Many authors have studies to relieve the pain after arthniscopic knee surgery. We undertook a randomized, double-blind trial to compare the efficacy of intraarticular morphme and bupivacaine between arthroscopic meniscus surgery group and cruciate ligament reconstruction group. As an results, intraarticular injection of morphine-bupivacaine combination is effective to control pain after minor athroscopic surgery such as menisectomy and meniscal repair ancf intraarticu]ar injection of mor- phine-bupivacaine combination is not effective to relieve pain after major arthroscopic surgery including cru- ciate ligament reconstruction. So, more potent analgesics should be adminishated.
Analgesia ; Analgesics ; Arthroscopy ; Bupivacaine* ; Injections, Intra-Articular ; Knee* ; Ligaments ; Morphine*

No abstract available.
Humans ; Stomach Neoplasms* ; Young Adult*

The congenital tracheoesophageal fistula without atresia of the esophagus is considered a rare variant, and the literature concerned to the tracheoesophageal fistula fistula without atresia is little in adult especially. The 22-year-old male was admitted to Yeungnam University Hospital with his chief complaints of weight loss (6 kg/6 months), abdominal discomfort, and intermittent coughing. The diagnosis was made by the endoscopy and esophagography. The fistula was 1.5 cm in diameter, 0.5 cm in length. The level was around second thoracic vertebra. The operation was performed transpleurally through the right third intercostals space and the fistula was secured with interrupted silk suture after division. The fibrotic adhesion was seen around the tracheoesophageal fistula. The postoperative course was uneventful, and postoperative esophagogram revealed no extraluminal leakage. Herewith we report this unusual case of isolated tracheo-esophageal fistula with review of literatures.
Adult ; Cough ; Diagnosis ; Endoscopy ; Esophagus* ; Fistula ; Humans ; Male ; Silk ; Spine ; Sutures ; Tracheoesophageal Fistula* ; Weight Loss ; Young Adult

Soft tissue related complications are quite frequent in limb lengthening. Muscle fibers may proliferate or regenerate after stretching injury over 10-20% of their original length. However, the cells which are engaged in this phenomenon are not confirmed yet. We chased the S-phase cells (phase for DNA replication) in the posterior leg muscle during limb lengthening by immunohistochemical technique. We lengthened the tibiae of fifteen New Zealand white rabbits. We divided them into three groups and each group is consisted of five rabbits. In group 1, we lengthened the left tibiae by 10% of their original length, in Group 2, 20%, and in group, 3, 25%, respectively, At the end of lengthening posterior muscles of lengthened left side and of controlled right side were fixed and processed for Immunohistochemical staining which could detect the incorporation of bromodeoxyuridine(BDU). Labelling index(LI:% of positively stained S-phase nuclei) of group 1 was zero. LI of groups for more than 20% lengthening (sum of group 2 and 3) was statistically significant. In conclusion, nuclei around or within the muscle tissue are in S-phase during limb lengthening which means proliferation of the muscle fivers or of the certain cells that abut muscle fibers.
Bromodeoxyuridine ; DNA ; Extremities ; Immunohistochemistry ; Leg ; Muscles ; Rabbits ; Tibia

Recently, the frequency of meniscal injury of knee has been increasing due to increase of sports activities. It has been known that bucket handle tear is the most common type of the entire injuries of the meniscus. We found 127 cases of meniscal tears and experienced 42 cases of bucket handle tears in the arthroscopic findings from Jan. 1991 to April 1994 in our hospital. We analysed 31 cases which were followed up for at least 1 year. The purpose of this study is to analyse the locking history and frequency, to discuss the several types of bucket handle tear in arthroscopic view, to introduce three portal techniques using posteormedial or posterolateral portal to resect the meniscus, and to analyse our clinical results. So we concluded as follows. 1. Among the 31 cases, 23 cases(74%) had an episode of locking. 2. We found many different types of bucket handle tears in arthroscopic view and the most common type was complete tear in a classic type(11 cases). 3. We were able to resect the meniscal fragment very easily using posteromedial or posterolateral portal. 4. We obtained satisfactory results in 24 cases(77%).
Knee ; Sports ; Tears

No abstract available.
Hemangioma* ; Ligation*

No abstract available.
Cytomegalovirus Infections*

Average anteversion of the femur is 15.3 degree. Ultrasound, computerized tomogram, and three dimensional reconstruction from CT or MRI have been used for more accurate measurement of the anteversion. There are two methods in measuing anteversion angle from CT scan:one is by drawing a mid line through long axis of the femoral neck (conventional method). Another is by drawing a line from the center of the head to that of the neck at the base of the trochanter using several cut slices (Murphy’s method). We compared these methods with fluoroscopic measurement of the Anteversion. We traced the change of the anteversion before and after closed femoral intramedullary (IMO) nailing to evaluate the origin of malrotation of the femur. 1. Normal anteversion angles were measured in 15 cases. Average anteversion angle was 6.9 degrees by conventional method, 12.3 degrees by Murphy’s method, and 12.2 degrees by fluoroscope. 2. Anteversion angles were measured after IM nailing in 18 cases. Average was 17 degrees by Murphy’s method and 15.2 degrees by fluoroscope. Mean of difference between these two methods sea 6.3 degrees. That was 1.7 degrees in normal side. 3. Change of the anteversion angle between before and after IM nailing was measured in 17 cases by fluoroscope. Average anteversion angle before the operation was 11.9 degrees and it was change to 15.8 degrees after operation. Mean of these change was 7.1 degrees. 4. Pereperative traction provides important information on change of anteversion. Reduction excessive flexion of proximal fragment was a origin of change of anteversion during nailing procedure. Conclusion : Malrotation of the femur after IM nailing must be keep in mind and it may be preventable by fluoroscopic control of the rotation in nailing procedure.
Femur ; Femur Neck ; Fracture Fixation, Intramedullary ; Head ; Magnetic Resonance Imaging ; Methods ; Neck ; Traction ; Ultrasonography

The most common cause of obstructive sleep apnea syndrome (OSAS) in childhood is adenotonsillar hypertrophy. Adenotonsillectomy improves the symptoms quite well in most cases. However, some patients could experience the OSAS again after adenotonsillectomy, who might have several risk factors such as incomplete operation, misdiagnosis, combined anatomical malformation, sinusitis or chronic allergic rhinitis, obesity, initial severe OSAS, and early onset OSAS. We report a case of 11-year-old obese boy who presented with snoring for several years. He was obese with body mass index (BMI) of 26.3 kg/m2 and also found to have fatty liver by ultrasonogram. Initial polysomnography (PSG) showed that he met the criteria of severe OSAS with the apnea-hypopnea index (AHI) of 70.5. He underwent adenotonsillectomy and symptoms improved immediately. Four months later symptoms were relieved with AHI of 0, but 1 year after the adenotonsillectomy he started to complain snoring again and the subsequent PSG results showed that OSAS has relapsed with AHI of 43. Paranasal sinus X-ray and physical examination showed sinusitis and re-growth of adenoid. Obesity was proved not to be a contributing factor because his BMI decreased to normal range (23.1 kg/m2) after diet control and regular exercise. Also, liver transaminase was normalized and fatty liver was disappeared on follow-up abdominal ultrasonogram. After treatment of sinusitis, symptoms were relieved with decreased AHI (8.5). This case suggests that simple adenotonsillectomy might not be the end of OSAS treatment in childhood. Patients who had adenotonsillectomy should be followed by subsequent PSG if symptoms recur. It is also important to be aware of risk factors in the recurrent OSAS for the proper intervention according to the cause.
Adenoids ; Body Mass Index ; Child ; Diagnostic Errors ; Diet ; Fatty Liver ; Follow-Up Studies ; Humans ; Hypertrophy ; Liver ; Obesity ; Physical Examination ; Polysomnography ; Reference Values ; Rhinitis ; Rhinitis, Allergic, Perennial ; Risk Factors ; Sinusitis ; Sleep Apnea, Obstructive ; Snoring

Intradural lumbar disc herniation is a rare disease. According to the reports of intradural lumbar disc herniations, most cases have developed as a chronic degenerative disc diseases. Traumatic intradural lumbar disc herniations are even rarer. A 52-year-old man visited our emergency center with numbness in his left calf and ankle after falling accident. Initial impression by radiologic findings was a spinal subdural hematoma at the L1 level. A follow up image two weeks later, however, did not demonstrate any interval change. The patient was decided to have an operation. In operative findings, a ruptured disc particle penetrating the ventral and dorsal dura was indentified after laminectomy. It was assumed to be a traumatic outcome not a degenerative change.
Ankle ; Emergencies ; Follow-Up Studies ; Hematoma, Subdural ; Hematoma, Subdural, Spinal ; Humans ; Hypesthesia ; Laminectomy ; Middle Aged ; Rare Diseases