Traumatic dislocation of the knee joint occurs very infrequently, but is one of the true emergencies in the orthopedic field. It is a serious injury, associated with extensive soft tissue demage and the danger of neurological and vascular involvement. There is a lot of theories about the mechanism of injury, the treatment and the incidence of complications. Generally they accept that in irreducible cases operative reduction is essential, but there is no uniformity of opinion on the treatment of the uncomplicated cases. This paper is based on 7 traumatic knee dislocations treated at Kang Nam Sacred Heart Hospital, Hallym College during the period from January 1980 till December 1984. The results of the study are as follows: 1. The patients are mostly injured due to the traffic accident and show even age distribution from twenties to fifties. 2. 5 cases out of 7, reduced at our hospital, were all anteriorly dislocated. 3. The posterior capsule and the posterior cruciate ligament were injured in all cases. 4. There were no significant differences between primary repair of soft tissues and the late reconstruction.
Accidents, Traffic ; Age Distribution ; Clinical Study ; Clothing ; Dislocations ; Emergencies ; Heart ; Humans ; Incidence ; Knee Dislocation ; Knee Joint ; Knee ; Orthopedics ; Posterior Cruciate Ligament

No abstract available.
Urachus*

PURPOSE: We studied the accuracy of high resolution computed tomography in staging chest wall/fissural invasion of peripheral lung cancer. MATERIALS AND METHODS: HRCT findings in 27 patients with suspected chest wall (n=18) or fissural (n=16) invasion of peripheral lung cancer were correlated with surgical and pathologic findings. The HRCT images were restrospectively evaluated for pleural thickenings adjacent to mass, maximal contact length (cm) between mass and chest wall/fissure, angle between the mass and chest wall/fissure, ratio of maximal contact to mass diameter, abnormality of extrapleural fat layer, mass extension across the fissure and fissural irregularity adjacent to mass. Various CT findings and the presence or absence of chest pain were correlated with surgical and pathologic findings. RESULTS: For the evaluation of chest wall invasion, abnormality of extraphleural fat layer was the most useful finding (sensitivity 100 %, specificity 36 %, accuracy 61 %). The remaining HRCT findings proved to have high sensitivity but low specificity, and a high false positive rate. For chest pain, sensitivity was 43 % and specificity, 82 %. In cases without chest pain, the positive predictive value of extraphleural fat abnormality was 44 % ; in the absence of chest pain and extrapleural fat abnormality,positive predictive value was zero. The evaluation of transfissural tumor invasion using variable HRCT findings proved to be accurate, especially when the criteria of mass extension across the fissure and fissural irregularity adjacent to the mass were used (accuracy 81 % and 75 %, respectively). CONCLUSION: Using the finding of 'extrapleural fat abnormeality', HRCT was accurate in the staging of chest wall invasion and its predictability was betten than that of other results obtained with conventional CT. Chest pain had high specificity but low prevalence, and extrapleural fat abnormality was more valuable in cases without chest pain. HRCT proved to be accurate in the evaluation of transfissural invasion of lung cancer using the findings 'fissural cross' and 'fissural irregularity'.
Chest Pain ; Humans ; Lung Neoplasms* ; Lung* ; Prevalence ; Sensitivity and Specificity ; Thoracic Wall* ; Thorax*

This study was undertaken to estimate the effects of the induction agents on the bioparameters such as changes in blood pressure, pulse rate, Apgar score, patients movement, fetal arterial and venous blood gas analysis, memory and emergence reactions. 116 parturients undergoing cesarian section were divided into two groups: ketamine group and thiopental group, and were given 1.2 mg/kg ketamine in ketamine group and 4 mg/kg thiopental sodium in thiopental group as an induction agent respectively. The results were as follows; I) Blood pressure increased in both groups, but ketamine group less increased than thiopental group statistically. Pulse rate did not increased in skin incision in ketamine group statistically. 2) The patient's movement were 5 case(9%) in ketamine group and 17 cases(29%) in thiopental group. 3) There was not significant difference in fetal arterial and venous blood gas analysis. 4) In Apgar score, ketamine group is better than thiopental group. 5) There was no psychologic side reactions in both groups. 6) Postoperative recalling of intraoperative awareness occured in seven patients(12%) only in the thiopental group.
Apgar Score ; Blood Gas Analysis ; Blood Pressure ; Cesarean Section ; Female ; Heart Rate ; Humans ; Intraoperative Awareness ; Ketamine* ; Memory ; Pregnancy ; Skin ; Thiopental*

Five volunteers received patch tests with 5% sodium lauryl sulfate (SIS) in solutions of differing pH. The irritant effect was monitored by visual scoring as well as by a laser Doppler vlelocimeter, evaporimeter, cutometer, and colorimeter. The non-invasive methods used in this study with the exception of the cutometer were effective in the evaluation of skin irritation. No significant differences in the skin responses to SIS in different pH solutions were found either clinically or by the non-invasive methods used for quantification. It was concluded that the pH of SIS is not a major factor in the degree of skin irritation produced by SIS.
Hydrogen-Ion Concentration* ; Patch Tests ; Skin ; Sodium Dodecyl Sulfate* ; Sodium* ; Volunteers

No abstract available.

During the last three years, from 1967 to 1970, three hundred and three cases of psoriasis were treated by Goeckrman's regimen and oral methotrexate, 270 cases and 33 cases respectively. Authors evaluated the clinical effectivness and side effect of methotrexate and it compared with the result of Goeckermans method and review about the articles. Of the 303 psoriatics, 140 were male(44%) and 163 were female(55.6%). The majority of the primary manifestation appeared in 16 to 30 year .age group with maximal occurence in the 16 year to 20 year age group (53 cases), but 33 cases were noted below the 10 years old age(Fig.2). The duration of the disease in most cases was 1 to 10 years,but the highest number, in 72 cases, was 1 to 5 years group(Fig 3 A, 3 B). 40 cases was in below 6 months. The methotrexate were administered orally, 2. 5 mg. tab., twice daily(5 mg) for 5 to 7 days, followed by 3 to 5 days resting in accordance with the, patient's condittion. The Goeckerman regirnen of 2% coal tar and 2% salicylic acid in vaselin applied to whole skin lesions in the night and the excess tar was removed frorn skin by gentle wiping with a gauze pat, saturated with Arachis oil, in the next morning, follawed by ultra-violet ray irradiation for 30 second at first day, then the dose increased 30 second daily to reach 5 min. After the ultra-violet irradiation bath was done, and one hour later 2% coal tar and 2% salicylic acid vaselin were applied again. These schedules were repeated 2 to 3 courses (20 to 30 days) in mast cases. In occasion of Goeckerman treatment, among the completely cleared 93 cases during the preveous treatment, the most cases were recurred within 3 to 12 months but 16 cases within 1 month. In occasion of methotrexate, the lesions recurred within 6 months to 2 years in 17 cases of the 33 cases, but 3 cases were within one month after completely cured preveously. The starting of remission, in Goeckerman methods, was noted within 7 to 14 days in most cases(13 cases), and in 3 cases it started within 3 to 4 days. And the completely clearing of the lesions noted within 20 to 25 days in most cases(16 to 21 cases). The starting of remission, in methotrexate treatment of 33 cases, was occurred within 1 to 2 weeks in most cases(27 cases), and completely clearing of lesions noticed within 14 ta 20 days in 28 cases. But in 2 cases it needed only 7 days to make completely clearing the skin lesions. The side effects of the Goeckerman's method were as follow : 1) Contact dermatitis due to tar hypersensitivity in 3 cases. 2) Mild local burn due to over dose irradiation of ultra-violet ray in 5 eases, otherwise no appreciable side effects were noted. The side effecst of methotrexate were noted in 17 cases among the 33 cases. 1) Aphtous ulcer in 4 cases, 2) Peptic ulcer in one case, 3) Tinitus in one case, 4) Other side effects such as dizziness, loss of appetite, headache, fatiguability were notable in 10 cases. 5) In addition to above mentioned sidle effects the blood chemistry include L.P.T., wbc count, platelet count, ESR, Hgb, and creatinine showed as follow before and after administration of methotrexate. a) The white blood cells, platelet count were tend to decrease after the administration of methotrexate than before one. b) Among 33 cases the SGPT levels were checked in 16 cases, and in most cases it raised more and less than before the administration of methotrexate, but only 8 cases were ahove the normal ranges(35 units). The SGOT level also raised after one course, but only 8 cases were above normal ranges(40 units). c) Hgb, ESR, creatinine showed no remarkable changes. In many references the effects and side effects of methotrexate were discussed, but their view were not uniform and variable. In the clinical improvement, recurrency, and side effects, the large single weekly dose of methotrexate had no fundamental differences compare with the author's small daily doses. We agree with the Ryan's report(11), in which the large single dose were not always safer and more effective than the small dose. Still there are many important problems to study about the dosage, interval of administration, and resting period in the treatment of psoriasis with methotrexate.
Alanine Transaminase ; Appetite ; Appointments and Schedules ; Arachis ; Aspartate Aminotransferases ; Baths ; Burns ; Chemistry ; Child ; Coal Tar ; Creatinine ; Dermatitis, Contact ; Dizziness ; Headache ; Humans ; Hypersensitivity ; Leukocytes ; Methotrexate* ; Peptic Ulcer ; Platelet Count ; Psoriasis* ; Salicylic Acid ; Skin ; Ulcer ; Ultraviolet Rays

Angiographic findings were analysed in 22 cases of coronary occlusive disease which were selected from 50 cases of coronary arteriographies done in Department of Radiology, Seoul National Un iversity Hospital from September, 1981 to August, 1984. There were 16 cases of single vessel disease, in which 12 were LAD involvement and 4 were RCA involvement, 2 cases of two vessel and 4 cases of three vessel disease. Site, degree and extent of stenotic involvement in those occlusive coronary diseases were anal ysed with review of literature for selective coronaryarteriography. Since coronary arteriography is the final and accurate examination for the evaluation of occlusive coronary arterial disease, it is expected to be widely used for the diagnosis of occlusive coronary arterial disease which is rapidly increasing recently in this country.
Angiography ; Coronary Disease ; Diagnosis ; Seoul ; United Nations

Thirty cases of segmental tibial fracture were treated during the period from January, 1980 to January, 1987. The following results were obtained. 1. Type I, high middle segment, was most common(16 cases, 52%). 2. High incidence of open fracture(22 cases, 71%). 3. Closed fractures were internally fixated whereas open ones, externally. 4. Higher union rates in intramedullary nailing. 5. External fixators, such as Monofixateur, were effective in severe open fractures.
Clinical Study ; External Fixators ; Fracture Fixation, Intramedullary ; Fractures, Closed ; Fractures, Open ; Incidence ; Tibia ; Tibial Fractures

Functional myelography, applying spinal movements(flexion-extension) in myelography, has been frequently used for accurate diagnosis of posture-related disorders such as herniated lumbar disc or spinal stenosis. Measurements were performed on functional myelographic findings of 62 patients, and in 24 cases surgically verified herniated lumber discs were present. The object of this study was to analyze changes in position and shape of the dural sac in spinal movements and confirm the clinical importance of functional myelography. The present study demonstrated that: 1) The anterior border of the dural sac was straight with flexion, but indented at the level of intervertebral space and this indentation was less prominent at L5-S1. 2) With extension, posterior indentation of the dural sac was more prominent at the level of the intervertebral space than the body, the A-P diameter of the dural sac was narrowed at all levels of the intervertebral spaces except L5-S1, and the dural sac moved anteriorly at the level of L5-S1 and all spinal bodies. 3) In surgically verified disc patients, anterior indentation of the dural sac was persistent in both flexion and extension views, and was more exaggerated with extension, but less prominent at L5-S1. In patient at L5-S1, anterior movement of the anterior dural border at the level of surgery was much decreased.
Diagnosis ; Humans ; Myelography* ; Spinal Stenosis