In order to observe the change of epicardial ECG(Eep), left ventricular pressure, left ventricular dp/dt and the development of arrhythmia during regional myocardial ischemia and reperfusion, proximal LAD was ligated for 30 minutes and reperfused suddenly for 30 minytes in eleven mongrel dogs which were grouped into control(n=6) and diltiazem(n=5) group. In diltiazem group, diltiazem infusion was started 10 minutes prior to reperfusion with the speed of 0.02mg/kg/min for 25 minutes. The amount of injury current was measured from TQ segment and ST segment changes of Eep, and its effect on the incidence of reperfusion arrhythmia was evaluated. Eep, LV pressure, LV dp/dt and ECG were simultaneously recoreded with the paper speed of 100mm/sec at predetermined time intervals, and 6 channel ECG(standard lead I, II, III, AVR, AVL, AVF) was recorded continuously with paper speed of 10mm/sec throughout the experiment. The results were as follows ; 1) After ligation of LAD, the polarity QRS of Eep changed to show monophasic shape from 3-4 minutes, TQ segment depressed to reach minumum level at 4-7 minutes and ST segment elevated to reach maximum level at 4-5 minutes. These changes recovered rapidly to pre-ligation state after reperfusion, and this tendency was not affected by diltiazem. 2) The absolute value of LV dp/dt max and LV dp/dt min decreased 10% at 2-4 minutes after LAD ligation, and began to recover from 7 minutes after reperfusion to reach peak recovery value at 20 minutes after reperfusion in control group. In diltiazem group, it decreased 15% after diltiazem infusion and began to recover from 1 minutes after reperfusion to reach peak recovery value at 7 minutes after reperefusion. 3) Ischemic ventricular fibrillation was observed at the time of maximum TQ depression and ST segment elevation and 4 out of 6 events were developed within 5 minutes after LAD ligation. The cases with Isch-Vf developed Rep-Vf without exception, which was observed in 8 out of 11 cases and was noted within 1 minutes after reperfusion except one. 4) Maximum ST elevation was significantly higher in group with Rep-Vf then in group without Rep-Vf(Rep-Vf(+);18.5+/-11.1, Rep-Vf(-);10.3e+/-6.9, p<0.05), and also maximum ST elevation was significantly higher in group with both Isch-Vf and Rep-Vf then in group with only Rep-Vf(Isch-Vf+Rep-Vf;28.5+/-7.8, Rep-Vf only;10,5+/-4.7, P<0.01). 5) The incidende of reperfusion ventricular fibrillation was 83% in control group(5 out of 6) and 60% in diltiazem group(3 out of 5), but the inhibitory effect of diltiazem on the reperfusion Vf could not be confirmed due to the difference of the incidence of ischemic Vf between the two groups(control group;67%(4 out of 6), ditiazem group;20%(1out of 5)). In conclusion, maximum injury current developed 4-7 minutes after coronary artery ligation, and maximum ST elevation value was significantly related with the development of ischemic Vf and reperfusion Vf, and the inhibitory effect of diltiazem on the reperfusion ventricular fibrillation could not be confirmed in this study.
Animals ; Arrhythmias, Cardiac* ; Coronary Vessels* ; Depression ; Diltiazem* ; Dogs ; Electrocardiography* ; Incidence ; Ligation* ; Myocardial Ischemia ; Reperfusion* ; Ventricular Fibrillation ; Ventricular Pressure

Gyrate atrophy of choroid and retina is a rare hereditary disorder, which is characterized by progressive decrease of visual acuity, nyctalopia, visual field constriction and posterior subcapsular cataract. The authors experienced a case of gyrate atrophy of choroid and retina in a 22 year-old male.
Cataract ; Constriction ; Gyrate Atrophy* ; Humans ; Male ; Night Blindness ; Visual Acuity ; Visual Fields ; Young Adult

No Abstract Available.
Arthroplasty* ; Knee*

No Abstract Available.
Arthroplasty* ; Congenital Abnormalities* ; Humans ; Knee*

To evaluate a relationship of lumbar lordosis between asymptomatic group and low back pain group, lumbar lordotic angle was measured from standing lateral lumbosacral roentogenogram of 360 men and women between 20 and 49 years of age. We excluded the patients with back deformity, moderate to severe degenerative change of lumbosacral spine, leg length discrepency, and degenerative change of lower leg in both groups. The lumber lordodsis angle was measured with two ways, lumbosacral angle and lumbolumbar angle respectively. Two angles have a line parallel to the top of second lumbar vertebra as the proximal boundary. The distal border of the lumbosacral angle is a line parallel to the top of sacrum. The distal border of the lumbolumbar angle is a line parallel to the bottom of fifth lumbar vertebra. With statistical analysis of the results, we came to followiing conclusion: 1. The mean lumbolumbar angle was 33.62° +0.62° (SEM: standard error of the mean) and the mean lumbosacral angle was 49.91° +0.59° in asymptomatic group. 2. The mean lumbolumbar angle was 34.79° +0.68° and the mean lumbosacral angle was 50.35° +0.76° in low back pain group. 3. No significant difference in lumbosacral and lumbolsacral angle between asymptomatic and low back pain group was identified using general linear models procedure(P>0.5). 4. Analyzing the data by sex, no significant difference in lumbosacral and lumbosacral angle was identified using general linear models procudure(P>0.05). 5. Analyzing the data by age group, no significant difference in lumbosacral angle was identified (P>0.05), but significant difference in lumbolsacral angle was identified using general linear models procedure(P=0.0045).
Animals ; Congenital Abnormalities ; Female ; Humans ; Leg ; Linear Models ; Lordosis ; Low Back Pain ; Male ; Sacrum ; Spine

In 1971, Harris introduced a metal backed acetabular cup to allow replacement of worn polyethylene cups and it has been popularly used now. In metal backed acetabular cup, dissociation between metal shell and polyethylene liner usually occurs with hip dislocation. We report a case of dissociation of polyethylene liner in metal bacded cup not associated with hip dislocation.
Acetabulum ; Hip Dislocation ; Hip ; Polyethylene

Since the use of Charnley hip prosthesis, total hip arthroplasty has been used for the treatment of coxarthrosis. However, aseptic lossening of the acetabular cup component in total hip arthroplasty remains the most common cause of failure and most serious complication. Cementless acetabular cup fixation in total hip arthroplasty is increasingly popular because of the high failure rates of cemented components, particularly in younger and more active patients. We have experienced 62 cases of CLS expansion acetabular cup developed by L. Spontorno, from January 1992 to January 1994. We analysed 41 CLS expansion acetabular cup components in 38 patients performed at the Department of Orthopedic Surgery, Kang Nam General Hospital with minimum follow up lyear(average 17.3 months). The object of this study is to evaluate the radiographic change of the cup inclination, horizontal and vertical migration of the CLS expansion acetabular cup by methods of Engh et al, and Callagham et al. The results were as follows: 1. The initial adequate contact fit were 39 hips and inadequate fit in 2 hips. 2. The initial acetabular inclination between 35 degrees and 55 degrees were 38 hips. 3. Vertical and/or horizontal migration was not occurred, except 2 hips which were complicated by deep infection. 4. Change of acetabular cup inclination than 5 degrees were not occurred. 5. Radiolucent line wider than 2mm was not found. 6. In final follow up of out 41 hips optimal stability was obtained in 39 hips, suboptimal stability was obtained in 2 hips, and definite instability was not found.
Acetabulum ; Arthroplasty, Replacement, Hip ; Follow-Up Studies ; Hip ; Hip Prosthesis ; Hospitals, General ; Humans ; Orthopedics ; Osteoarthritis, Hip

Intertrochanteric fractures are common in older age group. Recently better implant design and surgical technique have improved clinical results. But still many patients suffer from high morbidity and mortality, because of accompanying osteoporosis and various senile diseases. From January 1991 to June 1994, we treated 54 patients older than 70 years with intertrochanteric fractures of femur. Among them, 23 patients were followed up at our hospital and the other patients were informed from police station. Lost follow up was ten patients and final follow up were 44 patients. Mortality was analyzed for the detection of causative factors, such as age, sex, associated medical problems. type of fracture, degree of osteoporosis, type of operation, internal between injury and operation and duration of admission. The results were as follows; 1. 26 patients survived and 18 patients died(Mortality rate :40.9%) 2. 10 patients died within 1 year(Mortality rate :22.7%) 3. Mortality was related to associated medical problems, interval between in jury and operation and type of fracture, which were statistically significant(P < 0.05).
Aged ; Femur ; Follow-Up Studies ; Hip Fractures ; Humans ; Mortality ; Osteoporosis ; Police

Central retinal artery occlusion occurs rarely as a complication of spine surgery in prone position, but is quite tragic. The suggested cause are hypotensive anesthesia and increased external ocular pressure by headrest, sand bag or others. We experienced a case of left central retinal artery occlusion(CRAO) after surgery of C4-5 fracture-dislocation using a horseshoe headrest and report this case.
Anesthesia ; Prone Position ; Retinal Artery Occlusion ; Retinal Artery ; Spine

We present a 12-year-old female Klippel-Feil syndrome patient who underwent a surgical correction of thoracolumbar scoliosis. The patient had congenital fusion of the cervical vertebrae (C2,3,4,5,6) and showed the classic triad consisting of a low posterior hairline, short neck, and neck motion limitation. Because these patients may have a risk of neurological damage during airway management and subsequent positioning, anesthesiologists need to take care regarding the cervical spine pathology and degree of instability. In this case, fiberoptic bronchoscope guided intubation was performed. We discuss the anesthetic management of Klippel-Feil syndrome patients with a review of the relevant literature.
Airway Management ; Anesthesia ; Bronchoscopes ; Cervical Vertebrae ; Child ; Female ; Humans ; Intubation ; Klippel-Feil Syndrome* ; Neck ; Pathology ; Scoliosis ; Spine