No abstract available.
Uterus*

Anesthesia, General ; Hemorrhage ; Humans ; Incidence ; Palatine Tonsil ; Postoperative Hemorrhage ; Tonsillectomy

No abstract available.
Lymphangioleiomyomatosis*

No abstract available.
Glomus Tumor*

The incidence of conjoined twins is so rare that few anesthesiologists have an opportunity of managing them. Especially in Korea, there are only a few reports describing the anesthetic management for surgical separation of newborn conjoined twins. We experienced the successful anesthetic management for surgical separation of thoraco-xiphopagus conjoined twins without any particular problems. After applying the noninvasive monitors (ECG, pulse oximeter), one of the twins (twinA) with congenital heart disease was administered with intravenous ketamine for induction of anesthesia and intubated without neuromuscular blocker. Anesthesia was maintained with N2O-O2 and hand ventilation using Mapleson D breathing circuit. After maintaining airway of the twinA, the twinB was intubated and maintained with the same manner. Eighteen days after the separation procedure, the twinA with congenital heart disease died and the other one, twinB has been alive with normal growth and development.
Anesthesia ; Growth and Development ; Hand ; Heart Defects, Congenital ; Humans ; Incidence ; Infant, Newborn ; Ketamine ; Korea ; Neuromuscular Blockade ; Respiration ; Twins, Conjoined* ; Ventilation

Various methods have been used in the treatment of femoral shaft fractures in adults. In recent years, generally accepted two methods are intramedullary nailing and plate fixation. We followed and reviewed 121 cases of femoral shaft fracture in 116 patients, treated by operation in Orthopaedic Department, Presbyterian Medical Center, Chonju from 1980 to 1986. All cases were devided into 2 groups, intramedullary nailing(24 cases) and plate fixation (97 cases), and the two groups were compared each other. The results are as follows : 1. Most of intramedullary nails were used in relatively younger age group, before 50 yesrs of age. 2. The mean bony union time in plate fixation was 14 weeks and that in intramedullary nailing was 17.4 weeks. They showed about 3 weeks of difference. 3. In the group, whose operations were performed within 2 weeks after injury, showed high rate of bone union within 6 months, but in those whose operations were delayed more than 2 weeks showed marked decrease in bone union. And the rate of decrease was greater in plate fixation. 4. The recovery of knee joint motion above 110 was greater in intramedullary nailing (87.5%) than that in plate fixation(79.3%). 5. There was no difference in functional recovery between plate fixation and intramedullary nailing. 6. The complications, including delayed and nonunion, infection, metal failure, and limitation of knee joint motion, were more in plate fixation. 7. The risk of refracture is higher in plate fixation. Therefore plates must be removed after some period.
Adult ; Clinical Study ; Fracture Fixation, Intramedullary ; Humans ; Jeollabuk-do ; Knee Joint ; Protestantism

Experimental treatment by open reduction and internal fixation with modified tension band combined with external compression device was used for the patella fractures. Early post operative continuous passive motion and early weight bearing exercise was followed. This method was excellent for treatment of the patella fractures and prevention of post operative complications such as limitation of motion and post-traumatic arthritis of the knee joint. This experimental treatment was performed in 5 patients. and the results are as follows :1. Treatment by modified tension band combined with external fixator is useful for any type of the patella fracture. 2. By continuous passive motion and programed post operative rehabilitation, early painless recovery of wide range of motion of the knee joint and early weight bearing became possible. 3. Complications such as pain on motion, post-traumatic arthritis and limitation of motion of the knee joint was not seen. 4. This method is excellent for treatment of the patella fractures, and we are now trying to memodel the external fixator for cosmetic improvement and prevention of pin site problems.
Arthritis ; External Fixators ; Humans ; Knee Joint ; Methods ; Patella ; Range of Motion, Articular ; Rehabilitation ; Weight-Bearing

Treatment by External Fixation with External Compression Device was used for the displaced fractures of the proximal humerus. Especially in the old aged patient and patient with severe associated injury, this method was excellent for the early, painless motion of the shoulder and then good functional result. This experimental treatment was performed in 8 patients, and its merits were as follows: 1. The technique of operation was relatively easy, and was possible within a short time with minor injury. 2. The quality of reduction was good in all cases. 3. By the compression effect on the fracture site and firm maintenance of reduction during the treatment, solid healing as in internal fixation was possible. 4. Firm maintenance of reduction & minimal injury of soft tissue made possible early painless and wide ROM exercise, and then good functional result.
Humans ; Humerus ; Methods ; Shoulder

PURPOSE: To determine the frequency of complications and diagnostic accuracy of CT-guided percutaneous automated gun biopsy, and to compare the results with those reported for fine needle aspiration. MATERIALS AND METHODS: Using automated biopsy devices, 118 CT-guided percutaneous biopsies of pulmonary lesions were performed. An 18-gauge needle was used. Final diagnosis was made with operation or other methods. We retrospectively analyzed the frequency of complications and diagnostic yields of 118 biopsies. RESULT: Four of 118(3.3%) patients developed pneumothorax and two of these required chest tube insertion. Other complications were resolved spontaneously. 106 biopsies (89.8%) yielded sufficient tissue for pathologic evaluation. For cases of malignant and of benign disease, sensitivity was 91.8% and 87.7% respectively ; the corresponding figures for diagnostic accuracy were 88.5% and 78.9%. CONCLUSION: CT-guided automated gun biopsy of the pulmonary lesions is safe, witha pneumothorax rate comparable to that of fine needle aspiration. In the absence of a trained cytologist at the time of biopsy, the diagnostic accuracy of automated gun biopsy of pulmonary lesions compared favorably with the reported accuracy of fine needle aspiration.
Biopsy* ; Biopsy, Fine-Needle ; Chest Tubes ; Diagnosis ; Needles ; Pneumothorax ; Retrospective Studies

BACKGROUND: The laparoscopic cholecystectomy (LC) has been accepted as the procedure of choice for chronic cholecystitis. However in cases of acute cholecystitis, the safety and the efficacy of LC has not been fully determined. Thus we performed this study to assess the clinical outcomes of a LC for acute cholecystitis to evaluate it's efficacy and safety. METHODS: The authors retrospectively analyzed 1,164 LCs performed in Yeungnam University Hospital from May 1991 to March 1996. Among the 1,164 LCs, 118 were performed for acute cholecystitis and 1,046 were performed for chronic cholecystitis. The authors compared the mean operation time, the conversion rate to an open cholecystectomy (OC), the reasons for conversion, the complication rate, the postoperative hospital stay, and the postoperative use of analgesics between the patients with acute cholecystitis and the patients with chronic cholecystitis. RESULTS: In the 1046 patients with chronic cholecystitis, the mean operation time was 55.9 minutes, the conversion rate to an OC was 2.7%, the complication rate was 4.0%, the mean postoperative hospital stay was 3.3 days, and analgesics were used in 48% of the patients. However in the 118 patients with acute cholecystitis, the mean operation time was 65 minutes, the conversion rate to an OC was 11.8%, the complication rate was 16.9%, the mean hospital stay was 4.4 days, and analgesics were used in the 60% of the patients. Also the authors found that the longer duration of preoperative symptoms and an advanced state of inflammation (e.g., GB empyema or gangrenous changes) were the two most common causes of conversion to an OC in the case of acute cholecystitis. Although all the analyzed parameters (especially, the conversion rate and the complication rate) were higher in the patients with acute cholecystitis than they were in the patients with chronic cholecystitis, a LC for acute cholecystitis seems to be acceptable because there were no mortalities and there were no life threatening complications. CONCLUSIONS: From, the aspects of safety and efficacy, a LC can be performed in most patients with acute cholecystitis. However, it should be remembered that the prolonged duration of symptoms prior to a LC increases the conversion rate to O.C. and if we confront the advanced cholecystitis (GB empyem or gangrenous change) with difficult Calot's triangle during a L.C., early conversion to an OC should be considered.
Analgesics ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis ; Cholecystitis, Acute* ; Empyema ; Humans ; Inflammation ; Length of Stay ; Mortality ; Retrospective Studies