It is widely blieved that the new bone formation is provoked by fine electrical stress to bone. There have been maay experimental studies that showed much efforts to define these small amounts of electricity, and these fine electricities are being used in the orthopedic field for the treatment of various fractures, nonunions and pseudsrthrosia The auther has checked the electrical potentials changing in the course of fractvre hesling in rabbits femur. Comparing these data with that of the normal control group, the following results were obtained. 1. In the normal rabbit's femur the electrical potentisl was 13.6mV less on the concave side than on the convex side. This finding can be explained by the existence of stress generated potential or piexoelectricity. 2. Electrcal potentials on the fractured femoral sites were lowered significantly from that of the control group. So auther could confirm the existence of bioelectrical generated by increased electrical activity of the living bone. 3. The electrical potential of the fractured femoral site has been decreased 50% and 20% as low as that of the normal site at 8 weeks respectively. It is expected that these lowered electrical potentials may become dose to the normal values when the changed metabolic process due to the fractured bone is no longer functioning and it is believed to take human 2 years to get the normal value.
Electricity ; Femur ; Fracture Healing ; Humans ; Metabolism ; Orthopedics ; Osteogenesis ; Rabbits ; Reference Values

No abstract available.

Morphological changes of the kidney after ESWL in 130 patients are analyzed with CT at Dept. of Urology, Chung-Ang University Hospital from March 1987 to May 1987. Of 130 patients, 9 patients(6.9%) showed renal hematoma. Among 9 patients, 5 patients (3.8%) had subcapsular hematoma and 4 patients(3.1%) had parenchymal hematoma. We analyzed these 9 patients radiologically and clinically. These hematoma were clinically insignificant and self-limited in all cases. So ESWL can be regarded as a safe modality for treatment of the renal and ureteral calculi.
Hematoma* ; Humans ; Kidney ; Shock* ; Ureteral Calculi ; Urology

Hydrops fetalis is diagnosed when abnormal fluid collections are manifest in two or more fetal compartments, including abdominal ascites, pleural effusions, pericardial effusions, skin edema, polyhydroamniosis and placental edema. Although fetal hydrops was hystorically most commonly associated with Rh blood group isoimmunization, the availability of Rh immunoglobulin has increased the proportion of fetuses affected due to nonimmune etiologies. We have experienced a case of nonimmune hydrops fetalis at 32 weeks of gestation in a 27-year-old woman and reported that with brief review of related literatures.
Adult ; Ascites ; Edema ; Female ; Fetus ; Humans ; Hydrops Fetalis* ; Immunoglobulins ; Pericardial Effusion ; Pleural Effusion ; Pregnancy ; Skin

Diffuse telangiectatic type of pulmonary arteriovenous malformation (AVM) is an uncommon disease entity in which numerous small arteriovenous connections occur throughout the lungs. It has rarely been confirmed by pulmonary angiography. We report a case of diffuse telangiectatic pulmonary AVM occurring in a patient with dyspnea and confirmed by CT using the slab maximum intensity projection (MIP) technique and conventional direct pulmonary angiography.
Angiography ; Arteriovenous Malformations* ; Dyspnea ; Humans ; Lung ; Tomography, X-Ray Computed*

Although many improvements have been made in surgical technique, as well as preoperative and postoperative care, the pancreaticoduodenectomy remains a technically difficult procedure attended by relatively high morbidity and mortality rates. This study concerns a total of 43 patients that underwent a pancreaticojejunostomy using a polyethylene stent by the Dunking method in a pancreaticoduodenectomy at Soon Chun Hyang University Hospital from January 1990 to December 1996. The results obtained are as follows:1) In our study, there were 13 patients with pancreatic head cancer, 11 patients with ampulla of Vater cancer, 5 patients with distal common bile duct cancer, 4 patients with duodenal cancer, 3 patients with chronic pancreatitis, 3 patients with trauma, 3 patients with a choledochal cyst, 1 patient with stomach cancer. 2) There were 23 men (53.5%) and 20 women (46.5%). 3) Postoperative complications developed in 25 patients (58.1%). Of the complications, bleeding was the most commonly observed, after which, in order of frequency, wound infection, leakage at the anastomotic site, intestinal obstruction, and intraabdominal abscess were also observed. 4) The overall operative mortality was 13.9% (excluding emergency cases, mortality was 7.5 %). Four patients died of intraabdominal or gastrointestinal bleeding, one patient died of pancreatic leakage, and one of hepatic failure. 5) Transfusion during the operation (above 5 pints) was significantly correlated with operative morbidity. Preoperative percutaneous transhepatic biliary drainage (PTBD) with serum bilirubin greater than 10 mg/dl significantly decreased the operative morbidity. 6) A prothrombin time more than 13.9 second, serum albumin less than 3.0 g/dl, and an emergency operation were significantly correlated with operative mortality.
Abscess ; Ampulla of Vater ; Bilirubin ; Choledochal Cyst ; Common Bile Duct ; Drainage ; Duodenal Neoplasms ; Emergencies ; Female ; Head and Neck Neoplasms ; Hemorrhage ; Humans ; Intestinal Obstruction ; Liver Failure ; Male ; Mortality* ; Pancreaticoduodenectomy* ; Pancreaticojejunostomy* ; Pancreatitis, Chronic ; Polyethylene ; Postoperative Care ; Postoperative Complications ; Prothrombin Time ; Serum Albumin ; Stents* ; Stomach Neoplasms ; Wound Infection

The purpose of this study was to evaluate the effects of pre-incisional lidocaine injected into tonsils with low-dose fentanyl supplementation on the cardiovascular stability and on the developrnent of intraoperative arrhythmia for pediatric adenotonsillectomy under general anesthesia. Thirty-three pediatric patients undergoing adenotonsillectomy under general anesthesia were randomly aUocated to one of the 3 groups according to the medications used for anesthesia.; 1) N2-O2-halothane only, 2) N2-O2-halothane plus pre-incisional infiltration of 2% lidocaine and 1: 80,000 epinephrine into tonsils after tracheal intubation, 3) N2-O2-halothane plus 2 mcg/kg intravenous fentanyl before induction of anesthesia plus pre-incisional infiltration of 2% lidocaine and 1: 80,000 epinephrine into tonsils after tracheal intubation. All Patients received (0.01/kg+0.15) mg atropine sulfate and 5 mg/kg thipental sodium and inhaled N2-O2-halothane (2 L-2 L-2 vol%) for induction. Tracheal intubation was facilitated with 1.5 mg/kg succinylcholine. After tracheal intubation, anesthesia was maintained with 5% N2O in oxygen and 1 vo1% halothane. 0.1 mg/kg vecuronium was used for myorelaxation. SBP, DBP, MAP, and HR were measured at 1 min, 3 min after intubation, immediately after the incision of tonsils, and after the position change of endotracheal tube. ECG changes were also observed during surgery. After surgery, the degree of irritability and the recovery time were evaluated in all patients in the recovery room. The results were as follows; 1) In Gmup 3, the increases of systolic BP at 3 min and HR at 1 min after tracheal intubation were significantly lower than other two groups. 2) The maximum value of intraoperative systolic BP was the highest in Group 1, followed by Group 2, and then Group 3. 3) The peak intraoperative HR attained was the lowest in Group 3. Difference between Group 1 and 2 was not significant. 4) No cardiac arrhythmia was present in Group 3, 5) The degree of postaperative imtabiTity was the lowest in Gmup 3 and the highest in Group 1. In conclusion, these results indicate that supplementation of low-dose fentanyl and preincisional infiltration of tonsils with lidocaine for pediatric adenotosillectomy under genral anesthesia is useful in reducing cardiovascular instability during tracheal intubation and surgery as well as the incidence of intraoperative cardiac arrhythmia, and postoperative pain.
Anesthesia ; Anesthesia, General ; Arrhythmias, Cardiac ; Atropine ; Blood Pressure* ; Electrocardiography ; Epinephrine ; Fentanyl* ; Halothane ; Heart Rate* ; Heart* ; Humans ; Incidence ; Intubation ; Lidocaine* ; Oxygen ; Pain, Postoperative ; Palatine Tonsil* ; Recovery Room ; Sodium ; Succinylcholine ; Vecuronium Bromide

BACKGROUND: Dexmedetomidine has a sedative analgesic property without respiratory depression. This study evaluated the efficacy of dexmedetomidine as an appropriate sedative drug for monitored anesthesia care (MAC) in outpatients undergoing cataract surgery on both eyes compared with combination of propofol and alfentanil. METHODS: Thirty-one eligible patients were randomly divided into two groups on the first operation day. Dexmedetomidine was administered in group D at 0.6 microg/kg/h, and propofol and alfentanil was infused concomitantly in group P at a rate of 2 mg/kg/h and 20 microg/kg/h, respectively. Sedation was titrated at Ramsay sedation score 3. Iowa satisfaction with anesthesia scale (ISAS) of the patients was evaluated postoperatively. Systolic blood pressure (SBP), heart rate (HR), respiration rate (RR), and peripheral oxygen saturation (SpO2) were recorded throughout the surgery. For the second operation, the group assignments were exchanged. RESULTS: Postoperative ISAS was 50.3 (6.2) in group D and 42.7 (8.7) in group P, which was statistically significant (P < 0.001). SBP was significantly lower in group D compared with group P from the beginning of the operation. HR, RR, and SpO2 were comparable between the two groups. There were 8 cases (25.8%) of hypertension in group P, and 1 case (3.2%) in group D (P < 0.05). In contrast, 1 case (3.2%) of hypotension and 1 case (3.2%) of bradycardia occurred in group D. CONCLUSIONS: Compared with the combined use of propofol and alfentanil, dexmedetomidine could be used appropriately for MAC in cataract surgery with better satisfaction from the patients and a more stable cardiovascular state.
Alfentanil ; Anesthesia ; Blood Pressure ; Bradycardia ; Cataract ; Dexmedetomidine ; Eye ; Heart Rate ; Humans ; Hypertension ; Hypotension ; Iowa ; Outpatients ; Oxygen ; Propofol ; Respiratory Insufficiency ; Respiratory Rate

Unlike the small cell carcinoma of the lung, much remains to be discovered about the natural history and of optimal therapy of primary small cell carcinoma of the pancreas. We experienced a case of a primary small cell carcinoma of pancreas with both adrenal metastasis. The patient was a seventy-year old woman who had complained of right upper quadrant abdominal pain for 1 month. Chest x-ray revealed no abnormality. Abdominal CT scan showed a non-enhancing low density mass in uncinate process of pancreas, retropancreatic lymphadenopathy and well defined masses in both adrenal gland. CT-guided biopsy of pancreas showed small cell carcinoma. Herein, we report a case of primary small cell carcinoma of the pancreas with both adrenal metastasis and review the literature.
Abdominal Pain ; Adrenal Glands ; Biopsy ; Carcinoma, Small Cell* ; Female ; Humans ; Lung ; Lymphatic Diseases ; Natural History ; Neoplasm Metastasis ; Pancreas* ; Thorax ; Tomography, X-Ray Computed

OBJECTIVES: This study was done to evaluate present status of child and adolescent psychiatric practice in the view of medical consumers. Help seeking behaviour process after recognizing their children's problem, satisfaction with psychiatric service, and difficult problems during practice were evaluated, and variable factors affecting them were analysed. METHODS: Through 10 multi-center point epidemiologic survey, 540 parents and their psychiatrists were involved in this study by structured questionnaire. RESULTS: Above 70% of subjects reported positive response to psychiatric service. The barrier to psychiatric service were different by subjects' age. In children, parents' inability to identify severity of children's problem and proper management place were major reason. However in adolescent, children's lack of desire to receive help and parents' worry about stigma related to receiving help were major barrier to psychiatric service. CONCLUSION: These findings suggest the importance of interagency collaboration and education services. Researchers and policymakers should consider strategies to reduce barrier related to perceptions of mental health problems and services, especially in adolescents.
Adolescent ; Child ; Cooperative Behavior ; Education ; Epidemiologic Studies* ; Humans ; Mental Health ; Parents ; Psychiatry ; Surveys and Questionnaires