No abstract available.
Blood Glucose* ; Carcinoma, Hepatocellular* ; Humans

An unstable knee presents a real challenge to the orthopaedic surgern in view of the treatment. However, currently, as more and more of our citizens participate in the recreational activities that expose the always vulnerable knee joint to undue stress, and victims who are injured by traffic accident are increased. Orthopaedic surgeons are seeing more and more people who have knee instability severe enough to prevent them from participating in sports, in labor, and in the many other activities which may stress their knees. 95 patients suffering from ligamentous injuries of the knee have been treated by operation at Inje Medical College Paik Hospital from June 1, 1979 to February 28, 1983. 57 of the 95 patients with a minimum follow up of 6 months returned for evaluation. 1. Through the follow up study, we can obtain following results. 25 of 29 cases (86.2%), operated upon within 2 weeks of the time of injury, were good or fair(+), and 7 of 20 cases (35.0%), operated upon between 2 weeks and 3 months of the time of injury, were good or fair (−). 2. The most significant fact is that the result of 16 of 18 cases(88.9%), operated upon the anterior cruciate ligament, were good and excellent or fair(+), and 8 cases, operated upon posterior cruciate ligament, were all good and excellent or fair(+). 3. Cruciate ligament reconstruction using central one-third of the patellar ligament is more effective procedure for achieving static and functional stability of the knee than any others.
Accidents, Traffic ; Anterior Cruciate Ligament ; Follow-Up Studies ; Humans ; Knee Joint ; Knee ; Ligaments ; Patellar Ligament ; Posterior Cruciate Ligament ; Sports ; Surgeons

One fetal demise of twin pregnancy in the second or third trimester is an unusual and difficult problem in the managemcnt of pregnancy. It can be associated with an increased risk for mortality and morbidity in the remaining fetus and with maternal DIC. 255 twin gestations were delivered at our hospital between December 1984 and August 1998. 8 cases of twin pregnancies with one fetal demise were observed. We reviewed 8 cases of twin pregnancies with one fetal demise that had been managed conservatively. The incidence of twin pregnancies with one fetal demise was 3.14% in the study population. The incidence of preterm delivery was 87.5%. The perinatal mortality rate of surviving twins was 25%. There were no cases of maternal disseminated intravascular coagulation or infection. There were no cases of neurologic damages in the surviving twins. The main cause of neonatal death was prematurity. An expectant approach to the twin pregnancies with one fetal demise seems reasonable.
Dacarbazine ; Disseminated Intravascular Coagulation ; Female ; Fetus ; Humans ; Incidence ; Mortality ; Perinatal Mortality ; Pregnancy ; Pregnancy Trimester, Third ; Pregnancy, Twin*

BACKGROUND: To provide basic data to help construct regional EMSS. METHOD: Using preformed questionnaire, authors investigated prospectively data of 214 patients transferred directly to emergency medical center from other hospitals from May 11 to june 10,1998. RESULTS: 1. Total 214 patients were transferred directly to the emergency medical center of KNUH (14.4% of total), and 63.5% of patients excluding children were non-traumatic patients. 2. The peak age group was 5th decade (19.6%) with mean age of49.6 years old. The male to female ratio was 1.8 : 1. 3. The period between 08 : 00 to 16 : 00 was the most frequent arrival time of transfer patients (42.5%), and the proportion of patients for surgical departments were more common than those for other departments (53.7%). 4. the majority of patients were transferred from secondary hospitals (91.6%), but among them the proportion of mild non-traumatic and mild traumatic patients was 52.3%, and 72.0%. 5. The decision-maker for transfer was a patient himself or family members in 32.3% of severe and 26.8(/) of mild non-traumatic patients, compared with 37.5% of severe and 26.8% of mild traumatic patients. 6. The physician-to-physician communication prior to the patient's transfer was not carried out in 90.8% of severe and 85.9% of mild non-traumatic patients, compared with 75.0%of severe and 67.0%of mild traumatic patients. 7. The hospital ambulance was the most common mode of transfer (64.5%), but non-emergency vehicles such as a taxi or a private car was used for transfer in 21.5% of severe non-traumatic patients, and 12.5% in severe traumatic patients. 8. Transfer accompanied by medical personnel took place in 15.4% of severe non-traumatic patients, 25.0% in severe traumatic patients, and in 27.0% of severe non-traumatic patients, and 44.4% in severe traumatic patients transferred 4 by hospital ambulance. 9. Transfer took less than 1 hour in 66.9% of non-traumatic patients, and 45.2% of traumatic patients, but it took 1 hour or more in 27.7% of severe non-traumatic patients, and 43.7% of severe traumatic patients. 10. Transfer record accompanied the patient in 90.2% of total, but radiologic film and results of laboratory tests did not in 36.9% and 56.9% of severe non-traumatic patients, and in 12.5% and 43.7% of severe traumatic patients. CONCLUSION: It is considered that an appropriate triage system, interhospital transfer guidelines, good transfer records, cooperative interhospital communication, emergency medical information center, public information with education about regional EMSS, improvement of equipment in ambulance, and training of emergency personnel are necessary for effective and well-organized EMSS.
Ambulances ; Child ; Education ; Emergencies* ; Female ; Humans ; Information Centers ; Male ; Prospective Studies ; Surveys and Questionnaires ; Triage

The antihypertensive effect of verapamil, a calcium channel blocker, was studied in 12 cases of essential hypertension (mean age 49, range 24-64). After 6 weeks administration (80-160mg t.i.d.), the following results were obtained : 1) Before medication, average systolic and diastolic blood pressure was 176.3/108.6mmHg. After completion of therapy, blood presure fell significantly down to 154.8/94.2mmHg (p<0.01). 2) Heart rate decreased slightly from average 74.3 per minute prior to medication to 69.3 per minute at the end of study (p<0.01). 3) Side effects, among which constipation was most common, were mild and did not compel any patient to diacontinue therapy. In conclusion, verapamil seems to be a safe and effective first-line drug for hypertension along with diuretics or beta blockers.
Blood Pressure ; Calcium Channels ; Constipation ; Diuretics ; Heart Rate ; Humans ; Hypertension ; Verapamil*

Scintigraphic localization of therapeutic gelatin emboli were evaluated during and after transcatheterarterial embolization (TAE) in nine patients. Focal uptakes in the spleen suggesting adverse embolism were notedin three of 7 patients with hepatic neoplasms. Two of which were confiremd by CT. Scintiscan of the patient withdural arteriovenous malformation obtained during TAE demonstrated adverse pulmonary embolism, which dictatedchange in procedure. Scintiscan during TAE showed no advers deposition of the injected emboli in the patients withhemangioma of the back, who was safely treated by TAE. Scintigraphic study during or after TAE using radiolabeledgelatin particle with 99mTc seemed to be a useful modality for early detection of adverse embolism and forprevention of serious complications.
Arteriovenous Malformations ; Embolism ; Gelatin ; Humans ; Liver Neoplasms ; Pulmonary Embolism ; Spleen

Transient synovitis of the hip in children is a non-specific inflammatory and self-limited condition. It is also the most common cause of painful hip in children under ten years of age. Despite of the benign prognosis, there are many difficulties in distinguishing it from other diseases of the hip joint. It remains a common diagnostic problem for clinician because the clinical symptoms, physical findings, and conventional radiography is not pathognomonic of the condition. The authors paid attention to the increase of effusion in the affected hip and studied the value of the hip ultrasonography in 24 cases of transient synovitis from August 1985 to July 1987. The results are summerized as follows : 1. The ratio of male to female was 7 to 1, average age was 7.9 yrs, average hospitalization period was 4.5 days. 2. In simple X-ray studies, no bony change was detectable except for soft tissue signs in 68% of the cases. 3. Capsule-to-bone distance in sagittal ultrasonographic section revealed abnormal increase in 87.5% of the affected hip. 4. Average capsule-to-bone distance of affected hip joint was 7.50 mm, while that of the normal hip was 4.26 mm. 5. As shown in the above studies, ultrasonography can be considered good noninvasive technique in detection and follow-up of hip effusion. So, it is thought to be a valuable method in the diagnosis of transient synovitis of the hip in children.
Child ; Diagnosis ; Female ; Follow-Up Studies ; Hip Joint ; Hip ; Hospitalization ; Humans ; Male ; Methods ; Prognosis ; Radiography ; Synovitis ; Ultrasonography

No abstract available.
Fibrosis* ; Recurrence*

Obstructive jaundice of the bile duct resulting from tumor-producing copious, thick mucin, causing ductal obstruction and dilatation, has been reported very rarely. Also, the benign bile duct neoplasm is extremely rare. We report a case of a mucin-secreting villous adenoma of common hepatic duct causing obstructive jaundice and cholangitis. The patient was a 72-year-old male and had a 3 yeared history of common hepatic mass unchanged remarkably in size. The abdominal ultrasonogram and computed tomography revealed well circumscribed, more than 2cm sized mass on the CHD and ductal dilatation. We were able to get an interesting cholangioram showing irregular, nodular, ill defined filling defect in the extrahepatic bile duct, different from US and CT findings, And it was just caused by thick, copious mucin from the tumar. This case was confirmed as mucin-secreting villous adenoma after surgery.
Adenoma, Villous* ; Aged ; Bile Duct Neoplasms ; Bile Ducts ; Bile Ducts, Extrahepatic ; Cholangitis ; Dilatation ; Hepatic Duct, Common* ; Humans ; Jaundice, Obstructive ; Male ; Mucins* ; Ultrasonography

BACKGROUND: It has been found that sterss challenge with heat shock produces the acquisition of cellular resistance to ischemin injury in the hearts, which is associated with stress protein induction. The conventional heat shock(42degrees C of rectal temperature for 15min, anesthetized animal), however, is strong enough to endanger the animal life and then not suitable for practiocal application in human. The present study was performedd in an attempt to search the safely applicabel stress modalities to acquire the myocardial tolerance to ischemia-reperfusion in jury. METHODS: Male, Sprague-Ddawley rats(200-250g) were exposed to various stressful conditions, such as heat stimulation(environmental temperature of 42degrees C for 30min, live animal), swimming(20min), immobilization(60min), treadmill exercise(20M/min, 30min) and hyperbaric oxygenation(3atm, 60min) given once a day for 5 days. Twenty-four hours after the last application the hearts were isolated and perfused with oxygenated Krebs-Henseleit buffer solution by Langendorff method. Ischemia-reperfusion injury was produced by 20 min-global ischemia followed by 30 min-reperfusion. Cardiac mechanical function, lactate dehydrogenase release, the induction of stree proteins were assayed and compared dbetween the stressed dand the control animals. RESULTS: Upon reperfusion after ischemia the recovery of cardiac function was significantly improved in the stressed animals. The percentile recovery at 30min of reperfusion was in a range from 55.3%(swimming) to 89.3%(treadmill exercise), which was significantly higher than that of the control hearts(38%). The functional recovery of the conventional heat shocked heart was 57.7%. In stressed animals, lactate dehydrogenase release, which indicates myocardial cell injury, was significantly reduced by 20 to 30% compared to that for the control. The expression of an inducible form of 70 series stress protein, SP72, which was assayed by immunoblotting method, was markedly increased by heat stimulation while the other stress modalities failed to increase, it. There were no appreciable inductions of SP73(constitutive form) and GRR78 in the stressed animals. CONCLUSION: These results suggest that the cardiac protection from the ischemia-reperfusion injury could be induced by the repetitive non-fatal stress stimulations and that SP70 family proteins may be partly involved in the cardioprotective effect produced by heat stimulation, but not play the essential roles in anti-ischemic effects produced by other stress modalities.
Animals ; Heart* ; Hot Temperature ; Humans ; Immunoblotting ; Ischemia ; L-Lactate Dehydrogenase ; Male ; Oxygen ; Rats* ; Reperfusion ; Reperfusion Injury ; Shock