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

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*

Opiates have been used as analgesics in obstetrics since the Babylonian Sinee that time, a wide variety of opiates have been employed in an attempt to provide analgesia for childbirh. The effect of opioids on uterine contractility is of considerable interest. Morphine caused a concentration dependent decrease in the frequency of contraction of the estrous uterus, In contrast, both pethidine and pentazocine enhanced the contraction rate. The pregnant uterus showed little response to morphine, but exhibited an enhanced response to the stimulant activity of both pethidine and pentazocine.It has long been recognized that the tension development of uterine muscle is largely dependent on intracellular Ca2+ pools. Smooth muscle contraction is initiated by depolarization induced calcium entry into the myoplasm through voltage dependent calcium channels, The spontaneous or KC1-induced tension development in isolated uterine smooth musele is reduced by lowering the calium ion (Ca2+) concentration of the bathing medium. In our study, the effect of morphine, pethidine and pentazocine on estrous and pregnant uterine activity, and the effect of extracellular calcium on opiate induced uterine motility have been examined in rats in vitro The following results were obtained: 1) The frequency of contraction of the estrous and pregnant rat uteri in the control group decreased gradually with time. 2) Morphine caused a concentration- dependent decrease in the frequency of contraction of the estrous and pregnant rat uteri, but it was not significant 3) Pethidine and pentazocine caused a concentration dependent incrase in the frequency of contraction of the estrous and pregnant rat uteri.but it was not significant.4) Diazepam caused a concentration-dependent decrease in the frequency of contraction of the estrous and pregnant rat uteri. 5) Ketamine casued a concentration- dependent decrease in the frequency of contraction of the estrous and pregnant rat uteri, but it was not significant. 6) Addition of CaCI, to the Krebs Henseleit solution did not make any significant change in the result. 7) According to the condition of the estrous and pregnant rat uteri the change of contraction frequency was statistically significant in the control, morphine, pethidine and pentazocine groups.
Analgesia ; Analgesics ; Analgesics, Opioid ; Animals ; Baths ; Calcium ; Calcium Channels ; Diazepam* ; Female ; Ketamine* ; Meperidine ; Mice ; Morphine ; Muscle, Smooth ; Myometrium ; Obstetrics ; Pentazocine ; Rats* ; Uterus*

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

Isoflurane causes little myocardial depression, rapid onset and recovery during controlled hypotensive anesthesia. Nitroglycerin, vasodilating agent, has short plasma half-life and myocardial protective effect, is easy to cantrol, and has no direct toxic effect. Doxapram hydrochloride(doxapram Hcl), respiratory stimulant, has been found to be safe and significantly potent, but also has significant pressor effect when larger doses are administered. The purpose of this study was to evaluate the effects of doxapram on the hemodynamics after isoflurane and nitroglycerin-induced hypotensive anesthesia in dogs. Hemodynamic measurement including the value of left ventricular pressure, aortic pressure, pulmonary eapillary wedge pressure, pulmonary artery pressure, heart rate, cardiac output, maximal and minimal dP/dT were determined in 8 dogs before doxapram Hcl administration, Smin, 15min and 30min after doxapram Hcl administration. 1) Left ventricular pressure and aortic pressure increased at 5min and 15min after doxapram Hcl administration but did not change significantly at 30min compared to the preadministration values. 2) Pulmonary capillary wedge pressure and pulmonary artery pressure increased significantly at Smin and 15min, but did not change significantly 30min compared to the preadministration values. 3) Heart rate increased significantly at Smin, but did not change significantly at 15min and 30min compared to the preadministration value. 4) Cardiac output and body temperature did not change significantly at 5min, 15min compared to the preadministation values. 5) Maximal dP/dT increased signifieantly at Smin and 15min, but did not change at 30min compared to the preadministration value, minimal dP/dT increased significantly at 5min, but did not change at 15min and 30min compared to the preadministration value.
Anesthesia* ; Animals ; Arterial Pressure ; Arteries ; Body Temperature ; Cardiac Output ; Depression ; Dogs* ; Doxapram* ; Half-Life ; Heart Rate ; Hemodynamics* ; Isoflurane* ; Nitroglycerin* ; Plasma ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Ventricular Pressure

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