The posterior cruciate ligament plays as basic stabilizer of the knee. Therefore the knee becomes unstable when tibial insertion of the posterior cruciate ligament is avulsed. The diagnosis may be delsyed or missed because of surgeon's 1sck of awareness or rare condition. The authors treated seven cases of avulsion fracture of posterior cruciate ligsment at the tibial attachment ares ranged from ten to thirty-two years. There were five male and two female. The results were as follows : 1. The cause of all seven cases injury was traffic accident. 2. The physical findings were seven positive posterior drawer test, seven cases of abrasion or laceration over the anterior proximal tibial surface and antero-medial surfsce of the knee joint. 3. The associated injury was comminuted fracture of the tibia and femur (1 case), rupture of collateral ligsment and comminuted fracture of the tibia (1 case) and zygomatic fracture (1 case). 4. The treatment methods were four cancellous fixation, one K-wire fixation after epiphyseal plate fusion but each one pull out wire and dexon suture before epiphyseal plate fusion. 5. The motion of knee joint was within normal limit and no instsbility was inspected at the three months after reduction.
Accidents, Traffic ; Diagnosis ; Female ; Femur ; Fractures, Comminuted ; Growth Plate ; Humans ; Knee Joint ; Knee ; Lacerations ; Male ; Posterior Cruciate Ligament ; Rupture ; Sutures ; Tibia ; Zygomatic Fractures

Many patients whose chief complaint is headache caused by accident such as traffic accident, falling, or assaults visit to emergency center. Majority of these patients has mild or moderate symptoms, and there is no need to treat surgically. However, the fact that head injury can cause SIADH(syndrome of inappropriate secretion of antidiuretic hormone) is likely to be overseen. Acute hyponatremia might have been associated with death or permanent brain damage. Hyponatremia is best handled by early recognition and correction of a downward trend in the serum sodium. Unfortunately, this is often difficult in the head-injured patient, where hyponatremia may occur fairly rapidly and is confused by symptoms of head injury. when moderate to severe hyponatremia occurs, it is important to determine its etiology and expeditiously initiate corrective action. There has not been any reported case of the occurrence of symptomatic SIADH after mild head injury in Korea yet. The authors report the experience of three cases of symptomatic SIADH after mild head injury with review of the literatures.
Accidents, Traffic ; Brain ; Craniocerebral Trauma* ; Emergencies ; Head* ; Headache ; Humans ; Hyponatremia* ; Inappropriate ADH Syndrome ; Korea ; Sodium

No abstract available.
Female ; Obstetric Labor, Premature* ; Pregnancy ; Ritodrine* ; Tocolytic Agents*

It is well known that the medullary carcinoma of the breast is one of the special types of breast carcinoma with a good prognosis. At present, the medullary carcinoma of the breast is subclassified into 3 types: typical medullary, atypical medullary and nonmedullary carcinoma. Among them, the former has the best prognosis. We reviewed the film mammographic and ultrasonomammographic findings of 13 patients according to the reevaluated histopathologic diagnosis. Typical medullary carcinoma shows a well circumscribed mass with surrounding halo on film mammogram, and well defined mass with central intermediate echogenicity and peripheral low echogenicity and posterior acoustic enhancement on ultrasonomammogram. Atypical medullary carcinoma shows relatively well circumscribed mass with partial marginal obliteration on film mammogram, and irregular bordered mass with inhomogeneous echogenicity due to focal necrosis in the mass and associated findings of thick boundary, asymetrical lateral shadowing on ultrasonomammogram. Nonmedullary carcinoma shows lobulated mass with surrounding parenchymal distortion and skin thickening on film mammogram, and relatively well defined lobulating mass with surrounding parenchymal distortion and marked heterogeneous internal echogenicity on ultrasonomammogram. Therefore, differentiation between typical medullary carcinoma with good prognosis and atypical medulary or nonmedullary carcinoma with poor prognosis, may be possible by various diagnostic imaging modalities preoperatively. But further collective study shall be needed in near future.
Acoustics ; Breast Neoplasms ; Breast* ; Carcinoma, Medullary* ; Classification* ; Diagnosis ; Diagnostic Imaging ; Humans ; Necrosis ; Prognosis ; Shadowing (Histology) ; Skin

Hemoptysis is quite common in primary pulmonary disease, including tyberculosis and carcinoma, as well as in congenital heart disease. Rescently the authors had experienced a case of massive hemoptysis soon after extracorporeal circulation during open heart surgery. The patient had been diagnosed as pulmonary tuberculosis and triology of Fallot. After surgical procedure for pulomonary stenosis and A.S.D, massive hemoptysis occurred abruptly through the endotracheal tube and B.P. took a sudden fall by 40 Torr/systolic pressure. Bleeding source was proved to be on the left upper lobe. So left upper lobetomy had to be performed to control this massive hemoptysis.
Constriction, Pathologic ; Extracorporeal Circulation* ; Heart Defects, Congenital ; Heart* ; Hemoptysis* ; Hemorrhage ; Humans ; Lung Diseases ; Thoracic Surgery* ; Tuberculosis, Pulmonary

This is a ease report of intraluminal partial obatructian of an endotracheal tube after cuff ballooing, a complication of a malfunctioned endotracheal tube, This 18 year old female patient with herniated intervertebral disc of L4-5 was anesthetized for archotomy and removal of disc. Aneethesia was maintained with N2O-O2-halothanepancuronium after endotracheal intubation with a Murphy tube. (Porges-Latex-tube No. 7), manufactured in France. A few minutes later, airway obstruction signs such as sudden hypertension, tachycardia, resistance of the researvoir bag in inspiration, and delayed filling time of the reservoir bag in expiration appeared. We suspected kinking of the tube, tubal obstruction from secretions, bronchospasm etc, but we could not find the exact cause of airway obstruction in spite of detailed checking. After recovery of the patient from anesthesia we checked the extubated tube. There was intraluminal partial obstruction of the endotracheal tube according to increase of intracuff volume and pressure because of the thin walled, flexible tube and diffusion of N2O into the cuff. After extubation the patient returned to normal. We surmmerized this case and also reviewed with the literature.
Airway Obstruction ; Anesthesia ; Bronchial Spasm ; Diffusion ; Fallopian Tube Diseases ; Female ; France ; Humans ; Hypertension ; Intervertebral Disc ; Intubation, Intratracheal ; Tachycardia

A retrospective analysis of clinical findings in 23 patients with Y. pseudotuberculosis infection who visited Department of Pediatrics of Han Il Hospital from May. 1990 to June, 1992 was performed. 1) The most prevalent age group was 7 to 12 years (16 case: 69.6)and male-to-female ratio was 1.1:1. 2) Monthly distribution showed a high frequency in April, May and June (22 cases:95.7%) 3) The common symptoms were fever(23 cases:100%), abdominal pain (18 cases: 78.3%) vomiting(16 cases: 69.6%), diarrhea (13 cases: 56.7%), rash (13 cases: 56.5%)and acute renal failure (6 cases: 26.1%) in order of frequency, respectively. 4) The laboratory findings were anemia (17.4%), WBC>1(10E4/mm((73.9%), ESR>20mm/hr (91.3%), CRP>3+(91.3%), Positive Widal test (13.0%), BUN>20mg/dl (26.1%) and creatinine> 1.2mg/dl (26.1%). 5) The most common serotype was 4a (30.4%), followed by 4b, 5b, 2b, 2c, 5a, 1b, 1a, 6 in order of frequency. The results suggest that Yersinia pseudotuberculosis infection is one of the important causes of the important causes of fever, eruptive skin diseases and acute renal failure in Korean children and further studies including epidemiology, pathogenesis, etc, are needed.
Abdominal Pain ; Acute Kidney Injury ; Anemia ; Child ; Diarrhea ; Epidemiology ; Exanthema ; Fever ; Humans ; Pediatrics ; Retrospective Studies ; Skin Diseases ; Yersinia pseudotuberculosis* ; Yersinia*

This study was undertaken to determine whether verapamil protects renal function in rabbits with ischemic acute renal failure. Renal ischemia was induced by clamping bilateral renal arteries for 60 min. One group received intravenously an infusion of verapamil (lmg/kg) for 30 min prior to initiation of renal artery clamping and the other group received equal volume of saline. Renal blood flow was measured with flowmeter before (basal) and 24 hr after ischemia. Serum creatinine level increased 24 hr after ischemia and remained high to 72 hr. When verapamil was pretreated, the level 48 and 72 hr after ischemia was significantly decreased compared with saline insusion. Urine flow was markedly decreased 24 hr after ischemia and remained depressed to 72 hr, but it was significantly increased 72 hr after ischemia in verapa- mil-pretreatment animals as compared with the saline-infusion animals. GFR were markedly reduced 24 hr after ischemia and remained depressed to 72 hr, which was significantly prevented by verapamil pretreatment. Ischemia caused a significant increase in FEVa and a reduction in Uosm, and TcH2O, indicating impairment in urine concentrating ability of tubules, and the impairment was significantly attenuated by verapamil. The uptake of p-aminohippurate in cortical slices was depressed by ischemia, which was significantly prevented by verapamil pretreatment. In salineinfusion animals, renal blood flow was not significantly different between the basal value and that after 24 hr of reflow. Renal blood flow was not significantly altered by verapamil pretreatment. Anoxia/reoxygenation injury in the control renal slices was not significantly prevented by Ca channel blockers. These results suggest that verapamil exerts a protective effect in ichemic acute renal failure, and the beneficial effects may be attributed to effects other than vasodilation. These data also indicate that a reduction in GFR following ischemia does not result from change in renal blood flow.
Acute Kidney Injury* ; Animals ; Constriction ; Creatinine ; Flowmeters ; Ischemia ; Kidney Concentrating Ability ; p-Aminohippuric Acid ; Rabbits* ; Renal Artery ; Renal Circulation ; Vasodilation ; Verapamil*

OBJECTIVE: Creatine phosphokinase-MM(CPK-MM) and lactate dehydrogenase(LDH) are well known indices of muscular injury. To know the degree of muscular injury during spinal surgery, the author report serial measurement of serum CPK-MM and LDH4 level. METHODS: The authors investigated 23 patients who underwent lumbar spinal surgery without bone fusion or instrumentation. Peripheral venous blood samples were serially collected 1 day before surgery, operation day, postoperative 3rd, 7th, 14th and 28th day. Postoperative back pain was measured by visual analogue scale. We evaluated the relationship between number of operation level, serial changes of serum CPK-MM, LDH4, duration of surgery and postoperative back pain. RESULTS: CPK-MM activity was higher after surgery than before it and reached at maximal level on the postoperative 3rd day, and it was returned to normal level on the postoperative 7th day. The score of postoperative back pain scale was the highest on the postoperative 3rd day. CPK-MM activity was significantly correlated with operation level, duration of surgery, and postoperative back pain(P<0.05). In contrast, serum level of LDH4 showed no significant correlation with duration of surgery(P>0.05). CONCLUSION: Postoperative muscle injury is inevitable in all patient who underwent spinal surgery, and these injuries are related extent of exposure and duration of surgery. To reduce muscle injury and postoperative back pain, less invasive and shorter surgery in time is recommend.
Back Pain ; Creatine ; Humans ; L-Lactate Dehydrogenase ; Lactic Acid ; Spine*

Fibrolipomatous harmatomas are rare, benign, fibrolipomatous process of peripheral nerves. It usually manifests as a soft slowly growing mass consisting of proliferating fibrofatty tissue surrounding and infiltrating major nerves and their branches. The median nerve is affected in the great majority of cases. Intradural spinal cases are extremely rare. The authors present a very rare case of a fibrolipomatous harmatoma involving the intradural space of lumbar spine with review of pertinent literature.
Hamartoma* ; Median Nerve ; Peripheral Nerves ; Spine