No abstract available.
Compliance* ; Humans ; Psychopathology*

No abstract available.
Tibial Fractures*

Bilateral popliteal artery entrapment syndrome is a rare vascular disease, which leads to ischemic claudication as a result of disturbance to the blood flow from the abnormal relationship of the popliteal artery to the gastrocnemius muscle, a fibrous band or the popliteus muscle in the young male population. A 58-years-old male patient, complaining of ischemic claudication, coldness and 3rd toe gangrene of left leg of 1 month's duration was admitted to our institution. His left ankle-brachial index was decreased; therefore, a femoral artery angiography was performed, which revealed a total occlusion below the distal superficial femoral artery of the left leg. An EKG revealed atrial fibrillation, suggestive of a thromboembolism of the popliteal artery due to atrial fibrillation; therefore, Urokinase thrombolysis was attempted. After the Urokinase thrombolysis, popliteal artery entrapment syndrome was diagnosed, with MRI then performed for an anatomical diagnosis. The popliteal artery entrapment was type I, where the popliteal artery was displaced medial to the Gastrocnemius head. After complete removal of the popliteal artery aneurysm, interposition was performed with a contra lateral greater saphenous vein graft. A mild right popliteal artery aneurysm still remained, but surgery was not performed. Currently, the patent is surviving, without complications. Herein, the good results obtained for the surgical treatment of a severely affected leg, and the conservative treatment of a mildly affected leg, are reported.
Aneurysm ; Angiography ; Ankle Brachial Index ; Arrhythmias, Cardiac ; Atrial Fibrillation ; Diagnosis ; Electrocardiography ; Femoral Artery ; Gangrene ; Head ; Humans ; Leg ; Magnetic Resonance Imaging ; Male ; Muscle, Skeletal ; Peripheral Vascular Diseases ; Popliteal Artery* ; Saphenous Vein ; Thromboembolism ; Toes ; Transplants ; Urokinase-Type Plasminogen Activator ; Vascular Diseases

A retrospective analysis was performed on the 968 cases of fetal or pediatric autopsies over five year period (1990-1994), at the Seoul National University Children's Hospital. Age/mode distribution of cases were artificial abortus(30.6%), spontaneous abortus(12.0%), stillbirth(21.9%), neonates(29%), infants(2.8%) and children(0.9%). Male/female ratio was 1.21. Overall incidence of congenital anomalies was 60.8% and 34.0% of all cases had anomalies involving multiple organ systems. Percentage of cases with any anomaly was 71.6% in artificial abortus, 35.3% in spontaneous abortus, 59% in still births, 65.5% in neonates and 38.9% in infant and children. Common organ systems involved were the cardiovascular system (39.0%), musculoskeletal system (23.6%), nervous system (22.6%), gastrointestinal system (19.9%), and urinary system (14.6%). From these results, we found that the congenital anomalies were most significant diseases of the perinatal period and the cardiovascular anomalies were the most common anomalies of them.
Autopsy* ; Cardiovascular Diseases ; Cardiovascular System ; Child ; Humans ; Incidence ; Infant ; Infant, Newborn ; Musculoskeletal System ; Nervous System ; Parturition ; Perinatal Mortality ; Retrospective Studies ; Seoul*

A retrospective analysis was performed on the 968 cases of fetal or pediatric autopsies over five year period (1990-1994), at the Seoul National University Children's Hospital. Age/mode distribution of cases were artificial abortus(30.6%), spontaneous abortus(12.0%), stillbirth(21.9%), neonates(29%), infants(2.8%) and children(0.9%). Male/female ratio was 1.21. Overall incidence of congenital anomalies was 60.8% and 34.0% of all cases had anomalies involving multiple organ systems. Percentage of cases with any anomaly was 71.6% in artificial abortus, 35.3% in spontaneous abortus, 59% in still births, 65.5% in neonates and 38.9% in infant and children. Common organ systems involved were the cardiovascular system (39.0%), musculoskeletal system (23.6%), nervous system (22.6%), gastrointestinal system (19.9%), and urinary system (14.6%). From these results, we found that the congenital anomalies were most significant diseases of the perinatal period and the cardiovascular anomalies were the most common anomalies of them.
Autopsy* ; Cardiovascular Diseases ; Cardiovascular System ; Child ; Humans ; Incidence ; Infant ; Infant, Newborn ; Musculoskeletal System ; Nervous System ; Parturition ; Perinatal Mortality ; Retrospective Studies ; Seoul*

Ankle fractures in children often involve the physis. They are of particular importance because partial or entire growth arrest can occur and result in significant complications. We followed thirty-four ankle fracture involving distal physis of tibia and fibula for more than 1 year and analyzed them using the modified Salter-Harris classification, the Dias-Tachdjian classification and the type of fracture (closed or open), Complications occurred in eight cases (23.5%) – two of twenty-six closed fractures (7.7%) and six of eight open fractures (75%). The complications were more significant in open fractures. Angular deformity (5 cases), limb-length discrepancy (4 cases), incongruity of the joint surface (2 cases), fibular overgrowth (2 cases) and synostosis (1 case) occurred alond or combined. In three cases of them we performed surgical management (bone bridge resection or/and supramalleolar corrective osteotomy) and had satisfactory results. This study suggests that the incidence of complications is difficult to anticipate, but is correlated with severity of initial injuries of growth plate and soft tissue, and is much higher in open fracture. After physeal injury, children should be followed until skeletal maturity and the severe deformities can be prevented by early detection and correction of growth plate disturbance.
Ankle Fractures ; Ankle ; Child ; Classification ; Congenital Abnormalities ; Fibula ; Fractures, Closed ; Fractures, Open ; Growth Plate ; Humans ; Incidence ; Joints ; Synostosis ; Tibia

Twenty one patients with multiple, large or recurrent superficial bladder cancer were treated with intravesical Mitomycin C instillation after TUR, and another 22 patients were treated with TUR alone The Mitomycin C group and control group were statistically identical in tumor size, grade, multiplicity and recurrences. Mean follow-up period were 13.9 months in Mitomycin C group and 23.2 months in controls. Recurrence rate was 42.9% in Mitomycin C group, and 40.9% in controls during the first 3 months and it was 66.7% and 68.2% respectively during the 12 months. Recurrences per 100 patient months was lO.1 and 9.6 respectively and the interval between the treatment and the first recurrence was 6.69 and 7.28 months respectively. Two of 21 patients in Mitomycin C group and 4 of 22 patients in controls had recurrent tumors with progression in stage during the follow-up period. There was no significant difference between the 2 groups. Therefore we can conclude that intravesical Mitomycin C instillation is not effective in the prophylaxis of tumor recurrence in the special group of patients with high risk of recurrence. This result is contrary to the several reports indicating marked reduction of recurrence by Mitomycin C. We discussed some factors which might influence to the 2 different outcome.
Follow-Up Studies ; Humans ; Mitomycin* ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder*

In one case of advanced systemic scleroderma hyperbaric oxygen therapy was performed. The treatrnent were given in an one-man pressure chamber (made in Korea) at a pressure of 2. 5 atmospheres absolute pressure (AT.A). The pressure was increased in 5-7 minutes, kept constant for 1.5 hours and lowered in 5--7 minutes. After 16 weeks of the treatment, regression of the skin contraction was achieved, together with improved mobility of the joints and healing of ulceration.
Atmosphere ; Hyperbaric Oxygenation* ; Joints ; Scleroderma, Systemic* ; Skin ; Ulcer

BACKGROUND: The train of four (TOF) stimulation is valuable to study pharmacodynamics associated with the interaction between muscle relaxants and receptors in the neuromuscular junction. TOF fade expresses presynaptic effect diminished output of transmitters. The aim of this study was to examine differences in presynaptic effects of different relaxants by measuring the TOF ratio during the onset and offset of block. METHODS: Eighty four healthy adult patients of ASA grades I or II were included in the study. The muscle relaxants studied were vecuronium (0.08 mg/kg), atracurium (0.5 mg/kg), mivacurium (0.15 mg/kg), rocuronium (0.6 mg/kg) and succinylcholine (1.0 mg/kg, 0.1 mg/kg, 0.2 mg/kg, 0.4 mg/kg). The TOF ratios were measured at approximate height of first response in the TOF (T1) of 75, 50 and 25% during onset and offset. Especially its ratios were measured at first depress of T1 during onset and its corresponding T1 during offset following administration of subclinical doses of succinylcholine. RESULTS: In the non-depolarizing muscle relaxants, TOF fade is more evident during offset than onset (p<0.05). The extent of fade varies between muscle relaxants. The greatest TOF fade has been shown in rocuronium during onset. In the succinylcholine, the TOF fade is apparent during onset and related to doses given (p<0.05). However the significant TOF fade is not seen during offset. CONCLUSIONS: All muscle relaxants, including both depolarizing and nondepolarizing agent, have predominantly postsynaptic and presynaptic effects. Furthermore, the fact that moderate TOF fade after subclinical doses of succinylcholine occurred obviously during onset of block is possibly indicating a greater presynaptic receptor blocking action.
Adult ; Atracurium ; Humans ; Neuromuscular Blockade* ; Neuromuscular Blocking Agents* ; Neuromuscular Junction ; Neuromuscular Nondepolarizing Agents ; Receptors, Presynaptic ; Succinylcholine ; Vecuronium Bromide

No abstract available.
Leukemia, Myelogenous, Chronic, BCR-ABL Positive*