Previous applications of laser bone and cartilage ablation have focused largely on the CO2 and the Nd:Yag lasers, using both the continuous wave and rapid superpulsed mode, which revealed severe thermal damage such as tissue necrosis and carbonization of the remaining tissue. In contrast, Excimer lases have provided better histologic results with minimal or no thermal damage, but the ablation rate and cutting efficiency have remained unsatisfactory. Though arthroscopic partial menisectomy has become the accepted technique for dealing with tears in menisci, division of the meniscus is sometimes difficult in the confined joint space of the knee and is associated with iatrogenic injury to the articular cartilage. The ability to quickly and safely divide or remove meniscal tissue would be a distinct advantage. The Holmium:Yag laser has many potential advantages over the CO2 laster, the Nd:Yag laser and the Excimer laser. Its principal advantages include minimal mechanical trauma to the articular cartilage, greater access to tight or restricted area of the knee joint, and its ability to function in a saline medium and to resect meniscus with minimal tissue necrosis. We have evaluated the effectiveness of the Holmium:Yag laser 74 partial menisectomies of 57 patients. Among 74 meniscal tears, there were 35 medial and 39 lateral meniscal tears. The average operation time was 33 minutes in the menisectomy and hospital stay was average 3 days. There was no significant carbonization on the surrounding tissue. Menisectomy of the posterior horn was safe and easy and there was minimal iatrogenic articular cartilage damage.
Animals ; Carbon ; Cartilage ; Cartilage, Articular ; Holmium ; Horns ; Humans ; Joints ; Knee ; Knee Joint ; Lasers, Excimer ; Lasers, Solid-State ; Length of Stay ; Necrosis ; Tears

Extravasation necrosis due to intravenously administered fluids and drugs is an increasing problem in hospital practice. The incidence of extravasation is variable but skin necrosis is a potentially devastating complication of intravenous therapy. Local injection of hyaluronidase has been recommended for several types of infusion extravasations. The previous studies found hyaluronidase to be effective in the prevention of necrosis following intradermal nafcillin, 12% dextrose, sodium bicarbonate, aminophylline or vince alkaloids.The objectives of the study are to determine the dosage of hyaluronidase which is effective in reducing extravasation necrosis caused by 10% calcium-gluconate and to establish how soon after this extravasation it must be given to retain its effectiveness.Study I evaluated control versus only normal saline group and normal saline with hyaluronidase groups (dose:75,150,300,450 units; all in volume 2 ml, treatment delay:immediate, 15-minutes delay, half hour delay, one hour delay, three hour delay). Size and rate of eschar were compared between groups. Study II was undertaken to examine the evolution of calcium-gluconate induced soft tissue injury in the rabbit. The histologic findings of extravasation sites were compared between groups. A statistically significant protective effect was found in the treated group versus the nontreated group within 15 minutes to 30 minutes. The most effective protection was achieved by the immediate injection of 300 units dosage of hyaluronidase.In conclusion, in the 10% calcium gluconate-induced extravasation, the given data suggest that one can expect the most protective effect with a 300 units dosage of hyaluronidase and within half-hour delay in the treatment group.
Aminophylline ; Calcium* ; Glucose ; Hyaluronoglucosaminidase* ; Incidence ; Nafcillin ; Necrosis* ; Skin ; Sodium Bicarbonate ; Soft Tissue Injuries

PURPOSE: Joubert syndrome presents neonatal respiratory abnormalities and other clinical manifestations. Pathologically the patients show hypoplasia or agenesis of cerebellar vermis and other intracranial anomalies. Our purpose is to evaluate the clinical manifestations and MR findings of Joubert syndrome. MATERIALS AND METHODS: Among the patients presenting with clinical stigmata of Joubert syndrome and agenesis of vermis on MR imaging, eight patients who did not satisfied the criteria of Dandy-Walker malformation, tectocerebellar dysraphia and rhombencephalosynapsis were selected. MR findings and clinical manifestation were analyzed. RESULTS: On MR imaging, agenesis of the cerebellar vermis (all cases), hypoplasia of the cerebellar peduncle (6cases), fourth ventricular contour deformity(6cases), tentorial elevation (4cases), deformity of the lateral ventricles (4cases), dysgenesis of the straight sinus (3cases) were demonstrated. Other findings were abnormalities of corpus callosum (3cases), falx anomalies (3 cases), occipital encephalomeningocele (2 cases) and fluid collection in posterior cranial fossa (2cases). Clinical manifestations were developmental delay (5cases), abnormal eyeball movement (3cases), hypotonia (2 cases), neonatal rerspiratoy abnormality (2cases), etc. CONCLUSION: Joubert syndrome showed various clinical manifestations and intracranial anomalies. MR imaging is an useful modality in detection of the cerebellar vermian agenesis and other anomalies of the patients.
Christianity ; Congenital Abnormalities ; Corpus Callosum ; Cranial Fossa, Posterior ; Dandy-Walker Syndrome ; Humans ; Lateral Ventricles ; Magnetic Resonance Imaging* ; Muscle Hypotonia

No abstract available.
Nucleolus Organizer Region* ; Proliferating Cell Nuclear Antigen*

No abstract available.
Nucleolus Organizer Region* ; Proliferating Cell Nuclear Antigen*

No abstract available.
Hemangioma, Cavernous*

This study is comprehend the reality and characteristics of C.V.A. patients and to be helpful to its prevention and cure by resarching C.V.A. outpatient or inpatients who visited some of the oriental hospitals during three months from April 1 to June 30 1996 which are located in Taegu and Kungbuk Province, and concluded as follow: 1. The general characteristics of the subjects were: (1) 52.3% of the subjects were male. (2) In terms of age, 34.7% of them were in the sixties. (3) In terms of job, 28.5% of them were housewives(the highest percentage). (4) 77.6% of them had their spouses. (5) 67.2% of them were middle class. (6) In terms of educational background, 24.6% of them were literate of korean alphabets, and 23.4% were elemantary school gradurates. (7) 51.6% of them were outpatients. 2. 73.3% of the subjects experienced C.V.A. for the first time, and 23.1% were at recurrence, and 3.6% were chronic. 3. In terms of C.V.A. types, 49.8% of the subjects had cerebral hemorrhage, and 41.9% had cerebral infarction, and 8.3% had the others. In cerebral hemorrage, the percentage in "male, forties, job of sales service, unmarried, middle class, high educational background" were higher than the others respectively. And in cerebral infarction, the percentages in female, over seventies, official job, married, upper class were higher than the others respectively. 4. In terms of reasons of C.V.A. 49.5% of them were high blood pressure, and 24.2% were high stress, and 18.8% were overwork, and 4.0% were fatness, and 2.5% were heredity. In high blood pressure, the percentages in "high age, teacher, unmarried, lower class, low educa-tional background" were higher than the others respectively. 5. In terms of family members' C.V.A. , 56.7% of the subjects answered negatively, and 43.3% positively. In terms of the diseases which they had now except for C.V.A., 33.6% of them had hypertention, and 16.2% had diabetes, and 9.4% had neuralgia, and 4.0% had heart disease, and 16.6% had the otehrs, and 20.2% had no other disease. In heart disease, the percentages in "male, teachers, middlelower class, middle school graduates, inpatients" were higher than the others respectively. In neuralgia, the percentages in "fifties and sixties, housewives, spouse alive, upper class, literate of Korean alphabet" were higher than the others respectively. In terms of the diseases which they had now except for C.V.A., 33.6% of them had hypertension, and 16.2% had diabetes, and 9.4% had neuralgia, and 4.0% had heart diseases, the percentages in "fifties and sixties, housewives, spouse alive, upper class, literate of Korean alphabets" were higher than the others respectively. 6. In terms of the diseases which they had before C.V.A., 22.4% of them had hypertension, and 18.8% had diabetes, and 8.1% had heart diseases, and 11.2% had neuralgia and arthritis, and 7.8% had cancer, and 21.7% had the others. 7. In terms of exercise behaviors before C.V.A., 41.2% of them did nothing, and 58.8% did sometimes. 8. In terms of fatness level by self judgement, 36.1% of them thought "proper", and 41.1% thought themselves "fat(the highst percentage), and housewives(45.5%) thought themselves "fat". 9. In terms of favorite food, 50.2% of them liked meat, and 33.2% liked vegetables, and 13.0% liked fish. 10. In terms of fancy things of C.V.A. patients, 57.0% of them were non-smokers, and 53.1% were non-drinkers, and 55.2% disliked coffee. In smoking level, 16.6% of them smoked less than five pieces a day. In drinking, 18.0% of them drank half a glass of soju. In coffee, 25.3% of them drank a cup of coffee a day. 11. The level of satisfaction with C.V.A. patient-healing methods ; In medical therapy, 43.3% of C.V.A. patients thought it "usual", and 44.1% thought it "satisfactory" and 7.9% thought it "unsatis-factory". In acupunture and moxibustion 39.7% of the C.V.A. patients thought it "usual", and 53.0% thought it satisfactory" and 3.3% thought it "unsatisfactory". The level of satisfaction With Physiotherapy was average 61.7% and 4.0% was "unsatisfactory". From above statement, by considering those characteristics we should develop programs and materials to be health to the prevention and cure of C.V.A. and we should help hospitals and medical personnel families concerned to make use of them.
Arthritis ; Cerebral Hemorrhage ; Cerebral Infarction ; Coffee ; Commerce ; Daegu ; Drinking ; Female ; Glass ; Heart Diseases ; Heredity ; Humans ; Hypertension ; Inpatients* ; Male ; Meat ; Moxibustion ; Neuralgia ; Outpatients ; Recurrence ; Single Person ; Smoke ; Smoking ; Spouses ; Stroke* ; Vegetables

PURPOSE: To evaluate the radiologic findings of granulomatous colitis on double contrast barium enema and changes on follow-up studies. MATERIALS AND METHODS: Serial double contrast barium enemas of six patients with granulomatous colitis confirmed by endoscopic biopsy were reviewed. We analyzed the radiologic findings and their follow-up changes, including aphthous ulcers, lymphoid hyperplasia, deep ulcers, cobble stone appearance, geographic ulcers, asymmetric involvement of ulcers, skip lesions, sinus tract, fistula formation, pseudosacculation, focal stricture, and small bowel involvement. RESULTS: Pretreatment double contrast baruim enema findings were aphthous ulcers in five patients, deep ulcer in six, cobble stone appearance in five, longitudinal geographic ulcers in two, fistulas in one, pseudo-sacculations in two, focal stricture in one, and pseudopolyps in six. Also, anal ulcers were observed in two patients, asymmetric involvement of ulcers in three, skip lesions in four, and small bowel involvement in five in five patients proved to have inactive disease after treatment, aphthous ulcers and deep ulcers disappeared. Geographic ulcers of two patients and anal ulcer of one patients decreased in size or depth. Pseudosacculation in one patient disappeared. Pseudopolyps decreased in two patients, increased in one, and decreased after increase in two. One patient whose disease remained active after treatment showed maintenance or increase of ulcers or fistula. And their pseudosacculation or focal stricture unchanged and pseudopolyps decreased. CONCLUSION: The major radiologic findings of chronic granulomatous colitis on double contrst barium enema are aphthous ulcer, deep ulcer, cobble stone appearance, discontinuity of the lesion, and coexistence of ulcers and pseudopolyps. And, double contrast barium enema is good follow-up modality because its findings correlate with clinical course of the granulomatous colitis after treatment.
Barium* ; Biopsy ; Constriction, Pathologic ; Crohn Disease* ; Enema* ; Fissure in Ano ; Fistula ; Follow-Up Studies* ; Humans ; Hyperplasia ; Stomatitis, Aphthous ; Ulcer

PURPOSE: To evaluate the radiologic findings of granulomatous colitis on double contrast barium enema and changes on follow-up studies. MATERIALS AND METHODS: Serial double contrast barium enemas of six patients with granulomatous colitis confirmed by endoscopic biopsy were reviewed. We analyzed the radiologic findings and their follow-up changes, including aphthous ulcers, lymphoid hyperplasia, deep ulcers, cobble stone appearance, geographic ulcers, asymmetric involvement of ulcers, skip lesions, sinus tract, fistula formation, pseudosacculation, focal stricture, and small bowel involvement. RESULTS: Pretreatment double contrast baruim enema findings were aphthous ulcers in five patients, deep ulcer in six, cobble stone appearance in five, longitudinal geographic ulcers in two, fistulas in one, pseudo-sacculations in two, focal stricture in one, and pseudopolyps in six. Also, anal ulcers were observed in two patients, asymmetric involvement of ulcers in three, skip lesions in four, and small bowel involvement in five in five patients proved to have inactive disease after treatment, aphthous ulcers and deep ulcers disappeared. Geographic ulcers of two patients and anal ulcer of one patients decreased in size or depth. Pseudosacculation in one patient disappeared. Pseudopolyps decreased in two patients, increased in one, and decreased after increase in two. One patient whose disease remained active after treatment showed maintenance or increase of ulcers or fistula. And their pseudosacculation or focal stricture unchanged and pseudopolyps decreased. CONCLUSION: The major radiologic findings of chronic granulomatous colitis on double contrst barium enema are aphthous ulcer, deep ulcer, cobble stone appearance, discontinuity of the lesion, and coexistence of ulcers and pseudopolyps. And, double contrast barium enema is good follow-up modality because its findings correlate with clinical course of the granulomatous colitis after treatment.
Barium* ; Biopsy ; Constriction, Pathologic ; Crohn Disease* ; Enema* ; Fissure in Ano ; Fistula ; Follow-Up Studies* ; Humans ; Hyperplasia ; Stomatitis, Aphthous ; Ulcer

PURPOSE: The purpose of this study was to find if any clinical or laboratory factors have significant correlations with blood loss caused by a transurethral resection of the prostate (TURP). MATERIALS AND METHODS: The medical records of 218 patients who had undergone a TURP were retrospectively reviewed. For each patient, the preoperative factors evaluated included age, type of presentation (patients who had been treated due to acute urinary retention; retention group, patients who had been treated due to lower urinary tract symptoms; symptomatic group), blood pressure, complete blood count, coagulation screening, prostate size on transrectal ultrasonography (TRUS), urine analysis, urine culture, ECG and drugs. Intraoperative and postoperative factors were also evaluated, including type of anesthesia, operator, operating time, weight of resected prostate tissue, blood transfusion and prostate histology. These factors were analyzed with respect to blood loss during the TURP using student's t, ANOVA and chi-square tests. RESULTS: The mean intraoperative blood loss and resected prostate weight were 415 ml and 15g, respectively. The factors which were found to significantly correlate with blood loss during a TURP were: resected prostate weight (r=0.44, p=0.0001), prostate size on TRUS (r=0.32, p=0.001), operating time (r=0.31, p=0.001), preoperative urine culture (p= 0.020), preoperative antimicrobials taken (p=0.020), and prostate histology (p=0.048). CONCLUSIONS: Of the factors found to correlate with blood loss during the TURP, the only reversible factor was a preoperative urinary tract infection. So, we expect that the prevention of preoperative urinary tract infection and its effective treatment in patients might be helpful in decreasing blood loss during a TURP.
Anesthesia ; Blood Cell Count ; Blood Loss, Surgical ; Blood Pressure ; Blood Transfusion ; Electrocardiography ; Humans ; Lower Urinary Tract Symptoms ; Mass Screening ; Medical Records ; Prostate* ; Retrospective Studies ; Risk Factors* ; Transurethral Resection of Prostate ; Ultrasonography ; Urinary Retention ; Urinary Tract Infections