Total knee arthroplasty is indicated for painful joints, with or without deformity, secondary to rheumatoid arthritis, osteoarthritis, traumatic arthritis, and certain other forms of nonseptic arthropathy. Many patients with arthritic knees have symetrical involvement and thus require a bilateral operation. Staged bilateral arthroplastis were performed with many drawbacks such as prolonged hospitalization, repeated anesthetic risks, and increased cost. Simultaneous bilateral arthroplasty under one anesthesia by two teams offers several advantages over staged procedure. We studied the results of 145 total knee arthroplasties, performed over a five-year period, to compare unilateral(group I;45 knees), staged bilateral(group II; 24 knees), and simultaneous bilateral arthroplasties(group III; 76 knees) by 2 team approach. Duration of mean follow-up was 1 year and 9 months. The results are as flollows; 1. The mean anesthetic times were 189 minutes, 312 minutes, and 218 minutes for the group I,II,III, respectively. 2. The mean blood loss was 1075ml for the group I, 1644ml for the group II, and 1902ml for the group III. 3. The hospitalization period was 74.1 days in two stage procedures, while it was 48.6 days in simultaneous bilateral procedures. 4. Knee scores by Knee Rating Scale of Hospital for Special Surgery were increased to 85.3 points, 80.7 points, and 85.4 points for group I,II,III, respectively. 5. There were no difference in complication among three groups. 6. Group III had advantages such as reduced anesthetic risk, reduced rehabilitation period, and decreased cost.
Anesthesia ; Arthritis ; Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Congenital Abnormalities ; Follow-Up Studies ; Hospitalization ; Humans ; Joints ; Knee ; Osteoarthritis ; Rehabilitation

OBJECTIVE: This study was investigated on the relationship the degrees of proteinuria with the maternal characteristics, maternal and the neonatal outcomes. The correlation between the result of single urine protein- to-creatinine ratio and the amount of 24 hour urine protein was also investigated. METHODS: From December 1999 to June 2002, 63 patients were enrolled in this study. They were divided into two groups by the degree of proteinuria at 24 hour urine, single urine and dip stick test, respectively. Each two groups was compared with the maternal characteristics, gestational age, the maternal and the neonatal outcomes. The correlation between single urine protein-to-creatinine ratio and the amount of 24 hour urine protein was analyzed statistically. RESULTS: Each two groups of single urine and dip stick test had no differences in maternal characteristics, gestational age, maternal and the neonatal outcomes. However, in two of 24 hour urine, massive proteinuria group had poor maternal and neonatal outcomes compared with control group (p value 0.01). Single urine protein-to-creatine ratio and the amount 24 hour urine protein had borderline correlation (p value 0.064). CONCLUSION: The presence of proteinuria influences on maternal and neonatal outcomes. Moreover, the massive proteinuria group had more maternal and neonatal complication than control group. The result of single urine protein-to-creatine ratio had borderline correlation with the amount of protein in 24 hour urine collection.
Female ; Gestational Age ; Humans ; Hypertension, Pregnancy-Induced* ; Pregnancy ; Pregnancy* ; Proteinuria* ; Urine Specimen Collection

No abstract available.
Hematuria*

Emergent abdominal surgery in cirrhotic patients with ascites can result in dismal postoperative outcomes such as sepsis and hepatic failure. In the present case, small bowel resection followed by anastomosis by the hand-sewn method was performed for small bowel strangulation caused by an umbilical hernia; deceased donor liver transplantation was performed one week after the bowel resection because of deterioration of hepatic function. To the best of our knowledge, this is the first case of liver transplantation performed at only one week after small bowel resection; and although we obtained a good result, the optimal time to perform liver transplantation in this situation requires further evaluation.
Ascites ; Hernia, Umbilical* ; Humans ; Liver Failure ; Liver Transplantation* ; Sepsis ; Tissue Donors*

An open clinical trial was performed to test the efficacy and side effects of Pravastatin(Mevlotin(R)), HMG-CoA reductase inhibitor, administering 5mg twice daily for 12weeks in 30 patients of hypercholesterolemia in out patient clinics, Pusan National University Hospital. The total cholesterol, triglyceride and HDL-cholesterol were measured with enzyme methods and LDL-cholesterol was calculated indirectly by Friedewald formula. The result obtained were as follows: 1) The degree of change at the end points compared with baseline pretreatment levels were 26.1% fall in serum total cholesterol.36.6% fall in LDL-cholesterol, 20.8% fall in triglyceride and 14, 6% rise in HDL-cholesterol. And the rate of improvement more than moderate degree were 90.0% in total cholesterol(the fall of 10% or more), 53.3% in triglyceride (the fall 20% or more) and 33.3% in HDL-cholesterol(the rise of 7mg% or more). 2) The total cholesterol/HDL-cholesterol and LDL-cholesterol/HDL cholesterol ratios were decreased significantly from 6, 4+/-0.7 to 4.2+/-0.5(34.4%) and from 4.5+/-0.7 to 2.5 +/-0.4(44.4%) respectively. 3) The greatest fall in serum total cholesterol and LDL-cholesterol were observed in 2 weeks after administrating drug and thereafter fell gradually and maintained until 12 weeks of endpoint, but HDL-cholesterol showed significant rise from the 4 weeks of administration. On the other hand triglyceride showed remarkable fall in the measured values from the 4 weeks but statistical significance was observed only in 10 and 12 weeks after administration owing to wide individual variation of values. 4) There observed the tendency that the higher the initial pretreatment levels the greater the degree of fall in total cholesterol and triglyceride. 5) Neither side effects nor abnormal laboratory findings were shown during the period of observation. The results suggest that Pravastatin will be a useful and safe drug in the treatment of hyperlipidemia.
Busan ; Cholesterol ; Hand ; Humans ; Hypercholesterolemia* ; Hyperlipidemias ; Oxidoreductases ; Pravastatin ; Triglycerides

2268 cases of low back pain were analysed at the low back pain clinic, Department of Neurosurgery, Yongdong Severance Hospital Yonsei University College of Medicine from January to July 1986. 1) About 85.4% were in between 20's and 50's of age groups. 30's(25.7%) and 40's(24.7%) were common. Teenagers were about 5.9%. Male to female ratio was 1 : 1.1. 2) By occupations housewives were most common(40.5%), office workers 26.4% light workers 13.2%, and students 12.7% in order. But drivers(2.4%) and heavy workers(1.9%) were relatively rare. 3) About 30.7% of all patients had some history of trauma. Among them lifting was most common in 45.8%, exercise 17.8%, and traffic accident 10.8%. 4) About 37.8%(860 cases) had had various treatments before they came to our clinic. Among them, 63.6% had visited to other hospitals. 98 cases had had lumbar disc surgery at other hospitals. Among 860 cases physical therapies were 33.8%, acupunctures 22.8%, herb medications 13.4%, moxibustions 12.5%, chiropractics 5.5%, and religious methods 1.4%. 5) Diagnostic work up were done in 85%. Plain spine X-rays were taken in 97.8%, spine CT scan 53.7%, and myelography(Iopainidol) 7.6%. 6) Etiology of the low back pain were herniated lumbar disc 44.8%, mechanical low back pain syndromes 26.4%, degenerative spondylosis 22.1%, traumas 2.8%, spinal cord tumors 1.3%, failed back surgery syndromes 1.1%, spondylolysis 0.9%, spondylolisthesis 0.3% and infections 0.3%. 7) About 15.8% of all patients were admitted. Surgical treatments were done in 12.1%(275 cases), among them chemonucleolysis with chymopapain(Discase) were 6.6%(151 cases), lumbar discectomy 5.5%(122 cases) and posterior lumbar interbody fusion 2 cases. 8) In the past history 98 cases(4.3%) had had lumbar disc surgery at the other hospitals. Among them, 8 cases were reoperated.
Accidents, Traffic ; Adolescent ; Diskectomy ; Female ; Humans ; Intervertebral Disc Chemolysis ; Lifting ; Low Back Pain* ; Male ; Neurosurgery ; Occupations ; Spinal Cord Neoplasms ; Spine ; Spondylolisthesis ; Spondylolysis ; Spondylosis ; Tomography, X-Ray Computed

No abstract available.
Adult* ; Cerebrospinal Fluid* ; Humans

A 33-year-old woman was presented with dyspnea and chest discomfort after indigesting approximately 500ml of oil paint brush washing fluid. Hypoxic symptoms and radiographic infiltrates rapidly progressed. The patient was intubated and received mechanical ventilation. Bronchoalveolar lavage and transbronchial lung biopsies were performed. The CT scan of the lung showed bilateral extensive pneumonitis with necrosis and the lung tissue pathologic findings showed diffuse alveolar damage with extensive necrosis and numerous lipidladen macrophages. After intensive medical care with mechanical ventilation, her symptoms and radiological findings improved.
Adult ; Biopsy ; Bronchoalveolar Lavage ; Dyspnea ; Eating* ; Female ; Humans ; Lung ; Macrophages ; Necrosis ; Paint ; Pneumonia* ; Respiration, Artificial ; Thorax ; Tomography, X-Ray Computed

BACKGROUND: There has been reports which suggest that the morphologic feature of ventricular premature complex(VPC) might reflect the cardiac state. METHODS: To test this, we studied retrospectively the association between the morphologic feature of VPC(shape and duration) and cardiac state(structural and functional) by analysing the records of ECG(179 cases) obtained from reviewing echocardiogram performed in our hospital from 1988 to early 1991. Group 1(n=84) had VPC-QRS complexes with either smooth and uniterruped contour or narrow(<0.04 sec) notching and group 2(n=95) demonstrated VPC with broad(> or =0.04 sec) notching or shelves. Without taking into account of either the presence of the type of the underlying cardiac disease and other constitutional disease state, we classified the type of VPC on ECG according to the above criteria and analysed its simple association with cardiac size and functional state on echocardiogram. RESULTS: In group 1, 68 of 84 cases with a VPC had no notching. In group 2, the VPC-QRS duration was greater than group 1(0.154+/-0.022 vs 0.141+/-0.011 sec(mean+/-S.D.), p=0.0001).Left ventricular end-diastolic diameter(LVED) and ejection fraction(EF) showed a significant difference between the two groups(5.12+/-0.64 vs 5.72+/-0.95cm, p=0.0003 and 65.89+/-10.84 vs 60.82+/-15.5%, p=0.012 respectively). In group 2, 50 of 95 cases(53%) showed ejection fraction less than 64%. By defining left ventricular structural dilatation and functional impairment on echocardiogram as LEVD greater than 5.5cm and EF less than 64% respectively, the sensitivity and specificity of VPC morphology was 60% and 74% respectively. CONCLUSIONS: We conclude that a broadly(> or =0.04 sec) notched VPC of long duration(> or =0.15 sec) is a simple and reliable 12-lead ECG marker for an abnormal structural and functional state of the heart(dilatation and hypokinetic left ventricle), irrespective to underlying cardiac disease, while a VPC with smooth contour or narrow(<0.04 sec) notching with short duration(<0.15 sec) reflects a normal sized heart with normal systolic function.
Dilatation ; Electrocardiography ; Heart ; Heart Diseases ; Retrospective Studies ; Sensitivity and Specificity

The authors experienced a case of atypical type of idiopathic central serous chorioretinopathy that has bullous retinal pigment epithelium detachment and multiple leaking points. So, we report this case with the review of the literatures.
Central Serous Chorioretinopathy* ; Retinal Pigment Epithelium