We performed the partial or total meniscestomy in 143 cases with the meniscal injury by the arthroscopy or arthrotomy during the period from May, 1978. to November, 1987. There were 89 cases treated with arthroscopic partial, 11 csses treated with arthroscopic total, 16 cases with open partisl and 27 cases with open total meniscectomy. We did not include the cases of the discoid meniscus in the study. The statistic analyses were as follow ;1. The ratio of male to female was 106 to 37, and right to left was 79 to 64. 2. There were 82 cases in medial meniscus, and 61 cases in lateral meniscus. 3. The most common chief complaint and physical finding was pain, tenderness & McMurray(+). 4. The average period of hospitalization were 5 days in arthroscopic and 20 days in open meniscectomy. 5. The most cornmon associsted injury was the ACL injury in 36 cases. 6. The most common site and type of tear was the longitudinal tear at posterior horn. 7. In the preoperative arthrogram, the diagnostic accuracy was 78.3%. 8. The satisfactory results were 79.2% in arthroscopic and 64.7% in open meniscectomy.
Animals ; Arthroscopy ; Female ; Horns ; Hospitalization ; Humans ; Knee ; Male ; Menisci, Tibial ; Tears

Partial knee ankylosis is a recognized complication following open operative procedure, trauma and disease processes about the knee. It can result from the formation of intraarticular adhesion and contracture of the capsule as well as the shortening or adhesion of the quadriceps mechanism. Physical therspy and occasionally manipulation under the anesthesia may improve the results, but performed late, these methods will be useless. This is a review of 30 patients who had severe limitation of motion in the knee joint following open operative procedures or trauma about the knee and who were treated by the percutaneous release of adhesions under the arthroscopic control. The following results were obtained; There were 17 males and 13 females, and the age of release ranged from 23 to 69 years old (av. 42.8years old). The interval between arthroscopic adhesiolysis and the last follow-up evaluation ranged from 6 months to 5 years and 7 months(av. 23 months). The interval between the last open operative procedure or trauma and arthroscopic adhesiolysis ranged from 3 months to 4 years(av. 15 months). The average preoperative knee ROM was 38.8°the postoperative ROM was 121.1°and the average final knee ROM at follow-up was 102.6°So the average loss of ROM was 18.5°The arthroscopic adhesiolysis seems to be applied to the various conditions of the partial knee ankylosis and the results are better than the other surgical procedures when it was performed early enough.
Anesthesia ; Ankylosis ; Contracture ; Female ; Follow-Up Studies ; Humans ; Knee Joint ; Knee ; Male ; Surgical Procedures, Operative

In the treatment of Tb.knee, the preservation of mobility is an important issue, there are many difficulties due to pain and swelling in the trial of early ROM exercise, and various problems such as the recurrence of Tb. lesions, delayed wound healing and draining sinus formation. We analysed 30 cases of Tb. knee treated with synovectomy during 10 years since March, 1979. In Group I (25 cases), early ROM exercise were started about 4 weeks after synovectomy. And in Group II (5 csses), arthroscopic adhesiolysis was performed after minimum 6 month immobilization and chemotherapy following synovectomy. We compared the two Groups and the results were as followings: 1. Male was 15 patients and female was 15 patients, the average age was 28.1 years. 2. The average follow-up period was 18.3 months. 3. In Group I, the ROM exercise was performed before 4 weeks in 9 cases and after 4 weeks in 16 cases postoperatively. The average final ROM was 68.9° 4. Draining sinus formation was in 4 cases in Group I. 5. In Group II, arthroscopic adhesiolysis was performed in 5 cases after synovectomy and chemotherapy for average 8.8 months ranging from 6 to 14 months. 6. The average final ROM at follow-up was 111° in Group II. 7. In a case with the severe involvement of bone and cartilage in Tb. lesion at the synovectomy, ROM was reduced gradually to 50° after arthroscopic adhesiolysis. We could gain ROM of 120° by TKR. 8. Draining sinus formation was not found in Group II.
Cartilage ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Immobilization ; Joints ; Knee ; Male ; Methods ; Recurrence ; Wound Healing

This study was carried out to provide some principles for the improvement of clinical training in medical students. To investigate the current problems in our systems of clinical training, we made sev eral questionnaires and distributed to the individuals of each survey groups. Senior medical students (59), interns (31), residents (14) and medical staffs (15) were included in these survey groups. The summarized current problems in clinical training are as follows : 1) lack of personnels in charge of clinical training, 2) lack of objective criteria for the evaluation of clinical training, 3) lack of involvement of students in clinical patient management, 4) needs of improvement in contents of clinical education, 5) lack of strict execution of education program, 6) lack of places for clinical education, 7) lack of interests in clinical training of the staffs, 8) needs of the orientation for the students about hospital systems. With this summary we held workshop for the staffs (29) in charge of clinical education. The summarized methods to improve clinical education were to promote interests in clinical education of staffs, to select the personnel in charge of clinical education, to make assignment of patient to the students, to let the student write patient progress note, to improve evaluation method for clinical education, to orient student about clinical education.
Education ; Humans ; Linear Energy Transfer ; Medical Staff ; Students, Medical* ; Surveys and Questionnaires

This study was carried out to provide some principles for the improvement of clinical training in medical students. To investigate the current problems in our systems of clinical training, we made sev eral questionnaires and distributed to the individuals of each survey groups. Senior medical students (59), interns (31), residents (14) and medical staffs (15) were included in these survey groups. The summarized current problems in clinical training are as follows : 1) lack of personnels in charge of clinical training, 2) lack of objective criteria for the evaluation of clinical training, 3) lack of involvement of students in clinical patient management, 4) needs of improvement in contents of clinical education, 5) lack of strict execution of education program, 6) lack of places for clinical education, 7) lack of interests in clinical training of the staffs, 8) needs of the orientation for the students about hospital systems. With this summary we held workshop for the staffs (29) in charge of clinical education. The summarized methods to improve clinical education were to promote interests in clinical education of staffs, to select the personnel in charge of clinical education, to make assignment of patient to the students, to let the student write patient progress note, to improve evaluation method for clinical education, to orient student about clinical education.
Education ; Humans ; Linear Energy Transfer ; Medical Staff ; Students, Medical* ; Surveys and Questionnaires

BACKGROUNDS: Various methods have been devised for choosing the correct internal diameter (ID) of endotracheal tubes and the proper lengths for oral endotracheal tubes at different ages in children. This study was performed to evaluate the appropriate sizes of uncuffed endotracheal tubes and distance from upper incisor to carina in Korean children under 8 years old. METHODS: Five hundred thirty five children under 8 years in ASA class 1 and 2 were evaluated for the study by age groups: 0~3 months, 4~11 months and every each year until 8 years. Appropriate sizes were to permit a gas leak at 15~25 cmH2O with positive pressure ventilation. Distances from incisor to carina were at the point which bilateral lung sounds were noticed during slow extubation from endobroncheal intubation. RESULTS: Appropriate tube sizes were 3.0 mm to 3.5 mm for infants under 3 months, 3.5 mm to 4.0 mm for 4 to 11 months and ""4.15+0.28xage (yr) (mm)"" (R2=0.77, p<0.05) for children between 1 and 8 years old. Distances from upper incisor to carina were 12.0 cm for infants under 3 months, 13.7 cm for 4 to 11 months and ""14.5+0.6xage (yr) (cm)"" (R2=0.62, p<0.05) for children between 1 and 8 years old. CONCLUSIONS: We conclude that the endotracheal tube ID for the Korean children are a little greater than those of previous reports in foreign countries and airway lengths for the Korean children are similar to those of foreigners.
Child* ; Emigrants and Immigrants ; Humans ; Incisor* ; Infant ; Intubation ; Positive-Pressure Respiration ; Respiratory Sounds

PURPOSE: Various duplex criteria have been used to predict hemodynamically significant carotid artery stenosis. Clinicians have relied on published institutional experience for carotid duplex ultrasound interpretation. Duplex parameters for interpreting carotid artery stenosis severity consist of peak systolic velocity (PSV) and end-diastolic velocity of the internal carotid artery (ICA), the ratio of ICA PSV and end-diastolic velocity (EDV) to common carotid artery (CCA) PSV (PSVICA/CCA) and EDV (EDVICA/CCA). This study was performed to elucidate which duplex parameter can predict the severity of the carotid artery stenosis more accurately. METHODS: The carotid duplex ultrasound and angiographic results of 121 carotid arteries were analyzed. Receiver operater characteristic (ROC) curves were used to compare PSV, EDV, and both ratios in detecting > or =50%, > or =60%, and > or =70% stenosis of the internal carotid artery. RESULTS: The PSVICA/CCA ratio can accurately detect > or =50%, > or =60%, and > or =70% stenosis of the internal carotid artery. To detect > or =50% angiographic stenosis, a PSVICA/CCA ratio of 1.2 has a sensitivity of 83% and specificity of 77%. A PSVICA/CCA ratio of 1.8 can detect > or =60% angiographic stenosis with a sensitivity of 80% and specificity of 79%. Finally, a PSVICA/CCA ratio of 2.2 can detect > or =70% angiographic stenosis with a sensitivity and specificity of 70 and 89%, respectively. CONCLUSION: The PSVICA/CCA ratio can be used for detecting internal carotid artery angiographic stenosis. PSVICA/CCA ratios of 1.2, 1.8, and 2.2 are proper criteria for interpreting 50%< or =, 60%< or = and 70%< or = stenosis, respectively.
Carotid Arteries ; Carotid Artery, Common ; Carotid Artery, Internal ; Carotid Stenosis ; Constriction, Pathologic ; Sensitivity and Specificity

Occult papillary adenocarcinoma of the thyroid is known to be indolent, slow metastatic, and has a good prognosis. Occult thyroid carcinoma presenting as a blood-borne metastasis without obvious cervical lymph node involvement is extremely rare. A 65-year-old male patient was visited for hoarseness, dysphagia, and shortness of breath. Bronchoscopy with biopsy revealed a papillary carcinoma of thyroid by immunohistochemical staining. Head & neck CT revealed that involving both the upper esophagus and the posterior tracheal wall, extending into the mediastinum along the upper thoracic spine at T1-T2. We have experienced a rare case of occult papillary carcinoma which invaded the trachea, esophagus and fascia of thoracic spine. Treatment was initiated with radioactive iodine and external bean therapy.
Adenocarcinoma, Papillary ; Aged ; Biopsy ; Bronchoscopy ; Carcinoma, Papillary* ; Deglutition Disorders ; Dyspnea ; Esophagus* ; Fascia ; Head ; Hoarseness ; Humans ; Iodine ; Lymph Nodes ; Male ; Mediastinum ; Neck ; Neoplasm Metastasis ; Prognosis ; Spine ; Thyroid Gland* ; Thyroid Neoplasms ; Trachea*

Intraosseous arteriovenous malformation (AVM) in the craniofacial region is rare. When it occurs, it is predominantly located in the mandible and maxilla. We encountered a 43-year-old woman with Klippel-Trenaunay syndrome affecting the right lower extremity who presented with a left orbital chemosis and proptosis mimicking the cavernous sinus dural arteriovenous fistula. Computed tomography angiography revealed an intraosseous AVM of the sphenoid bone. The patient's symptoms were completely relieved after embolization with Onyx. We report an extremely rare case of intraosseous AVM involving the sphenoid bone, associated with Klippel-Trenaunay syndrome.
Adult ; Angiography ; Arteriovenous Malformations ; Cavernous Sinus ; Caves ; Central Nervous System Vascular Malformations ; Exophthalmos ; Female ; Hemangioma ; Humans ; Klippel-Trenaunay-Weber Syndrome ; Lower Extremity ; Mandible ; Maxilla ; Orbit ; Sphenoid Bone

A Case of Pellagra Induced by Isoniazid during Treatment of Pulmonary Tuberculosis Pellagra is a disease caused by a deficiency of nicotinic acid or niacin. It is mostly found among people eating corn-based diets in parts of China, Africa and India. It is also induced by drugs, such as isoniazid or 5-fluorouracil. Isoniazid inhibits the conversion of tryptophan to niacin and may induce pellagra, particularly in poorly nourished patients. Pellagra should be suspected whenever tuberculous patients under the treatment with isoniazid develop mental, neurological or gastrointestinal symptoms, even in the absence of typical skin changes. Herein, our experienced of a case of pellagra induced by isoniazid during treatment of pulmonary tuberculosis is reported. The patient was referred due to a skin rash and drowsy mental status. Her skin lesion developed during treatment for pulmonary tuberculosis. Her symptoms were improved after discontinuation of antituberculous agents and on the administration of nicotinamide.
Africa ; China ; Diet ; Eating ; Exanthema ; Fluorouracil ; Humans ; India ; Isoniazid* ; Niacin ; Niacinamide ; Pellagra* ; Skin ; Tryptophan ; Tuberculosis, Pulmonary*