Hip arthroscopy is technically demanding procedure and it is difficult to inspect the entire joint space. But with the development of instruments and the accumulation of results of research, the indications of hip arthroscopy are expanding. The operative arthroscopy of 18 joints was performed during the past four years. We used the supine position on the fracture table and anterolateral and lateral portals. Removal of traumatic loose bodies and synovial chondromatosis, lavage of pyogenic arthritis are excellent indications for the arthroscopic surgery of the hip joint. The results of the partial synovectomy and debridement for rheumatoid arthritis and other arthritis are satisfactory. The hip arthroscopy is beneficial to the diagnosis and treatment for the unexplained hip pain.
Arthritis ; Arthritis, Rheumatoid ; Arthroscopy ; Chondromatosis, Synovial ; Debridement ; Diagnosis ; Hip Joint ; Hip ; Joints ; Supine Position ; Therapeutic Irrigation

High septal deformities exert pressure on upper lateral cartilages and nasal bones and cause external deviation of the nose. However, detection of high septal deformities causing deviated noses is very difficult if a detailed intranasal examination is not performed. As well, the high septal border is a difficult area to approach via the endonasal rhinoplasty and is the weakest portion in the septum resulting in much difficulty in correcting deformities and in frequent later recurrence of deviation secondary to the healing process. In order to solve the above problems in 33 cases of deviated nose associated with high septal deformities, the authors evaluated deformities in the high septal border after separation of the septum from upper lateral cartilages and nasal bones. The high septal border is centralized by scoring after resection of the mid or lower-septal portion. And spreader grafts were applied to the convex sides of deviated septal borders to stabilize the high septal border and to prevent long-term recurrence of deviation. Also, to balance the traction force of side walls, the length of both upper lateral cartilages and nasal bones were equalized by resection in the longer side and grafting in the shorter side. Clinical follow-up ranged from 3 to 31 months. There was no surgical or septal complication. Also, there was no incomplete correction, recurrence of deviation, or compromized nasal support. All patients except 2 were satisfied with the aesthetic and functional results. We found that separation of septum from side walls allows detection and correction of higher septal deformities and that spreader graft allows long-term support and prevents later recurrence of deviation.
Cartilage ; Congenital Abnormalities* ; Follow-Up Studies ; Humans ; Nasal Bone ; Nose* ; Recurrence ; Rhinoplasty ; Traction ; Transplants*

No abstract available.
Thrombocythemia, Essential*

Primary malignant melanornn of the vagina is rare, with only about 130 reported cases worldwide. They presumably arise from melanocytes that are present in the vagina in 3% of normal wornen. Vaginal melanoma accounts for less than 1% of melanomas and less than 3% of primary malignant tumors of the vagina. Most of patients complain vaginal bleeding, vaginal discharge, foreign body sensation in order. The best treatment of vaginal melanoma rernains eni.gmatic, Many authors indicate that radical surgery may be the pcferred approach and the number of reported cases treated with radical surgery is increasing. But other author comment that no significant change in survival is apparent with radical surgery. Overall prognosis is poor as most patients have deeply penetrating lesions at the time of diagnosis. Recently, not only the effort to increase the survival rate but the quality of life including sexual function after treatment is becoming an important issue about treatment ot cancer patients. We experienced a case of primary malignant melanoma of the vagina treated with radical surgery and restored the sexual function by vulvovaginal reconstruction using gracilis myocutaneous flap. So we report this case with brief literature review.
Diagnosis ; Foreign Bodies ; Humans ; Melanocytes ; Melanoma* ; Myocutaneous Flap ; Prognosis ; Quality of Life ; Sensation ; Survival Rate ; Uterine Hemorrhage ; Vagina* ; Vaginal Discharge

BACKGROUND: Evening primrose oil(EPO) is a rich source of cis-linoleic acid and gammalinolenic acid(GLA) and has been used as a therapeutic agent in various skin diseases such as atopic dermatitis. OBJECTIVE: The purpose of this study was to evaluate the suppressive effect of EPO on murine contact sensitivity. METHODS: BALB/c mice were divided into 3 groups, positive control, experimental and negative control groups: the positive control group represents a group of mice which were sensitized and challenged with DNFB, the experimental group represents EPO-pretreated positive control group and the negative control group represents a group of mice which were challenged only. The changes of ear thickness were measured, and H & E staining and immunohistochemical staining for ICAM-1 expression of ear skin were performed to evaluate the histological changes of each group. RESULTS: The Pretreatment of mice with EPO resulted in suppression of contact sensitivity by more than 82%. On H & E staining, only a mild inflammatory reaction was observed in the dermis. Also ICAM-1 expression of keratinocytes, the intensity of the staining was significantly decreased in the experimental group compared with positive group. CONCLUSIONS: Our study indicates that EPO was able to suppress the induction of contact sensitivity.
Animals ; Dermatitis, Atopic ; Dermatitis, Contact* ; Dermis ; Dinitrofluorobenzene ; Ear ; Intercellular Adhesion Molecule-1 ; Keratinocytes ; Mice ; Oenothera biennis* ; Skin ; Skin Diseases

BACKGROUND: Data on the frequency of Herpes Zoster are sparse, especially in inpatients OBJECTIVE: The purpose of this study was to elucidate the epidemilogy and the clinical characteristics of herpes zoster in inpatients. METHODS: During a 3-year-Period from Jan. 1991 to Dec. 1991, 157patients with herpes zoster were evaluated in regard to annual, monthly and seasonal incidence age incidenee and sex ratio. Patients with herpes zoster were further assessed concerning associratel conditions, dermatomic distributions and complications. RESULTS: 1. The annual rate ranged from 2.6% to 3.3% (mean 2.8%) and the ratio of male to female was 0.85: 1. 2. There were no marked manthly of spasonal differences in herpsoster, ranging from 4.5% to 10.8% and 21.7% to 31.2%, respectively. 3. Herpes Zoster was seen most frequently in the 50-59 year age group(27.4%) 4. The dermatomic involvernent of herpes zoster was most freqer t of thoracic dermatome(51.6%) and others were trigeminal(19.1%), cervical(13.4%), lumbar(6.4%), sacral(5.7%), facial(1.9%) and generalized(1.9%). 5. The frequency of associated conditions in herpes zoster was in d scending order, hypertension, tuberculosis, diabetes mellitus, malignancy, SLE, gastric ulcer, chronic renal failiure, rheumatoid arthritis, idiopathic pulmonary fibrosis. 6. The most common complication of herpes zoster was postheret c neuralgia and others were ophathalmologic complications, secondary bacterial infection, keloicl, formation, generalized varicelliform eruption, recurrent herpes zoster. CONCLUSION: Herpes Zoster is a major problem in the Department of Dermatology, especially in inpatients.
Arthritis, Rheumatoid ; Bacterial Infections ; Dermatology ; Diabetes Mellitus ; Female ; Herpes Zoster* ; Humans ; Hypertension ; Idiopathic Pulmonary Fibrosis ; Incidence ; Inpatients* ; Male ; Neuralgia ; Seasons ; Sex Ratio ; Stomach Ulcer ; Tuberculosis

BACKGROUND: Data on the frequency of Herpes Zoster are sparse, especially in inpatients OBJECTIVE: The purpose of this study was to elucidate the epidemilogy and the clinical characteristics of herpes zoster in inpatients. METHODS: During a 3-year-Period from Jan. 1991 to Dec. 1991, 157patients with herpes zoster were evaluated in regard to annual, monthly and seasonal incidence age incidenee and sex ratio. Patients with herpes zoster were further assessed concerning associratel conditions, dermatomic distributions and complications. RESULTS: 1. The annual rate ranged from 2.6% to 3.3% (mean 2.8%) and the ratio of male to female was 0.85: 1. 2. There were no marked manthly of spasonal differences in herpsoster, ranging from 4.5% to 10.8% and 21.7% to 31.2%, respectively. 3. Herpes Zoster was seen most frequently in the 50-59 year age group(27.4%) 4. The dermatomic involvernent of herpes zoster was most freqer t of thoracic dermatome(51.6%) and others were trigeminal(19.1%), cervical(13.4%), lumbar(6.4%), sacral(5.7%), facial(1.9%) and generalized(1.9%). 5. The frequency of associated conditions in herpes zoster was in d scending order, hypertension, tuberculosis, diabetes mellitus, malignancy, SLE, gastric ulcer, chronic renal failiure, rheumatoid arthritis, idiopathic pulmonary fibrosis. 6. The most common complication of herpes zoster was postheret c neuralgia and others were ophathalmologic complications, secondary bacterial infection, keloicl, formation, generalized varicelliform eruption, recurrent herpes zoster. CONCLUSION: Herpes Zoster is a major problem in the Department of Dermatology, especially in inpatients.
Arthritis, Rheumatoid ; Bacterial Infections ; Dermatology ; Diabetes Mellitus ; Female ; Herpes Zoster* ; Humans ; Hypertension ; Idiopathic Pulmonary Fibrosis ; Incidence ; Inpatients* ; Male ; Neuralgia ; Seasons ; Sex Ratio ; Stomach Ulcer ; Tuberculosis

BACKGROUND: Cardiopulmonary bypass during open heart surgery causes systemic inflammatory respose. IL-10 is an anti-inflammatory cytokine that inhibits inflammatory process and protects organ function by down regulation of pro-inflammatory cytokine release and maintenance of blood level balance with pro-inflammatory cytokines. MATERIAL ateial and Method: Plasma IL-10 levels were measured and analyzed in 22 patients who underwent open heart surgery (11 cases of coronary artery bypass graft, 11 cases of valve replacement) under cardiopulmonary bypass since 1988 January to July at Department of Thoracic and Czardiovascular surgery, Yeungnam University Hospital. 1g of methylprednisolone was administrated to thirteen patients randomly. Blood samp.es were taken and collected at the time of induction of anesthesia, 10 min before cardiopulmonary bypass, 10 min after starting of CPB, 10 min aftr aortic cross clamping, 10 min after ACC release, and 10 min, 2 hours, and 5 hours after CPB respectively. The plasma levels of IL-10 were determined by enzyme-linked immunosorbent assays (ELISA). Wilcoxon-Raule Sum test was used for statistical analysis. In all 22 patients, cardiopulmonary bypass time was used for statistical analysis. In all 22 patients, cardiopulmonary bypass time was 171+/-41.4 min and aortic cross clamp time was 118+/-36.5 min. Peak IL-10 level was achieved at 10 min after ACC (361.0+/-52.81pg/ml) and was decreased sharply at 2 hours after CPB. Peak IL-10 level was correlated positively with aortic cross clamp time (p=0.011); however, it did not correlated with bypass time (p=0.181). In valve replacement group, mean IL-10 level at peak point was 567.89+/-107.69 pg/ml and was significantly higher than that of coronary artery bypass group (205.67+/-192.70 pg/ml) (p<0.001). ACC time in valve replacement group was significantly longer than that of coronary artery bypass group (p<0.01), however, bypass time was not (p=0.212). Thirteen patients with steroid pretreatment before starting of CPB showed relatively higher plasma IL-10 level than in control group, however, no statistical significance was noted (p=0.19). CONCLUSION: plasma level of IL-10 was increased in association with cardiopulmonary bypass and revealed peak at 10 min after ACC release. IL-10 level was correlated positively with ACC time. Therefore, systemic inflammatory respeonse in association with cardiopulmonary bypass could be decreased by reducing ACC time during cardiac surgery.
Anesthesia ; Cardiopulmonary Bypass* ; Constriction ; Coronary Artery Bypass ; Cytokines ; Down-Regulation ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-10* ; Methylprednisolone ; Plasma ; Thoracic Surgery ; Transplants

The clinical observations were made on 66 patients of renal injuries during the period from 1985 to 1991) The results were as follows: I. The renal injuries were classified as contusion, laceration, rupture, pedicle injury according to Cass and Luxenberg`s classification. The patient numbers of each group were 42 (63.6%), 11 (16.3%).11 (16.3%) and 2 (3%). 2. The sonography was useful by complementary diagnostic tool of excretory urography in major renal injuries. 3. The computerized tomography was useful in diagnosing combined injuries and detecting injuries which were not detected in excretory pyelography. 4. The treatment of many. major renal injuries could be done conservatively with detailed and accurate diagnosis using computerized tomography.
Classification ; Contusions ; Diagnosis ; Humans ; Lacerations ; Rupture ; Urography

The long QT syndromes have been classified into acquired or inheritary forms, both of which are associated with a characteristic type of life-threatening polymorphic ventricular tachycardia called torsade de points. Beta-adrenergic blocker is the first cholic treatment, but in those whom cardiac events are not prevented by beta - blockade, left thoracic sympathetic ganglionectomy may be useful in selected cases. A 50-year-old woman had an recurrent syncopal attack in which she was unconscious for 1-2 min and 1-2 times a month for 10 years. The EKG revealed that QT & QTc intervals were 744 and 632 msec respectively. Treatment with Beta-adrenergic blocker and calcium channel blocker was ineffective in preventing recurrence of syncopal spell. Therefore, she underwent left thoracic sympathetic ganglionectomy with thoracoscope. During the 9 months after operation, she was free of syncopal episodes and is doing well.
Calcium Channels ; Electrocardiography ; Female ; Ganglionectomy* ; Humans ; Long QT Syndrome* ; Middle Aged ; Recurrence ; Syncope ; Tachycardia, Ventricular ; Thoracoscopes*