The frequency of car accidents have contributed to increasing numbers and sevtrities of injuries to the supracondyle of the femur. the supracondylar fractures of the femur have always created complicated problems associated with restoration of the distal articular joint surface, avoidance of subsequent stiffness of the knee Joint, difflculties in management of the fracture. The author reviewed 31 supracondylar fractures of the femur in 31 patients who were treated in the department of Orthopedic Surgery, Kyungpook National University Hospital for the 6 and half years period from Jan., 1973 to Jun.,1979. The incidence of supracondylar fractures was more common in male than in female. Most of fractures occured in persons who are in their third and fourth decades. Ellciting cause were mainly traumatic and most of them were due to car accidents. The author has adopted the classification of supracondylar fracture of the femur by Neer. Of 31 cases of supracondylar fractures, there were 3 cases of Group 1 fracture, 10 cases of Group II-A fracture, 10 cases of Group II-B fracture, and 8 cases of Group III fracture. Sixteen cases were treated conservatively, 15 cases were treated by open reduction and internal flxation with various devices. The result was more satisfactory in cases by open treatment than In closed treatment.
Adult ; Classification ; Female ; Femur ; Gyeongsangbuk-do ; Humans ; Incidence ; Joints ; Knee Joint ; Male ; Orthopedics

Twenty-nine medical records of pneumothorax in newborns have been reviewed. These occurred during the 2 years from Jan. 1983 to Dec. 1984 at EWHU. The results were as follows 1) The incidence of pneumothorax in live births was 0.5%. 2) The incidence of pneumothorax was higher in full-term babies(65.5%), and more frequently in males(72.4%). 3) On radiologic evaluation, pneumothorax was 55.2% on the right side, 17.2% in both lungs and 20.7% associated with pneumomediastinum. 4) In newborns with pneumothorax, at one minute the Apgar Score of 0 to 2 was 34.5%, at five minutes the Apgar Score of 7 to 10 was 44.8%. 5) The motality of pneumothorax was 17.2%. 6) Within the first 24 hours in birth 83.8% of the pneumothorax in newborns had occurred. 7) The most common cause of pneumothorax in the newborn was meconium aspiration (58.6%) and incidence of postintubation pneumothorax 13.3%.
Apgar Score ; Humans ; Incidence ; Infant, Newborn* ; Live Birth ; Lung ; Meconium Aspiration Syndrome ; Mediastinal Emphysema ; Medical Records ; Parturition ; Pneumothorax*

No abstract available.
Gaucher Disease*

No abstract available.
Cholecystectomy* ; Cholecystectomy, Laparoscopic*

With advancement of endoscopical instruments and technique, gallstone diseases can be managed with laparoscopic cholecystectomy which has rapidly and radically changed the surgical treatment of gallstone diseases. The ideas of laparoscopic surgery was introduced by Germany gynecologist Semm, in 1967 and was first performed by French surgeon Mouret, Dubois in 1987. Although many reports of early laparoscopic cholecystectomy were excellent, many surgeons want to know the surgical results of laparoscopic cholecystectomy are enough good to perform comparing with the conventional cholecystectomy, especially in early complications and late complications. (continue...)
Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Gallstones ; Germany ; Laparoscopy

Porencephaly is a rare congenital anomaly characterized by a cavitary hole extending from the cerebral mantle to the ventricle of the brain and covered by leptomeningeal membrane. It is now generally believed that the porencephaly represents a fetal or neonatal destructive process of the neural tissue. Authors experienced an autopsy case of bilateral porencephaly in a 35-day-old Korean male infant who died of sepsis. The brain weighed 150 gms and morphologically well formed except for two large symmetric defects at the fronto-parietal region. These defects were characterized by cleft-like shape, covering the entire cerebral mantle with resultant direct communication between ventricular cavity and leptomeninges. Thin leptomeningeal trabeculae were covering the cavity. There was a smooth transition between ependyma and roof of the defects. There are focal, microscopic cerebral infarct and abscess without connection with the cavitary lesion. The remaining central nervous system was unremarkable.
Infant ; Male ; Female ; Infant, Newborn ; Humans

BACKGROUND: In recent years the duty of physician's explanation is involved in significant issues in the area of Medical Malpractice. The medicolegal aspects have become increasingly important as the Korean public has turned to the Courts for redness when their expectations of medical treatment are not met. The purpose of this paper is to set the duty to physician's explanation on medical treatment concerning the patient's consent by interpretations of our supreme court. METHODS: Interpretations of our supreme court in 9 cases were analyzed in legal aspects of physician's explanation on medical treatment. Also the causes and incidence of special anesthetic permission(SAP), and incidence of detailed explanation sheets(DES) were analyzed deparmentally. RESULTS: In 9 cases of interpretation of supreme court, 6 cases were recognized in consolation money due to violation of the duty to physician's explanation, 2 cases were recognized in consolation money and demand reparation for injury due to medical faults. CONCLUSIONS: The physician must provide full and appropriate explanation on meidcal treatment concerning the consent to patient, which is given the opportunity to ask questions or to make a choice if any is to be made.
Humans ; Incidence ; Jurisprudence ; Malpractice

A retrospective analysis was performed on 461 pediatric patients under one year of age who had received operation from 1983 to 1990 in department of anesthesiology of Ewha Womans University Hospital. Total number of operation showed incresing tendency, annually, 37 in 1983, 36 in 1984, 43 in 1985, 41 in 1986, 54 in l987, 89 in 1989, 81 in 1989, and 80 in 1990. The eletive and emergency operation com- prised 79% and 21%, respectively. The distribution of the patients by department was general surgery 217, plastic surgery l09, orthopedic surgery 23, neurosurgery l6, cardiothoracic surgery l6, urology 14, and otolaryngology 6. The average age distribution was 149 in 6.to l2 months, l00 in 1 to 3 months, 81 in 1 week to 1 month, 81 in 3 to 6 months, and 50 under 1 week of age. The male to female ratio was 2.7: l. The distribution of induction agents of general anesthesia was ketamine and succinylcholine (SCC) 317, without induction agent(awake intubation) 84, thiopental or diazepam and SCC 23, ketamine and pancronium or vecuronium l2. The most common technique of maintenence anesthesia was the balaced anesthesia. The distribution of disease entity by department was the following inguinal hernia was the most frequent in general surgery, cleft lip in palstic surgery, and hydrocephalus in neurosurgery. The postoperative complication developed in 31 of 461. The most common complications were the respiratory problems, the others were sepsis, heart failures, and convulsions. The motality rate was 1.73%.
Age Distribution ; Anesthesia ; Anesthesia, General ; Anesthesiology ; Cleft Lip ; Diazepam ; Emergencies ; Female ; Heart ; Hernia, Inguinal ; Humans ; Hydrocephalus ; Ketamine ; Male ; Neurosurgery ; Orthopedics ; Otolaryngology ; Postoperative Complications ; Retrospective Studies ; Seizures ; Sepsis ; Succinylcholine ; Surgery, Plastic ; Thiopental ; Urology ; Vecuronium Bromide

Succinylcholine, the short acting depolarizing muscle relaxant, is commonly used for endotracheal intubation. Succinylcholine induced hyperkalemia has been reported in patients with severe burn, massive traums, spinal cord injury, some neuromuscular diseases, and cerebral damage. In the present study, the serum potassium levels and ECG changes following intravenous injection of succinylcholine in three groups were investigated(group l: the patients without head injury, group ll: the patients with head injury with 24 hours, and group lll: the patients with head injury in 10~90 days). The results were as follows: 1) The serum potassium lovels increased significantly at 4 minutes, decreased slightly at 8 minutes and 10 minutes in group ll and lll(p<0.001). 2) The serum potassium levels(peak change ratio) were higher in group ll and lll than group l (between group l and ll, p<0.05: between group ll and lll, p<0.001). 3) Thwere were no significant differences between the maximal increase of K+ according to the degrees of consciousness. 4) Abnormal ECG finding following intubation appeared in fifty-five cases (91.7%). The amjority were sinus tachycardia in group 1 and ll and insignificant tall T wave in group ll.
Burns ; Consciousness ; Craniocerebral Trauma ; Electrocardiography ; Head Injuries, Closed* ; Humans ; Hyperkalemia ; Injections, Intravenous ; Intubation ; Intubation, Intratracheal ; Neuromuscular Diseases ; Potassium* ; Spinal Cord Injuries ; Succinylcholine* ; Tachycardia, Sinus

Direct laryngoscopy and endotracheal intubation is accompanied by mechanical stimulation of the laryngopharynx & by sympathetic timulation, as reflected by an increase in heart rate and blood pressure. The purpose of this study is to evaluate effects of certain drugs on blood pressure and heart rate during intubation. We intravenously administered some drugs prior to laryngoscopy and endotracheal intubation in adult patients with ASA class 1-2. Seventy-two patients were devided into four groups as follows: Group 1: Control group (none, n=18). Group 2: Lidocaine only (n=18). Group 3: Lidocaine (1 mg/kg) and d-Tubocurarine (3mg)(n=18). Group 4: Lidocaine (1mg/kg), d-Tubocurarine (3mg) and diazepam (0.1mg/kg)(n=18). Blood pressure, heart rate, mean arterial pressure, rate-pressure product, aterial blood gas were measured before induction, after induction, immediately after intubation and at 1, 2, 3 & 5 minutes after intubation. The results were as follows: 1) There were no significant differences in preinduction values of blood pressure, heart rate, rate-pressure product, arterial blood gas. 2) Systolic blood pressure increased significantly 2 minutes after the intubation in all groups and rapidly returned to the preinduction level in group 4, group 3 and then group 2 in that order compared to group l. 3) Diastolic and mean arterial pressure elevated significantly during intubation and rapidly retur- ned to the preinduction level in group 4, group 3 and then group 2 in that order compared to group l. 4) Heart rate increased significantly after the intubation in all groups and more rapidly returned to the preinduction levels 3 minutes after the intubation in group 4. 5) Rate-pressure product following the intubation was over 15,000 mmHg. beat/min in all groups, and more rapidly decreased 15,000 mmHg. beat/min at 2 minutes after the intubtion in group 4, 5 minutes after the intubation in group 3. 6) pH, PaCO2and PaO2values were within normal range following the intubation in all groups. In conclusion, it is suggested that the administration of lidocaine, d-tubocurarine and diazepam prior to the intubation is ideal for those patients with cardiovascular disease & increased intracranial pressure.
Adult ; Arterial Pressure ; Blood Pressure ; Cardiovascular Diseases ; Diazepam* ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Hypopharynx ; Intracranial Pressure ; Intubation* ; Intubation, Intratracheal ; Laryngoscopy* ; Lidocaine* ; Reference Values ; Tubocurarine*