No abstract available.

graft as a successful procedure that provides functional stabiIity. Complications reported include arthro5brosis, patellofemoral joint pain, patellar tendinitis, patellar tendon rupture, recurrent laxity, posterolateral instabi5ty, medial subluxation of the patella, chronic knee pain and painful neuroma. Among them, anterior knee pain was the rnost frequent eomplication. Authors performed arthroscopy assisted one tunnel technique for reconsction of the ACL using autogenous Bone Patellar tendon-Rone (BPTB) in 87 patients. Patients were divid@d into two groups based on the harvested side (knee) of the BPTB. Group 1 consisted of 45 cases of ipsilateral side and group 2 consisted of 42 cases of contralsteral side in harvesting the BPTB. The patients were foll4wed up for at least 12 months to determine whether using the BPTB harvested from the contralateral knee wguld reduce the anterior knee pain at the ACL reconstructed knee. Althaugh there were no statistically signifiqant differences between group 1 and 2 with regard to anterior knee pain, the prevalence of the anterior knee pain was less frequent in group 2 than group 1. This study showed that using the contralateral side harvested autogenous patellar tendon would be a possible protector for anterior knee pain and assists for early rehabilitation.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Arthroscopy ; Humans ; Knee ; Neuroma ; Patella ; Patellar Ligament* ; Patellofemoral Joint ; Prevalence ; Rehabilitation ; Rupture ; Tendinopathy ; Transplants

Acute normovolemic hemodilution is widely used to conserve blood and to minimize the need for homologous blood transfusion during operation. To evaluate the effects of aeute isovolemic hemodilution on hemodynamics and oxygen transport, pulmonary artery catheter and radial artery catheter were introduced in 8 patients in whom maxillofacial or Wertheim's operation were performed. Blood(estimated from allowable blood loss) was withdrawn from radial artery, and simultaneously replaced by intravenous administration of 5% plasmanate and Hartmann solution. Acute isovolemic hemodilution decreased the hematocrit level from 33.2+/-3.7% to 29.6+/-2.9%. Cardiac output increased significantly, which was associated with decreased systemic vaacular resistance. Oxygen transport and oxygen consumption increased despite a decrease in oxygen carrying capacity. Heart rate, mean arterial perssure, mean pulmonary arterial pressure, central venous pressure, and pulmonary capillary wedge pressure did not change significantly during hemodilution. The results indicate that blood perfusion and oxygenation to tissue were well maintained in the hemodilution of the magnitude used in this study. Therfore it could be concluded that acute isovolemic hemodilution is a safe and relatively simple method of conserving blood and minimizing homologous blood transfusion.
Administration, Intravenous ; Arterial Pressure ; Blood Transfusion ; Cardiac Output ; Catheters ; Central Venous Pressure ; Natural Resources ; Heart Rate ; Hematocrit ; Hemodilution* ; Hemodynamics ; Humans ; Oxygen ; Oxygen Consumption ; Perfusion ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Radial Artery

Acute normovolemic hemodilution is widely used to conserve blood and to minimize the need for homologous blood transfusion during operation. To evaluate the effects of aeute isovolemic hemodilution on hemodynamics and oxygen transport, pulmonary artery catheter and radial artery catheter were introduced in 8 patients in whom maxillofacial or Wertheim's operation were performed. Blood(estimated from allowable blood loss) was withdrawn from radial artery, and simultaneously replaced by intravenous administration of 5% plasmanate and Hartmann solution. Acute isovolemic hemodilution decreased the hematocrit level from 33.2+/-3.7% to 29.6+/-2.9%. Cardiac output increased significantly, which was associated with decreased systemic vaacular resistance. Oxygen transport and oxygen consumption increased despite a decrease in oxygen carrying capacity. Heart rate, mean arterial perssure, mean pulmonary arterial pressure, central venous pressure, and pulmonary capillary wedge pressure did not change significantly during hemodilution. The results indicate that blood perfusion and oxygenation to tissue were well maintained in the hemodilution of the magnitude used in this study. Therfore it could be concluded that acute isovolemic hemodilution is a safe and relatively simple method of conserving blood and minimizing homologous blood transfusion.
Administration, Intravenous ; Arterial Pressure ; Blood Transfusion ; Cardiac Output ; Catheters ; Central Venous Pressure ; Natural Resources ; Heart Rate ; Hematocrit ; Hemodilution* ; Hemodynamics ; Humans ; Oxygen ; Oxygen Consumption ; Perfusion ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Radial Artery

A recent resurgence of pertussis has raised public health concerns even in developed countries with high vaccination coverage. The aim of this study was to describe the clinical characteristics of infant pertussis, and to determine the relative importance of household transmission in Korea. The multicenter study was prospectively conducted from January 2009 to September 2011. We identified the demographic and clinical data from these patients and performed the diagnostic tests for pertussis in their household contacts. Twenty-one patients with confirmed pertussis were included in the analysis. All infections occurred in infants younger than 6 months of age (mean age, 2.5 months) who had not completed the primary DTaP vaccination except for one patient. Infants without immunization history had a significant higher lymphocytosis and longer duration of hospital stay compared to those with immunization. All were diagnosed with PCR (100%), however, culture tests showed the lowest sensitivity (42.9%). Presumed source of infection in household contacts was documented in 85.7%, mainly parents (52.6%). Pertussis had a major morbidity in young infants who were not fully immunized. Household members were responsible for pertussis transmission of infants in whom a source could be identified. The control of pertussis through booster vaccination with Tdap in family who is taking care of young infants is necessary in Korea.
Bordetella pertussis/genetics ; Diphtheria-Tetanus-acellular Pertussis Vaccines/immunology ; Female ; Humans ; Immunization, Secondary ; Infant ; Length of Stay ; Lymphocytosis/etiology ; Male ; Parents ; Polymerase Chain Reaction ; Prospective Studies ; Republic of Korea ; Whooping Cough/diagnosis/immunology/*transmission

To evaluate the clinical usefulness of fiberoptic intubation, we recorded the changes of arterial pressure, heart rate and cardiac output during fiberoptic nasotracheal and orotracheal intubation, while measuring the time taken for the intubation procedure. Anesthesia of pharynx was achieved by oral gargling of 10 ml of 4% lidocaine, and for nasotracheal intubation, nasal mucosa was anesthetized by application of 4% cocaine usirig cotton-tipped swabs. Anesthesia of the larynx and trachea was done by superior laryngeal nerve block with 6 ml of 2% lidocaine, and translaryngeal injection with 4% lidocaine by cricothyroid membrane puncture. After sedation with intravenous diazepam and fentanyl, awake fiberoptic (n=32) or orotracheal intubation (n=18) was performed on the patients (ASA class 1 or 2) in whom difficult intubation was expected. Mean arterial pressure, heart rate and cardiac output did not change significantly during intubation procedure, nor were these values significantly different between nasotracheal and orotracheal intubation group. The time taken by intubation procedure were compared, and there was no significant difference between two groups. In postoperative interviews, a few (3/28) patients complained discom-forts. It could be concluded that under approapriate anesthesia and sedation, awake fiberoptic nasotracheal or orotracheal intubation is a safe and useful approach producing minimal cardiovascular changes and discomforts.
Anesthesia ; Arterial Pressure ; Blood Pressure* ; Cardiac Output* ; Cocaine ; Diazepam ; Fentanyl ; Heart Rate* ; Heart* ; Humans ; Intubation* ; Laryngeal Nerves ; Larynx ; Lidocaine ; Membranes ; Nasal Mucosa ; Pharynx ; Punctures ; Trachea

Cholangiocarcinoma has been associated with various fibrocystic diseases of liver and biliary tract, but cholangiocarcinoma in polycystic liver disease (PLD) was extremely rare. It was reported that the prognosis of cholangiocarcinoma associated PLD was very poor and distant metastases were common. We report a rare case of intrahepatic cholangiocarcinoma associated with PLD in 58- year- old female who presented vague abdominal pain. She had also polycystic kidneys with normal renal function. MRI showed well demonstrated tumor with central scar and a adjacent large cyst in the left lobe of the liver. She underwent extended left lobectomy. On microscopic examination, the tumor was moderately differentiated cholangiocarcinoma having abundant fibrous stroma and necrosis and the adjacent cyst showed focal in situ carcinomatous changes in the lining epithelium.
Abdominal Pain ; Biliary Tract ; Cholangiocarcinoma* ; Cicatrix ; Epithelium ; Female ; Humans ; Liver Diseases* ; Liver* ; Magnetic Resonance Imaging ; Necrosis ; Neoplasm Metastasis ; Polycystic Kidney Diseases ; Prognosis ; Cholangiocarcinoma

Neuroblastoma is a soft tissue malignant tumor in the early childhood originating from the sympathetic nervous system, and usually occurs in the abdomen, thorax, and pelvis. It is rare in the head and neck region and primary cervical neuroblastoma (PCN) is very rare. We present 13-month old boy with slowly growing right neck mass confirmed neuroblastoma. The mass was excised with surrounding enlarged lymph nodes. Postoperative adjuvant chemotherapy was done. During chemotherapy enlarged lymph nodes were found and removed surgically. These nodes showed metastatic well differenciated neuroblastoma. Radiation therapy was added. The patient had total 15 times chemotherapy and 1500 cGy radiation, and there was no evidence after the second operation.
Abdomen ; Chemotherapy, Adjuvant ; Drug Therapy ; Head ; Humans ; Infant ; Lymph Nodes ; Male ; Neck ; Neuroblastoma* ; Pelvis ; Sympathetic Nervous System ; Thorax