No abstract available.
Gaucher Disease*

A case of lipoblastomatosis occuring in a 1 year and 10 month old boy is described. The tumor was first presented in the left foot at his age of 4 month, and was surgically removed. The tumor was grossly infiltrating skeletal muscle tissue, and was microscopically composed of lobulated fat tissue with prominent myxoid stroma and many immature mesenchymal cells and scattered multivacuolated lipoblasts. The tumor recurred 11/2 years later and was again removed. The tumor was equally lobulated and located inbetween skeletal muscle. However, this time lobulated tumor consisted almost entirely of mature fat tissue with scattered lipoblasts.

In a series of 93 cases of verified brain tumors visited to The National Medical Center from Nov. 1958 to March 1963 were studied clinically in regard to the ocular symptoms. The results of the study include following findings: 1. 81.3% of visual disturbances were present including 43 cases of monocular and binocular blindness. 2. Among 46 cases who were able to be examined, 78.7% showed abnormal visual fields. The most frequent type of field defect was homonymous hemianopsia, which showed high incidence in cerebral paragonimiasis. 3. The incidence of papilledema was 33.3%. They were mostly bilateral, and showed much higher incidence of 64.2% in infra tentorial tumors. 4. Optic atrophy was found in 36.5%. They were mostly of bilateral affection. There were no big difference between the incidence of primary optic atrophy and that of secondary. Primary atrophy were seen most frequently in cases of cerebral paragonimiasis as well as frontal and sellar region tumors. 5. The incidence of abnormal pupillary reflexes was 48.3%. Most of these cases are due te amaurotic mydriasis. Anisocoria occurred 17.2% of the series. 6. The incidence of nystagmus was 17.2% and was most frequently seen in cases of inf ra tententorial tumors. 7. 7.5% of abducens palsy were the most frequent occurence among extraocular muscle palsies. 8. It was specific that the affection of corneal sensibility was ipsilateral to the location of the tumors. The incidence of corneal affection was higher in cases of infratentorial tumors than that of supratentorial group. 9. Lagophthalmos occurred in 10.7% of the cases. All of them were due to facial palsy.
Anisocoria ; Atrophy ; Blindness ; Brain Neoplasms ; Facial Paralysis ; Hemianopsia ; Incidence ; Infratentorial Neoplasms ; Mydriasis ; Optic Atrophy ; Papilledema ; Paragonimiasis ; Paralysis ; Reflex, Pupillary ; Telescopes ; Visual Fields

Isolated absence of the ductus arteriosus is extremely rare condition although the ductus arteriosus may be hypoplastic or aplastic in association with other aortic arch anomalies. Authors described a case of isolated agenesis of the ductus arteriosus documented by postmortem examination of a newborn infant who died of pneumonia following operation for a large omphalocele. The heart showed ventricular septal defect. However, no other cardiovascular anomalies were associated in this case. There were three vessels that were taking off from the aorta consisted of the right brachiocephalic artery, left common carotid-artery and left subclavian artery. The anteriorly located pulmonary artery was divided into the right and left pulmonary arteries. There was no connection of vessel between the pulmonary artery and the aorta.
Abnormalities, Multiple/embryology/pathology ; Ductus Arteriosus/*abnormalities ; Heart Defects, Congenital/embryology/pathology ; Hernia, Umbilical/complications ; Humans ; Infant, Newborn ; Male

There is the trend of increasing number of outpatients who are requiring surgical intervention because of medical insurance and general improvement of economic state. Ambulatory surgical clinics are prospering in the United States. Thus we have analyzed 1957 cases of outpatient anesthesia excluding local infiltration performed by surgeons from total of 4302 cases o fout patient surgery during the 5 year period between 1975 and 1979. The results of this analysis were as follows: 1) Ketamine IM or IV was used as a sole agent in 500 cases who were under 12 years of age and mean operation and recovery time were 19.95 and 58. 45 minutes, respectively. 2) Mean operation and recovery time for 1,125 cases of pentothal+N2O+O2, anesthesia were 15. 55 and 108. 23 minutes, respectively. 3) For 321 cases of halothane+N2O+O2, anesthesia, mean operation and recovery time were 40.67 and 145. 94 minutes, respectively. 4) During recovery period there were no serious complications or mortality. 5) The majority of 1,125 among 1,957cases were gynecological outpatients and the rest were distributed among the surgical departments and dermatology, 6) Pentothal, nitrous oxide, halothane and ketamine were used safely for the outpatient anesthesia according to our experiences.
Anesthesia* ; Clinical Study* ; Dermatology ; Halothane ; Humans ; Insurance ; Ketamine ; Mortality ; Nitrous Oxide ; Outpatients ; Surgeons ; Thiopental ; United States

Myasthenia gravis is a rare disease entity in Korea, and its occurrence with a thymoma is even rarer. Myasthenia gravis has offered many difficult problems for the anesthesiologist because it affects respiratory muscles frequently and perioperative management of these patients is difficult. The authors aensthetized a patient with myasthenia gravis and thymoma. We report this experience with a brief literature review.
Humans ; Korea ; Myasthenia Gravis* ; Rare Diseases ; Respiratory Muscles ; Thymoma*

The occurrence of internal hernia through a defect in the broad ligament is a very rare condition, which may cause small bowel obstruction. This is a case of a 50-year-old woman who developed intestinal obstruction induced by internal hernia and who had undergone laparoscopic myomectomy 7 years prior to visiting our emergency room. Abdominopelvic computed tomography showed luminal narrowing of the ileum and dilatation of the pelvic loop of the small bowel at the left side of the uterus. We detected internal hernia through the defect in the broad ligament and managed it successfully by performing a laparoscopic procedure using a barbed suture, V-Loc (Covidien, Mansfield, MA).
Broad Ligament* ; Dilatation ; Emergency Service, Hospital ; Female ; Hernia* ; Humans ; Ileum ; Intestinal Obstruction ; Laparoscopy ; Middle Aged ; Phenobarbital ; Sutures* ; Uterus*

Purpose: This study used a mixed methods research design in an attempt to verify the effects of robot-assisted rehabilitation on the gait ability of stroke patients with hemiplegia, and thereby further understand the benefits and challenges of stroke patients’ experiences relying on robot-assisted rehabilitation. Methods: An exploratory sequential mixed methods study design was used in order to combine both quantitative and qualitative data. For the quantitative data collection, a total of 30 stroke patients with hemiplegia were recruited from one rehabilitation hospital. Qualitative data were collected through individual interviews using semi-structured questionnaires for a group of 15 patients who were currently undergoing robot-assisted rehabilitation. The data were analyzed through qualitative content analysis. Results: As a result of the quantitative analysis, there were significant differences between the two groups in terms of daily living activity patterns, total number of steps, and average walking speed. As a result of the qualitative analysis, the four main themes derived consisted of, ‘curiosity about the usage of robot-assisted rehabilitation,’ ‘pleasure experienced while using the robots,’ ‘insufficient information about robots,’ and ‘a lack of education about robot-assisted rehabilitation.’ Conclusions Robot-assisted rehabilitation had a significant effect on the walking ability of stroke patients with hemiplegia. Additionally, stroke patients with hemiplegia experienced difficulty during the course of their robot-assisted rehabilitation, due to a lack of sufficient information on correct usage techniques. These quantitative and qualitative findings could provide the basic foundation for the development of an educational program on robot-assisted rehabilitation.

Femoral stem fracture is an uncommon reason for the failure of total hip arthroplasty, with only 16 cases of fully coated stem fractures reported to date. Here we report a case in which a fully coated primary femoral stem fracture occurred after conversion to total hip arthroplasty for the non-union of an intertrochanteric fracture of the femur. Metallurgic evaluation of the etiology and mechanism revealed that the fracture was initiated by fatigue-related failure and completed by ductile failure on the posterior side of the fracture. Considering the recent trend of treating an intertrochanteric fracture with hip arthroplasty, possible stem failure should be considered, since most patients will have at least one of the known risk factors for stem fracture.
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Femur ; Hip ; Humans ; Risk Factors

Total hip arthroplasty in patients with chronically dislocated hips poses many challenging technical problems. Abnormal relationship of bones and soft tissues occurs in chronic complete dislocation of the hip (grade IV, Crowe's classification). Problems in placing the acetabular component in the true acetabulum include, first how to cover the acetabular component sufficiently, second how to fix it securely and last how to avoid excessive stretching of the neurovascular structures such as the sciatic nerve. The authors have introduced a technique of one stage distal femoral shortening in order to avoid excessive stretching of the neurovascular structures. From December 1988 to May 1996, the total hip arthroplasties combined with one stage distal femoral shortening were carried out in chronic complete dislocation of 44 hips (grade IV, Crowe's classification) and followed-up more than two years. This method has several advantages: It preserves wide and healthy proximal metaphysis of the femur, does not need greater trochanteric osteotomy, and provides many chances to choose the appropriate stem size and shape, especially in cementless total hip arthroplasty.
Acetabulum ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Dislocations ; Femur ; Hip Dislocation* ; Hip* ; Humans ; Osteotomy ; Sciatic Nerve