Due to its anatomical position and histological characteristics of thin capsule and low abundance of connective tissue, the spleen is a prime target for damage from blunt injury or during operation. Until recently, total splenectomy has been considered as safe operation for splenic injuries. But now, splenic salvage procedure or non operative treatment have become the standard care with knowledge for immunologic function of spleen, development of radiologic examination such as ultrasonography and abdominal CT, and report about high risk of mortality after splenectomy. Authors have experienced 27 patients with splenic injury admitted to the emergency department during 5 years 4 months period from 1991 to 1996. Among them, 10 patients were received total splenectomy, 2 patients partial splenectomy, 8 patients splenorrhaphy, one patients hemostasis, and 6 patients underwent nonoperative management.
Connective Tissue ; Emergency Service, Hospital ; Hemostasis ; Humans ; Mortality ; Spleen ; Splenectomy ; Tomography, X-Ray Computed ; Ultrasonography ; Wounds, Nonpenetrating

No abstract available.
Klippel-Trenaunay-Weber Syndrome*

The goals of hip arthroplasty have been to eliminate pain, decrease deformity, increase morbility and obtain stabiIity. Currently total hip replacement is the best avaliable procedure to accomplish these goals. A prospective study of total hip arthroplasty was begun at the orthopedic dept of Kyung Hee Medical College in 1974. Between May, 1974 and June, 1977. 69 total hip replacements of the Charnley type, the Trapesoidal-28 type and the Muller type were peformed by the authors. Of the 60 Patients involved in this study, 9 had bilateral operations. The Charnley type Prosthetic device was used in 56 cases, the Trapesoidal-28 type in 7 cases and the Muller type in 6 cases. Complications included wire breakage, dislocation, loosening, femur shaft perforation, nonunion of greater-trochanter, acetabular protrusion, transient femoral nerve palsy, femur shaft fracture, infection, socket lateralization, ectopic bone formation and death. In 59 patients of the 60 patients, 53 patients felt that they were definitely improved, 5 patients felt their condition was unchanged and 1 patient felt her condition was worse.
Acetabulum ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Clinical Study ; Congenital Abnormalities ; Dislocations ; Femoral Nerve ; Femur ; Hip Prosthesis ; Hip ; Humans ; Orthopedics ; Osteogenesis ; Paralysis ; Prospective Studies

No abstract available.
Analgesia* ; Animals ; Fenclonine* ; Mice* ; Naloxone* ; Swimming*

Fractures of the femoral head associated with hip dislocation are uncommon injury and all traumatic fracture-dislocation of the hip must be treated as surgical emergencies. But, there was no uniformity of treatment of fracture-dislocations of the hip were treated by operative and conservative methods in Chonbuk National University hospital were observed between March 1983 and January 1987; Operative treatment is included screw fixation method and fixation with bone pegs. And so, the followings were summsrized: 1. The most common cause was dash-board injury and patients sex was msle in majority. 2. Frequency of the type of femoral head fracture was the most in Pipkin type I, the next was type IV. 3. The better result was noted in operative treatment than in conservative method as above good. 4. Bone pegging method was relatively not superior to screw fixation. 5. The following complications were encountered, 1 case of sciatic nerve palsy, 1 case of traumatic arthritis.
Arthritis ; Clinical Study ; Clothing ; Dislocations ; Emergencies ; Head ; Hip Dislocation ; Hip ; Humans ; Jeollabuk-do ; Methods ; Sciatic Neuropathy

BACKGROUND: It has been known that arterial carbon dioxide tension is 4~5 mmHg higher than end-tidal carbon dioxide tension in healthy adults during general anesthesia. But negative arterial to end-tidal PCO2 difference was reported in pregnant patients undergoing cesarean section. The purpose of this study was to elucidate the difference between arterial and end-tidal PCO2 in anesthetized patients with reduced functional residual capacity. METHODS: 90 patients were divided into 3 groups i.e. control group (n=30), obese group (n=20, body weight more than 20% greater than ideal weight), pregnant group (n=40). All patients had no cardiac or respiratory abnormalities and never smoked. Arterial blood gas analysis and measurement of end-tidal PCO2 were done 20 minutes after induction of anesthesia in control and obese group and just before uterine incision and 20 minutes after fetal delivery in pregnant group. RESULTS: There were significant correlations between arterial and end-tidal PCO2 in all groups. The incidences of negative arterial to end-tidal PCO2 difference were 10% in control group, 40% in obese group, 42.5% in pregnant group (p<0.05). CONCLUSION: From this study, it is concluded that patients with reduced functional residual capacity have more incidences of negativity than normal patients in the values of arterial to end-tidal PCO2 difference during general anesthesia. So when the tight control of PaCO2 is required in patients with reduced FRC, we recommend to measure PaCO2 for better anesthetic management.
Adult ; Anesthesia ; Anesthesia, General ; Blood Gas Analysis ; Body Weight ; Carbon Dioxide* ; Carbon* ; Cesarean Section ; Female ; Functional Residual Capacity* ; Humans ; Incidence ; Pregnancy ; Smoke

Regular hemodialysis has been established as a way of treatment for end stage renal failure. In adults, hemodialysis 5 hours each time, three times weekly with one square meter hemodialyzer is now widely accepted as a standard, and there are many reports on long term follow up studies. Quite a large difference are present, however, in our community mainly originated from patient's poor compliance in frequent dialysis with short interdialysis interval. The author analyzed 200 cases of chronic renal failure who have received hemodialysis treatments during the 5 year period from July 1976 to June 1981 at the hemodialysis unit of the hanyang University Hospital and the following results are obtained; 1. Actual one year survival rate was much higher in thrice(87.1%) than one(35.1%) or twice(54.1%) weekly dialysis. 2. Long term(more than 6 months) complications were also more frequent in once(85.7%) or twice(70.2%) weekly treatments than in thrice(22.2%). The predominant complications were congestive heart failure, pericarditis, and infections. 3. Those who recieved three times weekly dialysis had better rehabilitation grades than the patients groups of twice or once weekly treatment. 4. Of peridialysis distressful symptoms, nausea, vomiting dizziness were less frequent in the group three times a week dialysis. In contrast, headache, hypotension, muscle cramps, and weakness were not significantly related with frequency of hemodialysis. 5. Those who voided a large amount of urine output had better survival and less frequent requirement of blood transfusions. 6. Main causes of death were due to patient poor compliance, hyperkalemia and cerebrovascular acidents. 7. Economic problems were the major cause of dialysis interruption.
Adult ; Blood Transfusion ; Cause of Death ; Compliance ; Dialysis ; Dizziness ; Follow-Up Studies ; Headache ; Heart Failure ; Humans ; Hyperkalemia ; Hypotension ; Kidney Failure, Chronic* ; Kidneys, Artificial ; Muscle Cramp ; Nausea ; Pericarditis ; Rehabilitation ; Renal Dialysis* ; Renal Insufficiency ; Survival Rate ; Vomiting

No abstract available.
Bronchopulmonary Sequestration*

PURPOSE: The objective of this study was to find the predictors and generate a prediction scoring model of nonresponse to intravenous immunoglobulin in patients with Kawasaki disease. METHODS: We examined 573 children diagnosed with KD at the Severance Children's Hospital between January 2009 and december 2012. We retrospectively reviewed their medical records. These patients were divided into 2 groups; the experimental group (N=433) and the validation group (N=140). Each group were divided into 2 groups the intravenous immunoglobulin nonresponders and the responders. Multivariate logistic regression analysis identified predictive factors of intravenous immunoglobulin nonresponders which make predictive scoring model. We practice internal validation and external validation. RESULTS: Multivariate logistic regression analysis identified male, cervical lymphadenopathy, changes of the extremities, platelet, total bilirubin, alkaline phophatase, lactate dehydrogenase, C-reactive protein as significant predictors for nonresponse to intravenous immunoglobulin. We generated prediction score assigning 1 point for (1) male, (2) cervical lymphadenopathy, (3) changes of the extremities, (4) platelet (< or =368,000/mm3), (5) total bilirubin (> or =0.4 mg/dL), (6) alkaline phophatase (> or =227 IU/L), (7) lactate dehydrogenase (> or =268 IU/L), (8) C-reactive protein (>77.1 mg/dL). Using a cut-off point of 4 and more with this prediction score, we could identify the intravenous immunoglobulin nonresponder group. Sensitivity and specificity were 52.5% and 82.4% in experimental group and 37.8% and 81.8% in validation group, respectively. CONCLUSION: Our predictive scoring models had high specificity and low sensitivity in Korean patients. Therefore it is useful in predicting nonresponse to intravenous immunoglobulin with Kawasaki disease.
Bilirubin ; Blood Platelets ; C-Reactive Protein ; Child ; Extremities ; Humans ; Immunoglobulins* ; Korea ; L-Lactate Dehydrogenase ; Logistic Models ; Lymphatic Diseases ; Male ; Medical Records ; Mucocutaneous Lymph Node Syndrome* ; Retrospective Studies ; Risk Factors ; Sensitivity and Specificity

No abstract available.
Blood Pressure* ; Body Mass Index*