Sixteen cases of congenital hemangiomata were treated with intralesional corticosteroid injectinn and followed up for 3 to 48 months. They consisted of 9 cases of strawberry hemangiomata with soft consistency, 4 cases of strawbery hemangiomata with firm consistency and 3 cases of cavernous hemangiomata. The results were as follows : 1) All the soft strawberry hemangiomata showed excellent response with marked shrinkage by single treatment. 2) The firm strawberry hemangiomata showed poor response with visible shrinkage after five times treatment, in average. 3) Among three cases of cavernous hemangiomata, one case with large palpable blood vessels in the lesion showed poor response, and two cases without palpable blood vessels in the lesion showed good response. 4) Temporary atrophy and pallor of the skin color were noticed in about half of the cases. Considering the concern of the patients parents, course of the hemangiomata., and the simplicity and effects of the treatment, this therapeutic method is regarded useful in the management of congenital hemangiomata, especially in soft st r awberry hemangiomata.
Atrophy ; Blood Vessels ; Fragaria ; Humans ; Pallor ; Parents ; Skin

A clinical analysis was done on 129 patients (131 cases) of the ankle fractures that were admitted and treated in Orthopedic Department, Inchon Christian Hospital from January 1973 to December 1980. The following results were obtained: l. Of the 129 patients, male was 104 patients and female 25 patients, the average age of the patients was 37. 2. The main cause of the injuries was traffic accident (38.2%), and the remain causes were industrial accident (28.2%), fall down (18.3%), slip down (11.5%), and sports injury (3.8%) in order. 3. The most common type by Lauge-Hansen classification was supination-external rotation type (37.4%). 4. In method of treatment, operative treatment was done in 72 cases and nonoperative in 59 cases. 5 The average duration of the cast immobilization in nonoperative treatment was 8 weeks and operative 7 weeks. 6. The better result was obtained by operative treatment than nonoperative one. 7. The most poor result was noticed in pronation-external rotation type according to Lauge-Hansen classification. 8. We agree that the accurate reduction of the lateral malleolus make the talus in good anatomic position in ankle joint. 9. We agree that Lauge-Hansen classification is useful in diagnosis and treatment of ankle fracture.
Accidents, Occupational ; Accidents, Traffic ; Ankle Fractures ; Ankle Joint ; Ankle ; Athletic Injuries ; Classification ; Clinical Study ; Diagnosis ; Female ; Humans ; Immobilization ; Incheon ; Male ; Methods ; Orthopedics ; Talus

Thirty-seven patient who had forearm bone fracture were treated by four different methods at the Department of Orthopedic Surgery, Soonchunhyang University Hospital from Jan. 1979 to March 1982. The obtained results are as follow; 1. Nineteen cases out of 37 cases of the forearm bone fracture were both forearm bones, 10 cases were ulna and 8 were radius fracture. 2. Twenty-three cases out of 37 were closed and 13 cases were open fracture, respectably. 3. The applied treatment were manual reduction with cast immobilization, intramedullary naliing, plate and screw fixation and combined. 4. Mean duration of primary bone union of the forerm bone fracture which were treated by plate and screw was 12. 4 weeks, combined fixation was 12.8 weeks, intramedullary nailing was 15.3 weeks and that of manual reduction and cast was 16 weeks in order. 5. Functional result was classified according to the rating system of Smith and Sage. The best method was plate and screw and the worst was manual reduction and cast immobilization. 6. D.C.P. fixation seems to be one of the best method in this series. Combined method, in a way of D.C.P. for radius and I–M nailing for ulna, is a method when shortening of operation time is inevitable.
Adult ; Forearm ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Fractures, Open ; Humans ; Immobilization ; Methods ; Orthopedics ; Radius ; Radius Fractures ; Ulna

Purpose: A laparoscopic radical nephrectomy (LRN) has emerged as the standard care in appropriate candidates with stage T1 renal tumors (7cm or less). We extended our experience of LRN to stage T2 renal tumors (greater than 7cm), and compared the results with those of LRN for stage T1 renal tumors, as well as with those of an open radical nephrectomy (ORN) for stage T2 renal tumors. Materials and Methods: Between January 2001 and December 2004, a total of 67 patients, who underwent LRN for renal cell carcinomas, were retrospectively subdivided into the LRNT1 (n=48, tumor size7cm) groups. The surgical outcomes and perioperative morbidities were retrospectively evaluated. Also, the results of the LRNT2 group were compared with those of the open radical nephrectomy T2 group (ORNT2, n=29). Results: Compared with the LRNT1 group, the LRNT2 group only had larger tumors, but comparable operation time, blood loss, variation in the creatinine value (Cr), analgesics requirements, time to ambulate and diet, hospital stay and complication rates. The tumor sizes were similar in the two groups (p=0.260). However, the LRNT2 group had shorter operation time (p=0.039), lesser blood loss (p=0.044), Cr (p=0.027), analgesic requirements (p<0.001) and time to ambulation, diet and hospital stay (p<0.001, all). Conclusions: A LRN for stage T2 renal tumors is feasible and efficacious. The surgical outcomes were comparable with those of a LRN for stage T1 tumors, with the advantages of decreased blood loss and more rapid recovery over that of an ORN for comparable tumors greater than 7cm in size.
Analgesics ; Carcinoma, Renal Cell* ; Creatinine ; Diet ; Humans ; Laparoscopy ; Length of Stay ; Nephrectomy* ; Retrospective Studies ; Walking

No abstract available.
Animals ; Brain* ; Ischemia* ; Prosencephalon* ; Rats*

BACKGROUND: Intravenous anesthetics such as propofol and ketamine have been known to have neuroprotective effects. However, the combination of these drug is not known. This study was conducted to determine the neuroprotective effects of propofol, ketamine or both after transient forebrain ischemia. METHODS: Twenty Sprague-Dawley rats (250-300 gm) were used. Anesthesia was induced with 4% isoflurane in oxygen and then maintained with 1 - 2% isoflurane in oxygen. Ischemic injury was induced by 10 minutes of both common carotid artery ligation and hypotension (MAP < 50 mmHg). All rats were randomly divided into four groups: group I; control group; group II; ketamine 10 mg/kg was administered 10 minutes before injury; group III; propofol (1 mg/kg/min) was administered until EEG isoelectricity; and group IV; ketamine 10 mg/kg and propofol 1 mg/kg/min was administered. The Rectal temperature was maintained at 38oC. After forebrain ischemia, neurologic scores were estimated at 1 hr, 2 hrs, 1 day and 2 days after recovery. The brain was removed 3 days after and stained with H-E stain. RESULTS: Neurologic and histologic scores of group II, III, IV were significantly lower than that of group I. However, there were no significant difference between group II, III and IV. CONCLUSIONS: Ketamine and propofol have neuroprotective effects in transient forebrain ischemia in rats. However, the combination of propofol and ketamine did not show any synergistic or additive effects.
Anesthesia ; Anesthetics, Intravenous ; Animals ; Brain ; Carotid Artery, Common ; Electroencephalography ; Hypotension ; Ischemia* ; Isoflurane ; Ketamine* ; Ligation ; Neuroprotective Agents* ; Oxygen ; Propofol* ; Prosencephalon* ; Rats* ; Rats, Sprague-Dawley

Insertion of a pulmonary artery catheter for the measurement of pulmonary artery pressures and cardiac output has been widely used for the management of patients undergoing open heart surgery. Complications of pulmonary artery catheter insertion include cardiac arrhythmia, thromboembolism, tricuspid valve injury, intracardiac knotting, pulmonary artery rupture. We experienced a case of catheter-related complication which was caused by suturing pulmonary artery catheter during right atrial bleeding control during open heart surgery. The catheter was attached to the right atrial wall by nylon suture and successfully removed by operation without significant complication.
Arrhythmias, Cardiac ; Cardiac Output ; Catheters* ; Heart* ; Hemorrhage ; Humans ; Nylons ; Pulmonary Artery* ; Rupture ; Sutures ; Thoracic Surgery* ; Thromboembolism ; Tricuspid Valve

Background: Osteochondral autologous transplantation (OAT) has been widely used in the treatment of osteochondral lesion of the talus (OLT). Previous studies have reported successful outcomes following the use of osteochondral autogenous grafts from the intercondylar notch of the knee or a non-weight-bearing region of the femoral condyle. However, donor-site morbidity of the knee joint has been observed in several cases. This study aimed to investigate the outcomes and safety of OAT with autografts from the ipsilateral lateral talar articular facet as an alternative donor site for medial OLT. Methods: Among 40 patients who underwent OAT, 29 patients were excluded. Eleven patients who underwent OAT with an osteochondral graft harvested from the ipsilateral lateral talar articular facet from 2011 to 2022 were retrospectively analyzed. The size of OLT was measured on ankle magnetic resonance imaging, including coronal length, sagittal length, depth, and area. Clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and a visual analog scale (VAS). Weight-bearing ankle radiographs were obtained postoperatively and at 1 year after surgery. Results: The average follow-up time after surgery was 64.7 months (range, 14–137 months). The average diameter of lesions was 8.8 mm (range, 8–9.9 mm). The average size of lesions was 51.2 mm2 (range, 33.6–71.3 mm2 ) , and all lesions included subchondral cysts. The average depth of lesions was 7.3 mm (range, 6.2–9.1 mm). Graft sizes ranged from 8 to 10 mm in diameter (8 mm, n = 1; 10 mm, n = 10) All measured clinical outcomes improved postoperatively, including the AOFAS scores (preoperative, 55.4 ± 9.0;1-year follow-up, 92.1 ± 7.6; p = 0.001) and VAS scores (preoperative, 5.5 ± 0.7; 1-year follow-up, 1.9 ± 0.8; p = 0.001). All weightbearing ankle radiographs of the graft and donor sites did not reveal arthritic change in the ankle joint, lateral talar dome collapse, and graft-site delayed union or nonunion at 1 year after surgery. Conclusions For a single medial OLT, harvesting autografts from the ipsilateral lateral talar articular facet without knee donorsite morbidities can be a good alternative in OAT for OLT.

OBJECTIVE: We conducted a retrospective cohort study to elucidate the natural course of unruptured intracranial aneurysms (UIAs) at a single institution. METHODS: Data from patients diagnosed with UIA from March 2000 to May 2008 at our hospital were subjected to a retrospective analysis. The cumulative and annual aneurysm rupture rates were calculated. Additionally, risk factors associated with aneurysmal rupture were identified. RESULTS: A total of 1339 aneurysms in 1006 patients met the inclusion criteria. During the follow-up period, 685 aneurysms were treated before rupture via either an open surgical or endovascular procedure. Six hundred fifty-four UIAs were identified and not repaired during the follow-up period. The mean UIA size was 4.5+/-3.2 mm, and 86.5% of the total UIAs had a largest dimension <7 mm. Among these UIAs, 18 ruptured at a median of 1.6 years (range : 27 days to 9.8 years) after day 0. The annual rupture risk during a 9-year follow-up was 1.00%. A multivariate Cox proportional hazards analysis revealed that the aneurysm size and a history of subarachnoid hemorrhage (SAH) were statistically significant risk factors for rupture. For an aneurysms smaller than 7 mm in the absence of a history of SAH, the annual rupture risk was 0.79%. CONCLUSION: In our study, the annual rupture risk for UIAs smaller than 7 mm in the absence of a history of SAH was higher than that of Western populations but similar to that of the Japanese population.
Aneurysm ; Asian Continental Ancestry Group ; Cohort Studies ; Endovascular Procedures ; Follow-Up Studies ; Humans ; Intracranial Aneurysm* ; Natural History* ; Retrospective Studies* ; Risk Factors ; Rupture ; Subarachnoid Hemorrhage

Exercise-induced ischemic ST responses were analyzed in 36 patients who presented with chest pain and had exercise test and the results were compared with their coronary angiographic findings. Among 36 exercise test positives, the incidences of one-, two- and three vessel disease, and left main disease were 25%(9 cases), 30%(11 cases), 25%(9 cases) and 9%(3 cases), respectively. The incidence of multivessel disease(i.e., two-to three vessel disease or left main disease) in patients with ST depression > or =2.0mm was 72% and that in those with ST depression of 1.0-1.9mm was 45%. In patients with downsloping ST depression, the incidence of multivessel disease was significantly higher than that of one vessel disease(86% vs 14%, p<0.001). But both incidences of one vessel disease and multivessel disease were similar in patients with flat and slowly upsloping ST depression. More than two thirds of patients with ischemic ST depression appearing in the first 6 minutes of exercise or those lasting past 7 minutes in recovery were associated with multivessel disease. It is concluded that attention to depth, type, appearance time and duration of ST depression during exercise test is particularly helpful in detecting patients with advanced coronary disease.
Chest Pain ; Coronary Artery Disease* ; Coronary Disease ; Coronary Vessels* ; Depression ; Electrocardiography* ; Exercise Test ; Humans ; Incidence