Colloidal gold 198Au were injected into 40 knee joints of rabbits for the study of the change of synovial membrane. We verified even distribution of Colloidal gold 198Au about knee joints by use of scintigraphy. After then, histopathological examinations were performed by periodic intervals. The following results are obtained form this study. l. Intra-articular injection of Colloidal gold 198Au into rabbit's knee joints resulted in a mild resctive inflammation at synovium. In was charscterized by an infiltration of eosinophils and by sclerotic changes in the subsynovium and by fibrosis of synovial vessels. 2. From this study, intra-articular injection of Colloidal gold 198Au may by benefit to treat the chronic synovial effusion in human.
Colloids ; Eosinophils ; Fibrosis ; Gold Colloid ; Humans ; Inflammation ; Injections, Intra-Articular ; Knee Joint ; Rabbits ; Radionuclide Imaging ; Synovial Membrane

The tibial plateau fracture is a fracture of the proximal end of the tibia, involving the weight bearing articular surface. This fracture often presents some problems in treatment and prognosis, because it is frequently accompanied by soft tissue injuries such as collateral ligament, cruciate ligament and menisci. During a period of 3 1/2 years, from Febuary 1980 to July 1983, We observed 78 cases of tibial plateau fractures at Gang Nam Sacred Heart Hospital. Of the above cases, 40 could be followed for a period of anywhere from 3 months to 3 years. They have been analysed according to the cause, classification, method of treatment and final result of treatment. Among these 21(52.5%) were treated by cast immobilization, 3(7.5%) by skeletal traction, 16 (40%) by open reduction and internal fixation. Thirty two cases (80% ) out of 40 indicated the result of the Acceptable group according to Hohl and Lucks criteria.
Classification ; Clinical Study ; Collateral Ligaments ; Heart ; Immobilization ; Ligaments ; Methods ; Prognosis ; Soft Tissue Injuries ; Tibia ; Traction ; Weight-Bearing

We recently experienced an unexpected episode of bilateral vocal cord paralysis following endotracheal extubation after uvulopalatopharyngoplasty and tonsillectomy in 64-year-old man. The patient had no any other clinical manifestations regarding larynx or vocal cord except sleep apnea syndrome prior to this operation. The surgical procedure lasted almost 120 minutes and surgery and anesthesia was uneventful. After restoration of his spontaneous respiration, we tried extubation as usual method. Regardless his effort of spontaneous respiration for several times, he was suddenly apneic and showed declining of arterial oxygen saturation on the pulse oximeter (SpO2). Then we tried reintubation as a decision of laryngeal spasm. This alternative episode of extubation and reintubation was tried again and the causative factor of this respiratory impairment was confirmed as bilateral vocal cord paralysis by fiberoptic bronchoscopic examination in the operating room. Almost two thirds of vocal cord function was restored after six months of operation.
Airway Extubation* ; Anesthesia ; Humans ; Intubation ; Laryngismus* ; Larynx ; Middle Aged ; Operating Rooms ; Oxygen ; Respiration ; Sleep Apnea Syndromes ; Tonsillectomy ; Vocal Cord Paralysis* ; Vocal Cords*

PURPOSE: Computed tomographic(CT), ultrasonographic(US) findings of solid and papillary epithelial neoplasm of the pancreas were correlated with pathologic findings for the better understanding of this disease entity. METHODS AND MATERIALS: A retrospective review of CT and US of 14 cases of solid and papillary epithelial neoplasm of the pancreas was carried out in terms of the margin, internal architecture, caicification and septation, and this was correlated with gross pathologic findings. RESULTS: CT and US findings were well defined round masses consisting of both solid and cystic components. Five cases were cystic, four cases were solid and five cases were mixed. Cystic portion of the tumor represented variable degree of hemorrhagic necrosis. Six cases contained foci of calcification, which were linear, marginal and amorphous. Marginal calcification interfered US examination of the mass in three cases. Internal septurn was demonstrated in four cases on CT, one case on US and three cases on gross specimen. CONCLUSIONS: Our results indicate that calcification and internal septurn were considered as a part of radiologic findings in solid and papillary epithelial neoplasm of the pancreas.
Necrosis ; Neoplasms, Glandular and Epithelial* ; Pancreas* ; Retrospective Studies

The clinico-pathological observation was done on 28 children with recurrent hematuria, who had been admitted to the Pediatric ward of NMC from January 1981 to July 1991. The results were as follows; 1) Most of the children with recurrent hematuria were over 6 years of age(24 cases, 85.7%)and the sex ratio was about 2.5:1. 2) IgA nephropathy (17 cases, 60.7%) was the leading pathologic lesion and mild focal nonspecific glomerulonephritis (5 cases), membranous nephropathy (2 cases), minimal chage (2 cases), Alport syndrome (1case), abnormal glomerular basement membrane (1 case) followed. 3) Types of recurrent hematuria ware gross in 22 cases and microscopic in 6 cases. Flank pain was noted only 1 case. The prodromal events of hematuria were upper respiratory infection in 15 cases and severe exercise in 2 cases. 4) There were no significant differences in clinical features and laboratory findings between IgA nephropathy and other pathologic lesions, except for higher frequency of proteinuria in former group. 5) During the follow-up periods, three cases were resulted in chronic renal failure and they were two cases of IgA nephropathy Class IV and one case of Alport syndrome. And one case of IgA nephropathy was resulted in nephrotic syndrom.
Child ; Flank Pain ; Follow-Up Studies ; Glomerular Basement Membrane ; Glomerulonephritis ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranous ; Hematuria* ; Humans ; Kidney Failure, Chronic ; Nephritis, Hereditary ; Proteinuria ; Sex Ratio

The mortality and morbidity of peritrochanteric fractures in the elderly are great due to preexisting diseases, the osteoporosis, and poor general conditions. Since the complications sometimes lead to death, it is utmost important to reduce the complications and to prevent them. Authors had experienced 42 peritrochanteric fractures over 65 years old from January, 1988 to December, 1992. Age incidence was distributed from 65 to 93 years. The sites of fractures were 17 femoral neck, 24 intertrochanteric, 1 subtrochanteric. The mortality at postoperative 6 months was 10.2%. The postoperative complications were 6 cardiovascular diseases, 3 pneunonia, 3 pressure sore etc. The results according to interval between injury and operation were not significant, but reducing risk factors following check-up of general conditions was significant. It was necessary in treatment of elderly peritrochanteric fractures to check the general conditions, to reduce risk factors, to choose appropriate method of operation and anesthesia, and to operate as soon as possible by experienced surgeon. Postoperative early ambulation was also significant at good results. The percutaneous pinning under local anesthesia was an recommendable method in patients with severely poor general conditions.
Aged ; Anesthesia ; Anesthesia, Local ; Cardiovascular Diseases ; Early Ambulation ; Femur Neck ; Humans ; Incidence ; Methods ; Mortality ; Osteoporosis ; Postoperative Complications ; Preexisting Condition Coverage ; Pressure Ulcer ; Risk Factors

BACKGROUND AND SIGNIFICANCE: Fungal infection of the central nervous system can be attributable to Cryptococcus, Nocardia, Mucor, Candida, and rarely Aspergillus. The types of nervous system involvement by Aspergillus can be divided into 4 groups : meningitis, meningoencephalitis, brain abscess, and single solid granuloma. Aspergillosis involving the central nervous system is a rare disease. Aspergillosis presenting as cerebral infarction has been rarely reported. We experienced one case of intracerebral abscess caused by Aspergillus, presenting as cerebral infarction. CASE: A 54-year-old male, with a history of diabetes mellitus for 7 years, was admitted with headache for 1 month. Initial CSF findings showed pleocytosis(180/ul), and increased protein(79mg/dl). On the 2nd admission day, the patient showed left hemiparesis, left facial palsy of central type and drowsiness. Brain MRI revealed right MCA infarction. Neurologic status was stationary for almost 2wks. The WBC count of CSF was increased to 1150/ul on the 14th admission day, and antituberculous medication was started. On the 27th admission day, deep drowsy mentality was noted. Treatment with steroid was done and then mentality was improved to drowsiness. Brain abscess was found in right frontotemporal area and there were herniation signs on the 29th admssion day. Aspiration was done. Aspergillus fumigatus was grown on fungus culture of CSF and amphotericin B was started. CONCLUSION: We report a rare case of intracerebral Aspergillosis, manifested by right MCA infarction and brain abscess.
Abscess* ; Amphotericin B ; Aspergillosis ; Aspergillus fumigatus ; Aspergillus* ; Brain ; Brain Abscess ; Candida ; Central Nervous System ; Cerebral Infarction* ; Cryptococcus ; Diabetes Mellitus ; Facial Paralysis ; Fungi ; Granuloma ; Headache ; Humans ; Infarction, Middle Cerebral Artery ; Magnetic Resonance Imaging ; Male ; Meningitis ; Meningoencephalitis ; Middle Aged ; Mucor ; Nervous System ; Nocardia ; Paresis ; Rare Diseases ; Sleep Stages

BACKGROUND: Transient myocardial ischemia that is recorded on Holter monitoring after a myocardial infarction is known to be a risk factor of myocardial reinfarction or death. However, it is still uncertain whether transient myocardial ischemia is a cause of ventricular arrhythmias or is simply an indicator of severe coronary artery disease. Therefore, we have studied the relation of ventricular arrhythmias to transient myocardial ischemia detected on Holter monitoring after a myocardial infarction. METHOD: We studied 40 patients with acute myocardial infarction who were performed Holter monitoring, 7 to 14 days after an attack. On Holter monitoring, we analyzed the prevalence, characteristics of transient myocardial ischemia and its relation to ventricular arrhythmias. RESULTS: 1) Among 40 patients(32 men, 8 women, mean age 53+/-13), transient myocardial ischemia was recorded in 13 patients(33%). ST elevation was observed in 2 patients, and ST depression, in 11 patients. Total episodes of transient myocardial ischemia were 65, of which only one episode was accompanied by chest pain, and total daily episodes were 4.8+/-1.4. Total daily duration of transient myocardial ischemia was 61.4+/-15.5 minutes and the duration of each transient myocardial ischemia was 15.8+/-2.1 minutes. 2) There were no significant differences in frequencies of single ventricular premature beast, bigeminy, trigeminy, ventricular couplets, and ventricular tachycardias between two groups with and without transient myocardial ischemia. CONCLUSION: It is concluded that transient myocardial ischemia on Holter monitoring after myocardial infarction is not a cause of ventricular arrhythmias.
Arrhythmias, Cardiac* ; Chest Pain ; Coronary Artery Disease ; Depression ; Electrocardiography, Ambulatory* ; Female ; Humans ; Male ; Myocardial Infarction* ; Myocardial Ischemia* ; Prevalence ; Risk Factors ; Tachycardia, Ventricular

BACKGROUND: Systemic hypertension produces varying degree of LVH which is associated with increased cardiovascular morbidiity. Previous studies have documented regression of LVH with various antihypertensives including calcium channel blockers, except diuretics and vasodilators. Recently echocadiographic assessment of the change of left ventricular mass(LVM) after antihyertensive therapy have been reported to offer prognostic cardiovascular information. The aim of this echocardiographic study is determining the influence of nicardipine, a calcium channel blocker, on the change of LVM in patients with essential hypertenison. METHODS: Left ventricular mass(LVM) and left ventricular mass index(LVMI) were measured by M-mode echocardiography in 15 patients with essential hypertension. Nicardipine, a calcium channel blocker, was administered for 6 months and two echocardiographies were done before and after administering, respectively. RESULTS: In the 15 patients treated for 6 months, systolic and diastolic pressure remained very significantly decreased compared with pressure before before therapy(135+/-15mmHg vs 168+/-26mmHg, and 86+/-7mmHg vs 105+/-16mmHg, both p<0.01). Concomitantly both LVM and LVMI decreased significantly(209+/-49g vs 235+/-71g, and 116+/-6g/m2 vs 131+/-38g/m2,both p<0.05). And no change was noted in left ventricular cavity size, demonstration that LVM reduction was due to regression of hypertrophy. CONCLUSION: This study showed that nicardipine produced a significant decrease in blood pressure, LVM, and LVMI over the 6 months period. And large and longterm controlled studies are needed for the clarification of the association between nicardipine and regression of LVH in hypertensive patients.
Antihypertensive Agents ; Blood Pressure ; Calcium Channel Blockers ; Calcium Channels ; Diuretics ; Echocardiography ; Humans ; Hypertension ; Hypertrophy ; Nicardipine* ; Vasodilator Agents

Diabetes mellitus is one of the leading metabolic diseases that cause an increasing rate of mortality and morbidity. Recently, rather than the current drug treatment, pancreatic islet transplantation has been regarded as a potentially promising strategy for insulin- dependent diabetes mellitus while preventing complications such as kidney damage, vascular damage, nerve damage, and blindness. Recently, a number of advanced islet encapsulation techniques have been designed to enhance the efficiency of islet transplantation, including cell sheet engineering and generation of 3D islet spheroids by high density suspension system (HDSS). Chondrocytes derived from cartilage sources have been used as an encapsulation biomaterial for islets not only for autograft but also for allograft and xenograft transplantation. Cartilage is an avascular, white connective tissue that is rich in extracellular matrix, and expandable in vitro. Hence, this tissue might have immunologically privileged properties that make it an intelligent cell source for manufacture of encapsulation biomaterials. However, cell sheet engineering and HDSS still have their respective limitations, which need to be elucidated. This review will describe the advantages and disadvantages of the current encapsulation techniques in order to provide a comprehensive foundation for further modifications and improvements of tissue engineering for islet transplantation.
Allografts ; Autografts ; Biocompatible Materials ; Blindness ; Cartilage ; Chondrocytes* ; Connective Tissue ; Diabetes Mellitus ; Extracellular Matrix ; Islets of Langerhans ; Islets of Langerhans Transplantation ; Kidney ; Metabolic Diseases ; Mortality ; Tissue Engineering ; Transplantation, Heterologous