No abstract available.

No abstract available.

PURPOSE: High flow rate (FR) and pressure limit (PL) strategy with time-cycled pressure-limited (TCPL) ventilator is employed routinely in the neonates. Theoretical basis of this strategy is the two-compartment theory that the lung with acute respiratory failure consists of units with different compliance and resistance. But such constant pressure strategy has the risk of ventilator induced lung injury. We compared the ventilatory indices and clinical outcomes of two different strategies, high FR-constant pressure and low FR-constant FR in the ventilator care of the neonates with acute respiratory failure. METHODS: For the neonates born in our hospital and treated with mechanical ventilation from March to August in 1997, two different ventilator strategies were employed randomly with flow control ventilator. In the high-FR group, the FR was fixed at 10 L/ min and the PL was adjusted according to the arterial blood gas analysis (ABGA) results. In the low-FR group, the FR was adjusted to 10 mL/kg of tidal volume. Sixty neonates were enrolled, 32 in high-FR and 28 in low-FR group. Ventilatory indices and clinical outcomes were statistically cornpared in the two groups. RESULTS: Perinatal factors were not different in the two groups. Initial ventilator settings, ABGA results and ventilatory indices were not different. The tidal volume, fraction of inspired oxygen, peak inspired pressure and oxygenation index were higher and dynamic compliance was lower in the high-FR group compared to the low-FR group after 3 to 72 hours of ventilator care. In clinical outcomes, incidences of pulmonary interstitial emphysema, pneumothorax and chronic lung disease were significantly lower in the low-FR group. CONCLUSION: Low-FR with constant FR strategy resulted in better clinical outcomes in the ventilator care of neonates. We conclude that constant FR strategy prevents damage of the better compliant lung units and decreases the incidence of acute and chronic complications of ventilator care.
Blood Gas Analysis ; Compliance ; Emphysema ; Humans ; Incidence ; Infant, Newborn* ; Lung ; Lung Diseases ; Oxygen ; Pneumothorax ; Respiration, Artificial ; Respiratory Insufficiency* ; Tidal Volume ; Ventilator-Induced Lung Injury ; Ventilators, Mechanical

PURPOSE: We evaluated the effects of amitriptyline in patients with urinary frequency or pelvic pain syndrome and compared with propiverine hydrochloride (BUP-4(R)) and diazepam (Valium(R)). MATERIALS AND METHODS: One-hundred and sixty-eight patients with urinary frequency or pain were included and 38 out of 168 patients were lost to follow up. The patients with interstitial cystitis, UTI and neurogenic bladder were excluded. Amitriptyline group were instructed to take 25mg to 75mg of amitriptyline before bed. Propiverine hy drochloride and diazepam group were instructed to take 20mg, 4-6mg before bed, respectively. The clinical effects and side effects were evaluated after 4 weeks of medication. RESULTS: In the amitriptyline group, 73.1% in 78 patients with frequency, 68.3% in 60 pain, 65.6% in 32 nocturia, 53.8% in 26 weak urinary stream, 53.8% in 13 dysuria, 72.7% in 11 urgency showed symptom improvement. Urinary frequency and pain score were significantly decreased in the amitriptyline group. In the propiverine hydrochloride group, 66.7% in 21 patients with frequency, 38.8% in 18 pain showed symptom improvement. In the diazepam group, 37.5% in 24 patients with frequency, 31.3% in 16 pain showed symptom improvement. Side effects of amitriptyline had appeared in 24 (27.6%) out of 87 patients; 17 cases of dry mouth, 10 drowsiness, 2 agitation, 2 nausea, 1 constipation and 1 skin rash. CONCLUSIONS: Amitriptyline is useful in vague voiding symptoms especially in urinary frequency and chronic pelvic pain syndrome. It is equally effective in both men and women. Side effects are minimal and tolerable. A double-blind placebo-controlled trial is necessary for general acceptance in the future.
Amitriptyline* ; Constipation ; Cystitis, Interstitial ; Diazepam ; Dihydroergotamine ; Dysuria ; Exanthema ; Female ; Humans ; Lost to Follow-Up ; Male ; Mouth ; Nausea ; Nocturia ; Pelvic Pain* ; Rivers ; Sleep Stages ; Urinary Bladder, Neurogenic

No abstract available.
Female ; Humans ; Urodynamics* ; Uterine Prolapse*

We reviewed 90 cases of popliteal cyst in 88 patients, managed at Department of Orthopedic Surgery, Severance Hospital from January 1976 to June 1985 and the following results were obtained. 1. The average age of the 88 patients was 42 years. There were 23 males and 65 females. Of the all patients, 47 were occured in right side and 39 the left. Two patients were both sides. 2. Of the all cysts, 62 were found to be bursa between the semimembranosus and the medial head of the gastrocnemius muscles(68.8%). 3. Associated adnormalities of the knee joint were apparent in 29(33%) and the most common abnormalities were osteoarthritis. 3. Associated adnormalities of the knee joint were apparent in 29(33%) and the most common abnormalities were osteoarthritis. 4. Communication of the cyst with the joint was apparent in 44 cases(49%). 5. Twelve patients were recurred and associated abnormality of the knee joint was osteoarthritis. Three patients were children and they had no abnormality of the knee joint. 6. Recurrence after primary operation was rare when the stalk of the cyst had been opened.
Child ; Clinical Study ; Female ; Head ; Humans ; Joints ; Knee Joint ; Male ; Orthopedics ; Osteoarthritis ; Popliteal Cyst ; Recurrence

With the recent development of tumor prosthesis, limb salvage technique has attributed to the preservation of the limb function in patients with malignant bone tumors around the knee without substantial difference of local recurrence and the survival rate. From Feb., 1991 to Sep., 1992, 9 patients were treated with limb salvage operation with total knee arthroplasty due to the malignant bone tumor around the knee at Dept. of Orthopedic Surgery, Kyungpook National University Hospital. We applied the above procedure mainly to young adult whose tumor was expected to be excised wide marginally without damaging major neurovascular structures. We evaluated the functional status of all 9 patients(4 osteosarcoma, 2 chodrosarcoma, 2 malignant fibrohistiocytoma, 1 malignant giant cell tumor) to estimate the efficacy of limb salvage operation with tumor prosthesis total knee arthroplasty. Mean follow up period was 10 months. Primary tumor site was 4 in distal femur, 5 in proximal tibia and stage was 4 IIa, 5 IIb. Range of the motion of knee is maximum 0°
Arthroplasty ; Arthroplasty, Replacement, Knee ; Artificial Limbs ; Extremities ; Femur ; Follow-Up Studies ; Giant Cells ; Gyeongsangbuk-do ; Humans ; Knee ; Limb Salvage ; Methods ; Orthopedics ; Osteosarcoma ; Prostheses and Implants ; Recurrence ; Survival Rate ; Tibia ; Young Adult

BACKGROUND: For the purpose of early detection of breast cancer, a localization biopsy is necessary in case of mammographically or ultrasonographically suspicious, but nonpalpable, breast lesions. METHODS: One hundred nine consecutive localization biopsies for nonpalpable lesions of the breast were performed upon 101 patients from May 1992 to September 1998. RESULTS: The localizations were done in 48 cases under the guidance of mammography and in 61 cases under the guidance of ultrasonography. Complications occurred in 15 cases (13.7%). The mean volume of the excised specimens was 11.6 cm3. The miss rate was 3.6% (4 cases). Malignant lesions of the breast were found in 16 cases (14.7%). Among the malignant lesions, 10 cases involved invasive ductal cancer. Among the patients diagnosed as having breast cancer, 8 patients were treated with a conservative operation, 5 patients with a modified radical mastectomy, and 2 patients with observation; 1 patient was discharged. The chance of a biopsy containing a malignant lesion was 16.7% if the biopsy was done because of mass, 9.8% for a microcalcification, and 11.1% for an abnormal asymmetric density. CONCLUSIONS: A needle localization biopsy can be performed accurately under local anethesia, and the volume of the excised specimen can be minimized, so the cosmetic effect is excellent and proper early treatment is possible in diagnosed cases of breast cancer.
Biopsy* ; Breast Neoplasms ; Breast* ; Humans ; Mammography ; Mastectomy, Modified Radical ; Needles* ; Ultrasonography

Avascular osteonecrosis has frequently occured in patients who have undergone transplantation of a kidney and generally has been considered to be a complication of the use of corticosteroids. But there are controversies regarding their dosage and duration of use in its influence on prevalence of avascular osteonecrosis. We analyzed the cases of our patients who underwent transplantation of a kidney and who we were able to follow up more than 8 months. l. Of a total of 300 patients, osteonecrosis developed in 24 joints of 12 patients. 2. Osteonecrosis was more frequently found in group of patients who were administered with larger doses of steroid. 3. Rejections of the transplanted kidney occured more frequently in those groups with osteonecrosis. 4. Most of rejections occured within 3 months after renal transplantation. 5. It took 4–26 months (average 12.3 months) the osteonecrosis could be found. 6. There were no differences in blood concentration of calcium phosphate and creatinine between osteonecrosis and non-osteonecrosis group. 7. Replacement arthroplasties were done in 10 joints without significant complication.
Adrenal Cortex Hormones ; Arthroplasty, Replacement ; Calcium ; Creatinine ; Follow-Up Studies ; Humans ; Joints ; Kidney ; Kidney Transplantation ; Osteonecrosis ; Prednisolone ; Prevalence

The onset of systemic scleroderma in the first. decade of lif occurs in less than 1.5% of instances. Systemic sclerodrma in childhood have been characterized by less severe visceral involvement and a benign course We report a boy, aged 7 years, with a history of Raynaid; phenomenon and dysphagia. He had a mask-like face, flexion contracture of hands and knee joints, digital pitting scars, ichthyosiform skin change on leg and hyperpigrnented induration on all extremities and trunk. Antinuclear antibodies were positive in nucleolar type and Scl-70 antiocy was also present. On radiologie study, the pattern of reflux esophagitis and resorption of the listal ends of all phalanges were nated. Histopathological findings were compatible with sclerodma. He was treated with Penicillamine-D and oral corticosteroic with good improvernent.
Antibodies, Antinuclear ; Cicatrix ; Contracture ; Deglutition Disorders ; Esophagitis, Peptic ; Extremities ; Hand ; Humans ; Knee Joint ; Leg ; Male ; Scleroderma, Systemic* ; Skin