No abstract available.
Arthritis, Juvenile*

Degloving injuries of the fingers receive digital sensory nerve damage as well as digital artery damage together with degloving of the finger skin at the time of injury. Although the finger is well covered with skin and the joint motion has completely recovered after the injury, if there is no sensation in the finger tip problems remain. From October, 1982 to December, 1985 Dong San Medical Center, Keimyung University did free digital sensory nerve grafts on 11 cases using the sural nerve. Follow up studies which lasted from 10 to 39 months showed good results. Therefore this free digital nerve graft operation is considered to be a favourable mothod in obtaining sensation for digital degloving injuries.
Arteries ; Fingers ; Follow-Up Studies ; Joints ; Sensation ; Skin ; Sural Nerve ; Transplants

From January to December 1984, 191 patients with associated ventricular septal defect(VSD) were studied in the cardiac cathetherization laboratory. Among theses 191 cases, 58 cases(30.4%) of subpulmonic VSD were identified by angiocardiography. Among the 59 cases of subpulmonic VSD, 12 cases(20.6%) were complicated with aortic infficiency(AI). The relative frequency of subpulmonic VSD increased with the increase of age and the frequency of complication of AI with the subpulmonic VSD also increased with the increase of age. The amount of left to right shunt in the patients with subpulmonic VSD and AI was small and Qp/Qs ratio was less than 2.0 in all of the 12 cases. Among the 12 patients 4 cases had a pressure gradient greater than 20 mmHg across the infundibular region of the right ventricle.
Angiocardiography ; Heart Septal Defects, Ventricular* ; Heart Ventricles ; Humans

A series of 84 cases operated upon for herniated intervertebral disc of lumbar region was studied with respect to the diagnostic value of myelographic examination. Various clinical signs including level of tenderness, sensory impairment, motor weakness, door-bell sign and Lasegue test, were reviewed. The clinical diagnosis derived from these signs was correct in 54.8%. The plain X-ray film showed narrowing of disc space in 44 cases. As to the myelographic findings, mode and level of indentation, positive and negative findings were analyzed and comparisons were made with operative findings. Among 84 cases, 47 cases showed lateral indentation, 32 cases central and 5 cases complete block. As to the level, L4~5 disc space was dominant. As a whole, the myelographic findings accurately corresponded with the operative findings in 77.4%, 65 cases. However, diagnostic accuracy was varied according to level, i.e., in case of L4~5 disc herniation, 45 cases among 53 cases showed correct myelographic diagnosis, while only 10 cases among 17 cases showed correct myelographic diagnosis in L5~S1 disc herniation. In addition, if electomyography and discography are added as diagnostic aid, the preoperative diagnostic accuracy will be higher but those are not available in our circumstance.
Diagnosis ; Intervertebral Disc ; Lumbosacral Region ; Myelography ; X-Ray Film

Among 157 cases operated upon, under the diagnosis of herniated intervertebral disc, we experienced 34 cases of discrepancies between myelographic and operative findings. We analysed these cases in the respect of patterns, causes and clinical significance of these discrepancies and the results were as follow; 1. Thirty four cases (21.7%) among 157 cases operated upon showed discrepancies between myelographic and operative findings. 2. These 34 cases consisted of 17 cases of level discrepancies, 9 cases of false positive and 8 cases of false negative. 3. The main cases of level discrepancies was indentation due to bony spur with/without adhesion. 4. The main cause of false positive was degenerative changes of the spine. In the detection of this false positive, plain X-ray of lumbosacral spine give important clue. In false positive, explorative paitial laminectomy and removal of bony spur or adhesiolysis was indicated because the effect of the spur or adhesion was same as that of herniated disc. 5. The causes of false negative were giant canal, congenitally narrow cul de sac, high cul de sac and far laterally seated disc herniation. In false negative, plain X-ray of lumbosacral spine afforded little diagnostic aid. In case of being compatible to disc herniation at a certain level through clinical signs, normal myelographic finding has less meanings and exploration is to be performed according to the clinical signs.
Diagnosis ; Intervertebral Disc ; Intervertebral Disc Displacement ; Laminectomy ; Spine

In the autoimmune hemolytic anemia abnormal antibodies directed against red cells are produced by the patient himself. The pathologic mechanism in which erythrocyte survival is decreased as a result of the deposition of specific antibody on the red cell surface is uncertain. The abnormal antibody is most freqeuntly of the lgG or IgM class and occasionally may be IgA. A case of autoimmune hemolytic anemia was confirmed by CBC and Coombs test in a 11years old boy. We are reporting the laboratory data and our experiences of the patient with the reviews of the literatures.
Anemia, Hemolytic, Autoimmune* ; Antibodies ; Coombs Test ; Erythrocyte Aging ; Humans ; Immunoglobulin A ; Immunoglobulin M ; Male

PURPOSE: The aim of this study was to evaluate the effect of inhaled nitric oxide(iNO) on gas exchange, hemodynamics and pulmonary inflammation in newborn piglets with E. coli induced septic lung. METHODS: Twenty three instrumented and ventilated piglets were randomized into three groups: CON(n=6), PCON(n=9), and PNO(n=8). In the piglets of the PCON and PNO groups, E. coli septic lung was induced by endotracheal instillation of E. coli. Ten ppm iNO was given continuously in the PNO group after endotracheal instillation of E. coli. All animals were mechanically ventilated for six hour with a peak inspiratory pressure of 30 cmH2O, frequency of 25 breaths/min, FiO2 1.0 and a positive end-expiratory pressure of 4 cmH2O. All measurements were made at one hour intervals during the experiment. At the end of the experiment, lung tissue was harvested for the analysis of myeloperoxidase activity, indicative of lung inflammation. RESULTS: All piglets with pulmonary instillation of E. coli developed E. coli sepsis. Piglets in the PCON group developed progresseve pulmonry hypertension, hypoxemia and hypercarbia compared to the CON group due to increased pulmonary vascular resistance, intrapulmonary shunt fraction and physiologic dead space fraction. iNO did not reverse pulmonary hypertension in the PNO group. However iNO significantly improved oxygenation, which was attributed to marked improvement of venous admixture and partial attenuation of increase in dead space fraction. Increased myeloperoxidase activity in PCON compared to CON was significantly attenuated in PNO. CONCLUSION: iNO improves oxygenation and lung inflammation in newborn piglets with E. coli induced septic lung.
Animals ; Anoxia ; Escherichia coli* ; Escherichia* ; Hemodynamics* ; Humans ; Hypertension ; Hypertension, Pulmonary ; Infant, Newborn* ; Lung* ; Nitric Oxide* ; Oxygen ; Peroxidase ; Pneumonia* ; Positive-Pressure Respiration ; Sepsis ; Vascular Resistance

No abstract available.
Ascitic Fluid* ; Ferritins*

To evaluate the predictive values of oxygenation index (OI), arterial-alveolar oxygen tension ratio (a/APO)2, and alveolar-arterial oxygen gradient ((A-a)DO2) for early recognition of responsiveness to high frequency oscillatory ventilation (HFOV) in very low birth weight infants with respiratory distress syndrome (RDS), 23 infants who received HFOV treatment for severe RDS after failing to be improved with conventional mechanical ventilation from July 1995 to February 1998 were included. Twelve infants survived with HFOV (Responder group), while 11 infants could not maintain oxygenation with HFOV and died (Non-responder group). Clinical record (of each patient) were retrospectively reviewed and compared with the respiratory indices. Mean (A-a)DO2 was significantly lower in the responder group than in the non-responder group at 2 hr after HFOV (p=0.024), and the difference was more remarkable at 6 hr (p=0.005). Death in the patient with (A-a)DO2 over 350 at 2 hr after HFOV therapy was 100% in sensitivity and 80% in specificity. The earliest significant difference of mean a/APO2 between two groups was noted at 6 hr after HFOV treatment (p=0.019). OI showed no significant differences between two groups. In summary, (A-a)DO2 was the most effective and sensitive respiratory index for predicting the responsiveness to HFOV in infants with severe RDS providing due as early as 2 hr.
Comparative Study ; High-Frequency Ventilation* ; Human ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Oxygen/blood ; Predictive Value of Tests ; Prognosis ; Pulmonary Gas Exchange* ; Respiratory Distress Syndrome/therapy* ; Respiratory Distress Syndrome/mortality ; Respiratory Distress Syndrome/diagnosis* ; Retrospective Studies ; Sensitivity and Specificity ; Treatment Outcome