BACKGROUND: The surgical removal of impacted mandibular third molar can result in considerable pain, swelling, and dysfunction that patient are incapable of work for several days. Factors contributing to post operative swelling, trismus and pain are complex. There is no question but that the procedure of surgically removing an impacted mandibular third molar is inherently a traumatic one and that some sequelae related to the inflammation response are expected. Meticulous surgical technique will minimize the sequelae of inflammation but will not prevent them. In an effort to minimize these sequelae the use of steroid was instituted. PATIENTS AND METHODS: Present study was to investigate the effect of one preoperative steroid injection in the masseter muscle to the patients(male 9, female 11) who needed prophylactic removal of bilateral , symmetrical, impacted wisdom teeth in the mandible on the complaint like swelling, trismus and pain. through Double-Blind test. RESULTS: 1. After 24 hours investigation, preoperative steroid injection had significantly reduced swelling with 39% and trismus with 57.5%. 2. 7th post operative day investigation, reduced swelling and trismus had shown, however, not significant. 3. There wasn't major difference from the group who took preve-ntive steroid in the visual analogue scale, the first analgesic intake time and the pain period. 4. There wasn't any adverse reaction of steroid for 20 patient From the above result, If the patients are not contraindication to steroid and pronounced post operative reaction can be expected the use of steroid to the surgical removal of impacted mandibular third molar is recommended.
Female ; Humans ; Inflammation ; Mandible ; Masseter Muscle ; Molar, Third* ; Trismus

Synovectomy of the knee in rheumatoid arthritis has been recommended as an effective procedure which improved symptoms such as pain, swelling, and limitation of motion. But some problems, such as limitation of range of motion, infection, long hospital days, occured in open synovectomy. Arthroscopic synovectomy yields reliable result compatible to open synovectomy with less invasiveness and postoperative morbidity. The authors analyzed 20 knees of 14 patients who has done synovectomy of knee in Kyung Hee University Hospital from September 1989 to October 1992. Of the 14 patients, thirteen were females and only one was male, ten knees were affected on the right and ten on the left respectively. Five knees were operated as open synovectomy and fifteen knees as arthroscopic synovectomy. In six patients, both knees were operated either open or arthroscopic synovectomies. The preoperative diagnosis of 20 knees were rheumatoid arthritis as clinically, serologically and radiologically, 13 knees are confirmed as pathologically. Average hospital days after operation were 19 days in open synevectomy and 11 days in arthroscopic synovectomy. Average operation time were 72 minutes in open synovectomy and 84 minutes in arthroscopic synovectomy. No complication occured as a result of these synovectomies. After average follow up of 19 monthes, 1 knee from 5 knees in open synovectomy and 3 knees from 15 knees in arthroscopic synovectomy had pain and intermittent swelling as postoperatively. And only 1 knee in open synovectomy had loss of range of motion. No other patients lost motion in their knees. Preoperatively 17 knees showed radiographic change of rheumatoid arthritis and 16 knees showed no progressive radiographic deterioration at final follow up. And patients overall showed a significiantly increased functional status postoperatively. In conclusion, the result obtained after arthroscopic synovectomy are comparable with those obtained after open synovectomy. In addition arthroscopic procedure had lessened postoperative morbidity as loss of range of motion, postoperative infection, long hospital days and useful as palliative surgery in advanced rheumatoid arthritis.
Arthritis, Rheumatoid ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Knee ; Male ; Palliative Care ; Range of Motion, Articular

At Orthopedic Department of Kyung Hee University Hospital, we performed 20 total knee replacements in 12 patients who had rheumatoid arthritis and 18 total knee replacements in 13 patients who had osteoarthritis during the period from August 1982 to May 1986. All patients were female. Comparative analysis was done between the two groups with a follow-up period ranging from 1 year to 4 years 8 months, average being 2 years and 3 months. The average age of rheumatoid arthritis patients was 10 years younger than osteoarthritis patients. The improvement of range of knee motion after total knee replacement was greater in rheumatoid arthritis comparing to osteoarthritis. Preoperative flexion contracture was more severe in rheumatoid arthritis than osteoarthritis, but after total knee replacement the average degree of flexion conrcacture was no significant difference between two groups. The average of preoperative Hospital Surgery Knee Rating Scale was low in rheumatoid arthritis group than in osteoarthritis group, but postoperative Knee Rating Scale was similar in both groups. It seems that the problem of wound was more frequent in rheumatoid arthritis than in osteoarthritis.
Arthritis, Rheumatoid ; Arthroplasty, Replacement, Knee ; Contracture ; Female ; Follow-Up Studies ; Humans ; Knee ; Orthopedics ; Osteoarthritis ; Wounds and Injuries

At Orthopaedic Department of Kyung Hee University Hospital, we performed 50 total knee replacement in 32 patients who had suffered from rheumatoid arthritis during the period from Aug. 1982 to Dec. 1987. We studied these cases and compared the results of total knee replacement surgery in preoperative ambulatory patients(group I ) with those in preoperative non-ambulatory patients(group II ). 1. Preoperatively, 19 patients were able to walk, and 13 patients were unable to walk. 2. 7 patients of bilateral TKR(36.8%) were included in group I, and 11 patients (86.9%) in group II. 3. The improvement of range of motion after TKR was greater in group II (34 degrees) and in group I, average postoperative range of motion was similar to the average preoperative ROM. 4. Flexion contracture was more markedly improved in group II. 5. In group I, the average preoperative knee rating score by Hospital for Special Surgery rating system was 38.8 and improved to 93.4 postoperatively. In group II, the average preoperative knee rating score was 27.4 and improved to 85.7 postoperatively. 6. Postoperatively most of the patients were able to walk without support except one cases of infection(group I ) and the other who had severe rheumatoid involvements in other joints (group II ). 7. Preoperative evaluation for involvements of cervical spine and surrounding soft tissue structure was necessary endotracheal anesthesia. 8. There was 2 cases of complications in group I, and 4 cases in group II.
Anesthesia, Endotracheal ; Arthritis ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Knee ; Contracture ; Humans ; Joints ; Knee ; Range of Motion, Articular ; Spine

BACKGROUND & PURPOSE: Of thalamic stroke syndrome, according to previous reports, the syndrome of hemiataxia and hemisensory loss (thalamic ataxia syndrome) is known to have localizing value confined to the lesion of posterolateral thalamus. And ataxia in thalamic ataxia syndrome is due to interruption of cerebellar outflow pathways. We observed the clinical characteristics of cerebellar manifestations in patients with thalamic ataxia syndrome to clarify intrathalamic cerebellar pathways because it is known that parts of cerebellar efferent fibers do not pass through the thalamus. METHODS: Ten patients with ataxia (5 men, 5 women ; mean age 64), out of 47 thalamic stroke patients admitted to Kyung Hee University Hospital from Jan. 1994 to May. 1995, were selected. The localization of the lesion was based on CT or MR imaging and ataxia was characterized in view of cerebellar functions - coordination of movement, regulation of equilibrium and muscle tone. RESULTS: Out of 10 patients, 4 patients were thalamic hematoma, 4 patients thalamic hematoma with intraventricular hemorrhage, 2 patients thalamic infarction. Four patients were hemiataxia-hemiparesis-hemisensory loss, 4 patients hemiataxia-hemisensory loss, 2 patients hemiataxia-hemiparesis. Posterolateral thalamus was involved in 4 patients, dorsal thalamus in 3 patients, posterolateral and dorsal thalamus in 3 patients. All patients had dysmetria, dysdiadochokinesia, kinetic tremor. Two patient has gait ataxia. Speech and ocular motility disturbances were not noted. CONCLUSION: Thalamic ataxia syndrome appeared in the lesion of posterolateral and dorsal thalamus. Common cerebellar manifestations symptoms of incoordination.
Ataxia* ; Cerebellar Ataxia ; Female ; Gait Ataxia ; Hematoma ; Hemorrhage ; Humans ; Infarction ; Magnetic Resonance Imaging ; Male ; Stroke* ; Thalamus ; Tremor

Quantitative serial measurements of Alpha-fetoprotein (a-FP) and Beta-human chorionic gonadotropin (B-HCG) using radioimmunoassay were performed in a patient with recurrent non-germinomatous germ cell tumor (NGGCT) into CNS during radiotherapy and chemotherapy. When the pineal tumor was initially presented, elevated levels of serum a-FP and B-HCG fell dramatically to normal rage after the completion of cranial irradiation (5,060cGy). Three months later, the patient had a rise in serum and CSF tumor markers coincident with recurrence of tumor into lumbal spinal canal. Serum levels were not changed despite of 15 days of whole spine irradiation (2,000cGy) although decreased remarkably 1 month after the completion of radiotherapy (4,230cGy). At the time of relapse in the suprasella area and the cerebellopontine angle, serum and CSF levels rised again. As a result of two courses of chemotherapy the tumor markers fell markedly, but the tumor was spread to other sites into CNS. We conclude serial measurements of a-FP and B-HCG are useful for the diagnosis of the non-germinomatous germ cell tumor into CNS and for monitoring disease activity.
alpha-Fetoproteins ; Cerebellopontine Angle ; Chorionic Gonadotropin ; Cranial Irradiation ; Diagnosis ; Drug Therapy ; Germ Cells* ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Pinealoma ; Radioimmunoassay ; Radiotherapy ; Rage ; Recurrence ; Spinal Canal ; Spine ; Biomarkers, Tumor*

The Saville's index of the lumbar spine and the Singh's index of the femoral neck is very simple method to measure degree of osteoporosis. Authors compared Singh's index and Savilles index with Dual Photon Absorptiometry(D.P.X.) and studied the reliability and clinical usefulness of two indices. We took the D.P.X. and simple L-spine lateral view in 103 patients in same time and also performed D.P.X. and both hips A-P view in 70 patients, then analyzed and compared each two indices with D.P.X. The Singh's index had less interpersonal difference and intrapersonal difference compared with Saville's spine index. There was some confidence of Singh's index and Saville's spine index compared with the D.P.X., but the relationship between Saville's spine index and D.P.X. was less promising than that of Singh's index. Authors suggest that the Saville's spine index has less clinical usefulness than Singh's index in measurement of osteoporosis.
Femur Neck ; Hip ; Humans ; Methods ; Osteoporosis ; Spine

No abstract available.
Hydronephrosis* ; Teratoma*

Twelve cases with paralytic elbow due to a traumatic lesion of the brachial plexus (eleven cases) and to poliomyelitis (one case) were treated by elbow flexorplasty from April, 1978 to February, 1984 Seven cases with available muscle for transfer were treated by muscle transfer, three cases withwhole arm type brachial plexus injury were treated by gracilis muscle transplantation, and two relatively fresh cases by neurotization. The three operated groups were assessed in range of active elbow motion, muscle power testing, and electromyography at final follow-up. In eight cases, the elbow flexorplasty were augmented by shoulder arthrodesis. The mean length of follow-up was twenty two months. The mean arc of restored active elbow motion was 93 degrees following muscle transfer, 100 degrees following gracilis muscle transplatation, and 35 degrees following neurotization. The overall mean arc of active elbow motion was 77.5 degrees. In the muscle testing, the mean scores of the elbow flexor power were 3+, 4−, and 3− following muscle transfer, grcilis muscle transplantation, and neurotization respectively. The overall mean score of restored elbow flexor power was 3− . The electromyographic findings also revealed corresponding restoration of the action potential in the flexor muscle in the three groups. One case of the transfer group failed after sternocleidomastiod muscle transfer, who subsequently received gracilis muscle transplantation with satisfactory result.
Action Potentials ; Arm ; Arthrodesis ; Brachial Plexus ; Elbow ; Electromyography ; Follow-Up Studies ; Nerve Transfer ; Poliomyelitis ; Shoulder

No abstract available.
Liver* ; Neoplasm Metastasis*