No abstract available
Constriction, Pathologic* ; Stents*

Authors have experienced a case of long standing chronic gonorrheal orbital cellulitis in a 50 years old Korean male. Surgical evacuation of pus discharges and microscopcially confirmed the gram negative intncellular and extracellular gonococcus. A brief review of the related literatures is present.
Humans ; Male ; Middle Aged ; Neisseria gonorrhoeae ; Orbit* ; Orbital Cellulitis* ; Suppuration

BACKGROUND: Although pedobarographic measurement is increasingly used for clinical and research purposes, relatively few published studies have investigated normative data. This study examined pedobarographic findings in young healthy adults with regard to sex-related differences and correlations among measurement indices. METHODS: Twenty young healthy adults (mean age, 22.4 years; standard deviation, 1.2 years; and 10 males and 10 females) were included. Weight bearing anteroposterior (AP) and lateral foot radiographs were taken, and dynamic pedobarographic data during treadmill walking and maximum ankle dorsiflexion were obtained. AP talo-first metatarsal angle, naviculocuboid overlap, lateral talo-first metatarsal angle, and plantar soft tissue thickness were measured on foot radiographs. Pedobarographic data including peak pressure and pressure-time integral were measured on five plantar segments: medial forefoot (MFF), lateral forefoot (LFF), medial midfoot (MMF), lateral midfoot (LMF), and heel. RESULTS: Male and female subjects significantly differed in body mass index (BMI, p < 0.001), AP talo-first metatarsal angle (p = 0.018), soft tissue thickness under the metatarsal head (p = 0.040) and calcaneal tuberosity (p < 0.001), maximum dorsiflexion during stance phase (p = 0.041), peak pressure on the MFF (p = 0.005) and LFF (p = 0.004), and pressure-time integral on the MFF (p = 0.018) and heel (p = 0.001). BMI was significantly correlated with soft tissue thickness under the metatarsal head (r = 0.521, p = 0.018) and calcaneal tuberosity (r = 0.585, p = 0.007), peak pressure on the MFF (r = 0.601, p = 0.005) and LFF (r = 0.487, p = 0.029), pressure-time integral on the heel (r = 0.552, p = 0.012), and total pressure-time integral (r = 0.755, p < 0.001). Maximum dorsiflexion demonstrated significant negative correlations with pressure-time integral on the MFF (r = −0.595, p = 0.007) and total pressure-time integral (r = −0.492, p = 0.032). Pressure-time integral varus/valgus index was significantly correlated with pressuretime integral forefoot/heel index (r = 0.472, p = 0.036). CONCLUSIONS: Sex-related differences in pedobarographic examination were observed, which could provide useful information in setting appropriate treatment goals and obtaining appropriate control data. The effects of subtalar motion in distributing plantar pressure should be investigated in a future study.
Adult* ; Ankle ; Body Mass Index ; Female ; Foot ; Head ; Heel ; Humans ; Male ; Metatarsal Bones ; Sex Characteristics* ; Walking ; Weight-Bearing

Recently, with the remarkable theoretical progress made in anesthesiology these years, reports are being made on the results of the study on the complications, minor or major, caused by previous general anesthesia. However, .the reports on incidence vary according to the reporters. According to Riding, the recent development of anesthesiology, anesthetic inatruments, knowledge of physiology, anesthetics, induction agents and muscle relaxants are said to have reduced the incidence of complications to a great extent. Riding, Gold and Dyrberg report that the factors capable of influencing the incidence of complication, in the post-operative period include age, sex, premedicants for anesthetics, inhalation method of anesthetics, time of anesthesia, muscle relaxant, use of induction agent, acid-base imbalance and developed knowledge of physioloy, operation site, mental state of patients before operation, general condition, anesthetic technique, and. adequate selection of medicine. Working for Department of Anesthesiology, Hanyang University, from October 1976 to August 1977, we selected, out of the patients who received general anesthesia, 523 males and 372 females, totalling 895, who showed no abnormal symptoms in their respiratory systems, circulatory systems and metabolic systems and observed the incidence of complication in the light of sex, age and operation site, the factors supposed to affect the incidence. An hour prior to the general anesthesia, the patients were given intramuscular injection with premedicants atropine 0. 01 mg per kg, Valium 0. 2 mg or Demerol 1 mg per kg of body weight. For induction of anesthesia, Epontol 10 mg per kg and succinylcholine 1 mg per kg of body weight were injected in the veins, then ventilation was made for a minute with mask and then endotracheal tubes were inserted. and then a minimum amount of air was injected. into the cuff of the endotracheal tube, and the ventilation was done in a semi-closed system. During the period of maintenance, anesthesia was administered in a semi-closed system with 0. 5~l. 0% halothane, 3 L/min of nitrous oxide, 2 L/min of oxygen; and if need be, muscle relaxant was injected into the vein. In case a nondenolarizing agent was used in the course of maintenance, atropine 0. 5~1. 0 mg and neostigmine 2.0 ~ 4.0 mg were injected into the vein for reversion at the recovery time. After the patient was completely recovered, the endotracheal tube was cautiously removed, so as not to give trauma to the throat. As for method of observations, 24 hours after the patient had recovered, we visited the patient in the ward, first observing the existence or nonexistence of incidence of minor complications, and then calculating the incidence by the distribution of sex, age and operation site. The outcome of the observation of the above results by statistics and by chi square test is as follows; 1) the incidence of complications after general anesthesia was high in females. 2) Age has not affected the incidence of complications. 3) The incidence of nausea was highest in the patients with abdominal operation. 4) The incidence of sore throat was highest in the head and neck patients. 5) The incidence of fever was highest in the abdomen patients. 6) The incidence of headache was highest in the head and neck patients.
Abdomen ; Acid-Base Imbalance ; Anesthesia ; Anesthesia, General* ; Anesthesiology ; Anesthetics ; Anesthetics, Inhalation ; Atropine ; Body Weight ; Diazepam ; Female ; Fever ; Halothane ; Head ; Headache ; Humans ; Incidence ; Injections, Intramuscular ; Male ; Masks ; Meperidine ; Methods ; Nausea ; Neck ; Neostigmine ; Nitrous Oxide ; Oxygen ; Pharyngitis ; Pharynx ; Physiology ; Propanidid ; Respiratory System ; Succinylcholine ; Veins ; Ventilation

Orbital neuroblastoma is the most common childhood metastatic malignant tumor almost always originating from the adrenal medulla; orbital primary origin is very rare. The authors experenced a case of orbital neuroblastoma. The patient was 3 year old Korean female child who was in apparently good health and no abnormalities noted of physical examminations when she developed ecchymosis of right lower lid. About two week later, she quickly developed a growing mass in the right lower orbital soft tissue. The mass was removed and his topathologically diagnosed as neuroblastoma. Radiotherapy was recommended. About 4 months bter, the patient was readmitted because of recurrence of orbital mass 3t the same site. At surgery, tumor was found invading inner and flooe wall of the orbital bone. The patient died of poor course of the disease, about one year after the onset of symptoms. It was suggested that this case was represented metastatic orbital neuroblastoma on histopathological base, but authors were unable to determine the primary site. A brief review of the related literatures is present.
Adrenal Medulla ; Child ; Child, Preschool ; Ecchymosis ; Female ; Humans ; Neuroblastoma* ; Orbit* ; Radiotherapy ; Recurrence

Hepatolithiasis is common in east Asia, but rare in the Western world. Recently, epidemiologic study on Korea gallstone disease showed that the portion of patients with hepatolithiasis among total gallstone patients is 14.1%. Hepatolithiasis is the cause of recurrent cholangitis and it is that risk factor of liver abscess, hepatic failure, or sepsis. Also, biliary cirrhosis and cholangiocarcinoma were developed from hepatolithiasis. The incidence of cholangiocarcinoma associated with hepatolithiasis is about 2.4~10% . We present three cases of unresectable cholangiocarcinoma diagnosed after removal of hepatolithiases by percutaneous transhepatic cholangioscopy.
Cholangiocarcinoma* ; Cholangitis ; Far East ; Gallstones ; Humans ; Incidence ; Korea ; Liver Abscess ; Liver Cirrhosis, Biliary ; Liver Failure ; Risk Factors ; Sepsis ; Western World

We have experienced a case of incompatible blood transfusion during general anesthesia in which 300ml of improperly typed blood were transfused. Upon discovery of the error, the transfusion was discontinued and the patient was immediately, carefully and aggressively treated with proper fresh blood, plasma expander(Rheomacrdex-D), fluids(Hartmanns solution and 10% dextrose in water) and drugs (Solu-Cortef 300 mg, furosemide 400 mg, 20% manitol 500 ml, digoxine 0. 5 mg, morphine 15 mg). The free hemoglobin in the plasma and urine and blood gas of the femoral or radial artery were rnonitorecl throughout the resuscitative procedure. It is felt that accidental incompatible blood transfusion of more than 300 ml should be preventable and that the patients life may be saved without serious complications with immediate and proper management.
Anesthesia, General* ; Blood Transfusion* ; Digoxin ; Furosemide ; Glucose ; Humans ; Morphine ; Plasma ; Radial Artery

BACKGROUND: The purpose of the study was to investigate prospectively the relation of lipoprotein(a)[Lp(a)],apoproteins and serum lipid parameters to restenosis after percutaneous transluminal coronary angioplasyt(PTCA). METHODS: One hundred and forty-five patients who received successful PTCA were enrolled and their serum levels of lipids, apoproteins and Lp(a) were measured before PTCA. After 6 months of follow-up, the patients were reevaluated for the development of restenosis by coronary angiography, treadmill test or thallium scan. RESULTS: A total 137 patients could be followed. Restenosis occurred in 71 patients(52%). Clinical parameters(e.g. age, sex, hypertension, diabetes, smoking) and angiographic parameters(e.g. lesion site, type and degree of stenosis) were not significantly different between the group without restenosis and the group with restenosis. Lipid parameters and apoproteins were not associated with restenosis. Lp(a) and Lp(a) phenotype analysis showed no significant difference between the two gruops. CONCLUSION: Serum lipid parameters, apoproteins and Lp(a) concentration are not associated with restenosis after PTCA and cannot be used as predictios of restenosis.
Angioplasty, Balloon, Coronary* ; Apoproteins ; Coronary Angiography ; Exercise Test ; Follow-Up Studies ; Humans ; Hypertension ; Lipoprotein(a)* ; Phenotype* ; Prospective Studies ; Thallium

BACKGROUND/AIMS: Infection of pancreatic necrosis is one of the leading cause of death in patients with severe necrotizing pancreatits. Because of high mortality rate up to 50%, immediate surgical debridement including pancreatectomy is recommended. However, early surgical treatment still showed high mortality rate and better treatment strategy is required. This study was conducted to evaluate the outcomes of early intensive non-surgical treatments in patients with infected necrotizing pancreatitis. METHODS: This study was based on retrospective analysis of 71 patients with acute severe necrotizing pancreatitis (APACHE II score>or=8, or Ranson's score>or=3, and pancreatic necrosis on CT scan), who were admitted to medical center during past 16 years. Infection of pancreatic necrosis was confirmed by fine needle aspiration, and early intensive medical treatments comprised of prophylactic antibiotics coverage, fluid resuscitation, organ preserving supportive measures, and percutaneous catheter drainage were carried out. RESULTS: Among the enrolled patients, infections were suspected in 46 patients, but fine needle aspirations were done only in 32 patients. In 21 patients, infections of necrotic tissue were confirmed by bacteriology, while other 11 patients showed no evidence of bacterial growth. Of 21 patients with infected necrosis, initial surgical interventions were performed in 2 patients, while initial medical treatments were performed in 19 patients. The success rate of medical treatment group in infected necrotizing pancreatitis was 79% (15/19). The mortality rate of medical treatment group and surgical treatment group was 5% (1/19) and 50% (1/2). CONCLUSIONS: Early intensive medical treatment seems to be a good therapeutic strategy, even if the infection has developed in pancreatic necrosis. Further prospective randomized studies are required to confirm this finding.
Bacterial Infections/diagnosis/*prevention & control ; Humans ; Pancreatitis, Acute Necrotizing/complications/diagnosis/*therapy ; Retrospective Studies ; Treatment Outcome

Recent studies suggested that platelet activation with surface expression of P-selectin may be related to a loss of viability and early clearing from circulation by monocytes and macrophages of the reticuloendothelial system. We have studied platelet activation during hemodialysis with a cuprophane membrane in eighteen patients with uremia. Blood samples were obtained at the begining of the hemodialysis(sample I) and after 1 hr of hemodialysis (sample II), and at the end of hemodialysis from the venous line (sample III). Platelet surface expression of P-selectin(CD62) was determined by flow cytometry. Percentage of positive platelets(% PP) of P- selectin was measured 43.9+/-15.6 % in sample I, 36.9+/-16.0% in sample II, and 40.1+/-13.1% in sample III. No statistical differences in P-selectin expression were observed in sample I, II, and III throughout the period of hemodialysis although platelet P-selectin expression after 1 hour of hemodialysis showed a slightly decrease(P=0.44). However, a significant increase in fluorescence occurred in samples from uremic patients(43.0+/-15.6%) with respect to low fluorescence was seen in normal control sera(14.6+/-11.2%). Our study shows that the substantial and irreversible platelet P-selectin expression might be contributing factors in early clearing of platelet from circulation in uremic patients.
Blood Platelets* ; Flow Cytometry ; Fluorescence ; Humans ; Kidney Failure, Chronic ; Macrophages ; Membranes ; Monocytes ; Mononuclear Phagocyte System ; P-Selectin* ; Platelet Activation* ; Renal Dialysis* ; Uremia