Osteochondritis dissecans occurs most commonly in knee joint and often in elbow, ankle, shoulder, hip than in other joint. In osteochondiritis dissecans, an area of subchondral bone undergoes avascular necrosis and degenerative change ususlly occurs in cartilage overlying it. During the course of disease, unless interrupted by treatment or spontaneous healing, the necrotic bone and cartilage seperates from adjacent bone and cartilage and together becomes loose body. To promote healing, the proper treatment is necessary before degenerative change developes. The authors reviewed 11 cases of osteochondritis dissecans which recieved treatment at Severance hospital from January 1972 to December 1981. The results were obtained as follows: 1. The incidence of osteochondritis dissecans in male was a little more frequent than that of female and 50% were observed in the age of 16 to 30 years. 2. The most common symptom and sign was pain and limitation of motion, instability senastion, tenderness, snapping sound in order of frequency. 3. The most common area involved was the knee in 9 cases, 5 cases involved the medial femoral condyle, 4 cases involved the lateral femoral condyle. The ankle and elbow was 1 case for each. 4. Eight(72.7%) of 11 cases had history of trauma. 5. Among 9 cases of knee inlovement, 5 (55.6%) cases were associated with rupture of meniscus. 6. The methods of treatment were as follows. Conservative..................................................................1 Operative Curettage and drilling........................................................6 Excision......................................................................3 Curettage and bone graft.......................................................1 Internal fixation..............................................................1 7. Conservative treatment was performed in one case, but failed. So, all 11 cases recieved operative treatment and obtained satisfactory results in 72.8%.
Ankle ; Cartilage ; Curettage ; Elbow ; Female ; Hip ; Humans ; Incidence ; Joints ; Knee ; Knee Joint ; Male ; Necrosis ; Osteochondritis Dissecans ; Osteochondritis ; Rupture ; Shoulder

Myasthenia gravis is believed to be an autoimmune disease involving morphologic and electrophysiologic disturbances of motor end plates brought about by circulating antibodies against acetylcholine receptors. Its treatment includes the use of steroids, anticholinesterase, immunosuppression and plasmapheresis. Plasmapheresis, in particular, is used either as a stand-alone temporary measure for its often dramatic, though short-lived, effect, or as an adjunctive treatment. Plasmapheresis is considered to be essential not only in preventing and treating myasthenic crisis but in preoperative management of myasthenia gravis, usually before thymectomy. the authors here report a case of myasthenia gravis that underwent preoperative plasmapheresis followed by the use of atracurium for muscle relaxation during anesthesia for thymectomy.
Anesthesia* ; Antibodies ; Atracurium ; Autoimmune Diseases ; Immunosuppression ; Muscle Relaxation ; Myasthenia Gravis* ; Plasmapheresis* ; Receptors, Cholinergic ; Steroids ; Thymectomy

This project is based on the hypothesis that induced hyperthermia may prevent or treat the prolonged muscular relaxation caused by intraoperative hypothermia or by unknown origin. In some researches, one of the causes of postoperative respiratory depression is residual curarization which is usually resulted from hypothermia. But, there is no articles about the twiteh response in hyperthermia. The 10 mongrel dog with no muscular, renal or hepatic disease were classfied into 3 groups according to the type of muscle relaxants, atracurium group, pancuronium group and norcuron group. In each case, induced hyperthermia was applied on one side and normothermia was maintained on the other side. Muscular twitch response from the TOF stimulation was recorded. This experiment was repeated with tourniquet application in order to avoid the effect of systemic circulation. The muscular twitch response appeared faster in hyperthermia group than in normothermia group regardless of the type of muscle ralaxants. Now, therefore, we can utilize the results by inducing hyperthermia to treat and prevent the postoperative hypoxia caused by intraoperative hypothermia as well as excessive use or inade- quate reverse of muscle relaxants.
Animals ; Anoxia ; Atracurium ; Dogs ; Fever* ; Hyperthermia, Induced ; Hypothermia ; Muscle Relaxation ; Pancuronium ; Relaxation ; Respiratory Insufficiency ; Tourniquets ; Vecuronium Bromide

Total anomalous pulmonary venous return(connection) is a congenital heart disease. Especially, the reports of the patients with double connections of all pulmonary veins were rare. An infant who underwent operation for total anomalous pulmonary venous return had double drainge of all pulmonary veins to both left vertical vein and anomalous descending vein. This second lesion was not diagnosed preoperatively, but in operative field. Operative treatments were performed by ligation of left vertical vein and central pulmonary vein-to-left atrium anastomosis without ligation of the descending anomalous vein. For these less common variants fo total anomalous pulmonary venous return,a more detailed and precise understanding of morphology can facilitate accurate surgical repair. And also, early detection of the disease is an another issue for a good prognosis.
Heart Defects, Congenital ; Humans ; Infant ; Ligation ; Prognosis ; Pulmonary Veins ; Scimitar Syndrome* ; Veins

Serum pseudocholinesterase activities, using butyrylthiocholine as substrate, measured in 639 employees of Korea Cancer Center Hospital in 1993. Overall mean value of pseudocholinesterase was 9.38+/-2.10 U/ml, 10.6+/-2.10 U/ml in male, and 8.58+/-1.67 U/ml in female, respectively. Male in the first five decades of life had higher pseudocholinesterase activity than female, and after the age of 50 tbere was no intersexual difference. These findings suggest that adults before the age of 50, male has higher pseudocholinesterase activity than female.
Adult* ; Butyrylthiocholine ; Female ; Humans ; Korea ; Male ; Pseudocholinesterase*

Diltiazem was administered by two different dosages with 200 ug/kg 1V+10 ug/kg/min infusion, 400 ug/kg 1V+20 ug/kg/min infusion, in order to assess the interaction between sevoflurane and diltiazem on the cardiovascular function and oxygenation in dogs during inhalation of 1.0 MAC of sevoflurane. Significant decrease in heart rates, mean arterial pressure, pulmonary vascular resistance, systemic vascular resistance, coronary perfusion pressure were observed. Subsequently rate pressure product, as a parameter of myocardial oxygen consumption, decreased with no significant changes of oxygen extraction ration in 1.0 MAC of sevoflurane anesthesia with the above dosages of diltiazem in dogs. The author concludes that concomittent use of diltiazem in clinical doses induced tolerable hemodynamic depression and no untoward effects on oxygenation during maintenance of anesthesia with 1 MAC of sevoflurane. These combination would be safe for anesthetic cares in patient with ischemic heart diseases and coronary arterial diseases in which adequate oxygen supply in the heart is essentially necessary.
Anesthesia* ; Anesthetics ; Animals ; Arterial Pressure ; Depression ; Diltiazem* ; Dogs* ; Heart ; Heart Rate ; Hemodynamics ; Humans ; Inhalation ; Myocardial Ischemia ; Oxygen Consumption ; Oxygen* ; Perfusion ; Vascular Resistance

No abstract available.
Ligaments* ; Osteotomy*

No abstract available.
Hearing Loss* ; Hearing* ; Uveomeningoencephalitic Syndrome*

Regional anesthesia is generally recommended over general anesthesia for non-cardiac surgeries in patients with severe pulmonary hypertension (PH) caused by pulmonary disease. However, pre-, and intra-, postoperative management are critical for patients with severe PH even when regional anesthesia is performed. This is the first reported case of carbon dioxide retention and administration of the appropriate treatment during non-cardiac surgery performed under spinal/epidural anesthesia and analgesia in a patient diagnosed with chronic cor pulmonale accompanied by severe PH.
Analgesics, Opioid ; Anesthesia ; Anesthesia and Analgesia ; Anesthesia, Conduction ; Anesthesia, General ; Carbon Dioxide* ; Carbon* ; Critical Care ; Humans ; Hydrogen-Ion Concentration ; Hypertension, Pulmonary ; Lung Diseases ; Pulmonary Heart Disease*

BACKGROUND: Many reports on the change of pseudocholinesterase activity in pregnant women showed that it declines during pregnancy and in the immediate postpartum period. In Korea, there are two papers that show dissident results. However, they didn't prove that the subjects in their studies had genotypically normal enzyme. So, we compared the pseudocholinesterase activities between nonpregnant and term-pregnant women who have the genotypically normal enzyme. METHODS: We measured the dibucaine, fluoride, chloride number as well as the pseudocholinesterase astivity using butyrylthiocholine as substrate by automatic analyser, urea and scoline numbers using benzoylcholine as substrate by manual technique in nonpregnant(n=15) and term-pregnant(n=15) women aging 20 to 40 years old before induction of anesthesia. RESULTS: The dibucaine, fluoride, chloride, urea and scoline numbers(mean+/-SD,%) in female subjects were 86+/-1.2, 50+/-5.2, 5+/-2.4, 47+/-2.8 and 92+/-2.0, respectively. There were two subjects showing low pseudocholinesterase activity(<4.8 U/ml) and the one(3.9 U/ml) was in nonpregnant group, the other(4.5 U/ml) in term-pregnant group. We found that they had genotypically normal enzymes because their inhibition numbers were within normal ranges. Pseudocholinesterase activity(mean+/-SD) in term-pregnant group(7.04+/-1.30) was significantly decreased compared with that in nonpregnant group(9.15+/-2.01)(P<0.01). CONCLUSIONS: We conclude that in subjects with the genotypically normal enzyme, term-pregnant women had significantly lower pseudocholinesterase activity than nonpregnant ones did.
Adult ; Aging ; Anesthesia ; Benzoylcholine ; Butyrylthiocholine ; Dibucaine ; Female ; Fluorides ; Humans ; Korea ; Postpartum Period ; Pregnancy ; Pregnant Women ; Pseudocholinesterase* ; Reference Values ; Urea