A case of pigmented villonodular synovitis developed in the right ankle joint is reported. The patient was a 25 years old house wife who had complained marked swelling and tenderness over the anterolateral aspect of the right ankle for 2 years. Roentgenological studies showed marked swelling of the ankle joint and erosion of the neck of the talus. Synovectomy of the affected joint was performed. The tumor mass, measuring about 7cm×5cm×2cm in size, was yellowish brown in colour, elastic and soft in consistency, and contained several well encapsulated nodules.
Ankle ; Ankle Joint ; Humans ; Joints ; Neck ; Spouses ; Synovitis, Pigmented Villonodular ; Talus

No abstract available.
Ligaments* ; Magnetic Resonance Imaging* ; Tendons* ; Transplants*

We have experienced a reexpansion pulmonary edema(RPE) during general anesthesia. This patient has undertaken the decortication operation due to right sided massive pleural effusion and fibrothorax. Generally reexpansion pulmonary edema is believed to oceur only when a chronically collapsed lung is rapidly reexpanded by evacuation of large amount of air or fluid in pneumothorax and pleural effusion. The pathogenesis of RPE is unknown and is probably multifactorial. The implicated etiologies are chronicity of collapse, technique of reexpansion, increased pulmonary vascular permeability, airway obstruction, loss of surfactant and pulmonaty artery pressure changes. The outcome of RPE may be fatal, so physician treating lung collapse must be aware of the possible causes and endeavor to prevent the occurrence of this complieation.
Airway Obstruction ; Anesthesia, General* ; Arteries ; Capillary Permeability ; Humans ; Lung ; Pleural Effusion ; Pneumothorax ; Pulmonary Atelectasis ; Pulmonary Edema*

Although the endotracheal intubation using laryngoscope can usually be performed under general anesthesia, it may be very difficult in situations such as head and neck trauma, hemorrage, or deformity. Recently we performed antegrade fiberoptic nasotracheal intubation with a guide wire. A 15-month aged female child with mandibular fracture was scheduled for open reduction and internal fixation under general anesthesia. She was anticipated difficult intubation due to displacement of the fracture site. After induction of anesthesia, we passed an adult fiberoptic bronchoscope (O.D. 3.8 mm, LF-2, Olympus optical co, Japan) to vocal cord via right nostril. Then a guidewire was inserted through the suction port of bronchoscope, and bronchoscope was removed in a state of guidewire in situ. We slid the endotracheal tube over guidewire according to Seldinger's technique. We think that nasotracheal intubation using an adult fiberoptic bronchoscope and a guidewire is good for children under 2 years old who are expected the difficult intubation.
Adult ; Anesthesia ; Anesthesia, General ; Bronchoscopes* ; Child ; Child, Preschool ; Congenital Abnormalities ; Female ; Head ; Humans ; Intubation* ; Intubation, Intratracheal ; Laryngoscopes ; Mandibular Fractures* ; Neck ; Suction ; Vocal Cords

We have compared the findings of MRI with those of hip arthroscopy in 22 hips in adults with pilinful hip diseases. From March l995 to March 1997. We performed arthroscopy of the hips in symptomatic 22 patients. Fifteen cases were men and the mean average age was 46 years old. Preoperatively, the patients was diagnoseil with careful physical examinations and MR arthrogram or MR1. Among them, acetahular lahrum tears were 13 cases. synovial lesions were 3 cases and avascular necrosis of femoral head were 6 casee. We have examed cartilage softening, indentation or defect of femoral head and acetabulum, acetabular lahrum, loose hodies and synovial lesion hy arthroscopy. Under the arthroscopic guide, We had resected the torn Jahrum in S cases, removed a loose hodies such as synovial chondromatosis in 1 case and excised a synovial pathology in 2 cases. The others had a open arthrotomy in 8 cases. The sensitivity of MRI was 89.5% and its accuracy was 77.3% compared with arthroscopic findings. Average follow-up lengths was 8.6 months and 17(77.3%) of 22 patients were improved clinically. The arthroscopy of the hip is less invasive and a useful investigation for painful hip diseases for labral tears and synovial lesions in adults cspecially when standard MRI fails to prove a exact hip joint pathology, but it may be useless in avascular necrosis of femoral head. Also it is technical demanding and necessary to long-term follow-up.
Acetabulum ; Adult ; Arthroscopy ; Cartilage ; Chondromatosis, Synovial ; Diagnosis* ; Fimbriae Proteins ; Follow-Up Studies ; Head ; Hip Joint ; Hip* ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Necrosis ; Pathology ; Physical Examination

A serum ferritin level is now the most sensitive and specific assay for iron deficiency. Incidence of iron deficiency anemia was determined by means of the serum ferritin level and the response to iron therapy, and changes in serum ferritin level were observed in 421 hospitalized pediatric patients with various diseases. The results were as follows : 1. Incidence of anemia was 45% of total hospitalized patients. Incidence of iron deficiency anemia was 5.9% of total patients and 13.3% of patients with anemia. It was most common between 6 moths and 2 years of age. 2. Serum ferritin levels were below 10ng/ml in 20(range;1-8.8ng/ml) and between 13.2 -24.5ng/ml in 5 out of 25 patients with iron deficiency anemia. Determination of the serum ferritin level, therefore, was thought to be an accurate method for the diagnosis of iron deficiency anemia. 3. Mean serum ferritin levels were 152.1ng/ml in total patients, 143.4ng/ml in patients without anemia, 7.9ng/ml in patient with iron deficiency anemia, and 199.9ng/ml in patients with anemia of other causes. Iron deficiency anemia was easily differentiated from the anemia of other causes by serum ferritin level. 4. Serum ferritin levels were elevated to significantly higher level in leukemia, aplastic anemia, rheumatoid arthritis, liver diseases and chronic infections.
Anemia ; Anemia, Aplastic ; Anemia, Iron-Deficiency* ; Arthritis, Rheumatoid ; Diagnosis ; Ferritins ; Humans ; Incidence ; Iron* ; Leukemia ; Liver Diseases ; Moths

The 747 corneal epithelial erosion cases were evaluated clinically from January 1986 to February 1988 at Catholic University Medical College, St. Mary's Hospital. The results were as follows: 1. Out of 747 corneal epithelial erosion cases, 286 cases(38.3%) and 283 cases(37.9%) resulted from mechanical and postoperative causes, respectively. 2. The large number of cases were foung in the age group of 1 to 9 years(21.9%) and in the ages older than 60 years(l9.8%), which were in proportion to the said causes. 3. The onset of corneal erosion after cataract extraction within postoperative 3 weeks(56.1%) was most common. There were 115 cases(45.3%) in which corneal erosions developed after the cataract extraction lasted up to 2 weeks. 4. The cure rate of corneal erosion was 85.0%(635 cases), and in corneal erosion developed after cataract extraction was 89.8%(254 cases). 5. There was no statistical significance in the frequency of corneal erosions developed after cataract extraction among diabetics and nondiabetics.
Cataract Extraction ; Humans

With Xenon gas inhalation method, the authors measured the rCBF from 14 AVM patients who were checked into the Neurosurgical Department of Kyung Hee Medical College. In nine of them, we detected the rCBF within 24 hours after operation ; in comparison with the clinical progress, we got the results as follows; 1) The amount of rCBF before operation was 62.9+/-12.7 in adjacent regions around the AVM, and 67.8+/-14.7 in the contralateral hemisphere. These values were lower than normal rCBF, undoubtedly demonstrating the development of cerebral steal phenomenon. 2) After total excision of AVM, the amount of rCBF was 77.5+/-20.7(11.6+/-21.5% increase) in adjacent regions around AVM, and 79.6+/-16.3(8.9+/-17.0% increase) in the contralateral hemisphere. As the cerebral steal phenomenon was disappeared, 80% of clinical symptoms and signs were restored, which showed the interrelation between the rCBF and clinical progress. 3) The measurement of rCBF by Xenon gas inhalation method does no harm to human body, and can be carried out with ease and safety. 4) It is thought that in the case if AVM patient, the measurement of rCBF by Xenon gas inhalation method is a good parameter for diagnosis and follow up of AVM's patients.
Arteriovenous Malformations* ; Diagnosis ; Hemodynamics* ; Human Body ; Humans ; Inhalation ; Xenon

Using Xenon inhalation method, the authers measured the rCBF's within 24 hours before and after the operation of 4 AVM patients. We found the obliteration of the cerebral steal syndrome in all cases and the loss of initial shunt peak in 2 cases after excision of AVM. We discussed these hemodynamic changes in AVM and reviewed the literatures.
Hemodynamics ; Humans ; Inhalation ; Intracranial Arteriovenous Malformations* ; Xenon

Spontaneous hematomyelia is an acute expanding lesion by the hemorrhage within the substance of the located primarily in the gray matter. It is necessary to have urgent operation to preserve the remainding cord function. We are reporting a rare case of spontaneous hematomyelia extending from T-8 to T-10 of unknown cause of which transverse symptoms have largely subsided after surgical evacuation of the liquefied hematoma.
Hematoma ; Hemorrhage ; Spinal Cord Vascular Diseases*