BACKGROUND: Hemoptysis is a common clinical symptom, responsible for 11% of admission to the hospital chest service. Correct diagnosis, accurate localization of the bleeding source and proper management are imperative to reduce the risk of massive hemoptysis. We performed the study to define the optimal time of fiberoptic bronchoscopy in 63 patients with hemoptysis admitted to Kyung Hee University Hospital between Aug 1989 and Aug1992. METHODS: Retrospective analysis of medical records concerning the cause, amount, duration of hemoptysis and the timing of fiberoptic bronchoscopy in 63(M:F=36:27) patients. RESULTS: 1) The main causes of hemoptysis were pulmonary tuberculosis(52.4%) bronchiectasis(27.0%) and lung cancer(11.1%). 2) The bleeding sites were localized in 26 Patients(41.3%). 3) The rates of localization of bleeding site were not related to the amount and duration of hemoptysis. 4) The rates of localization of bleeding site were 61.8%(21/34) during hemoptysis,18.2%(122) within 24hr after resolution of hemoptysis, 14.3%(1/7) thereafter. CONCLUSION: Early bronchoscopy, especially during hemoptysis may show higher rates of successful localization than delayed bronchoscopy.
Bronchoscopy* ; Diagnosis ; Hemoptysis* ; Hemorrhage* ; Humans ; Lung ; Medical Records ; Retrospective Studies ; Thorax

No abstract available.
Tinnitus*

PURPOSE: To evaluate the efficiency of lateral plate fixation using minimally invasive plate osteosynthesis (MIPO) technique as a treatment of distal tibial metaphyseal fracture. MATERIALS AND METHODS: Among the patient who were treated from March, 2002 to September, 2004, the cases of twenty patients with distal tibial metaphyseal fracture treated by lateral plate fixation using MIPO technique who were able to be followed up for at least one-year period were reviewed in this study. According to AO/OTA classification, five were type A1, twelve cases were type A2 and other three cases were type A3, and among them two cases were open fracture type I according to the Gustillo-Anderson classification. Radiologic studies and clinical assessment described by Daniel et al and complication following the treatment were evaluated. RESULTS: At a mean of 16.4 weeks (range 11 to 23), all fractures united without secondary procedures. According to clinical assessment, all cases had good and excellent result, and there were no complications. CONCLUSION: The lateral plate fixation using MIPO technique of distal tibial metaphyseal fracture is an efficient method of treatment with high functional recovery rate which minimize soft tissue damage, decreases the risk of infection and incidence of nonunion at the same time as the classic MIPO technique does, and it is a useful alternative method when there is a anteromedial soft tissue damage.
Classification ; Fractures, Open ; Humans ; Incidence

PURPOSE: The purpose of this study was to investigate usefulness of locking compression plate (LCP) as an open reduction technique by evaluating clinical results obtained from the patients with lateral malleolar fracture treated by internal fixation using LCP after open reduction. MATERIALS AND METHODS: Among the patients with lateral malleolar fracture, the 28 patients who were treated by internal fixation using Locking compression plate after an open reduction and were able to be followed up for more than 6 months were included in this study. Final postoperative evaluation was done based on the Meyer's clinical and radiologic evaluation system. RESULTS: All cases achieved anatomical reduction and fixation of the reduction postoperatively. 28 minutes were taken meaningly from the incision to the fixation of LCP plate after the anatomical reduction. Everage bony union time was 8.2 weaks, and the result was excellent in 23 cases (82%), good in 5 cases (17%) and poor result was abscent according to the criteria of Meyer et al. One case of post traumatic arthritis and one case of superficial infection on the operation site were found, but non-union, delayed union and malunion were not occurred. CONCLUSION: The internal fixation after open reduction using LCP is an effective treatment method in treating lateral malleolar fracture of the ankle since it offers advantages including easy application and a greater stability due to its capability of maintaining exact anatomical reduction even though the screw does not penetrate the medial cortex of fibular to add the stability and rigidity of the fixation.
Ankle ; Arthritis ; Humans

PURPOSE: To evaluate the clinical result of two stage reimplantation of infected total knee arthroplasties, using an antibiotics impregnated articulating cement spacer. MATERIALS AND METHODS: Out of total 7 cases with infected total knee arthroplasties, 4 cases treated with two stage reimplantation, using an antibiotics impregnated articulating cement spacer were included in this study. After the treatment of infected total knee arthroplasties, the treatment of infection was evaluated by physical examination, radiologic studies, and hematologic studies. The results were evaluated using the Hospital for Special Surgery Knee Score (HSS). RESULTS: As results, 4 infected knee cases treated with two stage reimplantation did not have reinfection at the time of the follow up, and physical, laboratory, and radiologic studies were all within normal range. The range of motion of the reimplanted knees were from -5degrees in extension to 130 degrees in flexion, with an average of 117 degrees. The average score of the Hospital for Special Surgery Knee Score was 87. CONCLUSION: In conclusion, two stage arthroplasties, using antibiotics impregnated articulating cement spacer was an effective therapy not only for the treatment of the infection after the total knee arthroplasty but also effectiveness for recovery of the knee function.
Anti-Bacterial Agents* ; Arthroplasty* ; Follow-Up Studies ; Knee* ; Physical Examination ; Range of Motion, Articular ; Reference Values ; Replantation*

BACKGROUND: Transthoracic fine needle aspiration and biopsy(TNAB) has become a frequently used technique in the investigation of the intrathoracic lesions because of its safety, reliability, and accuracy. METHOD: Data on 125 patients who underwent TNAB from 1990 through 1994 were studied to determine the diagnostic sensitivity, accuracy and complications of this procedure as related to lesion type and location. RESULTS: 1. The over-all diagnostic sensitivity of TNAB was 61.6%(77 of 125 patients). 2. The diagnostic yields were as high as 89.9% for malignant lesions, but a specific diagnosis of benign lesions were obtained only in 30% of benign lung lesions. 3. The correlation between results of TNAB cytology and of final histology was as high as 88.2%. 4. Lung lesions that were greater than 3cm in size had a higher proportion of correct diagnosis(73.3%) as compared with lesions 3cm or less in size(38.1%). But there was no significant difference between the central and peripheral lung lesions. 5. There were no serious complications to TNAB. In 12.8% of the procedures a pneumothorax developed, indicating a chest tube in 1.6% of the procedures. In 2 cases, minimal hemoptysis developed which did not require treatment. CONCLUSION: In our experience, TNAB represents a minor and safe procedure, which permits a direct approach to localized malignant lung lesions with a high degree of accuracy.
Biopsy* ; Biopsy, Fine-Needle ; Chest Tubes ; Diagnosis ; Hemoptysis ; Humans ; Lung* ; Pneumothorax

No abstract available.
Arnold-Chiari Malformation*

It is well known that involvement of the cranial nerves is a relatively common manifestation of tuberculous meningitis because tuberculous exudate is most likely to be located at the base of brain and in the basal cisterns. We reviewed 73 adult patients under the diagnosis of tuberculous meningitis at Hanyang University Hospital during last three and a half years from March, 1986. Patients were classified into two groups according to the presence or absence of cranial nerve palsies. Cranial nerve palsies were noted in 22 patients (30.1%) at the time of admission or in the early period of antituberculous therapy. The oculomotor and abdcens nerves were most commonly involved, followed by the optic nerve. In 10 cases with oculomotor nerve palsy, 7 cases were noted to have involvement of both pupils and extraocular movements, 2 had involvement of one pupil only and one remaining case involved extraocular movements only (spared pupil). Cranial nerve palsies developed 7 to 89 days (median, 21.5) after initial symptoms, and in 10 cases their palsies disappeared within 15 to 65 days (median, 40.9). The incidence of SIADH and basal meningeal involvement were much higher in the cranial nerve palsy group. Increase of total protein and decrease of sugar in initial CSF examination were significant (p<0.05) in the cranial nerve palsy group.
Adult* ; Brain ; Cranial Nerve Diseases* ; Cranial Nerves* ; Diagnosis ; Exudates and Transudates ; Humans ; Inappropriate ADH Syndrome ; Incidence ; Oculomotor Nerve Diseases ; Optic Nerve ; Paralysis ; Pupil ; Tuberculosis, Meningeal*

Gout is a metabolic disorder manifested by hyperuricemia due to genetic or acquired diseases. The pathognomic lesion is the tophus which fine crystals of monosodium urate are deposited in articular carti- lage, synovia, tendon sheaths and other periarticular structures, epiphyseal bone, subcutaneous layers of the skin, and interstitial areas of the kidney. Frequent sites of tophaceous deposit are the external ear and subcutaneous deposits in the finger tips, palms and soles. Tophaceous gout involving the space of bipartite patella is very unusual and has not been reported before in Korea. So, we report a case of 38 year old male patient who presented with tophaceous gout involving the space of bipartite patella with review of literatures.
Adult ; Ear, External ; Fingers ; Gout* ; Humans ; Hyperuricemia ; Kidney ; Korea ; Male ; Patella* ; Skin ; Synovial Fluid ; Tendons ; Uric Acid

Von Hippel-Lindau disease is a rare disorder which involves multi-organs including cerebellum and retina. Recently we have experienced 2 cases of von Hippel-Lindau disease. The case 1 was a 19-year-old female with chief complaint of severe headache accompanied by vomiting on admission. Computed tomogram of brain showed space occupying lesion in the posterior fossa. She was rapidly deteriorated and diagnosed as brain death on the basis of physical and neurological examination and electroencephalogram. Kidney specimens removed for the transplantation and cerebellum obtained by partial autopsy reveled bilateral renal cell carcinomas and hemangioblastoma, respectively, on the microscopic examination.. The case 2 was a 23-year-old male who visited to our hospital due to headache, gait disturbance, and visual loss in the right eye. The findings of brain CT, vertebral angiography, ophthalmoscope, retinal angiogram, and operation were compatable to cerebello-retinal angiomatosis. With reviewing of some literatures, we present 2 cases of von Hippel-Lindau disease.
Angiography ; Angiomatosis ; Autopsy ; Brain ; Brain Death ; Carcinoma, Renal Cell ; Cerebellum ; Electroencephalography ; Female ; Gait ; Headache ; Hemangioblastoma ; Humans ; Kidney ; Male ; Neurologic Examination ; Ophthalmoscopes ; Retina ; Retinaldehyde ; Vomiting ; von Hippel-Lindau Disease* ; Young Adult