From March 1988 to August 1989, 51 knees with clinically suspected meniscus injuries were examined by both MRI and arthroscopy and compared their findings prospectively on the basis of arthroscopic findings to determine the accuracy of MRI in detecting meniscus injury of the knee. We used 2.0 tesla superconducting magnet imager(Spectro-20000, GoldStar, Korea) to obtain MR imaging. Our protocol for imaging was producing Tl sagittal images by spinecho technique and T2 coronal images by gradient echo technique, interleaved at 4mm continuously while the patient's knee was in 8–10 degrees of external rotation and surface coil was placed posteriorly to the knee in supine position. We grouped and correlated the findings of MRI with the arthroscopic findings. With this noninvasive MRI, we could obtain multiplanar, high quality images without compliations. Compared with the arthroscopic findings, MRI resulted in a high diagnostic accuracy of 96 and 86 percent for the medial and lateral meniscus, respectively. And it aided in optimal surgical planning for the clinically suspected meniscus injuries.
Arthroscopy ; Knee ; Magnetic Resonance Imaging ; Menisci, Tibial ; Prospective Studies ; Supine Position

Pigmented contact dermiatitis is a disease resulting from recirrent contact dermatitis due to hypersensitivity to cosmetic components, which produces secondery bizarre dark brown hyperpigmentation. Histological examinaition of this condition reveals liquefaction degeneration of the basal cells of the epidermis and melanopbages in the upper dermis. We report a case of pigmented contact dermatitis from musk tibeten, which was diagnosed by the histological examination, the patch and photopatch tests. Residul hisperpigmentation was seen on the region of the patch testing.
Dermatitis, Contact* ; Dermis ; Epidermis ; Hyperpigmentation ; Hypersensitivity ; Patch Tests

PURPOSE:The pathogenesis of short stature in growth hormone(GH) deficiency is believed to be based on the growth failure of growth plate chondrocytes by reduced growth hormone dependent insulin-like growth factor- I (IGF- I ) level in serum. Therefore, author studied the growth promoting effect of IGF- I purified from human serum on the chondrocytes, cultured from rat rib cartilage. METHODS:Rat rib cartilage were treated with type II collagenase and hyaluronidase and were cultured in Ham's F-12 culture media containing 10% fetal calf serum. Growth promoting effect of IGF- I was measured by MTT dye by adding 20ng/ml IGF- I purified by protein-diol 120 column(YMC Co, Japan) from human serum, to 1*104 cultured chondrocytes separated into each of 96 well culture vessel. RESULTS: 1) When elution time of biotin labeled IGF- I by protein pak 300sw column was compared to elution time of standard molecular weight, IGF- I exists as large complex of 150Kd and small complex of 50Kd with free 7Kd form in serum before acid treatment. After acid treatment, IGF- I exists as small complex of 50Kd with free 7Kd form. 2) IGF- I purified from blood samples, as compared to genetic engineering product standard IGF- I , showed good parallelism in competition inhibition curve by purity analysis utilizing IGF- I antibody, and thus it is assumed that complex protein as inhibiting factor for purified IGF- I does not exist. Furthermore, complex protein was not present on the Western ligand method using biotin-labeled IGF- I ligand after purified IGF- I transferred to nitrocellulose paper following SDS-PAGE electrophoresis. 3)IGF- I of 20ng/ml showed 30% growth promoting effect, when rat rib chondrocyte culture with Dulbeco's modified Eagles medium(DMEM) is considered to show maximum growth promoting effect, while with pure culture medium, DMEM, showing minimum effect. CONCLUSIONS:The results of this study suggest that IGF- I purified by this method assumes the role of growth promoting effect on the chondrocytes, and that the described method of radioimmuno assay of IGF- I also could effectively remove inhibiting protein complex, therefore allowing more accurate assay.
Animals ; Biotin ; Cartilage ; Chondrocytes* ; Collagenases ; Collodion ; Culture Media ; Eagles ; Electrophoresis ; Electrophoresis, Polyacrylamide Gel ; Genetic Engineering ; Growth Hormone ; Growth Plate ; Humans* ; Hyaluronoglucosaminidase ; Molecular Weight ; Rats* ; Ribs* ; Staphylococcal Protein A

Olivary hypertrophic degeneration (OHD) is caused by lesions in dentato-rubro-olivary pathway(myoclonic triangle) and responsible for palatal myoclonus and other involuntary movements. We report the clinical features and magnetic resonance imaging(MRI) findings of 5 patients with OHD. All patients had previous brainstem hemorrhage mainly involving pontine tegmentum in four patients and right superior cerebellar peduncle in one patient T2-weighted MR] revealed round or oval shaped high signal area in the ventral or ventrolateral portion of the medulla. Their clinical presentations were as followings: palatal myoclonus (4 case), ocular myoclonus (3 case), pharyngeal and laryngeal myoclonus (2 case), limb myoclonus (2 case), head shaking (I case) and perioral tremulous movement (1 case). The frequency of myoclonus was 70-170/minute and the median time interval between the insult of the primary lesion and the onset of myoclonic symptoms was 2 months. OHD shown as hyperintense lesions on T2 weighted MRI should be differentiated from ischemic, neoplastic or other pathologic lesions. The characteristic clinical presentations and the location of primary lesions involving myoclonic triangle may be helpful in differential diagnosis from primary medullary lesions.
Brain Stem ; Brain* ; Diagnosis, Differential ; Dyskinesias ; Extremities ; Head ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Myoclonus

The purpose of study was to examine the effect of supportive touch on the surgical patients with anxiety in the operation room. The method of this study has been carried out under the similar experiment of Nonequivalent control group pretest-posttest design by conveniently selecting 25 experimental group and 25 control group totalling 50 patients in immediatery prior to surgery in the operation room. The data were collected from June. 22, 1998 through Aug. 28, 1998 at C-University hospital in Seoul. The subjects were 50 adult patients who were operated under general anesthesia and had undergone laparotomy. They did not have any complication, were alert enough to be interviewed and agreed willingly to participate in this study. The tool for measurement was the testing protocol for Trait-State anxiety developed by spilberger and the visual analogue scale developed by cline etc. and blood pressure, pulse rate and respiration rate and blood sugar level. SPSS program was used for the analysis. The hemogenety of the control and experimertal group was examined by x2-test and t-test. The results of this study are as follows: 1. There was the significant difference of the state anxiety between the experimental group and the control group (P=0.012) Just before surgery. 2. There was a partially significant difference in the vital signs between the experimental group and control group just before surgery. (systolic blood pressure: P=0.000, diastolic blood pressure: P=0.972, pulse rate: P=0.572, resp rate: P=0.186). 3. There was the significant difference of the blood sugar level between the experimental group and the control group(P=0.002) just before surgery. 4. There was a partially significant difference in the vital signs and blood sugar level of the experimental group and the control group when pre-therapeutic and post-therapeutic readings were compared. (systolic blood pressure: P=0.000, diastolic blood pressure: P=0.035, pulse rate: P=0.796, resp rate: P=0.242, blood sugar level: P=0.002).
Adult ; Anesthesia, General ; Anxiety* ; Blood Glucose ; Blood Pressure ; Heart Rate ; Humans ; Laparotomy ; Reading ; Respiratory Rate ; Seoul ; Vital Signs

No abstract available.
Rabbits*

Photoplethysmography(PPG) employs an infrared light-emitting diode to transmit light into the skin noninvasively. Light reflected from blood cells is received by a photocell or phototrotransistor which permits recording of the pulsatile cutaneous microcirculation. The use of PPG for vascular measurements in extremities is not new. Since Hertzmann, in 1938, first described the technique to measure skin blood flow, a few investigators have used PPG for clinical application. However, experimental reports on the photoplethysmographic assessment of blood flow after arterial reanastomosis are rare. We assessed the changes of blood flow after reanastomosis of the femoral artery in rabbits using photoplethysmography. We divided 20 rabbits into 3 experimental groups. In Group I, the femoral artery was surgically exposed and clamped for 60 minutes. In Group II, the femoral artery was surgically exposed and clamped, as in Group I, and then severed and anastomosed crudely in order to creat thrombus formation. In Group IU, the femoral artery was prepared as Group II and then anastomosed carefully to ensure patency. Blood flow was measured by photoplethysmography on the anteromedial aspect of the right hind leg, every 15 minutes for the fisrt 2 hours, at the 3rd day, I week, and II weeks post-operatively. The following results were obtained l. After the removal of vascular clamp, the mean time for the pulse wave to return to normal form was 63±24.0 minutes in Group I and 63±18.7 minutes in Group III. There was no statistically significant difference beween the two groups. When the wave form was normalized, it remained so continuously. 2. After the removal of vascular clamp, the mean time for the wave amplitude to return to normal was 108±11.2 minutes in Group I and 102±16.4 minutes in Group III. There was no statistically significant difference between the two groups. 3. The thrombosis which obstructed blood flow was formed within the first 60 minutes(mean time: 49±12.4 minutes) in all the animals in Group II. When the thrombosis was formed, it was readily detected by the change of wave form and by decrease in amplitude. 4. It is concluded from this experiments the changes of blood flow after reanastomosis of the femoral artery in rabbits were accurately assessed by PPG. It is suggested that PPG can be used clinically in monitoring blood flow after arterial reanastomosis.
Animals ; Blood Cells ; Extremities ; Femoral Artery ; Humans ; Leg ; Microcirculation ; Photoplethysmography ; Rabbits ; Research Personnel ; Skin ; Thrombosis

During the period from January 1987 to May 1988, arthroscopic partial meniscectomy had been performed in 95 knees of 94 patients. Of the 94 patients, there were 66 males and 28 females ranging in age from 10 to 49 years(mean, 27.4 years). The mean follow up period was 22.1 months (range, 15 to 32 months). Both medial and lateral menisci were affected in 6 knees, so 101 menisci were removed. In the group studied, there were 35 tears of medial, 29 tears of lateral and 37 tears of discoid meniscus. In the 101 tears of meniscus, 22 cases of longitudinal tear, 37 cases of bucket handle tear, 19 cases of flap tear, 13 cases of transverse tear, 5 cases of horizontal tear and 5 cases of complex tear were observed. Most frequently associated lesion was ACL injury (9 cases), and 4 cases of loose body and 4 cases of synovial plica syndrome were also found. The sensitivity of diagnosis with physical examination only was 63.6% and improved with arthrography to 70.4%, and with arthrography and CT to 80.0%. Satisfactory result including excellent and good was 76.6% and no major complication was accompanied.
Arthrography ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Knee ; Male ; Menisci, Tibial ; Physical Examination ; Tears

BACKGROUND: Mushroom poisonings are infrequent but potentially fatal. Most fatalities are due to the amatoxin containing species, particularly Amanita phalloides, Amanita virosa, Amanita verna which cause fulminant hepatic failure often with encephalopathy. METHODS: We experienced twenty two patients with acute mushroom poisoning admitted to Dong San hospital, Keimyung University through emergency department between January 1990 and September 1997. RESULTS: Mean age of the patients was 40.0 years and the ratio of male to female was 1 : 0.83. Seasonal distribution is 10 patients in July, 3 in August and 9 in September. The mean interval between ingestion and early symptom onset was 9.7 hours. Most of the patients had early gastrointestinal symptoms; abdominal pain, nausea, vomiting and diarrhea. except for a patient with associated mental change. The subsequent symptoms and signs follow up admission were fulminant hepatic failure(72.7%), renal failure(31.8%), mental change(27.3%), acute pancreatitis(9.1%), pericardial effusion(4.5%) and erythematous rash(4.5%). The outcomes of the patients were recovery(72.7%), death(18.2%) and hopeless discharge(9.1%). CONCLUSION: The patients who have mushroom poisoning are misdiagnosed as having viral gastroenteritis and are discharged frequently. The doctors and people should be educated not to overlook the severity of mushroom poisoning.
Abdominal Pain ; Agaricales* ; Amanita ; Diarrhea ; Eating ; Emergency Service, Hospital ; Female ; Follow-Up Studies ; Gastroenteritis ; Humans ; Liver Failure, Acute ; Male ; Mushroom Poisoning* ; Nausea ; Seasons ; Vomiting

We have reviewed 1211 burn patients who had visited our emergency department of Keimyung University Dongsan medical center between April 1995 to March 1997. The following results were obtained; 1) On age and sex distribution, the highest incidence of age group was under 10 year and old in 321 cases(26.5%). Male was affected more frequently than female, the incidence being 847 cases(70.1%) and 364 cases(29.9%). The ratio of male to female was 2.3:1. 2) No monthly and seasonal differences could be recognized. We found winter season having the highest 319 cases(26.3%), followed by autumn, spring and summer. 3) An analysis of causes in burns showed that flame burns were 527 cases(43.1%), scalding burns, 486 cases(40.2%), electrical burns, 96 cases(8.1%) and chemical burns, 48 cases(4.1%). 4) Domestic accidents accounted for 639 cases(52.7%), occupational for 286 cases(23.6%), traffic accidents for 160 cases(13.2%), suicides for 122 cases(10.1%), formentation for 4 cases(0.4%). 5) Most of patients 699 cases(57.7%) were affected with 2nd degree burn in depth, 1st degree for 413 cases(34.1%) and 3rd degree for 99 cases(8.2%). 6) The trunk was the anatomical region most commonly affected followed by upper and lower limbs. 7) 243 cases(20.5%) of all were accompanied by some complications. The main complications were would infection noted in 212 cases(17.5%), pneumonia in 179 cases(14.8%), acute renal failure in 160 cases(13.2), contracture in 155 cases(13.0), urinary tract infection in 24 cases(2.0%), Curling ulcer in 20 cases(1.6%) in order. 8) The over-all mortality rate was 73 cases(6.1%). The mortality rate of the patients with inhalation injury were 33 cases(45.3%). Causes of death were due to sepsis in 54 cases(4.5%), ARDS in 11 cases(0.9%), acute renal failure in 5 cases(0.4%), upper GI bleeding in 2 cases(0.2%), purmonary edema in 1 cases(0.1%).
Accidents, Traffic ; Acute Kidney Injury ; Burns* ; Burns, Chemical ; Cause of Death ; Contracture ; Duodenal Ulcer ; Edema ; Emergency Service, Hospital ; Female ; Hemorrhage ; Humans ; Incidence ; Inhalation ; Lower Extremity ; Male ; Mortality ; Pneumonia ; Seasons ; Sepsis ; Sex Distribution ; Suicide ; Urinary Tract Infections