Pellegrini-Stieda's disease is a post-traumatic disorder of the knee. It is characterized by a crescentric-like bony formation in the region of the medial condyle of the femur, which usually makes its appearance upon roentgenographic examination three or more weeks after injury to the knee. During the three and a half years from January 1979 to July 1982, eleven patients were treated by conservative method and only one patient was treated by operation. The results were as follows; l. All give a history of trauma. 2. The major findings in this disease were pain in motion, local tenderness, and limitation of motion. 3. In roentgenographic findings of these cases, we noted the followings: 1) The most common site of the calcification was the proximal area of the tibial collateral ligament. 2) In seven cases (58%), the evidence of calcification was noted in 4 weeks to 12 weeks following original trauma. 3) Eight cases (67%) showed a radiolucent area from 0.5 to 3mm in thickness between the bony shadow and the femur. 4) Eight cases (67%) showed a crescentric shape of calcified area. 5) In seven cases (58%), the size of calcified mass was 1.5 to 3.5cm in length and 1 to 3mm in width. The mean size of calcified mass about 3cm in length and about 2.5mm in width. 4. Eleven cases were treated conservatively and one case was treated operatively. The results were satisfactory, and all patients were able to return to their works.
Clinical Study ; Femur ; Humans ; Knee ; Medial Collateral Ligament, Knee ; Methods

BACKGROUND/AIMS: Smoking is major cause of lung cancer. However, the prevalence of lung cancer in never-smokers increasing recently. This study investigated the clinical characteristics of advanced lung cancer in never-smokers. METHODS: We anlyzed the clinical characteristics including demographics, bronchoscopic features, stage, and serum tumor markers, of never smokers with lung cancer seen at Kosin University Hospital from January 2001 to December 2008. RESULTS: There were 105 never smokers with lung cancer (mean age 61 years, 82 females), comprising 83 (79%) adenocarcinomas, 9 (8.6%) squamous carcinomas, and 13 (12.4%) undifferenciated carcinomas. The overall median survival time (MST) was 18.7 months. The MST was longer in females (21.6 vs. 13.7 months, p = 0.03), patients younger than 60 years (19.2 vs. 17.5 , p = 0.019), and those with adenocarcinoma (21.6 vs. 8.8 months, p = 0.038), and a neuron-specific enolase level of less than 15 ng/mL (22.4 vs. 13.4 months, p = 0.014). CONCLUSIONS: We analyzed the clinical characteristics of advanced lung cancer in never smokers. A more comprehensive study is need to compare never-smokers and smokers with lung cancer and to determine the appropriate treatment for non-smokers.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Demography ; Female ; Humans ; Lung Neoplasms ; Phosphopyruvate Hydratase ; Prevalence ; Smoke ; Smoking ; Biomarkers, Tumor

During administration of anesthesia, intraoperative blood pressure control is very important. Sometimes a hypertensive or anti-hypertensive agent is used in order to maintain blood pressure at an adequate level; alpha-agonist and beta-blocker are drugs frequently used. Alpha-agonists are used in various ways including their application together with local anesthetics during an operation for the purpose of vasoconstriction, to control systemic absorption of local anesthetics, to extend the duration of action, or to reduce bleeding from the surgical site. In addition, alpha-agonists are used in cardiopulmonary resuscitation. Beta-blockers are used widely as a therapeutic agent for hypertension, angina, and arrhythmia, and to lower portal pressure in liver cirrhosis. Here, we are reporting the case of acute pulmonary edema that occurred after the administration of phenylephrine, in order to maintain blood pressure in a 52-year-old female patient with liver cirrhosis. The patient was underwent emergent decompressive craniectomy for intracranial hemorrhage without acknowledging her long-term use of a beta-blocker medication.
Absorption ; Anesthesia ; Anesthetics, Local ; Arrhythmias, Cardiac ; Blood Pressure ; Cardiopulmonary Resuscitation ; Decompressive Craniectomy ; Female ; Hemorrhage ; Humans ; Hypertension ; Intracranial Hemorrhages ; Liver Cirrhosis ; Middle Aged ; Phenylephrine ; Portal Pressure ; Pulmonary Edema ; Vasoconstriction

BACKGROUND: Endobroncheal intubation or extubation may occur accidentally when the patient's neck is flexed or extended even in the appropriate endotracheal intubation. The purpose of this study is to examine the effect of fixation or unfixation of the endotracheal tube at the teeth level on the displacement of its distal end when the patient's neck is extended or flexed. METHODS: This study was conducted in 37 patients who underwent endotracheal general anesthesia. The patients with the evidence of pathology in head, neck and chest were excluded from the study. Individual patient's displacement in endotracheal tube tip compared unfixed cases with fixed cases when the change of neck position. The moved distance was measured by fiberoptic bronchoscope. The data were statistically analyzed by Student's paired t-test. RESULTS: The endotracheal tube moved away from the carina when the patient's neck was extended, while it moved toward the carina when flexed in all cases. When the patient's neck was extended the average distance displaced 1.2 0.7 cm in fixed cases and 1.1 0.9 cm in unfixed cases. when the neck was flexed, they were 1.2 0.5 cm and 1.0 0.8 cm respectively. There were not statistically significant between the fixed and the unfixed cases. CONCLUSIONS: It is concluded that the displacement of the endotracheal tube is not related to its fixation or unfixation at the teeth level and therefore, unfixation does not provide any benefits in terms of the displacement of the distal end of the tube in adult trachea.
Adult ; Anesthesia, General ; Bronchoscopes ; Head ; Humans ; Intubation ; Intubation, Intratracheal ; Neck* ; Pathology ; Thorax ; Tooth ; Trachea

No abstract available.
DNA* ; Herpesvirus 4, Human* ; Nasopharyngeal Neoplasms* ; Polymerase Chain Reaction*

Objectives: . To determine the appropriate anatomical borders of implantation on the temporal bone in a cadaver study, and to develop a simplified surgical technique for Baha Attract implantation through a small incision along the hairline using anatomical evidence and a navigation system. Methods: . In a cadaver study, 20 human adult dry skulls were used to find flat areas of the temporal bone for Baha Attract magnet implantation. Four borders of the “optimal surgical site” were defined: Asterion line, occipitomastoid suture line, sigmoid sinus line, and digastric groove line. In three patients, we implanted the Baha Attract according to the newly developed surgical procedure and validated the feasibility of this technique with a navigation system. Results: . We identified the appropriate position of the implant on the temporal bone, suggesting a simplified surgical technique for Baha Attract with a small incision. We determined the spot of implantation, and the implants were inserted through a small surgical incision (<2.5 cm) under local anesthesia; the procedure lasted approximately 30 minutes. Conclusion . The optimal surgical site of the temporal bone is a safe and easily accessible location for implantation of the Baha Attract.

No abstract available.
Angina Pectoris* ; Electrocardiography* ; Pheochromocytoma*

Transfusion-related acute lung injury (TRALI) is defined as a new episode of acute lung injury that occurs during or within 6 hours of a completed transfusion, which has been the leading cause of transfusion-related death. We present a suspected case of TRALI in a 30-year-old parturient with gestational ITP scheduled for cesarean section. The parturient developed hypoxemia and pulmonary edema after platelet concentrate transfusion during perioperative period. The parturient completely recovered after an oxygen support for 4 days. It is important to recognize TRALI as soon as possible to minimize perioperative morbidity and mortality.
Acute Lung Injury ; Adult ; Anoxia ; Blood Platelets ; Cesarean Section ; Female ; Humans ; Oxygen ; Perioperative Period ; Platelet Transfusion ; Pregnancy ; Pulmonary Edema ; Purpura, Thrombocytopenic, Idiopathic

Tracheostomy is a relatively common surgical procedure that is performed easily in an operating room or intensive care unit. Open tracheostomy is needed in patients requiring prolonged ventilation when percutaneous tracheostomy is inappropriate. Sometimes, it is difficult to achieve bleeding control in the peritracheal soft tissue, and in such cases, we usually use diathermy. However, the possibility of an electrocautery-ignited surgical field fire can be overlooked during the procedure. This case report serves as a reminder that the risk of a surgical field fire during tracheostomy is real, particularly in patients requiring high-oxygen therapy.
Diathermy ; Fires* ; Hemorrhage ; Humans ; Intensive Care Units ; Operating Rooms ; Oxygen* ; Tracheostomy* ; Ventilation

It is important to obtain a good exposure of the root exit zone(REZ) of the facial nerve during microvascular decompression(MVD) for hemifacial spasm(HFS). For this purpose, authors dissected cerebellar cortical artery in addition to exposing the proximal portion of lower cranial nerves. During MVD for HFS, surgeons frequently meet a cerebellar cortical artery along the inferolateral aspect of cerebellar hemisphere. It is usually hemispheric branch of anterior inferior cerebellar artery(AICA) or posterior inferior cerebellar artery(PICA). It is reason that authors have dissected the outside arachnoid membrane attached pia mater of cerebellar cortical artery with a arachnoid knife or microscissor but preserve the inside arachnoid membrane attached dura mater. Microsurgical retractor is placed inferolaterally between cerebellar cortical artery and cerebellar hemisphere and elevated from the floor of the posterior fossa. The subarachnoid cisterns over the lower cranial nerves are opened with sharp dissector and wide operative fields and good exposure of REZ of facial nerve is obtained.
Arachnoid ; Arteries* ; Cranial Nerves ; Dura Mater ; Facial Nerve ; Hemifacial Spasm* ; Membranes ; Microvascular Decompression Surgery* ; Pia Mater