In the classical ballet dancers, ankle joints are frequently overused. Especially the Pointe and the Releve are the two basic steps of ballet dance which cause the narrowing of the posterior aspect of the ankle joint. Posterior impingement syndrome of the ankle joint is defined as impingement occuring at the anatomical interval between the posterior tibial articular surface and os calcis. The purpose of this study is to describe the anatomy and etiology of this injury and to review the non-operative and operative treatments. Sixteen cases of posterior impingment syndrome had been treated between March 1994 and March 1995. Ten dancers were professional and six were students. The patients was divided 3groups by etiologic factor. Group 1 is anatomical problem factor, Group 2 is overuse factor and Group 3 is ankle sprain factor. Thirteen dancers (81.2%) improved with conservative treatment including local steroid injection. Among the other three dancers, operation was performed in one case. The other two cases stopped dancing. The result was good in one dancer after operation. In the classic ballet dancers, posrerior impingement syndrome was frequent disorder and major etiologic factors are anatomical problem and overuse. Operation was necessary in only group l. It is good result in conservative treatment and operation.
Ankle Injuries ; Ankle Joint* ; Ankle* ; Dancing ; Humans

PURPOSE: Chronic lung disease is a cause of significant morbidity and mortality in the neonatal respiratory distress syndrome. Although the exact mechanisms leading to the development of chronic lung disease are unknown, there is increasing evidence indicating that pulmonary inflammation contributes to the pathogenesis. The proinflammatory cytokines, interleukin(IL)-1beta, IL-8 may have a role to play in initiating the inflammatory response that is seen in chronic lung disease. In contrast, IL-10 is an antiinflammatory cytokine. The abnormal persistent inflammatory process in chronic lung disease may be due to dysregulation of these proinflammatory cytokines. So, to describe cytokine profiles of chronic lung disease in neonate, we analysed the IL-1beta, IL-8 and IL-10 levels in bronchoalveolar lavage fluid by ELISA technique. METHODS: We obtained bronchoalveolar lavage samples from 14 respiratory distress syndrome infants without chronic lung disease and 8 respiratory distress syndrome infants with chronic lungisease. The cytokine levels were assayed. RESULTS: The results were as follows: 1) IL-1beta levels were higher in chronic lung disease group(205.16+/-360.21pg/rnl) than group without chronic lung disease(21.21+/-26.14pg/ml)(P<0.05). 2) IL-8 levels were also higher in chronic lung disease group(166.16+/-347.26pg/ml) than group without chronic lung disease(49.85+/-105.27pg/ml)(P>0.05). 3) In contrast, IL-10 levels were lower in chronic lung disease group(78.29+/-138.69pg/ml) than group without chronic lung disease(111.29+/-155.27pg/ml)(P>0.05). CONCLUSION: These results suggest that the dysregulation of cytokines contributes to the pathogenesis of chronic lung disease. The difference in cytokine levels of bronchoalveolar lavage fluid can be used as a predictor for development of chronic lung disease.
Bronchoalveolar Lavage Fluid* ; Bronchoalveolar Lavage* ; Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Infant ; Infant, Newborn ; Interleukin-10 ; Interleukin-8 ; Lung Diseases* ; Lung* ; Mortality ; Pneumonia ; Respiratory Distress Syndrome, Newborn

No abstract available.
Brain Neoplasms* ; Brain* ; Child* ; Humans

BACKGROUND: Induction of anesthesia with propofol commonly associated with reduction in systemic arterial pressure, especially in elderly and high risk patients. This reduction is influenced by the dose and rate of propofol injection. The aim of this study was to examine the effect of different injection rate of propofol on vital signs, dose requirement and induction time during induction period. METHODS: Unpremedicated one hundred and twenty ASA physical status I and II patients aged 20~60 years scheduled for elective surgery were randomly allocated into one of four (150, 300, 600, 1200 ml/hr) groups according to speed of injection of propofol during induction period. Loss of verbal contact was taken as the end-point of induction. Vital signs, SpO2, dose requirement of propofol and induction time were checked. RESULTS: As the injection rate of propofol became slower, there were significant reduction in induction dose and increase in induction time (p<0.05). For example, induction dose and time were 1.82 mg/kg, 223 +/- 58 sec in 150 ml/hr group and 3.14 mg/kg, 50 +/- 11 sec in 1200 ml/hr group, respectively. Also, decrease in systolic and diastolic pressure were less marked at lower injection rates. CONCLUSIONS: Slower injection of propofol produces less vital sign changes and dose requirement for the induction of anesthesia.
Aged ; Anesthesia* ; Arterial Pressure ; Blood Pressure ; Humans ; Propofol* ; Vital Signs*

No abstract available.
Rectal Neoplasms*

No abstract available.
Rectal Neoplasms*

Congenital cystic adenomatoid malformation of the lung is a rare form of congenital cystic disease of the lung and associated with developmental arrest of bronchioles in embryonic life. We report 3 cases of congenital cystic adenomatoid malformation which are classified as type I, II and III according to the morphological classification by Stocker et al. The first case was a 6-year-old female with a mass in the lower lobe of the right lung. The mass was composed of several cysts which were filled with inflammatory exudate and lined by ciliated pseudostratified columnar epithelium (type I + II). The second case was a 4-year-old female with a mass in the middle lobe of the right lung. It was composed of numerous small cysts which were uniform sized and contained inflammatory exudate. These were lined by ciliated columnar and pseudostratified columnar epithelium (type II). The third case was a stillborn female at 27 weeks of gestation. There was generalized edema and severe ascites. The left lower lobe consisted of an ill-defined solid area and small cysts. The solid lesion was composed of bronchiole-sized cysts lined by non-ciliated cuboidal epithelium (type II + III).
Female ; Humans ; Cysts

STUDY DESIGN: Thirty-fiye thoracolumbar and lumbar burst fractures treated with pedicle screw instrumentation were assessed on loss reduction. OBJECTIVE: To compare the mechanical results of simple posterior fixation and posterior fixation with anterior augmentation by anterior interbody fusion, disc space fusion or longer construct. SUMMARY OF BACKGROUND DATA: Althrough the pedicle screw instrumentation provides good mechanical stability, two segment fixation without anterior column augmentation may not be adequate to withstand the repeated axial load. METHODS: Fifteen patients were treated with two segment fixation alone(Group 1), seven with anterior interbody fusion(Group 2), another seven with disc space fusion(Group 3) and remaining six with longer construct involving two segments abode the fracture(Croup 4). Change of anterior body height, upper disc height, lower disc height, kyphotic angle, inter-screw angle and gross screw bend- ing were measured using post-operative and follow-up lateral radiographs. RESULTS: Comparing the two groups(Croup 1 Ys. Group 2, 3, 4), the Group 1 showed definitely more loss of reduction than those groups which had anterior augmentation. But, loss of anterior body height was not significantly different. Comparing the four groups, loss at upper and lower disc height was significantly greater in the Group 1 than the Group 2. Change of kyphotic angle was significantly higher in the Group 1 than the Group 4 and change of inter-screw angle was also higher in the group 1 than every other group. Seyen patients in the Group 1 showed gross screw bending, but none in the Group 2, 3 and 4. All the seven patients with screw bending showed loss of inter-screw angle more than 5 . CONCLUSIONS: These results mean that anterior column augmentation is necessary for the treatment of thoraco-lumbar burst fracture. All the three methods(Group 2,3,4) are effective to prevent excessive loss of correction and screw bending. The best method should be selected considering the characters of each fracture.
Body Height ; Follow-Up Studies ; Humans

We present a case of pemphigus vulgaris developed during pregnancy. The clinical features of this patient were similar to those of hetpes gestationis. By immunofluorescence studies we found that the patient's serum contained autoantibodies to intercellular substance of epidermis. Direct immunofluorescence microscopy of a perilesional skin also demontrated immunoglobulin deposition in the intercellular areas. Additionally we did in vitro C3 staining for further confirmation of the diagnosis but it was negative in basement membrane zone. This patient was initially treated with corticosteroid and azathioprine. Several months later gold compound was given instead of azathioprine and corticosteroid with good therapeutic response.
Autoantibodies ; Azathioprine ; Basement Membrane ; Diagnosis ; Epidermis ; Fluorescent Antibody Technique ; Fluorescent Antibody Technique, Direct ; Humans ; Immunoglobulins ; Microscopy ; Pemphigus* ; Pregnancy* ; Skin

Restoration of the M-P joint of a damaged or lost joint by trauma, tumor and others is necessary for adequate function of the hand. Several procedure have been described for restoration of the M-P joint. We experienced a case of vascularized joint transter for a lost joint by trauma. After 1 year and 2 months follow-up, there have been no degenerative change and no pain.
Follow-Up Studies ; Hand ; Joints