To define the effectiveness of surgical management of the mallet finger deformity due to extensor tendon injury in children, we analyzed 9 patients who had operative treatment of mallet finger deformity in children from Jan. 1994 to Mar. 1997. The types of tendon injury in this series were as follows: 7 cases with tendon laceration, 1 case with crushing injury and 1 case with unknown injury The average period of follow up were ranged 2 years and 1 month. The clinical results were evaluated hy Kanies seale12) and Crawford scale5). An excellent result was obtained in 4 cases(44%), a good result in 5 cases(56%) according to Crawford scale and excellnt result in 9 cases(I00%) in Kanies scale, consecutively. Meticulous surgical repair of the lacerated tendon provided good result.
Child* ; Congenital Abnormalities* ; Fingers* ; Follow-Up Studies ; Humans ; Lacerations ; Tendon Injuries* ; Tendons*

BACKGROUND: Thromboembolism is the major complication in patients with the insertion of cardiac prosthetic valves. The purpose of this study is evaluate the risk factors about the formation of left atrial thrombi after cardiac valve replacement. METHOD: Transesophageal(TEE) and transthoracic echocardiography(TTE) were done to evaluate postoperative cardiac condition in 98 patients with cardiac prosthetic valves from Jan. 1991 to Oct 1991. Several clinical and echocardiographic parameters were analyzied to evaluate the relationship with the formation of left atrial thrombi. RESULT: In univariate analysis, important factors related to the formation of left atrial thrombi are type of operation (p=0.027), postoperative left ventricular function(p=0.003), preoperative(p=0.037) and postoperative systolic ventricular size(p=0.024). However, in multivariate analysis postoperative left ventricular size(p=0.017), presence of previous thrombi(p=0.014), preoperative left atrial size(p=0.014) and postoperative left atrial size(p=0.014) are significant factors. CONCLUSION: Patients with high risk and low risk for the formation of left atrial thrombi after valve replacement can be identified by readily available clinical and echocardiographic variables.
Echocardiography ; Heart Valves ; Humans ; Multivariate Analysis ; Risk Factors* ; Thromboembolism

No abstract available.
Thromboangiitis Obliterans*

No abstract available.
Myelitis, Transverse* ; Retrospective Studies*

Epidural anesthesia for cesarean section requires sensory blockade up to T4 level. 18 to 20 ml of 0.5% bupivacaine, 1.5 to 2.0% lidocaine, or 3.0% chloropmcaine usually produces an adequate sensory blockade to T4 level. However, when we used that amount of local anesthetics, most of the patients often complained of mild to moderate pain or discomfort during delivery of baby, manipulation of peritoneum or the uterus. So we feeled the need of increase in dosage of local anesthetics and we used 26 ml of local anesthetics or local anesthetic-fentanyl mixture. This study was undertaken to measure plasma concentration of lidocaine and observe the possible systemic toxicity of local anesthetics with the total dosage of beyond maximum recom-mended dose. Epidural anesthesia were performed with a 17 gauge Tuohy needle and local anesthetics were injected as follows. Group 1 (n;17): 0.5% bupivacaine 100 mg+2% lidocaine 80 mg+fentanyl 100 ug (50 ug/ml) Group 2 (n; 15): 2% lidocaine 520 mg without epinephrine Group 3 (n; ll): 2% lidocaine 480 mg + fentanyl 100 ug All groups were received 26 ml of local anesthetics or local anesthetic-fentanyl mixture. We checked the level of anesthesia, length of spinal column, cardiovascular changes, plasma concen- tration of lidocaine, toxic systemic reactions and patient's complaints. The plasma concentration of lidocaine were measured by immunofluorescence assay at 2, 5, 7, 10, 12 and 15 minutes after injection of local anesthetics. The results were as follows; 1) The peak plasma concentration of lidocaine were measured 12 minutes after administration of local anesthetics in the group 2 and 3. 2) Sensory blockade up to T4 level could be accomplished within 10 minutes after epidural anesthesia in the group l. 3) In the group 2 and 3, onset of action was more rapid. These groups had a tendency to fall in blood pressure than the group 1, but recovered soon with small dose of ephedrine. 4) In one patient, maximum peak plasma concentration of hdocaine was 6.8 ug/ml, but no adversereaction was observed. Above results suggested that 26 ml of local anesthetics in all groups could be used for appropriate anesthesia for cesarean section with minimal camplications and patient's satisfaction.
Anesthesia ; Anesthesia, Epidural* ; Anesthetics, Local* ; Blood Pressure ; Bupivacaine ; Cesarean Section* ; Ephedrine ; Epinephrine ; Female ; Fentanyl ; Fluorescent Antibody Technique ; Humans ; Lidocaine ; Needles ; Peritoneum ; Plasma* ; Pregnancy ; Spine ; Uterus

Epidural anesthesia for cesarean section requires sensory blockade up to T4 level. 18 to 20 ml of 0.5% bupivacaine, 1.5 to 2.0% lidocaine, or 3.0% chloropmcaine usually produces an adequate sensory blockade to T4 level. However, when we used that amount of local anesthetics, most of the patients often complained of mild to moderate pain or discomfort during delivery of baby, manipulation of peritoneum or the uterus. So we feeled the need of increase in dosage of local anesthetics and we used 26 ml of local anesthetics or local anesthetic-fentanyl mixture. This study was undertaken to measure plasma concentration of lidocaine and observe the possible systemic toxicity of local anesthetics with the total dosage of beyond maximum recom-mended dose. Epidural anesthesia were performed with a 17 gauge Tuohy needle and local anesthetics were injected as follows. Group 1 (n;17): 0.5% bupivacaine 100 mg+2% lidocaine 80 mg+fentanyl 100 ug (50 ug/ml) Group 2 (n; 15): 2% lidocaine 520 mg without epinephrine Group 3 (n; ll): 2% lidocaine 480 mg + fentanyl 100 ug All groups were received 26 ml of local anesthetics or local anesthetic-fentanyl mixture. We checked the level of anesthesia, length of spinal column, cardiovascular changes, plasma concen- tration of lidocaine, toxic systemic reactions and patient's complaints. The plasma concentration of lidocaine were measured by immunofluorescence assay at 2, 5, 7, 10, 12 and 15 minutes after injection of local anesthetics. The results were as follows; 1) The peak plasma concentration of lidocaine were measured 12 minutes after administration of local anesthetics in the group 2 and 3. 2) Sensory blockade up to T4 level could be accomplished within 10 minutes after epidural anesthesia in the group l. 3) In the group 2 and 3, onset of action was more rapid. These groups had a tendency to fall in blood pressure than the group 1, but recovered soon with small dose of ephedrine. 4) In one patient, maximum peak plasma concentration of hdocaine was 6.8 ug/ml, but no adversereaction was observed. Above results suggested that 26 ml of local anesthetics in all groups could be used for appropriate anesthesia for cesarean section with minimal camplications and patient's satisfaction.
Anesthesia ; Anesthesia, Epidural* ; Anesthetics, Local* ; Blood Pressure ; Bupivacaine ; Cesarean Section* ; Ephedrine ; Epinephrine ; Female ; Fentanyl ; Fluorescent Antibody Technique ; Humans ; Lidocaine ; Needles ; Peritoneum ; Plasma* ; Pregnancy ; Spine ; Uterus

Although halothane is generally anesthetic of choice for asthmatics due to its bronchodilatory action, its combined use with aminophylline should be discouraged. This report is a 43-year-old male who had primary closure and open reduction internal fixation (ORIF) for facial avulsion injury and zygomatic tripod fracture under N2O-O2-halothane anesthesia. About 90 minutes after the procedure, the patient who had aminophylline infusion for an acute bronchospasm developed a sudden cardiac arrest. The immediate cardiopulmonary resuscitation was applied and the patient was recovered without any neurological deficit. At the time, the serum theophylline concentration of the patient was 16 microgram/ml which was in the range of normal therapeutic dose. The cause for this cardiac arrest by halothane is unknown, but possibly a drug interaction between halothane and aminophylline might have contributed, since halothane sensitizes the heart to exogenous catecholamines.
Adult ; Aminophylline* ; Anesthesia ; Bronchial Spasm ; Cardiopulmonary Resuscitation ; Catecholamines ; Death, Sudden, Cardiac ; Drug Interactions* ; Halothane* ; Heart ; Heart Arrest* ; Humans ; Male ; Theophylline

No abstract available.
Colon* ; Gastrointestinal Hemorrhage* ; Varicose Veins*

SUMMARY: Benign fibrous histiocytoma of the knee is a very rare entity. We report on one case of benign fibrous histiocytoma that involved the patellar fat pad, an areas of involvement not previously reported. Diagnostic arthroscopy was performed to show retrobulging of infrapatellar fat pad without specific synovial changes. The lesion was completely resected. At short-term follow-up, all symptoms were resolved. Arthroscopy can be used as an diagnostic tool for identification of intraarticular lesions of the knee, but appears not to be a good tool for clean removal of mass within patellar fat pad.
Adipose Tissue* ; Arthroscopy ; Follow-Up Studies ; Histiocytoma, Benign Fibrous* ; Knee

Midtrimester genetic amniocentesis is an important diagnostic tool in prenatal genetic diagnosis and counseling. We can identify karyotypes with metaphase chromosome analysis of cultured amniocytes. Marker chromosomes are defined as unidentified structurally abnormal chromosomes. Incidence of marker chromosomes in the previous reported studies was 0.6-1.5/1,000. They occurred more frequently with advanced maternal age. Ascertainment of chromosomal origin is important because it may be associated with malformation and developmental abnormalities. Recently, identification of the origin and composition of marker chromosomes has been made possible by the use of fluorescent in situ hybridization (FISH). Most marker chromosomes are known to be originated from chromosome 15 or 22, X, Y. We have experienced a case of non-15, non-22 marker chromosome prenatally detected in amniocentesis and FISH, so we reported it with a brief review of literature.
Amniocentesis ; Chromosomes, Human, Pair 15 ; Counseling ; Diagnosis ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Incidence ; Karyotype ; Maternal Age ; Metaphase ; Pregnancy ; Pregnancy Trimester, Second