, levels of HDL-cholesterol in nephrotic syndrome were lower but the difference was significant statistically. 2) In liver cirrhosis, the result showed much lower levels than normal control group with high significance. 3) In both hyper-and hypothyroidism group, the levels of HDL-cholesterol were significantly lower than normal control group. 4) In chronic alcoholism, the levels were significantly higher than normal control group. 5) Except for the group of chronic alcoholism, the levels of HDL- cholesterol were higher in female groups than male groups, but was of no significance statistically.
Alcoholism ; Cholesterol ; Female ; Humans ; Hyperthyroidism ; Hypothyroidism ; Liver Cirrhosis ; Male ; Nephrotic Syndrome

A procedure descried by Fontan and Baudet in 1971 successfully bypassed the right ventricle in Tricuspid Atresia patients, after then many modification of the Fontan operation had been described and applied to many cyanotic complex heart patients. Forty patients with a variety of cardiac malformation underwent the Fontan operation at Seoul National University hospital (September 1978 to June 1986). The age at operation ranged 2 months to 18 years. Each number of cases according to basic cardiac anomaly was as follows; 17 in Tricuspid Atresia, 17 in Univertricular Heart, 2 in Double outlet of Right Ventricle, 2 in Transposition of the Great Arteries and 2 in Criss-cross heart. Total mortality rate after the Fontan operation was 50%. There was only one late death (>30 days). Mortality rate under 4 years of age (67%) was higher than that between 4 and 18 years of age (40%). we observed a significantly higher mortality for patients who, in the immediate postoperative period, had central venous pressure greater than 25cm H2O. 45% among survivals did not require further medication. Although mortality rate after the Fontan operation is much higher than that in the foreign literature, operative mortality will decline with the increased expirence of surgeon and the effective patients selection.
Arteries ; Central Venous Pressure ; Crisscross Heart ; Fontan Procedure* ; Heart ; Heart Ventricles ; Humans ; Mortality ; Postoperative Period ; Seoul ; Tricuspid Atresia