This report presents a case of a 17-year-old-girl who developed a, Kaposis varicelliforrn eruption(eczema herpeticum) during oral prednisolone therapy in order to control pemphigus foliaceus. Diagnosis was made by the history, clinical feature and histologic examination. Within 24 hours after the initiation of therapy with ribavirin(Viramid), new lesions had ceased to develop.
Diagnosis ; Kaposi Varicelliform Eruption* ; Pemphigus* ; Prednisolone

Whether indwelling urethral catheter should be removed after urethroplasty or visual internal urethrotomy in patients with posterior urethral injured is still controversial. From May 1990 to February 1995, 28 patients with posterior urethral injury underwent retrograde pericatheter urethrography for the purpose of the evaluation of urethral continuity in the timing of the removal of indwelling urethral catheter. The indwelling catheter was removed in 24 patients whose urethra did not have any extravasation, and 4 patients had detectable extravasation. We conclude that retrograde pericatheter urethrogram is the most useful radiologically diagnostic method to evaluate in the timing of the removal of indwelling urethral catheter and to obtain the objective parameter of urethral patency in posterior urethral injured patients, postoperatively.
Catheters* ; Catheters, Indwelling ; Humans ; Urethra ; Urinary Catheters

Avulsion injury of the flexor digitorum profundus tendon from distal phalanx is considered as a rare injury. Accrording to the classification by Leddy and Pacter, this case is Type III, which is a large bony fragment retained by the tendon. The distal pulley prevents retraction beyond the middle phalanx. We are reporting a case with brief review of literatures.
Classification ; Tendon Injuries ; Tendons

BACKGROUND: The purpose of our study was to evaluate the functional and radiologic outcomes of additive augmentation sutures through rotator cuff for proximal humeral fractures stabilized locking plate in elderly patients. METHODS: We enrolled 74 patients over the age of 60 years who received internal fixation using locking plates for proximal humeral fractures. Of these, 50 patients had additive augmentation sutures through rotator cuff. The mean age at the time of surgery was 72.1 years (range, 60-89 years), and the mean follow-up period was 17.5 months (range, 12-62 months). The humeral neck-shaft angle and humeral head height were used as radiological markers to assess the effect of additive augmentation sutures through rotator cuff. We allocated the patients who received additive augmentation sutures into group A and those who did not into group B. RESULTS: At the final follow-up, the mean Korean Showlder Society score and Constant scores were 88.96 +/- 12.1 and 86.6 +/- 11.9, respectively, in group A and 86.21 +/- 11.8 and 85.3 +/- 11.7, respectively, in group B (p=0.368, 0.271). At the final follow-up, the mean loss in humeral neck-shaft angle from the time of immediate postoperative measurement was 1.6degrees in group A and 4.8degrees in group B, whereas the mean loss in humeral head height was 0.82 mm in group A and 0.52 mm in group B (p=0.029, 0.178). CONCLUSIONS: The surgical outcomes of internal fixation using locking plates for proximal humeral fractures were clinically and radiologically good in elderly patients over the age of 60 years without any observable complications. Further, the loss of humeral head shaft angle at the final follow-up from its initial postoperative measurement was significantly smaller in patients who received an additive augmentation suture than in those who did not. Thus, we conclude that augmentation sutures are a beneficial option for elderly patients that clinicians can consider at the time of surgical decision making.
Aged* ; Decision Making ; Follow-Up Studies ; Humans ; Humeral Head ; Rotator Cuff ; Shoulder Fractures* ; Sutures*

BACKGROUND: A novel technique for the repair of tears of the upper subscapularis tendon—intraarticular knotless fixation—has been introduced recently. The purpose of this study was to evaluate the clinical and structural outcomes of arthroscopic intraarticular knotless fixation for the treatment of upper subscapularis tendon tears. METHODS: We retrospectively analyzed the clinical and radiological outcomes of 27 patients who underwent arthroscopic intraarticular knotless fixation for upper subscapularis tendon tears. Finally, a total of 10 patients who could participate in at least a 6 month follow-up of magnetic resonance imaging evaluation and in a least 1-year follow-up on an outpatient basis were enrolled in our study. The mean age at the time of operation was 60.7 years, and the mean duration of follow-up was 14.7 months. Two patients had concomitant tears of the supraspinatus tendon and 8 patients had concomitant tears of the supraspinatus and the infraspinatus tendons. RESULTS: The clinical and radiological outcomes improved after the patients had undertaken arthroscopic intraarticular knotless fixation. The mean visual analogue scale score for pain during motion improved from 6.7 preoperatively to 1.4 at the final follow-up (p<0.001). The mean Constant score improved from 59.3 preoperatively to 79.6 at the final follow-up, and the mean the University of California at Los Angeles score, from 21.7 to 30.2, respectively (p<0.001 and p<0.001). The upper subscapularis tendon tear was healed in every patient except one (90%), for the patient had suffered from a postoperative trauma that resulted in a retear. CONCLUSIONS: We found that arthroscopic intraarticular knotless fixation gives good clinical and structural outcomes for the repair of upper subscapularis tendon tears. Arthroscopic intraarticular knotless fixation provided such a reliable and efficient restoration of the subscapularis tendon footprint that we anticipate it will become a widely-used procedure for upper subscapularis tendon tears.
Arthroscopy ; California ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Outpatients ; Retrospective Studies ; Shoulder ; Tears* ; Tendons* ; Treatment Outcome

BACKGROUND: Management of massive rotator cuff tears can be challenging because of the less satisfactory results and a higher retear rate regardless of the use of open or arthroscopic repair technique. METHODS: We retrospectively analyzed 102 cases of massive rotator cuff tear treated with either open or arthroscopic repair. Open repair was performed in 38 patients; and arthroscopic repair, in 64 patients. The mean age at the time of surgery was 59.7 years in the open group and 57.6 years in the arthroscopic group. RESULTS: The Constant score increased from the preoperative mean of 55.9 to 73.2 at the last follow-up in the open repair group and from 53.8 to 67.6 in the arthroscopic repair group (p<0.001 and <0.001, respectively). The University of California at Los Angeles (UCLA) score increased from a preoperative mean of 17.7 to 30.8 at the last follow-up in the open group and from 17.5 to 28.7 in the arthroscopic group (p<0.001 and <0.001, respectively). No statistically significant difference in the Constant and UCLA scores was observed between the two groups at the last follow-up (p=0.128 and 0.087, respectively). Retear was found in 14 patients (36.8%) in the open group and 39 patients (60.9%) in the arthroscopic group (p=0.024). CONCLUSIONS: Open and arthroscopic repairs of massive rotator cuff tears may provide satisfactory clinical results with no significant difference. However, a significantly lower retear rate was observed for the open repair group compared with the arthroscopic repair group.
Arthroscopy ; California ; Follow-Up Studies ; Humans ; Retrospective Studies ; Rotator Cuff* ; Shoulder ; Tears* ; Tendon Injuries

An 18-Year-old male hemophiliac with high titer of factorVIII inhibitor, stage V hemophilic arthropathy in right knee joint and a history of hematuria and retroperitoneal hemorrhage was admitted because of acute and massive bleeding of epistaxis, pulmonary hemorrhage and intestinal bleeding. The bleeing was not controolled by massive infusion of factorVIII concentrates but by prothrombin complex concentrates and high dose of factorVIII concentrates. He showned symptoms of sustained fever and diffuse pulmonary infiltration which was diagnosed as pulmonary hemosiderosis by MRI. We suppressed his immune reaction by prednisolne to prevent the formation of factorVIII inhibitor. He has been followed up for 3 years and shown no massive bleeding there-after.
Adolescent ; Epistaxis ; Fever ; Hematuria ; Hemophilia A* ; Hemorrhage ; Hemosiderosis* ; Humans ; Knee Joint ; Magnetic Resonance Imaging ; Male ; Prothrombin

PURPOSE: With the development of bipolar device, which complement the weak points of conventional monopolar device, TURP became more appliable in large volume prostate. We evaluated the possibility and effectivity of bipolar TURP in large volume prostate by analysing treatment results. MATERIALS AND METHODS: Total 78 male patients who received bipolar TURP in our center between April 2004 and December 2006, were divided into two groups based on prostate volume (>75g = large volume prostate group, <75g = control group). We compared each of age, prostate volume, resection volume, operation time, IPSS, Qmax, change of serum Na+ & hemoglobin, and perioperative complications. RESULTS: There was no statistical difference between preoperative IPSS and postoperative IPSS between the both groups. In preoperative status, Qmax was statistically higher in small volumed prostate group. But, after bipolar TURP, Qmax of each group were significantly improved, and statistical difference between the two groups were disappeared. Patient age, prostate volume, resection weight, hemoglobin down, hospitalization day, catheterized duration were statistically higher in the large volume prostate group. But, in the clinical aspect, these differences were acceptable. Immediate postoperative hematuria and hypothermia were more frequent in large volume prostate group. Long term complication rates were almost the same in two groups, and there was no TUR syndrome in both groups. CONCLUSION: Transurethral resection of large volume prostate (>75g) using bipolar device is as effective as of general (<75g) prostate hyperplasia. Bipolar TURP can be another therapeutic option of large volume prostate, which in the past indicated open prostatectomy, to escape from higher surgical morbidity.
Catheters ; Complement System Proteins ; Hematuria ; Hospitalization ; Humans ; Hyperplasia ; Hypothermia ; Male ; Prostate* ; Prostatectomy ; Transurethral Resection of Prostate* ; United Nations

BACKGROUND: Lidocaine or verapamil are used as an antiarrhythmic agent or agent blunting the cardiovascular changes induced by intubation or extubation during anesthesia. After recovery from general anesthesia with muscle relaxants, most patients remained in a residual paralytic state, hence it might develop easily recurarization by factors that affect neuromuscular transmission. Lidocaine and verapamil are well known as agents to potentiate the neuromuscular block. We investigated the effects of lidocaine or verapamil on neuromuscular transmission in vitro. METHODS: Square wave, 0.2 ms duration at a frequency of 0.1 Hz supramaximal or train of four stimuli was applied and the twitch height response was recorded mechanomyographically on rat phrenic nerve hemidiaphragm preparations. Dose responses of rocuronium, lidocaine, verapamil, rocuronium pretreated with lidocaine or verapamil, lidocaine pretreated with rocuronium, and verapamil pretreated with rocuronium were observed by cumulative method, and effective doses (Lag dose, ED50 and ED95) between a pretreated and nonpretreated agent were compared statistically. TOF ratios were observed at 80, 70, 40 and 30% of the control twitch height value during the observation of dose responses. RESULTS: Lag dose, ED50 and ED95 of rocuronium were reduced significantly after pretreatment of lidocaine, verapamil or their mixture, and the dose response of lidocaine, verapamil or their mixture were also reduced significantly by rocuronium pretreatment. TOF ratios at the point of each twitch height decreased significantly after pretreatment. CONCLUSIONS: Lidocaine or verapamil itself did not affect the neuromuscular transmission but might have potentiated the neuromuscular blocking effect induced by rocuronium. However, in excessive doses, these agents produced neuromuscular blockade. Consequently, in the residual neuromuscular block induced by rocuronium, lidocaine or verapamil may enhance recurarization.
Anesthesia ; Anesthesia, General ; Animals ; Humans ; Intubation ; Lidocaine* ; Neuromuscular Blockade* ; Phrenic Nerve ; Rats ; Verapamil*

Endoscopic sphincterotomy(EST) is now an established therapeutic procedure for various disorder of the pailla of Vater, the biliary tract, and the pancreas. From November 1992 to September l993, 123 cases of E.S.T were performed in our hospital. The success rate of EST was 97.8%, and choledocholithiasis was the indication for EST in 63. 4% of cases. Among 78 cases of choledocholithiasis, 47 cases were presence of gall bladder with stone (16 cases) or without stone (31 cases), especially 46 cases were assisted with needle type papillotome and 23 cases were assisted with guidewire. EST hae relatively low complications and is the therapy of choice for choledocholithiasis and various diisease of biliary tract. Guidewire assisted stanard papillotome probable reduce the use of needle type papillotome in the difficult cases that EST with pull type papillotome was impossible.
Biliary Tract ; Choledocholithiasis ; Needles ; Pancreas ; Sphincterotomy, Endoscopic* ; Urinary Bladder