BACKGROUND: Recently, clinical use of fresh frozen plasma(FFP) has increased in all blood transfusion activity. But inappropriate uses of FFP may be serious problem due to adverse transfusion reactions, viral transmission, and economic aspects. The aim of this study is to justify clinical indication of FFP by receiving the inappropriate use of them. METHODS: Analyzing hospital records of 115 patients transfused with FFP at Kyung Hee Medical Center from January to April 1998, retrospectively, we investigated the purpose of transfusions, the volume of transfused FFP, and the results of pre- and post-coagulation tests. RESULTS: The most common purpose of transfusions of FFP was plasma volume replacement after surgical operation. Coagulation tests of pre- and post-transfusion were performed 85% and 47%, respectively. Fifty-seven patients(88%) transfused FFP have shown normal results in pre-coagulation tests, and the volume replacement with FFP was done inadequately in 62 cases(54%). CONCLUSION: We conclude that, in order to eliminate side effects due to inappropriate use of FFP, and protect patients, it is necessary to make guidelines of FFP transfusion, educate hospital staffs regularly, and perform pre- and post-coagulation tests routinely for the patients who need FFP transfusion. (Korean J Blood Transfusion 10(1): 5-12, 1999)
Blood Group Incompatibility ; Blood Transfusion ; Hospital Records ; Humans ; Plasma Volume ; Plasma* ; Retrospective Studies

Between Feb. 1992 and Apr, 1995, the authors have performed arthroscopic abrasion arthroplasty in 78 knees of 76 patients with degenerative osteoarthritis. The followup period was between 24 and 58 months, with on an average of 41 months. All patients had Zarins grade IV articular cartilage change. The results were as follows. 1. Of the total 78 knees, results were excellent in 25(32%), good in 33(42A), fair in 12(17%), poor in 8(10%) knees respectively. 2, The best results were obtained patellofemoral abrasion arthroplasty. 3. The poor results were obtained in patients with the both femoral condyle, lesion. 4. The results were much better in young age group (below 40 years). Aroscopic abrasion arthroplasty is not a curative but palliative method. But it could be an appealing altemative to total knee arthroplasty or high tibial osteotomy or can be performed postoperated after these reconstructive proeedures.
Arthroplasty* ; Cartilage, Articular ; Follow-Up Studies ; Humans ; Knee* ; Osteoarthritis* ; Osteotomy

No abstract available.
Child* ; Heart Diseases* ; Heart* ; Humans ; Incidence* ; Tricuspid Valve Insufficiency*

A comparative observation was done on 139 patients of the lower ureteral stone, those were applied cystoscopic manipulation with 3 different types of stone dislodger at the Department of Urology, Seoul Adventist Hospital, during the periods from Jan. 1982 to June 1985. During that periods, we applied end-loop catheter in 48 patients, blunt-tip Dormia basket in 38 patients. The results were as follows; 1. The success rate of passage of dislodger beyond the stone was the highest in filiform-tip Dormia basket (97.4%) and loop catheter was the lowest (8l.3%). 2. The success rate of the primary stone extraction with filiform-tip Dormia basket was the highest (86.8%). 3. Indwelling of the dislodger in the ureter loop catheter was the most successful method among them(62.5%). 4. Of the cases of passage beyond the stone, the success rates of the stone extraction were very high and similar in their results, as in 92.3% with loop catheter, in 90.9% with blunt-tip Dormia basket, in 91.9% with filiform-tip Dormia basket. 5. The overall success rate of stone extraction was 75.0% in loop catheter, 75.5% in blunt-tip Dormia basket 89.5% in filiform-tip Dormia basket.
Catheters ; Humans ; Seoul ; Ureter ; Urolithiasis ; Urology

PURPOSE: To evaluate the radiologic findings of alimentary anthrax. MATERIALS AND METHODS: 19 patients with alimentary anthrax, which was caused by ingestion of contaminated beef, were included in this study. The diagnosis was made .b.y demonstration of Bacillus anthracis in smear and culture of the contaminated meat. We evaluated the clinical manifestations and the findings of thoracic, abdominal radiographs, cervical, abdominal ultrasonograms and abdominal CT scans. RESULTS: Out of the 19 patients with the alimentary infection, 9 had oropharyngeal form, 18 had abdominal form and 8 had combination of oropharyngeal and abdominal form. The patients had general symptoms and signs such as fever, chill, myalgia. Clinical symptoms and signs were sore throat, throat injection, throat ulcer and patch in oropharyngeal form, and nausea, vomiting, abdominal pain, diarrhea, and gross GI bleeding in abdominal form. Radiologic findings included enlarged cervical lymph nodes(36%) in oropharyngeal form, and paralytic ileus(26%), ascites(26%), hepatomegaly(21%), enlarged mesenteric lymph nodes(26%), small bowel wall thickening(5%) in abdominal form. In two patients, late complications occurred as intestinal obstruction due to ileal stricture with perforation, and inflammatory changes of pelvic cavity due to ileovesical fistula. CONCLUSION: Radiologic findings of alimentary anthrax are difficult in differentiation from those of other inflammatory bowel disease, but those radiologic findings with clinical manifestations may be helpful in diagnosis and evaluation of disease process in patients with alimentary anthrax.
Abdominal Pain ; Anthrax* ; Bacillus anthracis ; Constriction, Pathologic ; Diagnosis ; Diarrhea ; Eating ; Fever ; Fistula ; Hemorrhage ; Humans ; Inflammatory Bowel Diseases ; Intestinal Obstruction ; Meat ; Myalgia ; Nausea ; Pharyngitis ; Pharynx ; Tomography, X-Ray Computed ; Ulcer ; Ultrasonography ; Vomiting

Wegener's granulomatosis is a disease of unknown etiology that is characterized by the clinicopathologic complex of necrotixing granulomatous vasculitis of the upper and lower respiratory tract, glomerulonephritis, and variable degrees of small vessel vasculitis. Recently Antineutrophil Cytoplasmic Antibody (ANCA) has been reported to be a highly specific test for the diagnosis of Wegener's granulomatosis. We have experienced a patient of Wegener's granulomatosis in a 11 year old girl who was admitted with complaints f arthralgia, hematuria, convulsion and associated with otitis media and sinusitis. Serologic test of C-ANCA was positive and histologic findings of the kidney showed crescentic glomerulonephritis with sclerosis and surrounding infiltration of multinucleated giant cells. Patient was treated with pulse methylprednisolone without improvement. The clinical course progressed rapidly and expired due to the renal failure, gastrointestinal bleeding and status epilepticus. A brief review of literatures was made.
Antibodies, Antineutrophil Cytoplasmic* ; Arthralgia ; Child ; Diagnosis ; Female ; Giant Cells ; Glomerulonephritis ; Hematuria ; Hemorrhage ; Humans ; Kidney ; Methylprednisolone ; Otitis Media ; Renal Insufficiency ; Respiratory System ; Sclerosis ; Seizures ; Serologic Tests ; Sinusitis ; Status Epilepticus ; Vasculitis ; Wegener Granulomatosis*

The Graf stabilization has been introduced in treating lumbar spinal disorder associated with posterior instability. This study reviewed some problems of the Graf instrumentation as a soft stabilizer. The purpose of this study is to analyse the problems of the soft stabilization in spinal instability. We reviewed 145 cases which were operative treatment using the Graf instrument for lumbar spinal disorder associated with posterior instability at our department from May, 1991 to Dec, 1995. The mean follow up periods was 29 months ranging from 24 months to 6 years 8 months. Of the 145 cases, 22 cases were showed the problem. The diagnostic method were simple x-ray, flexion-extension lateral stress view and CT scan. Results were as follows : Adjacent segmental instability was 10 cases(6.9%), disc space narrowing was 8 cases(5.5%), screw loosening was 3 cases(2.1%) and breakage of the Graf band was 1 case(0.6%). The problems of the soft stabilization were adjacent segmental instability, disc space narrowing, screw loosening, and breakage of the Graf band. But the rate of adjacent segmental instability and disc space narrowing was lower than other lumbar spinal instrumentation.
Follow-Up Studies ; Tomography, X-Ray Computed

PURPOSE: To evaluate CT findings of internal hernia. MATERIALS AND METHODS: Three patients with internal hernia had abdominal CT scans and two of them had small bowel follow through examinations. The CT features of two patients with retroanastomotic and one patient with left paraduodenal hernia were evaluated and correlated with small bowel follow through examinations, and surgical findings. Two patients with retroanastomotic hernia had a history of subtotal gastrectomy with antecolic gastrojejunostomy. The diagnosis of internal hernia was made on the basis of surgical find ings in two patients of retroanastomotic hernia, and characteristic barium study findings in one patient of left paraduodenal hernia. RESULTS: The small bowel follow through examination showed small bowel loops gathered in a circumscribed mass in the left mid abdomen, and delay in passage through these loops. In case of left paraduodenal hernia, abrupt narrowing of the distal duodenum could be identified. The characteristic CT findings of all three patients were whorling of the mesentery and mesenteric vessels in the left mid-abdomen. In the patient with left paraduodenal hernia, after resolution of the gastrointestinal symptoms, a follow-up CT scan showed spontaneous disappearance of whorling of the mesentery and mesenteric vessels suggesting spontaneous resolution of the hernia. In the other two cases, upon exploration of the abdomen, dilatation of afferent duodenum caused by adhesion between ligament of Treitz and adjacent bowel walls, and retro- anastomotic herniation of the efferent loops were found. CONCLUSION: The usual diagnosis of internal hernia is based on the appearance of the small bowel follow through examination. However, we consider that the whorling appearance(we call it whorling sign) of the mesentery and mesenteric vessels on CT scan is also suggestive of internal hernia in patients under clinical suspicion.
Abdomen ; Barium ; Diagnosis ; Dilatation ; Duodenum ; Follow-Up Studies ; Gastrectomy ; Gastric Bypass ; Hernia ; Humans ; Ligaments ; Mesentery* ; Tomography, X-Ray Computed

Since March 1993, high resolution ultrasonography has been performed in Pusan National University hospital as a routine preoperative check for patients with suspected or malignant thyroid nodules, identified by initial screening with fine-needle aspiration biopsy. Our one-year experience with 66 cases from June 1993 to June 1994 is as follows: 1) On the permanent sections, the nodule was a papillary thyroid carcinoma in 45.5%, a follicular adenoma in 27.3%, a adenomatous goiter in 22.7%, and a cyst in 4.5% of the total 66 cases, respectively. 2) Ultrasonographically, additional smaller nodule(s) was present in 60% of cases with a papillary thyroid carcinoma; also, papillary carcinomas were present in 61.1% of the permanent sections. In 2 cases of follicular adenomas, the additional nodules were papillary carcinomas on the permanent sections. 3) Multiple small calcifications within the nodule were found in 50.0% of the cases with a papillary thyroid carcinoma. 4) Enlargement of the jugular chain of nodes was found in 21.2% of the 66 cases, and was microscopically positive in 92.9% of the cases. Although not an essential element in initial screening, an ultrasonographic study of the thyroid may be quite useful in patients with suspected or malignant thyroid nodule.
Adenoma ; Biopsy, Fine-Needle ; Busan ; Carcinoma, Papillary ; Goiter ; Humans ; Mass Screening ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule* ; Ultrasonography*

Postoperative hemorrhage after eardiopulmonary bypass(CPB) is one of the major causes of morbidity and mortality. Approximately 3% of patients have undergone surgical reexploration after open heart surgery. Coagulopathies after CPB are due to multiple hemostatic defects caused by hemodilution of procoagulants, firbrinogen, platelet, drugs and mechanical destruction by CPB machine. Thromboelastography(TEG) is the measures of viscoelastic properties of blood coagulation by providing information on the interaction of all the coagulation precursors and gives more clinically useful information on coagulation than that available from routine coagulation tests (RCT) or activated coagulation time(ACT). TEG is simple to use and can be performed within 30 minutes of blood sampling. Thirty-five patients of open heart surgery(12 were cyanotic and 23 were noncyanotic patients) were studied for the coagulation with TEG, ACT and RCT before and after CPB. Reaction time(R time), Coagulation time(R+K time), Maximum amplitude(MA), A60(Amplitude 60 min after MA), A60/MA index(Whole blood clot lysis index) and alpha angle were mea- sured in TEG, and at the same time RCT and ACT were also measured. Statistical analysis were performed by Student-t test for, significance, and 6 of TEG and 5 of RCT measurements were evaluated by multiple regression analytic methods(stepwise methods) for the correlation. The results were as follows: 1) TEG measurements before CPB were R time; 9.5+/-2.0min., R+K time; 14.6+/-2.7 min., MA; 52.4+/-3.6mm., A60; 45.1+/-4.5mm, Alpha; 46.2+/-5.50 and after CPB R time, 12.3+/-3.6min., R+K time, 24.3+/-16.4min., MA; 41.7+/-5.8min, A60; 36.4+/-4.4mm, Alpha, 32.0+/-8.90, respectively. There were significant differences between the measurements before and after CPB(P<0.005). 2) Before and after CPB, There was no significant difference between cyanotic and noncyanotic group in TEG 3) There was no fibrinolysis after CPB on TEG 4) There was significant correlation at the level of 95% significance after CPB following as; (1) R time vs aPTT and fivrinogen (2) R+K time vs PT, platelet and fibrinogen (3) MA vs platelet and PT (4) A60 vs platelet and fibrinogen (5) Alpha angle vs PT, aPTT, fibrinogen and Platelet 5) As the result of Multiple Regression Analytic Methods, R+K time, MA and Alpha angles after CPB could predict aPTT of RCT at the level of 99.5% signficance, In summary, thromboelastography is simple and easy to use in operating room for the diagnosis of coagulopathies compared with RCT.
Blood Coagulation ; Blood Platelets ; Cardiopulmonary Bypass* ; Diagnosis ; Fibrinogen ; Fibrinolysis ; Heart ; Hemodilution ; Hemostasis* ; Humans ; Mortality ; Operating Rooms ; Postoperative Hemorrhage ; Thoracic Surgery ; Thrombelastography*