No abstract available.
Pancreatic Pseudocyst*

Tibial plateau fractures are a common injury which often produce major disability. The extent of actural damage is always greater than that suggested by X-ray, a situation which, if not appreciated, can easily lead to a complacent surgical attitude. Although recent studies suggest that early knee motion and perhaps better surgical technique have improved clinical end-results, still recent series show unaccepatble results in 20-40 percent of cases. The authors analyzed the 37 cases of the tibial plateau fractures treated at the Department of Orthopaedics, Catholic University Medical College, Kang-Nam St. Mary's Hospital and following results were obtained. 1. The highest incidence was in the 5th decade and the next was 4th, and most frequent cases of trauma was pedestrian car accident(83%). 2. The most common fracture type was type VI by Schatzker classification and next was type II. 3. Among 37 cases, 27 were treated by open reduction and internal fixation and 14 out of those 27 cases meeded bone graft for the elevation of the tibial articular surface. 4. According to Blokker's criteria(1984), 32(86.6%) out of 37 cases had satisfactory result. Among 5 cases of unsatisfactory results 3 cases developed varus tilting of the tibial plateau more than 10 during the early stage (6–12 weeks post operation) of follow-up and those 3 were Schatzker's type VI fracture. 5. It is thought that open anatomical reduction of articular surface bone graft, internal fixation and early joint motion are the best way for the treatment of depressed or displaced fracture. 6. It is found tha Schatzker's type VI fracture has a tendency to develop varus tilting through the proximal tibial fracture before it unites completely.
Classification ; Follow-Up Studies ; Humans ; Incidence ; Joints ; Knee ; Tibial Fractures ; Transplants

Open tracheostomy has been indicated for patients who require prolonged mechanical ventilation or respiratory care in order to avoid lots of complications during long-term endotracheal intubation. Because there are a number of disadvantages and serious complications in standard open tracheostomy, a simpler, safe and minimally invasive procedure such as percutaneous dilatational tracheostomy (PDT) and translaryngeal tracheostomy (TLT) were introduced as an appropriate procedure that can be administered at bedside. In terms of prevention of complications, minimal invasive tracheostomy techniques are more advisable for post open heart surgery patients. After two failed attempts at respirator weaning, we experienced a successful TLT for a 71-year-old male patient with intractable post CABG pneumonia post-op 15 days in an intensive care unit. During and post-TLT courses were not eventful. The cannula was removed 2 weeks after TLT and the patient was subsequently discharged to ward.
Aged ; Catheters ; Heart* ; Humans ; Intensive Care Units ; Intubation, Intratracheal ; Male ; Pneumonia ; Respiration, Artificial ; Thoracic Surgery* ; Tracheostomy* ; Ventilator Weaning

BACKGROUND: Psoriasis is a chronic relapsing disease characterized by epidermal hyperproliferation and epiderrnal and dermal inflammatory cell infiltration. The etiology of this disease is still unclear. Recently, there has been growing interest in the probable role of a T cell mediated immune response in the pathogetiesis of psoriasis. The infiltrating cells in psoriatic lesions have been iden- tified by monoclonal ant~ibodies and T cells were found to be the major infiltrating type. OBJECTIVE: This stud was done to investigate the difference of cellular infiltration and adhesion molecule exg!ressions between early and late skin lesions of psoriasis using immunohistochernical studies. Methpds : Patients with psoriatic lesions were divided into two groups. The early gr oup were defined as having skin lisions that had lasted for about 4 weeks, and late group were defined as having skin lesions that had lasted for more than 8 weeks. Then biopsy specirnens were stained using monoclonal antibidies for CD4, CD8, CD1, LFA-1, and ICAM l. RESULTS: 1. CD4 positive cells,vere tly increased in both the early and late groups compared with CD8 positive cells. Z. CD8 positive cells were significantly increased in the late g~roup compared with the early group. 3. CDl-posit,ive dendri!ic cells were more nurnerous in the late group than the early group. 4. There were no significant differences between the early and late group with regard to numbers of LFA-1 positive (ells. 5. ICAM-1 were more strongly expressed on epidermal keratinocytes in the late than the early group. CONCLUSION: CD4-positive cells are important in early and late psoriatic lesions and CD8 positive cells playi more important role in late than early lesions. ICAM-1 and LI'A-1 play a role in cell adhesion of infiltrating cells and lymphocytic rnigration to the epidermis.
Biopsy ; Cell Adhesion ; Epidermis ; Humans ; Intercellular Adhesion Molecule-1 ; Keratinocytes ; Lymphocyte Function-Associated Antigen-1 ; Psoriasis ; Skin ; T-Lymphocytes

BACKGROUND: Psoriasis is a chronic relapsing disease characterized by epidermal hyperproliferation and epiderrnal and dermal inflammatory cell infiltration. The etiology of this disease is still unclear. Recently, there has been growing interest in the probable role of a T cell mediated immune response in the pathogetiesis of psoriasis. The infiltrating cells in psoriatic lesions have been iden- tified by monoclonal ant~ibodies and T cells were found to be the major infiltrating type. OBJECTIVE: This stud was done to investigate the difference of cellular infiltration and adhesion molecule exg!ressions between early and late skin lesions of psoriasis using immunohistochernical studies. Methpds : Patients with psoriatic lesions were divided into two groups. The early gr oup were defined as having skin lisions that had lasted for about 4 weeks, and late group were defined as having skin lesions that had lasted for more than 8 weeks. Then biopsy specirnens were stained using monoclonal antibidies for CD4, CD8, CD1, LFA-1, and ICAM l. RESULTS: 1. CD4 positive cells,vere tly increased in both the early and late groups compared with CD8 positive cells. Z. CD8 positive cells were significantly increased in the late g~roup compared with the early group. 3. CDl-posit,ive dendri!ic cells were more nurnerous in the late group than the early group. 4. There were no significant differences between the early and late group with regard to numbers of LFA-1 positive (ells. 5. ICAM-1 were more strongly expressed on epidermal keratinocytes in the late than the early group. CONCLUSION: CD4-positive cells are important in early and late psoriatic lesions and CD8 positive cells playi more important role in late than early lesions. ICAM-1 and LI'A-1 play a role in cell adhesion of infiltrating cells and lymphocytic rnigration to the epidermis.
Biopsy ; Cell Adhesion ; Epidermis ; Humans ; Intercellular Adhesion Molecule-1 ; Keratinocytes ; Lymphocyte Function-Associated Antigen-1 ; Psoriasis ; Skin ; T-Lymphocytes

Fractures of the hip in children are rare. The reported incidence is low. It is known that the force required to fracture the bone in childhood is of great magnitude. Rang(1983) reported several important differences between childhood and adult fractures. And Morrissy (1980) also reported differences in treatment. The complications of the femoral neck fractures in children are avascular necorsis, premature epiphyseal closure, nonunion, coxa vara, and infection. The reported incidence of avascular necrosis varies from 20 to 60 percent. Many methods of trestment for this complications are introduced up to now. However, a definite method could not be found. Therefore, we reported two cases of femoral neck fracture which complicated the avascular necrosis for whom non-weight bearing trestment after osteosynthesis were given for 16 and 25 months, respectively. In these two cases, we could obtain the following results. Fracture union was not hindered by avasculsr necrosis of the femoral head. Non-weight bearing could prevent the collapse of necrotic head, and seemed to help revascularization of the necrotic head.
Adult ; Child ; Coxa Vara ; Femoral Neck Fractures ; Femur Neck ; Head ; Hip ; Humans ; Incidence ; Methods ; Necrosis ; Prognosis

A 64-year-old female with earcinoma of esophagogastic junction developed gangrene of left arm after esophagogastrectomy to require amputation of the arm. The patient had no known cardiac disorder before the operation but showed marked arrhythmia during the procedure. The general anesthesia was carried out with penthothal-succinylcholine induction and maintenance with N2O-O2-halothane.
Amputation ; Anesthesia, General* ; Arm ; Arrhythmias, Cardiac ; Female ; Gangrene* ; Hand* ; Humans ; Middle Aged

STUDY DESIGN: Medical record-based survey. PURPOSE: To survey the overall incidence of the intra- and postoperative complications and sequelae, and to propose the preventive measures to reduce complications in the spinal tuberculosis surgery. OVERVIEW OF LITERATURE: There is no study focused on the surgery-related complications and sequelae, with some touching lightly on the clinical problems. METHODS: There were 901 patients in this study, including 92 paraplegics. One hundred eighty-six patients had no visible deformity, while those of 715 patients were visible. Six hundred fifty-nine patients had slight to moderate non-rigid kyphosis, and 56 had severe rigid kyphosis. Sixty-seven out of 92 paraplegics had slight to moderate non-rigid kyphosis, and 25 had severe kyphosis. There were 134 cervical and cervicodorsal lesions, 518 thoracic and thoracolumbar lesions, and 249 lumbar and lumbosacral lesions. Seven hundred sixty-four patients had primarily anterior surgeries, and 137 had posterior surgeries. Instrumentation surgery was combined in 174 patients. RESULTS: There were intra- and postoperative complications: direct large vessel and neurological injuries (cord, roots, nerves), late thrombophlebitis, various thoracic cavity problems, esophagus and ureter injuries, peritoneum perforation, ileus, wound infections, stabilization failure, increase of deformity and late adjacent joint and bone problems. Thrombophlebitis and sympatheticolysis symptoms and signs in the lower limbs were the most common complications related with anterior lumbar and lumbosacral surgeries. Kyphosis increased in 31.5% of the non-instrumented anterior surgery cases (42% in children and 21% in adults). CONCLUSIONS: The safe, effective and most familiar surgical procedure should be adopted to minimize complications and sequelae. Cosmetic spinal surgery should be withheld if functional improvement could not be expected.
Child ; Congenital Abnormalities ; Esophagus ; Humans ; Ileus ; Incidence ; Joints ; Kyphosis ; Lower Extremity ; Peritoneum ; Postoperative Complications ; Spine* ; Thoracic Cavity ; Thrombophlebitis ; Tuberculosis* ; Tuberculosis, Spinal ; Ureter ; Wound Infection

OBJECTIVE: To evaluate the prevalence of drooling in children with cerebral palsy and to determine their parents' needs for adequate treatment. METHOD: 107 children with cerebral palsy who attended to the pediatric rehabilitational treatment center were investigated whether they had the problems related with drooling. For the children with drooling, the severity of drooling was measured with subjective and objective measurement tools, and the types of cerebral palsy were classified. The parents answered to the questionnaire for several problems caused by drooling and whether they wanted treatment for drooling or not. RESULTS: 25 (23%) out of 107 children with cerebral palsy had drooling problems. 16 (64%) of them were spastic quadriplegic, which was the most common type. Parents of 17 (68%) drooling children had much uncomfortable feeling to drooling, and of 21 (84%) parents wanted treatment. In 21 (84%) children, their therapists felt difficulties during their treatment sessions due to drooling. CONCLUSION: 23% of children with cerebral palsy in rehabilitation clinic had drooling and most of their parents wanted treatment for drooling.
Cerebral Palsy* ; Child* ; Humans ; Muscle Spasticity ; Parents ; Prevalence ; Surveys and Questionnaires ; Rehabilitation ; Sialorrhea*

Metabolic syndrome, a constellation of cardiovascular disease risk factors, is a global pandemic. Over 30% of the adult population in both South Korea and the United States are currently classified as having metabolic syndrome. Vascular endothelial function is a precursor of future atherosclerotic cardiovascular disease. Conduit artery flow-mediated dilation using ultrasonography is considered the non-invasive, gold standard for assessing nitric oxide-mediated vascular endothelial function. Patients with metabolic syndrome commonly exhibit increased insulin resistance and hyperglycemia, which are thought to impair vascular endothelial function by increasing oxidative stress and reducing nitric oxide bioavailability in the vascular endothelium and in smooth muscle cells. Previous findings have indicated that long-term aerobic exercise has a positive effect on impaired vascular endothelial function in metabolic syndrome patients, but the underlying mechanisms have not been fully elucidated. Therefore, further studies are needed that will apply different exercise modalities and intensities with the goal of improving vascular endothelial function in patients with metabolic syndrome, as well as investigation of the associated mechanisms. Ultimately, well-designed future studies will help to establish and develop exercise prescription and/or exercise therapy programs that can reduce cardiovascular disease risk and improve cardiovascular health in metabolic syndrome patients.
Adult ; Arteries ; Biological Availability ; Cardiovascular Diseases ; Endothelium, Vascular ; Exercise ; Exercise Therapy ; Humans ; Hyperglycemia ; Insulin Resistance ; Korea ; Myocytes, Smooth Muscle ; Nitric Oxide ; Oxidative Stress ; Pandemics ; Prescriptions ; Risk Factors ; Ultrasonography ; United States