A 29 years old man was scheduled for carinal resection & tracheobronehial reconstruction under the diagnosis of malignant tumor in the carina. 1 ml of morphine-scopolamine was given intramusculary for premedication. After induction with pentothal-Na and succinylcholine, anesthesia was maintained with halothane, N2O, and flaxedil (Gallamine). Radial artery cannula was inserted for blood gas analyze sampling, and EKG was monitored continuously. Tumor mass was infiltrated from carina to right upper lobe opening and right lower lobe had severe bronchiectatic change. Right pneumonectomy, resection of carina and end to end anastomosis of trachea and left bronchus were performed without any trouble. During this procedure, anesthesia had been continued with left bronchial tube which was intubated through operating field. Left bronchial ventilation had increased resistance, elevated PCO2, and lowered pH & PO2. Partial ohstruction of left upper bronchial opening was suspected during this left bronchial ventilation due to deep bronchial intubation.
Adult ; Anesthesia* ; Bronchi ; Catheters ; Diagnosis ; Electrocardiography ; Gallamine Triethiodide ; Halothane ; Humans ; Hydrogen-Ion Concentration ; Intubation ; Pneumonectomy ; Premedication ; Radial Artery ; Succinylcholine ; Trachea ; Ventilation

PURPOSE: Studies on the incidence and mortality of refractures after primary osteoporotic fracture are limited by the relatively rare incidence of such refractures and small sample sizes. The objectives of this research were: 1) to determine the incidence of osteoporotic refractures and fracture locations and 2) to assess mortality rates associated with osteoporotic refracture over a median follow up of 3 years using nationwide claim database. MATERIALS AND METHODS: Patients over 50 years of age who had an osteoporotic fracture that was confirmed operationally were enrolled. Refracture was defined as that after 6 months of an untreated period. Mortality rate was calculated using the Charlson comorbidity index and was analyzed using Cox proportional hazards regression analysis. RESULTS: A total of 18956 first-time instances of osteoporotic fracture were reported between 2007 and 2012 after a median follow up of 3.1 years (range, 1 to 7 years). Among 18956 patients, 2941 (15.50%) experienced refracture. After follow up for 1 year, cumulative mortality rates for re-fracture and non-refracture groups were 9.1% and 7.2%, respectively. After adjusting for covriates, mortality rate was 1.2 times greater in patients with re-fracture than in patients without re-fracture over a median follow up of 3 years (hazard ratio: 1.20, 95% confidence interval: 1.08–1.34, p<0.001). CONCLUSION: The incidence of osteoporotic re-fracture in this nationwide study was 15.5%, and the mortality rate of re-fracture patients was 1.2 times higher than that of non-refracture patients over a median follow up of 3 years.
Comorbidity ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Mortality ; Osteoporotic Fractures ; Sample Size

OBJECTIVE: To determine the effectiveness of body weight- supported treadmill training on gait pattern in children with cerebral palsy METHOD: Seventeen children with cerebral palsy were given with body weight-supported treadmill training. The gait training was offered on treadmill and they were trained five times a week, 20 minutes a session for three weeks. To evaluate the ambulatory function, we estimated the walking distance for one minute and gait analysis before and after the treatment. Gait analysis was done for 11 children with Vicon 370 computerized gait analyzer and linear parameters, kinematic and kinetic data were obtained. RESULTS: Walking distance for one minute increased from 6.74+/-6.16 m to 11.06+/-7.98 m. In linear parameters by gait analysis, gait speed (0.15+/-0.18 m/sec to 0.23+/-0.24 m/sec, p<0.05), cadence (53.0+/-26.3 steps/min to 65.9+/-35.7 steps/min, p<0.05), and stride length (0.30+/-0.17 meters to 0.35+/-0.18 meters, p<0.05) increased following body weight-supported treadmill training. Also, there was a significant difference in knee flexion during loading response. CONCLUSION: In rehabilitation of cerebral palsy, body weight- supported treadmill training improved gait pattern. So, we recommend this gait training method for children with cerebral palsy.
Cerebral Palsy* ; Child ; Gait ; Humans ; Knee ; Rehabilitation ; Walking

PURPOSE: We investigated if there was any change of the growth plate after recovery of bone length by distraction osteogenesis in the shortened long bone. MATERIALS AND METHODS: Three groups of 15 immature rabbits underwent shortening osteotomy of their right tibia by 20, 30, 40%, with minimal injury to the surrounding soft tissue, and distraction osteogenesis was performed to recover the original length. Radiographic, histomorphometric, and immunohistochemical studies were done to evaluate the activity of the growth plate. RESULTS: No significant difference was found between the lengths of both tibiae when the rabbits became mature. Three groups also showed no difference in the activity of the growth plate regardless of the amount of lengthening. CONCLUSION: These results suggest that distraction osteogenesis to recover the original length of bone does not disturb the physeal growth activity if the soft tissue envelope remains intact.
Growth Plate* ; Osteogenesis, Distraction* ; Osteotomy ; Rabbits ; Tibia*

Very rarely, clips used for the ligation of intracranial aneurysms become detached and subsequently migrate into the spinal canal, causing lumbar pain or radiculopathy by compressing nerve roots or inducing inflammatory processes in their newly established location. However, it is easy to overlook the migration of the clip, because there may be either no noticeable symptoms, or a herniated disk may be mistakenly diagnosed as being the source of the present symptoms. Herein, the authors report a case in which an aneurysmal clip migrated into the spinal cord.
Aneurysm* ; Intervertebral Disc Displacement ; Intracranial Aneurysm ; Ligation ; Radiculopathy ; Spinal Canal* ; Spinal Cord

OBJECTIVES: To evaluate changes of the gait pattern and the clinical improvement in patients with degenerative arthritis of the knee after total knee arthroplasty (TKA). METHOD: Gait analysis was performed in 64 patients with degenerative arthritis of the knee at pre- and post-surgery 1 year, also Hospital for Special Surgery (HSS) knee score and Visual analogue scale (VAS) for clinical assessment were investigated. RESULTS: 1) In the HSS knee score and VAS, there were statistically significant improvement after surgery (p<0.05). 2) In the postoperative gait analysis, all the linear parameters except single limb support period were significantly improved (p<0.05). Single limb support period was improved, but statistically insignificant. All the kinematic and kinetic parameters also were significantly improved (p<0.05). CONCLUSION: This study suggests that gait analysis can be used for quantitative evaluation of the effects of total knee arthroplasty in patients with degenerative arthritis of the knee.
Arthroplasty* ; Evaluation Studies as Topic ; Extremities ; Gait* ; Humans ; Knee* ; Osteoarthritis*

Muscle herniation is a relatively common disorder in the extremities, particularly in the lower extremity where the tibialis anteior muscle is the most commonly affected. Usually muscle herniation is asymptomatic or mild but a few patients complain of cramping or severe pain. We report a case of a bilateral hernia of the tibialis anterior muscle that was confirmed by dynamic ultrasonography.
Diagnosis* ; Extremities ; Hernia ; Humans ; Lower Extremity ; Muscle Cramp ; Ultrasonography*

Background: Hematologic malignancies have a relatively lower prevalence than major solid cancers, although the incidence of hematologic malignancies has significantly increased in recent years. However, understanding the current status of hematologic malignancy is significantly challenging because basic data regarding this malignancy are insufficient in the Korean population. Methods: From 2005 to 2015, the status of seven codes of hematologic malignancy, containing 24 subcodes defined using a classification defined by the Korean Classification of Disease-6, was analyzed. The number of new patients, crude incidence rate, prevalence rate, and age-standardized incidence rate were also investigated. Results were analyzed based on National Health Insurance Service (NHIS) data. Results: The number of new patients showed an overall increase over time and a rate of increase up to 56.7% for 10 years. The number of male patients was higher than that of female patients, with the majority of patients aged greater than 60 years. The incidence and prevalence rates have increased steadily. Conclusions Consistent with the previous studies, this study might be useful to understand the current status of hematologic malignancy and might contribute to the improvement of national public healthcare.

Background: Except for data in the Korea Hemophilia Foundation Registry, little is known of the epidemiology of congenital bleeding disorders in Korea. Methods: Data were obtained from the Korean Health Insurance Review and Assessment Service (HIRA) database. Results: From 2010 to 2015, there were 2,029 patients with congenital bleeding disorders in the Korean HIRA database: 38% (n = 775) of these patients had hemophilia A (HA), 25% (n = 517) had von Willebrand disease (vWD), 7% (n = 132) had hemophilia B (HB), and 25% (n = 513) had less common factor deficiencies. The estimated age-standardized incidence rate (ASR) of HA and HB was 1.78–3.15/100,000 and 0.31–0.51/100,000, respectively. That of vWD was 1.38–1.95/100,000. The estimated ASR of HA showed increase over time though the number of new patients did not increase. Most patients with congenital bleeding disorders were younger than 19 years old (47.8%), and most were registered in Gyeonggi (22.1%) and Seoul (19.2%). Conclusion This is the first nationwide population-based study of congenital bleeding disorders in Korea. This study provides data that will enable more accurate estimations of patients with vWD. This information will help advance the comprehensive care of congenital bleeding disorders. We need to continue to obtain more detailed information on patients to improve the management of these diseases.

We report here the results of surveys for external quality assessment of blood bank tests performed in 2008. Survey specimens were sent three times to 460, 470 and 473 participant institutes, and the response rates for the 1st, 2nd and 3rd trial were 97.6%, 97.7%, and 97.7%, respectively. Test items for the surveys were ABO grouping, Rh (D) typing, crossmatching, direct antiglobulin test, antibody screening and antibody identification test. The average accuracy rates of ABO grouping and Rh typing were 100% and 98.3-100%, respectively. In crossmatching test, the accuracy rates were 97.5-99.7% for the compatible samples, 92.4-99.2% for the incompatible samples, and 88.2-98.9% for the samples which could be detected as incompatible only by antiglobulin method. The accuracy rates of direct antiglobulin test were 98.4-99.7% for negative samples and 93.4-99.7% for positive samples. The correct results were reported by 99.6-100% of the surveyed institutions for antibody screening test and 98.2-100% for antibody identification test. Twenty-three institutions gave repeatedly incorrect answers for crossmatching test. Ten institutions out of them gave incorrect answers for all the test specimens sent out 3 times last year.
Academies and Institutes ; Blood Banks ; Coombs Test ; Korea ; Mass Screening