Osteochondroma is one of the most common benign tumor. But, intraarticular occurrence is very rare. This tumor have been thought not a true neoplasm hut a developmental malformation or harnartoma. The authors experienced a case of intaarticular osteochondroma arising from inferior pole of pateUa, projecting into the infrapatellar fat pad. The tumor was excised surgically, and symptoms were relieved.
Adipose Tissue ; Knee ; Osteochondroma* ; Patella*

PURPOSE: Keratoconus is a bilateral noninflammatory ecstatic disease of cornea. Clinical manifestations and treatments are well-described , but the exact pathophysiology has many debates. There are many reports on pathologic abnormalities of keratoconus, but few reports on epithelial adhesion complex. The authors investigated the abnormalities in epithelial adhesion complex of keratoconus. METHODS: Using 4 corneas from 4 recipients of penetrating keratoplasty, examination was done with transmission electron microscope (Hitachi-600, Japan) after proper fixation and staining. Central and peripheral portion of each corneal tissues were examined. RESULTS: In two tissues, severe degeneration of basement membrane and Bowman's layer were found. Some degree of abnormalities was found in other tissues, which had minimal change. Some of hemidesmosomes, the most distinct part of adhesion complex, were found only in well-maintained tissue but the distribution was abnormal. CONCLUSIONS: The fact that basal plasma membrane had selectively more degenerations and changes than intercellular plasma membrane implies pathophysiology of keratoconus on adhesion complex, basal plasma membrane, basement membrane and Bowman's layer. Further study on this issue will reveal more information as to its pathophysiology.
Basement Membrane ; Cell Membrane ; Cornea ; Hemidesmosomes ; Keratoconus* ; Keratoplasty, Penetrating

BACKGROUND: It is not clear whether mild hypothermia (34 degrees C) enhances stress hormonal responses during surgery under general intravenous anesthesia. The purpose of this study was determine how mild hypothermia affects hemodymic and stress hormonal responses introperatively and during extubation in patients undergoing cerebral aneurysm surgery under general intravenous anesthesia. METHODS: Anesthesia was induced intravenously with thiopental sodium 5 mg/kg, succinylcholine 1 mg/kg, and maintained with 50% O2, 50% N2O, and propofol using a target controlled system; Diprifusor(R) (3-5 microgram/ml) and muscle relaxation were administered with intravenous vecuronium intermittently. For the normothermia and the hypothermia groups, body temperatures were maintained at 36.9+/-0.3degrees C and 34.2+/-0.2 degrees C, respectively, up to the recovery room. Hemodynamic changes were recorded continuously. Arterial blood gas analysis, glucose, hemoglobin, stress hormones comprising epinephrine, norepinephrine, ADH, ACTH and cortisol were measured at whilst awake, intraoperatively, and just after extubation. RESULTS: Hemodynamic changes from the awake control state to postextubation were not significantly different between the normothermia and hypothermia groups. In the control awake state, all five hormonal concentrations were similar in the two groups. Intraoperatively and during extubation, all hormonal concentrations tended to be lower in the hypothermia group than in the normothermia group, except epinephrine during extubation. During the same period, all except ACTH decreased sufficiently to reach statistical significance (P < 0.05) versus the awake control state. But no significant differents were found between the two groups. CONCLUSIONS: Our data suggest that intraoperative mild hypothermia dose not significantly affect hemodynamic changes or the plasma concentrations of stress hormones.
Adrenocorticotropic Hormone ; Anesthesia ; Anesthesia, Intravenous* ; Blood Gas Analysis ; Body Temperature ; Epinephrine ; Glucose ; Hemodynamics* ; Humans ; Hydrocortisone ; Hypothermia* ; Intracranial Aneurysm ; Muscle Relaxation ; Neurosurgery ; Norepinephrine ; Plasma ; Propofol ; Recovery Room ; Succinylcholine ; Thiopental ; Vecuronium Bromide

Traumatic hip joint dislocations account for 2–5% of total joint dislocations. Bilateral asymmetric hip joint dislocation with anteriorly and posteriorly dislocation is an even more rare case because it was according to G. Loupasis reported in 11 cases only since 1879. We want to report 2 cases of bilateral asymmetric hip joint dislocation with unilateral acatabulum fracture which happened in our hospital. Bilateral asymmetric dislocation of hip joint accompanied by unilateral fracture of acetabulum is a very rare case so statistical verification cannot be done. However, close examinations are required at early treatment and follow-up because the patterns of dislocation and fracture of hip joint are variable and an orthopedic emergent condition and several complications may occur at both hip joints.

No abstract available.
Drug Therapy* ; Granulocytes* ; Humans* ; Lung* ; Neutropenia*

PURPOSE: Although remarkable progress has been made in efforts to control measles since measles vaccines became available for use, the longterm success of their vaccination programmes has been questioned, with the worldwide resurgence of the disease. This resurgence has increased attention on the inadequacy of current immunization programmes. In 1993 there have been measles outbreaks in Seong-nam city located near the sourthern Seoul, Korea. To characterize further the epidemiology of measles in Seong-nam city, we analysed demographic characteristics of measles cases reported for the year 1993. METHODS: With the cooperation of the nurse teacher in elimentary school, the data of measles cases were collected and each case was confirmed at local clinics, hospital or general hospital, including inha General Hospital. RESULTS: 1) Out of 645 cases(male: female = 1.08:1) the children above 5 yrs of age were 586 cases of which 529 cases(90.3%) were vaccinated on after 15 months of age. After the survey, measles occurred in 1.9% of the 11 elementary school students. Children with past MMR vaccination history showed milder course of measles than those without the vaccination history. 2) Out of 87 patients who had been brought to Inha General Hospital, 55%(n=48) was 6 to 1 5 months of age, 13%(n=11) was 15 months to 4 years of age, and 32%(n=28) was 5 to 14 years of age, which showed two major outbreaks: those in which of the cases occurred below 16 months of age and those in which considerable cases occurred among school-age persons. 3) Below 15 months of age, most of the cause of the unvaccination were inadequate access to medical care and lack of public awareness in some communities, with the resulting lack of d emand for immunization services. The causes of unvaccination above 15 months of age were neglect or oblivion in 35%(n=2 0), mild acute illness not contraindicated to vaccine use in 21%(n=12), economic difficulty in 8. 8%(n=5), vaccine omission after natural measles before 12 months of age in 7%(n=4). CONCLUSIONS: Despite the high uptake of measles vaccine there is currently a nationwide e pidemic of measles, especially among the school-age groups. Secondary vaccine failure is also thought to be important cause of measles ortbreak as well as primary vaccine failure. A booster dose of measles vaccine may be necessary to reduce the measles outbreak to allow the goal of measles elimination to be achieved, with the reinforcement of age-appropriate Immunization.
Child ; Disease Outbreaks* ; Epidemiologic Studies* ; Epidemiology ; Female ; Gyeonggi-do* ; Hospitals, General ; Humans ; Immunization ; Korea ; Measles Vaccine ; Measles* ; Seoul ; Vaccination ; Vaccines

The purpose of this clinical study was to evaluate the postoperative pulmonary function and ventilatory reserve in patients over 60 years of age. The author analysed 40 anesthetic patients who underwent abdominal surgery at the Department of Anesthesiology of Pusan National Universtiy Hospital from Mach 1, 1987 through July 31, 1988. Only those patients who have had normal or nearly normal cardiopulmonary function were selected and those who developed postoperative pulmonary complications were excluded from the study. The results were as follows: 1) On the first postoperative day, the FVC of the upper abdominal surgery group was 44% of the preoperative value, 2.84+/-0.68 1/sec, and that of the lower abdominal surgery group was 64% of the preoperative value, 2.84+/-0.36 1/sec, (p<0.001). 2) On the first postoperative day, the FEVI of the upper abdominal surgery group was 37% of the preoperative value, 2.24+/-0.64 1/sec, and that of the lower abdominal surgery group was 51% of the preoperative value, 2.43+/-0.31 1/sec, (p<0..01). 3) On the first postoperative day, the MMEF of the upper abdominal surgery group was 55% of the preoperative value, 2.50+/-0.36 1/sec, and that of the lower abdominal surgery group was 75% of the preoperative value, 2.55+/-0.71 1/sec, (p<0.001). 4) The preoperative FEVI/FVC ratio of the upper abdominal surgery group was 79%, and that of the lower abdominal surgery group was 84%. In the postoperative period, there were no significant differences between the upper and lower abdominal surgery group. 5) In the upper and lower abdominal surgery group, postoperative pH and PaCO2 values were found to be changed insignificantly. 6) In the upper and lower abdominal surgery groups, postoperative PaO2 values were found to be decreased significantly(p<0.05).
Anesthesiology ; Busan ; Humans ; Hydrogen-Ion Concentration ; Postoperative Period ; Respiratory Function Tests

BACKGROUND: Amoxicillin/clavulanate (A/C) is a combination of a broad spectrum -lactam antibiotic amoxicillin and the potent -lactamase inhibitor clavulanate. A/C 7:1 combination is known to be equal in its clinical efficacy and to have less gastrointestinal adverse effects compared to conventional A/C 4:1 combination. We estimated in vitro antimicrobial activities of the 7:1 combination (AMOCLA Duo) and the conventional 4:1 combination against clinical bacterial isolates known to be the major causes of acute otitis media or sinusitis. METHODS: Total 183 strains isolated from clinical specimens of patients at Seoul National University Hospital were tested for minimal inhibitory concentraion (MIC). Streptococcus pneumoniae and Haemophilus influenzae were tested by microdilution broth method and other bacterial species by agar dilution method according to the recommendations of National Committee for Clinical Laboratory Standards (NCCLS). RESULTS: AMOCLA Duo was compared with the 4:1 combination in respect to MIC50, MIC90 and MIC range. For total 183 strains (30 methicillin-susceptible Staphylococcus aureus, 30 methicillin-sus-ceptible Staphylococcus epidermidis, 25 penicillin-susceptible S. pneumoniae, 42 penicillin-resistant S. pneumoniae, 33 H. influenzae and 23 Moraxella catarrhalis), mean MICs did not show statistically significant difference between the 2 combinations but they did for H. influenzae and M. catarrhalis. CONCLUSIONS: As for the total test strains, in vitro antimicrobial activity of AMOCLA Duo was equal to that of the conventional 4:1 combination. For each species, H. influenzae and M. catarrhalis showed significant difference between mean MICs of the 2 combinations but other species did not. We do not suppose, however, that in case of H. influenzae this difference is of practical and clinical significance according to the NCCLS interpretive criteria for MIC. Although M. catarrhalis showed statistically very significant difference of MICs, this difference can be clinically solved due to the higher dose of amoxicillin in AMOCLA Duo.
Agar ; Amoxicillin* ; Bacteria* ; Clavulanic Acid* ; Haemophilus influenzae ; Humans ; Influenza, Human ; Moraxella ; Otitis Media ; Pneumonia ; Seoul ; Sinusitis ; Staphylococcus aureus ; Staphylococcus epidermidis ; Streptococcus pneumoniae

BACKGROUND: Uvulopalatopharyngoplasty (UPPP) is one of the most common treatments for patients with obstructive sleep apnea syndrome (OSAS) who suffer from repetitive apnea and oxygen desaturation during sleep. It is important to properly manage the patient's airway in the PACU after surgery in order to prevent potential airway-related postoperative complications. METHODS: 20 patient cases of ASA I or II who were over 20 years old and had undergone UPPP under general anesthesia were reviewed. In PACU, Posterior pharyngeal airway space (PAS) was measured on a lateral cranial radiograph at both supine and sitting positions and the blood pressure and oxygen saturation were measured. RESULTS: PAS significantly increased in the sitting position (avg. 11.7 mm in supine, 15.7 mm in sitting, P < 0.05) but there was no influence on the blood pressure or oxygen saturation. CONCLUSIONS: PAS is associated with the patency of the airway and the increase of PAS in patients in the sitting position while in the PACU is helpful to airway management following UPPP.
Airway Management ; Anesthesia, General ; Apnea ; Blood Pressure ; Humans ; Oxygen ; Sleep Apnea, Obstructive ; Supine Position

BACKGROUND: We investigated the causative agents of hemorrhagic diarrhea which occurred in newborn babies in a hospital nursery in July, 2002. Rotavirus was not confirmed as the cause because only a few patients were positive for rotavirus test while most others with hemorrhagic diarrhea were negative. Therefore, patients with bloody stool were tested for Salmonella, Shigella, rotavirus, adenovirus, enterovirus, astrovirus, and enterohemorrhagic Escherichia coli (EHEC). METHODS: Bloody stools from 12 newborns with hemorrhagic diarrhea were tested. Polymerase chain reaction (PCR) of shiga-toxin gene was performed for EHEC. Rotavirus and adenovirus were tested with latex agglutination kit (Orion Diagnostica). Reverse transcription (RT)-PCR was performed for enterovirus. To detect astrovirus, RNA was extracted with Viral RNA Mini Kit (QIAGEN), reverse-transcribed with random hexamer, and PCR-amplified with specific primers. RESULTS: Of the 12 patients tested, seven (58%) were positive for astrovirus RT-PCR while all were negative for Salmonella, Shigella, EHEC, rotavirus, adenovirus, and enterovirus. CONCLUSIONS: Although diarrhea caused by astrovirus is known to be milder than that caused by rotavirus, our cases showed that astrovirus could cause serious bloody diarrhea in newborn babies.
Adenoviridae ; Agglutination ; Cross Infection ; Diarrhea* ; Enterohemorrhagic Escherichia coli ; Enterovirus ; Humans ; Infant, Newborn* ; Latex ; Nurseries, Hospital ; Polymerase Chain Reaction ; Reverse Transcription ; RNA ; RNA, Viral ; Rotavirus ; Salmonella ; Shigella