The central venous catheter(Quinton) was replaced in the right atrium for chemotherapy and blood sampling to a eight-year old girl with acute lymphoblastic leukemia. The catheter was flushed with heparin two times daily and the chemotherapeutic drug regimens by CCSG-105 protocol were vincristine, prednisone, L-asparaginase, daunomycin, methotrexate, cyclophosphamide, cytosine arabinoside, 6-mercaptopurine and adriamycin. On day 31 of catheterization, the lumen for blood sampling was blocked. From day 60 of catheterization, anorexia, nausea, vomiting, abdominal distension and tachypnea were developed. Echocardiogram, lung scan, pulmonary function test(PFT), arterial blood gas analysis (ABGA) were done. Two cemtimeters in diameter of thrombosis was found in the right atrium on echocardiogram. The lung scan showed slight decrease in uptake of Tc-99m on the whole lung fields. Restrictive ventratory impairment on PFT and decreased PaO2(48 mmHg) on ABGA were found. To lysis of thromboembolism, urokinase(4,400 IU/kg for initial 10 minutes and the 4,400 IU/kg for 12 hours) was injected intravenously and aspirin(30 mg/kg/d, po) was given. The thrombosis was disappeared from the atrium on echocardiogram and PaO2 was increased up to 97 mmHg temporary. The catheter was removed but total haziness on the right middle and lower lobes were developed after 5 days. The same dose of urokinase was injected just infront of the embolism through Pitfall catheter for 8 days intermittently as results of pulmonary angiography. Symptoms and PaO2 were alleviated and the lung was expanded with mild atelectasis on day 55 of the first fibrinolytic enzyme therapy. Although the frequent complications of central venous catheter are catheter occlusion and infection, we have to check the development of thromboembolism with echocardiogram periodically or in case of unexplained respiratory symptoms.
6-Mercaptopurine ; Angiography ; Anorexia ; Blood Gas Analysis ; Catheterization ; Catheters ; Central Venous Catheters* ; Cyclophosphamide ; Cytarabine ; Daunorubicin ; Doxorubicin ; Drug Therapy ; Embolism ; Enzyme Therapy ; Female ; Heart Atria ; Heparin ; Humans ; Lung ; Methotrexate ; Nausea ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prednisone ; Pulmonary Atelectasis ; Tachypnea ; Thromboembolism* ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Vincristine ; Vomiting

A new fibrinogen system, consisting of highly concentrated fibrinogen and thrombin, is going to be applied in many clinical fields. Especially in injuries of the cartilagenous joint surface as chondral or osteochondral fractures, replantation of the fragments must be considered mandarory in order to preserve joint congruence and to prevent further destruction of the articular cartilage. The authors have an encouraging results by using this fibrin adhesive system (F.A.S.) in the experimental works.
Cartilage, Articular ; Fibrin Tissue Adhesive ; Fibrinogen ; Joints ; Replantation ; Thrombin

No abstract available.
Echocardiography*

The common bile duct and the duct of Wirsung cojoin at the level of the duodenum, forming the major. papilla of Vater. Existence of a double major papilla, i.e., two neighboring independent papillary structure:, is infrequent. In our endoscopy unit we have experienced one case of double papilla of Vater wherein canulation of the common bile duct and pancreatic duct could be accom plished through either orifice independently.
Common Bile Duct ; Duodenum ; Endoscopy ; Pancreatic Ducts

A case of multilocular solitary cyst of the kidney containing approximately 5000 ml. of fluid has been reported along with a literatural review.
Bone Cysts* ; Kidney*

No abstract available.
Humans ; Liver Cirrhosis* ; Liver*

Authors had analyzed 35 patients of traumatic posterior dislocation of the hip which was treated at Kyungpook National University Hospital during the period of 7 years from 1972 to 1978. 21 of the 35 dislocation of the hip had sustained the injury by automobile accidents. 33 patients were reduced by closed reduction under general anesthesia. Within one week following closed reduction, intra-articular bony fragments were removed in 4 patients and posterior fragments of acetabular fractures were reduced and fixed with screws in 8 patients. 17 of the 35 patients were followed for eight months to 91 months, average 38 months. The results were rated according to criteris of the Stewart and Milford. Satisfactory results were obtained in 11 patients and those of 9 patients were reduced within 12 hours after injury. As the complication, avascular necrosis, myositis ossificans and osteroarthritis were developed in two patients, four patients, and seven patients respectively.
Acetabulum ; Anesthesia, General ; Automobiles ; Dislocations ; Gyeongsangbuk-do ; Hip ; Humans ; Myositis Ossificans ; Necrosis

We measured normal range and mean value of the posterior laxity of normal knee which might be reference for objective and accurate diagnosis, decision of operative indication and position of knee during fixation of ligament, and role of quadriceps building in posterior cruciate ligament injury patients. These results were obtained by measurement and analysis of posterior laxity of normal knee by means of KT-2000 Knee Ligament Arthrometer. We measured 184 Korean adults (100 males, 84 females), and their average age, height, weight, and thigh circumference were 29.8 years, 165.8cm, 59.8kg, 41.2cm, respectively. At 25 degrees of knee flexion, mean posterior displacement of normal knee was 21.2mm with 15lb posterior tibial loading, 2.41mm with 20lb posterior tibial loading. And when quadriceps were tense, laxity was 0.79mm and 0.95mm at the same degree of knee flexion. At 75 degrees of knee flexion, the results were 0.57mm, 0.58mm, 0.26mm, and 0.28mm respectively. Right to left difference of posterior displacement with 20lb posterior tibial loading was 0.07mm at 25 degrees of knee flexion and 0.06mm at 75 degrees of knee flexion. We thought that above 75 degrees of knee flexion is suitable for knee position at the time of graft fixation because 75 degrees of knee flexion markedly decreased(75%) posterior displacement compare to 25 degrees of knee flexion. When quadriceps were tense, remarkable decrease of posterior laxity of normal knee was checked(58%), so we noticed quadriceps building is important to management of posterior cruciate ligament injury patients.
Adult ; Diagnosis ; Humans ; Knee ; Ligaments ; Male ; Posterior Cruciate Ligament ; Reference Values ; Thigh ; Transcutaneous Electric Nerve Stimulation ; Transplants

In order to study the clinical characteristics of primary acute angle closure glaucoma, we analyzed the data of 72 eyes from 63 patients with the disease from January 1, 1990 to December 31, 1993 to the Department of Ophthalmology of Chonnam University Hospital. The mean age of the patients was 63.3 years and female and male ratio was 5.9:1. And the mean IOP at first visit was 53.2 mmHg. There was no significant difference of rop between right and left eyes, and 11 patients had the disease in both eyes. 38% of the patients developed the disease in winter time. The development of the disease was closely associated with physical illness and emotional stress. 39 eyes(49.3%) of them was required filtering surgery because medication and laser treatment was insufficient to lower IOP.
Female ; Filtering Surgery ; Glaucoma, Angle-Closure* ; Humans ; Jeollanam-do ; Male ; Ophthalmology ; Stress, Psychological ; Trabeculectomy

BACKGROUND: The proper management of the patients with hypotention remains a difficult clinical problem. This study was designed to evaluate the efficacy and safety of gepefrin in the treament of symptomatic hypotensive patients in outpatient clinic of university hospital. METHODS: Thirty milligrams of Gepefrin was given twice daily for 4 weeks in 30 patients with hypotension(6 males, 24 females ; 23-60 years of age). Blood pressure, heart rate, subjective symptoms and side effects were checked before medication and at the end of 1st, 2nd, 3rd, 4th week of medication. RESULTS: 1) Grpefrin increased sitting systolic blood pressure significantly(p<0.05) by the end of 1st week and thereafter. 2) Hypotensive symptoms were improved in 76% of hypotensive patients and overall rate of usefulness was 70%. 3) Heart rate did not change significantly. 4) One patient complained of loose bowel movement and another one, of anorexia among 30 study patients and all laboratory parameters were within normal limits before and after drug treatment, thus the rate of safety was 93%. CONCLUSION: Results from this study suggests that gepefrin 60mg daily increases the blood pressure mildly and improves the symptoms moderately in symptomatic hypotensive patients.
Ambulatory Care Facilities ; Anorexia ; Blood Pressure ; Female ; Heart Rate ; Humans ; Hypotension* ; Male ; Quality of Life