Local anesthesia for arthroscopic procedure of the knee is an increasinglv popular technique that avoids the use of general anesthesia and the associated risks of respiratory depression, aspiration, and postoperative sedation. Many authors, for example McGinty etc., Martin, Yoshiya etc., advocated local anesthesia as safe and efficient method for arthroscopic procedures of the knee. We performed arthoroscopy of the knee under local anesthesia on 150 patients for diagnostic and operative purposes between January l993 and December l996. The technique of local anesthesia that we used was that 20cc of 0.5%; bupivacaine with I:200,000 epinephrine was injected into superolateral portal of the knee joint and additional 10-20cc ot 1% lidocaine into the arthroscopic portals. Pnevmatic tourniquet wa, not applied in all cases. We analysed the 150 cases and the results were as follows; The diagnostic arthroscopy was performed in 50 cases and the operative arthroscopy was in 100 cases. The duration ot local anethesia was from 4 hours to 12 hours, with an average of 6 hours. In 35 cases arthroscopy was performed as outpatient procedure and average hospital stay excluding other problem was 5 days. No complication related to systemic toxicity by local anesthetics was observed. Conclusively arthroscopy of the knee under local anesthesia is safe and effective procedure to avoid the risks of general anesthesia but patients selection is very important.
Anesthesia, General ; Anesthesia, Local* ; Anesthetics, Local ; Arthroscopy* ; Bupivacaine ; Epinephrine ; Humans ; Knee Joint ; Knee* ; Length of Stay ; Lidocaine ; Outpatients ; Respiratory Insufficiency ; Tourniquets

PURPOSE: The purpose of this study was to analyze the MR findings of childhood adrenoleukodystrophy regarding the extent of white matter degeneration and the pattern of enhancement, and to correlate these findings with clinical manifestations. MATERIALS AND METHODS: Six male patients (5-13 years old;mean age, 8.7 years) of biochemically confirmed adrenoleukodystrophy were included in this study. We evaluated the extent of white matter degeneration which was shown as high signal intensity on T2-weighted image, and the pattern of enhancement. Also we correlated the MR findings with clinical manifestations of symptoms and the results of evoked potential studies. RESULTS:The most common sites of predominant involvement were occipital deep white matter, optic radiation, and splenium of corpus callosum (n = 4, 66.7%). The other sites of predominant involvement were frontal deep white matter (n = 1, 16.7%) and pyramidal tract with cerebellum (n = 1, 16.7%). After contrast enhancement, there was peripheral rim enhancement surrounding the most severely affected areas in five cases (83. 3%). These findings were consistent with clinical symptoms in five cases (83.3%), but the results of evoked potential studies were consistent with clinical symptoms in only two cases (33.3%). CONCLUSION:In childhood adrenoleukodystrophy, MRI can clearly demonstrate specific tracts of involvement and these findings were well correlated with clinical manifestations.
Adrenoleukodystrophy* ; Cerebellum ; Corpus Callosum ; Evoked Potentials ; Humans ; Magnetic Resonance Imaging* ; Male ; Pyramidal Tracts

Tamoxifen is a nonsteroidal triphenylethylene delivative that has been widely used in the treatment of breast cancer. tamoxifen is indicated for the adjuvant treatment of breast cancer in women following total mastectomy or segmental mastectomy, breast irradiation and chemotherapy. tamoxifen has been shown to have significant benificial effect in the treatment of breast cancer patient as hormonal therapy. However ,there is mounting evidence that tamoxifen may affect other hormon sensitive organs, including the uterus and ovaries. An increased risk of endometrial polyps, endometrial hyperplasia and adenocarcinoma has been reported in tamoxifen treated women. We have met cases of endometrial polyp and endocervical polyp which were associated with tamoxifen use, after modified radical mastectomy for infilterating ductal carcinoma of breast . So we report these cases with the brief review of literatures.
Adenocarcinoma ; Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Drug Therapy ; Endometrial Hyperplasia ; Female ; Humans ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Ovary ; Polyps* ; Tamoxifen* ; Uterus

OBJECTIVES: E-cadherin is a transmembrane protein that is one of the key players involved in cell to cell adhesion. Loss of E-cadherin expression is suggested to promote tumor invasion and distant metastasis in tumor development. Recently, it has been proposed E-cadherin function requires its linkage to the cytoskeleton through catenins. So defects in catenins may cause defective E-cadherin function and promote tumor invasion. We intend to evaluate the expression of E-cadherin and alpha-, beta-, gamma- catenin in tissues of human endometrial carcinoma to analyze the patterns of cell adhesion molecules' expression in endometrial carcinoma and to investigate the relationship between status of cell adhesion molecules and various clinicopathological factors. MATERIALS AND METHODS: The present study investigated the immunohistochemical expression of E-cadherin and alpha-, beta-, gamma- catenin in 33 paraffin embedded formalin fixed tissues of endometrial carcinomas. RESULTS: Aberrant E-cadherin, alpha-, beta-, gamma- catenin expression was observed in 33.3(11 of 33), 27.3(9 of 33), 18.2 (6 of 33), and 51.5(17 of 33) % of the specimens, respectively. Statistically significant correlation was found between aberrant expression of E-cadherin and lymph node metastasis and cell types other than endometrioid adenocarcinoma. Aberrant pattern of gamma- catenin expression also correlated with deep myometrial invasion. But alpha-, beta- catenin expression were not correlated with any clinicopathological parameters. Using Kaplan-Meier curves, abnormal expression of E-cadherin correlated closely with poor survival (p<0.05). CONCLUSION: We revealed aberrant expression of these cell adhesion molecules in part of patients with endometrial carcinoma. Aberrant expression of E-cadherin was correlated with lymph node metastasis and cell types other than endometrioid adenocarcinoma and aberrant expression of gamma-catenin was related with deep myometrial invasion.
Cadherins* ; Carcinoma, Endometrioid ; Catenins* ; Cell Adhesion ; Cell Adhesion Molecules ; Cytoskeleton ; Endometrial Neoplasms* ; Female ; Formaldehyde ; gamma Catenin ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Paraffin

No abstract available.
Dialysis* ; Peritonitis* ; Salmonella*

No abstract available.
Dialysis* ; Peritonitis* ; Salmonella*

No abstract available.

PURPOSE: The purpose of our study is to evaluate the diagnostic significance of clinical findings, WBC count, ESR, CRP, simple X-ray, ultrasonography and bone sanning in neonates. MATERIALS AND METHODS: From January 1995 to May 1998, we have experienced 14 cases of pyogenic osteomyelitis and pyogenic arthritis in neonates. The mean age of patients was 16.7 days and the involved sites were 6 cases of pyogenic arhtritis of hip, 5 cases of pyogenic arthritis of hip with proximal femur osteomyelitis, 2 cases of pyogenic arthritis of shoulder with proximal humerus osteomyelitis and 1 case of proximal tibia osteomyelitis. RESULTS: The most frequent clinical signs were local swelling and pseudoparalysis of involved extremity. Laboratory findings showed that elevated ESR was in 11/14 (79%), positive CRP in 6/8 (75%), leukocytosis in 6/14 cases (43%). Abnomal findings in simple X-ray was in 7/13 (54%), positive bone scanning findings in 3/8 (37.5%), positive ultrasonographic findings in 11/11 cases (100%). CONCLUSIONS: ITherefore we concluded that careful physical examination and ultrasonography were important for early diagnosis of bone or joint infection in neonates
Arthritis ; Diagnosis* ; Early Diagnosis ; Extremities ; Femur ; Hip ; Humans ; Humerus ; Infant, Newborn* ; Joints* ; Leukocytosis ; Osteomyelitis ; Physical Examination ; Shoulder ; Tibia ; Ultrasonography

The purpose of this study was to determine whether there is an association between disk displacement of the Temporomandibular Joint (TMJ) and dentofacial asymmetry in orthodontic patients. The subjects consisted of 60 female orthodontic patients between the ages of 18 and 38 years (mean age 23.3 years) who had visited the Department of Orthodontics at Seoul National University Dental Hospital from January 2000 to April 2002. On the basis of magnetic resonance imaging (MRI) of their bilateral TMJs, the subjects were divided into four groups: bilateral normal group (twenty-one persons); disk displacement of right TMJ group (six persons); disk displacement of left TMJ group (nine persons); and disk displacement of both TMJs group (twenty-four persons). Postero-anterior (PA) cephalograms and diagnostic models which had been taken before orthodontic treatment were measured. In the linear measurements, a line connecting the right and left Latero-Orbitale (Lo) represented the horizontal reference line (H). The vertical reference line (V) was constructed as a line bisecting and running perpendicular to H. One-way analysis of variance (ANOVA) was used to test whether the mean values of measurements between groups were significantly different. In addition, Bonferroni's multiple comparison test was performed at a level of 0.05. The results were as follows : 1. In the diagnostic model analysis, the overjet, right molar relationship, and left molar relationship were significantly different among the four groups. 2. In the PA cephalometric analysis, differences in the right and left vertical position of the lower first molar and Ag were significantly dissimilar among the four groups. 3. If the disk displacement of TMJ was present on one side, the ipsilateral ramus was shorter, resulting in asymmetry in the vertical position of Ag. This study indicated that dentofacial asymmetry might be related to the disk displacement of TMJ.
Female ; Humans ; Magnetic Resonance Imaging ; Molar ; Orthodontics ; Running ; Seoul ; Temporomandibular Joint*

PURPOSE: To assess the role of the preoperative portal vein embolization (PVE) in patients in need of major hepatectomy. MATERIALS AND METHODS: Total of 11 cases consisted of Klatskin tumor (n:6), gallbladder cancer (n=2), and hepatocellular carcinoma (n=3). After percutaneous transhepatic puncture of portal vein (right:7, left:4), the embolization of 1st order branch of right portal vein was done with Gentamicin soaked Gelfoam cubes. Radiologically, the angle between the middle hepatic vein and the inferior vena cava was measured on pre- and post-PVE CT (F/U :10 days) to evaluate the hypertrophy of the left lobe. Clinically, amount and nature of the drained bile through the PTBD tube of both lobes were analyzed in 5 patients with Klatskin tumor. The interval between PVE & operation was 10-24 days. Operative findings & the changes of postop. total bilirubin were analyzed and the complication after procedure was checked. RESULTS: There was decrease in mean angle between the middle hepatic vein and the inferior vena cava from 35.9 degree to 23.9 degree, but it was insignificant statistically (p=0.09). The embolization of right portal vein was done and there was increase in amount of drained bile from the nonembolized left lobe by 2-3 folds 8-14 days after PVE. The color and consistency between both lobes were significantly different; right lobe was darker in color and softer in consistency. Postoperative total bilirubin increased by 2-3 folds 1 to 4 days after PVE and normalized 10 to 14 days after PVE. Most of the patients had mild abdominal pain and fever after PVE and 1 patient had localized hematoma at puncture site which was subsided spontaneously. CONCLUSION: The preoperative portal vein embolization is a useful method for minimizing postoperative liver failure in patients in need of major hepatectomy.
Abdominal Pain ; Bile ; Bilirubin ; Carcinoma, Hepatocellular ; Fever ; Gallbladder Neoplasms ; Gelatin Sponge, Absorbable ; Gentamicins ; Hematoma ; Hepatectomy* ; Hepatic Veins ; Humans ; Hypertrophy ; Klatskin's Tumor ; Liver Failure ; Portal Vein* ; Punctures ; Vena Cava, Inferior