Partial knee ankylosis is a recognized complication following open operative procedure, trauma and disease processes about the knee. It can result from the formation of intraarticular adhesion and contracture of the capsule as well as the shortening or adhesion of the quadriceps mechanism. Physical therspy and occasionally manipulation under the anesthesia may improve the results, but performed late, these methods will be useless. This is a review of 30 patients who had severe limitation of motion in the knee joint following open operative procedures or trauma about the knee and who were treated by the percutaneous release of adhesions under the arthroscopic control. The following results were obtained; There were 17 males and 13 females, and the age of release ranged from 23 to 69 years old (av. 42.8years old). The interval between arthroscopic adhesiolysis and the last follow-up evaluation ranged from 6 months to 5 years and 7 months(av. 23 months). The interval between the last open operative procedure or trauma and arthroscopic adhesiolysis ranged from 3 months to 4 years(av. 15 months). The average preoperative knee ROM was 38.8°the postoperative ROM was 121.1°and the average final knee ROM at follow-up was 102.6°So the average loss of ROM was 18.5°The arthroscopic adhesiolysis seems to be applied to the various conditions of the partial knee ankylosis and the results are better than the other surgical procedures when it was performed early enough.
Anesthesia ; Ankylosis ; Contracture ; Female ; Follow-Up Studies ; Humans ; Knee Joint ; Knee ; Male ; Surgical Procedures, Operative

No abstract available.

No abstract available.
Thyroid Gland* ; Thyroid Nodule*

No abstract available.
Compartment Syndromes*

This is to report the technique of reversed iliac leg stent-graft in endovascular treatment for isolated internal iliac artery (IIA) aneurysm, which had significant size discrepancy between the common iliac artery (CIA) and external iliac artery (EIA) in 3 patients from different hospitals. Three patients were a 85- and two 82-year-old men. Treated were right IIA aneurysms, sized 6.5x6.2 cm, 5.0x4.0 cm, and 4.1 cm in longest diameter, respectively. The diameters of the right CIA and right EIA measured 21 mm/11 mm, 15 mm/11 mm, and 20 mm/10 mm, respectively. In all cases, reversed iliac leg stent-grafts were prepared on-site; unsheathed and mounted upside-down manually, and deployed in each right CIA. Post-stent-graft angiograms showed complete exclusion of the aneurysms, except for minimal type 1 endoleak in one case. This technique is a useful treatment option in patients with isolated IIA aneurysm.
Aged, 80 and over ; Aneurysm* ; Endoleak ; Endovascular Procedures ; Humans ; Iliac Aneurysm ; Iliac Artery* ; Leg* ; Male

To evaluate left ventricular diastolic function in patients with coronary artery disease, gate radionuclide ventriculography was performed prospectively in 42 patients who were admitted to Seoul National University Hospital from November 1985 to August 1986 because of anterior chest pain. All patients had no valvular heart disease, congenital heart disease, cardiomyopathy and arrhythmia, and no abnormal vall motion in gated nuclide ventriculography and contrast left ventriculography. 25 patients with more than 50% of stenosis in coronary arteriography were compared with 17 control subjects without stenosis. The following results were obtained; 1) There were no significant differences between normal controls and patients with coronary artery disease in the analysis of the parameters of the left ventricular systolic function, such as ejection fraction (EF), peak ejection rate (PER), time to peak ejection rate (TPER) and ejection time (TES, TES/BCL). 2) Same results were found with those of the left vnetricular diastolic function, such as peak filling rate (PFR), diastolic time interval (DTI, DTI/BCL), rapid diastolic filling interval and time to late diastolic filling (TLDF). 3) The percent contribution of late diastolic filling to stroke volume (%LDF/SV) was more increased in patients with coronary artery disease than the normal control subjects (38.2+/-12.4% vs 28.3+/-7.8%, P<0.01). 4) As the results of above, it can be concluded that the percent contribution of late diastolic filling to stroke volume (%LDF/SV) obtained by using the non-invasive method of gated radionuclide ventriculography can be a sensitive parameter for early evaluation of the left ventricular diastolic dysfunction in coronary artery disease.
Angiography ; Arrhythmias, Cardiac ; Cardiomyopathies ; Chest Pain ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Gated Blood-Pool Imaging ; Heart Defects, Congenital ; Heart Valve Diseases ; Humans ; Prospective Studies ; Radionuclide Ventriculography ; Seoul ; Stroke Volume

BACKGROUND: The median effective dose, ED(50), of rocuronium bromide for inserting the laryngeal mask airway (LMA) in children was not known. The purpose of this study was to determine the clinical ED(50) (cED(50): median value of rocuronium dose of 6 set of crossing success and failure by Dixon's up-and-down method) of rocuronium to insert a LMA in pediatric patients. METHODS: Children aged 2 to 12 years (n = 21) and scheduled for urologic, orthopedic, plastic or ophthalmic surgery lasting less than 2 hr under general anesthesia were enrolled in this study. After applying a standard cardiorespiratory monitor, all patients received thiopental sodium 5 mg/kg for induction of anesthesia. Insertion of LMA was attempted 90 seconds after administration of rocuronium and manual ventilation with 8 vol% of sevoflurane. We recorded the movement of patients, blood pressure and heart rate. The initial dose of rocuronium was 0.3 mg/kg, and in accordance with Dixon's up-and-down method, the rocuronium concentration for consecutive patients in each patient was varied with increments or decrements of 0.05 mg/kg based on the result of previous patient. RESULTS: The cED(50) of rocuronium required to insert a LMA was 0.09 mg/kg with 8 vol% sevoflurane. With isotonic regression, cED95 of rocuronium was 0.13 mg/kg (95% confidence intervals 0.096-0.14 mg/kg). CONCLUSIONS: This study demonstrated that the cED(50) and cED(95) of rocuronium were 0.09 mg/kg and 0.13 mg/kg in children respectively. It provides satisfactory conditions for LMA insertion in anesthetized children and decreases the excessive hemodynamic change.
Aged ; Androstanols ; Anesthesia ; Anesthesia, General ; Blood Pressure ; Child ; Heart Rate ; Hemodynamics ; Humans ; Laryngeal Masks ; Methyl Ethers ; Organothiophosphorus Compounds ; Orthopedics ; Plastics ; Thiopental ; Ventilation

A 44-year-old man, who had a history of myocardial infarction (MI) due to thrombotic occlusion of right coronary artery (RCA) aneurysm, visited emergency department presenting with ST-segment elevation myocardial infarction (STEMI). The patient had been on oral anticoagulant therapy (warfarin) from the first thrombotic event, but the medication had been recently changed to aspirin 4 months before the second event. Emergent coronary angiography revealed thrombotic total occlusion of RCA with heavy thrombotic burden from middle RCA to the ostium of the posterior descending branch. Combination pharmacotherapy was performed with anticoagulants (heparin), fibrinolytics (urokinase), and Glycoprotein IIb/IIIa antagonists (abciximab), in addition to mechanical thrombosuction. However, on hospital day 2, the patient complained recurrent chest pain and again underwent coronary angiography, which revealed distal embolization of large thrombus to the posterior lateral branch. Coronary flow was recovered after repeated mechanical thrombosuction was performed. This case has shown the importance of aggressive combination drug therapy, accompanied by mechanical thrombosuction in patient with myocardial infarction due to thrombotic occlusion of coronary artery aneurysm and the importance of unceasing life-long anticoagulant therapy in those particular patients.
Adult ; Aneurysm* ; Anticoagulants ; Aspirin ; Chest Pain ; Coronary Aneurysm ; Coronary Angiography ; Coronary Occlusion* ; Coronary Vessels* ; Drug Therapy ; Drug Therapy, Combination ; Emergency Service, Hospital ; Glycoproteins ; Humans ; Myocardial Infarction* ; Thrombectomy ; Thrombosis ; Warfarin*

PURPOSE: Sometimes chronic subdural hematoma can be developed following posttraumatic subdural hygroma. The purpose of this study is to investigate its incidence, the duration required for their conversion, and characteristic CT and MR findings of subdural hygroma and chronic subdural hamatoma. MATERIALS AND METHODS: We studied 8 patients with persistent posttraumatic subdural hygroma which consquently developed chronic subdural hamatoma. The patients were examined with CT initially and foilowed-up with CT in 3 and MR in 5. We analyzed the location of the lesion, the change of the density or signal intensity, the change of the size, and the degree of enhancement and mass effect. RESULTS: The duration required for the formation of hematoma was 48-166 days (mean, 76 days). The characteristic CT findings of subdural hygroma were a crescentric lesion with CSF density along the inner table without contrast enhancement. The mass effect was minimal. The CT findings of chronic subdural hematoma were higher density than that of hygroma in all cases, increase in thickness and size in 3 cases, and contrast enhancement along the inner membrane of the hematoma in 5 cases. The signal intensities of the subdural hygroma were identical to those of CSF on both T1 and T2 weighted images, whereas, those of chronic subdural hematoma were higher. CONCLUSION: The increased signal intensity on T1 weighted MR images and increased attenuation or contrast enhancement of the lesion on CT may suggest the conversion of subdural hygroma into chronic subdural hematoma.
Hematoma ; Hematoma, Subdural, Chronic* ; Humans ; Incidence ; Lymphangioma, Cystic ; Membranes ; Subdural Effusion*

To investigate the effect of maternal job activity on the preterm delivery, low birth weight infant and spontaneous abortion, 1646 delivery data were analyzed from Jan. 1991 to Dec. 1992 in Chungnam University Hospital. The results obtained were as follows; 1. The percentage of subjects who had job during pregnancy was 20.3% and the variables of maternal age, education level, prepregnancy weight, maternal height, number of abortion showed significant difference in the distribution of subjects whether they had job or not. 2. There were no significant difference between the group who had job during pregnancy and those who had no job in the mean gestational period, number of spontaneous abortion, rate of preterm delivery and spontaneous abortion. However mean birth weight and rate of low birth weight showed significant difference between the groups. 3. The rate of preterm delivery of the group who had job were higher than those who had no job activity in the subgroup of 35 years or more age, prematurity history presence, 2 or more abortion history, obstetric complication presence, but there were no significant difference. The rate of low birth weight also higher in the group who had job than those who had no job activity in the same subgroup except obstetric complication presence. 4. The rate of spontaneous abortion of the group who had job were higher than those who had no job activity in the subgroup of 35 years or more age, below high school, height of 163cm or above, but there were no significant difference. 5. Rate of preterm delivery still showed better results in the group who had job than the group who had no job when adjusted for variables related, but there was no statistical significance. 6. Rate of low birth weight still showed better results with statistical significance in the group who had job than the group who had no job when adjusted for variables related. 7. Spontaneous abortion had occured less frequently in the group who had job than the group who had no job when adjusted for variables related. 8. Rate of preterm delivery and low birth weight were lower in the group of teacher, bank clerk, medical personnel, citizen servant than the group who had no job, but higher in the job of company employee, commerce. Spontaneous abortion was most frequent in group of commerce, and the group of teacher, company employee showed higher rate of abortion than the group who had no job.
Abortion, Induced ; Abortion, Spontaneous* ; Birth Weight ; Chungcheongnam-do ; Commerce ; Education ; Female ; Humans ; Infant, Low Birth Weight* ; Infant, Newborn ; Maternal Age ; Pregnancy