Transient synovitis of the hip in children is a non-specific inflammatory and self-limited condition. It is also the most common cause of painful hip in children under ten years of age. Despite of the benign prognosis, there are many difficulties in distinguishing it from other diseases of the hip joint. It remains a common diagnostic problem for clinician because the clinical symptoms, physical findings, and conventional radiography is not pathognomonic of the condition. The authors paid attention to the increase of effusion in the affected hip and studied the value of the hip ultrasonography in 24 cases of transient synovitis from August 1985 to July 1987. The results are summerized as follows : 1. The ratio of male to female was 7 to 1, average age was 7.9 yrs, average hospitalization period was 4.5 days. 2. In simple X-ray studies, no bony change was detectable except for soft tissue signs in 68% of the cases. 3. Capsule-to-bone distance in sagittal ultrasonographic section revealed abnormal increase in 87.5% of the affected hip. 4. Average capsule-to-bone distance of affected hip joint was 7.50 mm, while that of the normal hip was 4.26 mm. 5. As shown in the above studies, ultrasonography can be considered good noninvasive technique in detection and follow-up of hip effusion. So, it is thought to be a valuable method in the diagnosis of transient synovitis of the hip in children.
Child ; Diagnosis ; Female ; Follow-Up Studies ; Hip Joint ; Hip ; Hospitalization ; Humans ; Male ; Methods ; Prognosis ; Radiography ; Synovitis ; Ultrasonography

39 patients with tibial shaft fracture had treated by open reduction and internal fixation with AO DCP and screws applying on the medial surface of the tibia, at the Department of Orthopedic Surgery, Ulsan Dongkang Hospital, from January, 1983 to December, 1985. A clinical study was done on all the 39 cases with the follow-up check over 1 year. In general, because the lateral surface of the tibia is well covered by rich soft tissue, it is popularized to apply the plate on the lateral aspect of the tibia. In our department, we applied the plate on the medial aspect of the tibia, which resulted in mimi-zing soft tissue injuries and, by inserting the screws perpendicular to the surface of the bone, increased stability of the fixation; and therefore resulted in relatively short operation time, relatively low incidences of infection and non-union; but there had been some drawbacks such as focal skin necrosis, hematoma, adhesion after fixatives removal, and cosmetic disfiguring. But there were no problems during the follow up periods. So, this is a recommandable procedure of internal fixation with the plate for the tibial shaft fractures.
Clinical Study ; Fixatives ; Follow-Up Studies ; Hematoma ; Humans ; Incidence ; Necrosis ; Orthopedics ; Skin ; Soft Tissue Injuries ; Tibia ; Ulsan

BACKGROUND: Whether monitored anesthetic care (MAC) under total intravenous anesthesia can substitute for spinal anesthesia in knee arthroscopic surgery in regard to frequency of postoperative complications, degree of postoperative pain and degree of the satisfaction of patients and operator was investigated. METHODS: Sixty healthy patients were allocated randomly into a spinal group (n = 30) who received spinal anesthesia and an MAC group (n = 30) who received TIVA for anesthesia for arthroscopic surgery. All patients were NPO for 8 hours before surgery were premedicated and monitored with an EKG, noninvasive blood pressure and pulse oximeter. Heavy 0.5% bupivacaine, 10 - 12 mg, was used for spinal anesthesia and fentanyl 2ng/kg, propofol 1 mg/kg, ketamine 0.3 mg/ kg, and ketorolac 30 mg were given intravenously for induction and propofol was maintained at 3 - 4 mg/kg/h for TIVA. Local anesthetics infiltration was done at the arthroscopic portal site and fentanyl 25ng and propofol 20 mg were added intermittently. Postoperative complication (nausea, vomitting, back pain, dizziness, pain or voiding difficulty) and satisfaction of the patients and surgeon were investigated by VAS and 5 grade methods, respectively. RESULTS: The frequency and degree of back pain, pain at the operative site and voiding difficulty occured less and the VAS was decreased in the MAC group while in the recovery room, 6 hours and the day after the operation. The grade of satisfaction of the patients and that of the surgeon were also high in the MAC group. CONCLUSIONS: These results show that, if careful airway management is provided, MAC under TIVA is a more useful anesthetic method than spinal anesthesia in an arthroscopy.
Airway Management ; Anesthesia ; Anesthesia, Intravenous* ; Anesthesia, Spinal* ; Anesthetics, Local ; Arthroscopy* ; Back Pain ; Blood Pressure ; Bupivacaine ; Dizziness ; Electrocardiography ; Fentanyl ; Humans ; Ketamine ; Ketorolac ; Knee ; Pain, Postoperative* ; Postoperative Complications* ; Propofol ; Recovery Room

Hip and knee replacement arthroplasty is one of the important causes of pulmonary embolism, of which the incidence was reported to be from 2 to 16% But, there are no reports about the incidence of pulmonary embolism after these operations in Korea. The authors' intention was to study the incidence and clinical manifestations of pulmonary embolism after hip and knee surgery. Lung perfusion scans and inhalation scans were done preoperatively and 7 days postoperatively for 139 hip or knee replacement arthrosplasty patients in Asan Medical Center. We studied 62 cases of avascular necrosis of the femoral head, 33 cases of femur neck fractures, 45 cases of degenerative arthritis of the hip and knee joints and 17 cases of other diseases. In this study, hip replacement arthroplasties were done in 114 cases, knee replacement arthrosplasties in 25 cases. On preoperative lung scan, high or intermediate probability findings of pulmonary embolism were shown in 18 cases and all of them were asymptomatic. 139 cases showed normal or low probability on preoperative lung scan, of which 5 cases were changed to high probability and 7 cases to intermediate probability on postoperative lung scan. Four of the 7 intermediate probability cases were confirmed to be pulmonary embolism on pulmonary angiography. Of these 9 cases, hip replacement arthroplasties were done in 6 cases and knee replacement arthroplasties in 3 cases. There were 5 cases of osteoarthritis of hip and knee, 3 cases of avascular necrosis of femoral head and 1 case of femoral neck fracture. We concluded that preoperative and postoperative incidences of pulmonary embolism in Korea were similar to those in western countires. Most of the pulmonary embolism patients were asymptomatic and so lung perfusion scans and inhalation scans were helpful in the early diagnosis of pulmonary embolism.
Angiography ; Arthroplasty, Replacement, Hip ; Arthroplasty, Replacement, Knee ; Chungcheongnam-do ; Early Diagnosis ; Femoral Neck Fractures ; Head ; Hip ; Humans ; Incidence ; Inhalation ; Intention ; Knee Joint ; Knee ; Korea ; Lung ; Necrosis ; Osteoarthritis ; Osteoarthritis, Hip ; Perfusion ; Pulmonary Embolism

Primary leiomyosarcoma of lung is extremely rare and often diagnosed as a mass on routine chest radiography. Although advances have been made in treatment protocols, leiomyosarcoma remains one of the more difficult soft tissue sarcomas to treat. Surgical resection is usually curative for small and well-differentiated sarcomas. For poorly differentiated and non-resectable tumors, chemotherapy and radiation therapy are used as neoadejuvant or palliative treatment options. Generally, leiomyosarcomas are known to be resistant to radiation therapy alone. The authors experienced a 68-year-old woman who was diagnosed leiomyosarcoma by routine chest radiography. Although disease progression was observed despite of chemotherapy, radiation therapy reduced the size of tumor. This paper describes the curative potential of radiation therapy for primary pulmonary leiomyosarcomas through a case report and literature review.
Aged ; Clinical Protocols ; Disease Progression ; Drug Therapy ; Female ; Humans ; Leiomyosarcoma* ; Lung ; Palliative Care ; Radiography ; Radiotherapy ; Sarcoma ; Thorax

STUDY DESIGN: Six patients with the lumbar kyphosis who underwent the circumferential fusion by posterior-anterior-posterior method were reviewed retrospectively from January 1998 to June 1999. OBJECTIVES: To determine whether patients with lumbar kyphosis can be successfully treated by circumferential fusion by posterior-anterior-posterior method. SUMMARY OF LITERATURE REVIEW: In the lumbar kyphosis, many procedures have been reported to correct the deformity, including multiple osteotomy, transpedicular vertebral resection, posterior interbody fusion, etc. Circumferential fusion by posterior-anterior-posterior method is suggested in this report as a valuable technique for excellent deformity correction and maintenance. MATERIAL AND METHODS: The surgery consists of posterior structural release with decompression followed by anterior structural release with interbody fusion by use of bone graft and posterior fixation. Clinical and radiologic results of the lumbar lordosis, sacral inclination and C7 plumb-line were assessed. RESULT: The mean segments of anterior and posterior fusion were 2.8 and 3.5 respectively. All clinical symptoms of patients had been improved in more than good. The average angle of lumbar lordosis was corrected from kyphosis 2.8degree preoperatively to lordosis 31.2degree postoperatively. At the last follow-up, the average loss of correction was 2.3degree . The average angle of sacral inclination was corrected from 6.7degree to 50.8degree . The distance from supero-posterior corner of S1 to C7 plumb line was reduced from 11.0 cm to 2.75 cm. CONCLUSION: The circumferential fusion by posterior-anterior-posterior method offer an effective surgical treatment, which produce excellent deformity correction, fusion rate, maintenance of the correction and good clinical outcome.
Animals ; Congenital Abnormalities ; Decompression ; Follow-Up Studies ; Humans ; Kyphosis* ; Lordosis ; Osteotomy ; Retrospective Studies ; Transplants

We used in situ hybridization histochemistry with synthetic oligonucleotide probes to examined the effects of unilateral 6-hydroxydopamine lesions (which eliminated tyrosine hydroxylase mRNA containing cells in mesencephalon) on enkephalin, dynorphin, and substance P mRNA exprssion in the striatum. The expression of tyroxine hydroxylase mRNA on ipsilateral substantia nigra pars compacta, which reflect dopamine activity, totally decreased for 2weeks after lesioning. After lesioning 1week, 2weeks, and 4weeks, a significant increase of the expression of enkephalin mRNA in ipsilateral to the lesioned striatum was observed (p<0.05). Substance P mRNA expressions were depressed significantly in ispsilateral to the lesioned striaturm, whereas enkephalin mRNA expressions were elevated in consecutive sections from striatal aresas in all rat model. The effect of lesions on dynorphin mRNA expressions in ipsilateral to the lesioned striatum less robust, but significant decreased tendency was observed (p<0.05). These data show that the expression of enkephalin, dynorphin and substance P mRNA is differentially regulated by mesostriatal dopaminergic system.
Animals ; Basal Ganglia* ; Dopamine ; Dynorphins ; Enkephalins ; In Situ Hybridization ; Models, Animal* ; Neuropeptides* ; Oligonucleotide Probes ; Oxidopamine ; Rats* ; RNA, Messenger ; Substance P ; Substantia Nigra ; Tyrosine 3-Monooxygenase

OBJECTIVE: There were few recent study concern about usefulness of cochlear hydrops analysis masking procedure (CHAMP) in progression of Ménière's disease. The purpose of this study is to analyze changes in the CHAMP as advancement of Ménière's disease. METHODS: We studied 19 cases of ‘ Definite’ group of Ménière's disease. We assumed progression of Ménière's disease would be checked by pure tone threshold by four tone average (4PTA), low tone average (LPTA). We also compared electrocochleography (ECoG), dizziness handicap inventory (DHI), tinnitus handicap inventory (THI) as parameters for progression of Ménière's disease to CHAMP latency delay and amplitude ratio. Chi-square test was used as a statistical method. RESULTS: In the group of patients had abnormal amplitude ratio, ECoG value were not improved, but there was not statistically significant (odds ratio [OR]=5.727, p>0.05). Better DHI and THI score were not necessarily construed as the improvement value in the CHAMP (p>0.05). In amplitude ratio abnormal group, 4PTA was aggravated, but not statistically significant (OR=1.5, p>0.05). In the group of patient had abnormality in both latency delay and amplitude ratio, LPTA was relatively aggravated (OR in latency delay: 2, OR in amplitude ratio: 10); however, reveals no statistically significance between them (p>0.05). Change of ECoG, hearing threshold including 4PTA and LPTA with progression of Ménière's disease were not correlated significantly with latency delay or amplitude ratio of CHAMP. CONCLUSION: We conclude that CHAMP does not reflect clinical features with progression of Ménière's disease.
Audiometry, Evoked Response ; Dizziness ; Edema ; Endolymphatic Hydrops ; Hearing ; Hearing Loss ; Humans ; Masks ; Meniere Disease ; Methods ; Tinnitus ; Vertigo

To clarify the correlations between the body height and maximum femoral length, we carried out orthoscanographic study in 187 normal adult Koreans (male; 80, female; 107). The results are as follws: 1. The average femoral length was 43.73±2.13cm for male, and 40.53±2.03cm for female. 2. The ratio of the femoral length to the height was 26.10±0.82% for male, and 35.91±0.77% for female. The coefficient of correlation was 0.78 and 0.80, respectively. 3. The regression equation was Y= −7.76+0.31X for male Y= −2.85+0.28X for female. (X: body height. Y: maximum femoral length)
Adult ; Body Height ; Female ; Humans ; Male

This report aimed to provide a summary of the 2023 survey results on the external quality assessment (EQA) scheme for the general transfusion medicine test and general transfusion antibody test programs in Korea. Proficiency testing materials were prepared at the Asan Medical Center for biannual distribution to participating laboratories. The accuracy rates and number of participating laboratories were as follows: ABO typing, 99.8%–100.0% (n=940, n=940); RhD typing, 99.8%–100.0% (n=924, n=918); crossmatching, 95.6%–99.4% (n=802, n=825); unexpected antibody screening, 99.4–100.0% (n=358, n=358); direct antiglobulin test (DAT) using a polyspecific reagent, 99.3%–100.0% (n=296, n=292); DAT using anti-immuno globulin G monospecific reagent, 100.0% (n=76, n=76); and DAT using antiC3d monospecific reagent, 97.3%–100.0% (n=73, n=73). The 2023 EQA scheme for transfusion medicine program has improved and maintained the standards of the participating laboratories.