Synovectomy of the knee in rheumatoid arthritis has been recommended as an effective procedure which improved symptoms such as pain, swelling, and limitation of motion. But some problems, such as limitation of range of motion, infection, long hospital days, occured in open synovectomy. Arthroscopic synovectomy yields reliable result compatible to open synovectomy with less invasiveness and postoperative morbidity. The authors analyzed 20 knees of 14 patients who has done synovectomy of knee in Kyung Hee University Hospital from September 1989 to October 1992. Of the 14 patients, thirteen were females and only one was male, ten knees were affected on the right and ten on the left respectively. Five knees were operated as open synovectomy and fifteen knees as arthroscopic synovectomy. In six patients, both knees were operated either open or arthroscopic synovectomies. The preoperative diagnosis of 20 knees were rheumatoid arthritis as clinically, serologically and radiologically, 13 knees are confirmed as pathologically. Average hospital days after operation were 19 days in open synevectomy and 11 days in arthroscopic synovectomy. Average operation time were 72 minutes in open synovectomy and 84 minutes in arthroscopic synovectomy. No complication occured as a result of these synovectomies. After average follow up of 19 monthes, 1 knee from 5 knees in open synovectomy and 3 knees from 15 knees in arthroscopic synovectomy had pain and intermittent swelling as postoperatively. And only 1 knee in open synovectomy had loss of range of motion. No other patients lost motion in their knees. Preoperatively 17 knees showed radiographic change of rheumatoid arthritis and 16 knees showed no progressive radiographic deterioration at final follow up. And patients overall showed a significiantly increased functional status postoperatively. In conclusion, the result obtained after arthroscopic synovectomy are comparable with those obtained after open synovectomy. In addition arthroscopic procedure had lessened postoperative morbidity as loss of range of motion, postoperative infection, long hospital days and useful as palliative surgery in advanced rheumatoid arthritis.
Arthritis, Rheumatoid ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Knee ; Male ; Palliative Care ; Range of Motion, Articular

No abstract available.
Anterior Cruciate Ligament*

A 25-year-old male with asthma suffered from generalized urticaria, angioedema and syncope associated with exercise after ingestion of food made with wheat flour. Skin prick test with bread showed strong positive reaction(++++), but with wheat flour, a weak positive(+). Challenge test with wheat flour, and food made with wheat flour, without or with exercise, were done several times. Exercise such as 25 min of running on treadmill following 30 min after 50 grams of bread or 50 grams of hot pepper-stuffed rice cake only showed positive reaction such as generalized urticaria, angioedema and hypotension, but not with 15 grams of bread or 15 grams of hot pepper-stuffed rice cake. Ingestion of bread in such high amounts as 15 grams alone did not trigger reaction, not even with is min of exercise. This is the first clear case of food dependent exercise induced anaphylaxis (FDEIA) in which the allergic reaction depended on both the amount of food ingested and the amount of exercise was clarified.
Adult ; Anaphylaxis* ; Angioedema ; Asthma ; Bread ; Eating ; Flour* ; Humans ; Hypersensitivity ; Hypotension ; Male ; Running ; Skin ; Syncope ; Triticum* ; Urticaria

No abstract available.
Anti-Bacterial Agents* ; Prevalence* ; Shigella*

Intravertebral vacuum cleft in collapsed vertebra was considered as a typical finding of avascular necrosis. However, several authors reported some cases of intravertebral vacuum cleft in primary or secondary neoplasm, or in spondylitis emphasiging the differenhal diagnosis. MRI is known to be a useful diagnostic modality for diferentiation between benign and malignanct conditions causing vertebral collapse. We report MRI findings of two cases with intravertebral vacuum cleft diagnosed as posttraumatic collapse with avascular necrosis on radiological and clinical bases.
Diagnosis ; Magnetic Resonance Imaging ; Necrosis ; Spine ; Spondylitis ; Vacuum*

Soft tissue coverage of heel defects has long been a difficult problem. In 1982, Iron reported eight cases of heel defects in children using an ipsilateral posterior thigh flap with use of the Hoff-man's skeletal fixation apparatus for immobilization. We report three cases of heel defects treatment in children using ipsilateral posterior thigh flap and detach flap in an average 13 days with aid of single photon emission computed tomography(SPECT) for evaluation of circulation status of flap.
Child ; Fracture Fixation ; Heel ; Humans ; Immobilization ; Iron ; Thigh ; Tomography, Emission-Computed, Single-Photon

Fat containing masses, except mediastinal lipomatosis, of the thorax are uncommon. In spite of uncommonoccurences, as CT can detect not only the fat content but also the presence and character of the non-fattycomponent of the mass, accurate preoperative diagnosis can usually be made in most cases of fat containingmediastinal masses. Authors report 6 cases of fat containing mediastinal masses, that were diagnosedpreoperatively by CT scan, comprising 2 cases of limpoma(combined with plexiform neurofibroma in a case), 1liposarcoma, 1 thymolipoma, and 2 cases of omental hernia through Morgagni foramen.
Diagnosis ; Hernia ; Lipomatosis ; Neurofibroma, Plexiform ; Thorax ; Tomography, X-Ray Computed

No abstract available.
Animals ; Nephrons* ; Population Characteristics* ; Rats*

Since the introduction of percutaneous mitral valvotomy(PMV) in 1984, PMV was an effecive alternative to surgical commissurotomy in selected patients with severe mitral stenosis. Also PMV was an excellent palliative strategy in such patients who were high risk for operative management or longterm anticoagulation was not feasible. We performed PMV in a patient with very tight mitral stenosis and severe pulmonary hypertension under the general anesthesia because the patient was anticipated to be uncooperative due to mental problem, who was diagnosed as schizophrenia 16 years ago. Robinol was used for premedication and i.v fentanyl was used for maintenance of anesthesia. Inoue balloon was introduced into the LV and gradual ballooning was performed with favorable results. Total anesthesia time and interval from internal jugular vein puncture to the completion of valvuloplasty were 1 hour 45 min and 40 minutes respectively. Hemodynamic variables were improved immediately after intervention and mitral valve area was increased from 0.5cm2 to 1.3cm2.
Anesthesia ; Anesthesia, General* ; Fentanyl ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Jugular Veins ; Mitral Valve ; Mitral Valve Stenosis* ; Premedication ; Punctures ; Schizophrenia*

The Saville's index of the lumbar spine and the Singh's index of the femoral neck is very simple method to measure degree of osteoporosis. Authors compared Singh's index and Savilles index with Dual Photon Absorptiometry(D.P.X.) and studied the reliability and clinical usefulness of two indices. We took the D.P.X. and simple L-spine lateral view in 103 patients in same time and also performed D.P.X. and both hips A-P view in 70 patients, then analyzed and compared each two indices with D.P.X. The Singh's index had less interpersonal difference and intrapersonal difference compared with Saville's spine index. There was some confidence of Singh's index and Saville's spine index compared with the D.P.X., but the relationship between Saville's spine index and D.P.X. was less promising than that of Singh's index. Authors suggest that the Saville's spine index has less clinical usefulness than Singh's index in measurement of osteoporosis.
Femur Neck ; Hip ; Humans ; Methods ; Osteoporosis ; Spine