The authors did clinical analysis of 34 cases of suppurative athritis of hip for period of three years from Jan. 1973 to Jan. 1976 at Dept. of Orthopedics, Catholic Medical Center. Through this study following results were obtained. 1. Most of the patients were under the age of 6 years including twenty-six males and eight females. 2. Lag period to treatment in 10 cases was within 3 days, 14 cases within a week: most of these series were treated within a week. 3. Frequent clinical symptom and signs were pain on hip 34 cases, fever 30 cases, limited motion of hip 24 cases and flexion contracture 8 cases. 4. Causative micro-organism was isolated in the cases of diseased hip: Staphylococcus aureus in. 24 cases, β-hemolytic streptococcus in 8, pneumococcus 1, and Gram positive bacillus 1 cases. 5. The laboratory findings included leucocytosis over 15,000 per mm in 31 cases, increased erythrocyte-sedimentation rate 15mm per hour in 33 cases. All the cases were leucocytosis with increased ESR but. 5 were only increased ESR. 6. In authors experience early incision and drainage with specific antibiotics were a choice of treatment in the acute supprative arthritis of hip 7. Result become progressibly less satisfactory in proportion in the length of time after onset at which treatment is started. a) When sufficient time has elapsed for adhesion to develop the pocket to the head thus can not be drained properly by the active movements. Indeed, it is possible, that may be actually harmful in promoting absorption from such pocket. b) In case of long standing erosion of cartilage with denuded bone areas hinder or prevent efficient active movements. c) In case of long duration, blood stream infection is an ever present danger, as well as a aggrevation of existing organic disease by the infective process.
Absorption ; Anti-Bacterial Agents ; Arthritis ; Arthritis, Infectious ; Bacillus ; Cartilage ; Child ; Contracture ; Drainage ; Female ; Fever ; Head ; Hip ; Humans ; Male ; Orthopedics ; Rivers ; Staphylococcus aureus ; Streptococcus ; Streptococcus pneumoniae

Acute digitalization with ouabain were performed 28 times in 20 intact Mongrel dogs, who were devided into four groups : i.e. 1) Control group; Acute digitalizations were performed to observe the changes of the plasma potassium and sodium concentrations and the concomittent electrocardiographic findings. 2) Group 1;-Electrolyte solution, either KCl or NaCl, was infused during acute digitalization to observe the influences of these ions on the actions of cardiac glycoside, especially arrhythmia producing action. 3) Group 2 ; -The K depleted group and the Na depleted group was each made by the measure of diet control and the usage of oral diuretics to observe the influences of the state of depleted electrolyte (K or Na) on the action of cardiac glycoside during acute digitalization. 4) Group 3 ; -The intravenous infusion of either KCl or NaCl solution was introduced as the cardiac arrhythmia by the ouabain was produced to observe the effects of these ions on the digitalis induced arrhythmia. The results obtained were summarized as follows. (1) The arterial plasma concentration of potassium was increased during acute digitalization. The rise occurred at early stage, and the maximal increase of potassium was observed at the ventricular tachycardia. The average increase was 0.65 mEq/L as compared to control value (p<0.05). The arterial plasma concentration of sodium was reduced during acute digitalization. The fall occurred following the rise of plasma K level. The maximal reduction of sodium was observed after ventricular tachycardia, and the average decrease was 5.2 mEq/L as compared to control value (p<0.05). (2) Rapid increase up to toxic level of the plasma potassium concentration occurred occasionally during acute digitalization in the group with KCl infusion. This result was best explained due to the inhibitory action of cardiac glycoside on the K transport. (3) The interesting change was on T wave, which showed the peaking at late portion. This change occured in 60.6% during digitalization with ouabain, and paralleled mostly, but not consistently and even sometimes inversely, with the shift of plasma potassium concentration. It is tempting to assume that the change of T wave was resulted from an altered potassium gradient across the myocardial cells rather than a ssuming the changes of the plasma K level. (4) Just prior to intoxication, the marked prolongation of PR interval and ST depression were observed in about 70~80% of the cases studied. These changes might be applicable to a clue of the cardiac glycoside overdosage. (5) The intravenous infusion of KCl suppressed markedly the arrhythmia producing action of the cardiac glycoside, and resulted in prompt and dramatic abolishing, of digitalis induced arrhythmia. The intravenous infusion of KCl solution, however, produced A-V block or dissociation occasionally. This finding would be likely resulted from the additive or synergistic action of K and cardiac glycoside in suppressing A-V conducting system. (6) The NaCl infusion affected nothing to the arrhythmia producing action of cardiac glycoside. (7) The K depletion reduced markedly the threshold of the heart to the toxic effects of cardiac glycoside. (8) Potent diuretics in the state of deficient diet would produce clinically significant hypopotassemia and hyponatremia or both. The inducced hypopotassemia may provoke serious cardiac arrhythmia in the digitalized patients or animals.
Animals ; Arrhythmias, Cardiac ; Depression ; Diet ; Digitalis ; Diuretics ; Dogs ; Electrocardiography ; Electrolytes* ; Heart ; Humans ; Hypokalemia ; Hyponatremia ; Infusions, Intravenous ; Ions ; Ouabain ; Plasma ; Potassium ; Sodium ; Tachycardia, Ventricular

No abstract available.
Diagnosis, Differential* ; MMPI*

The type-specific PCR and the sequence analysis of 56 kDa gene of Orientia tsutsugamushi infected in field rodents specimens have shown intratypic genetic heterogeneity in genotype Karp. In sequence comparison, this genetic heterogeneity was mainly due to insertion or deletion of a repeated unit in variable domain I (VDI) region. These results suggested that genetic duplication or deletion of the specific sequence rnight be involved in intratypic genetic heterogeneity of Orientia tsutsugamushi.
Genetic Heterogeneity* ; Genotype* ; Orientia tsutsugamushi* ; Polymerase Chain Reaction ; Rodentia ; Sequence Analysis

No abstract available.
Humans ; Liver Function Tests* ; Liver*

We report a case of 53-year-old man with plasmacytoid transitional cell carcinoma of the urinary bladder, which may be confused with plasmacytoma. The patient initially presented with gross hematuria and dysuria for two months. Cystoscopy and radiologic studies revealed multiple intraluminal protruding masses on the urinary bladder invading perivesical fat tissue. After urinary cytologic examination and cystoscopic biopsy, radical cystectomy and pelvic lymph node dissections were done. Urine cytology showed single cells and poorly cohesive cells with round eccentric nuclei, bi-or multi-nucleation, indistinct nucleoli, coarse chromatin, and abundant basophilic cytoplasm within relatively clear background. The cytologic findings of tumor cells were similar to the plasma cells seen in plasmacytoma. The tumor of the bladder was composed of discohesive, individual cancer cells with diffuse pattern that simulated lymphoma or plasmacytoma. Immunohistochemical and electron microscopic studies clearly established the epithelial nature of the neoplasm. Recognition of this plasmacytoid type of transitional cell carcinoma of the urinary bladder can avoid the misdiagnosis.
Child ; Male ; Female ; Humans ; Biopsy

There are ethnic differences in the timing of sexual maturation. However, averages of sexual maturity rating (SMR) for Korean adolescents were not available until recently. The purpose of this study was to determine averages for the SMR of adolescent girls and boys in Korea. The study population included 3,249 boys and 3,337 girls. The sample comprised 2,406 from the Seoul area, 2,441 from a medium-sized city and 1,739 from rural areas. Data were obtained through questionnaires and physical examinations for SMR given by pediatricians from 1991 to 1992. Sexual maturity was graded using the Tanner scales. This was a cross-sectional study. In boys, the first growth of the testes (SMR 2) was observed at a mean age 12.7 years (from 10.4 to 15.1 years of age for 95% of them). SMR 3 and SMR 4 of genitalia were 14.2+/-1.4, 15.4+/-1.3 years of age, respectively. Adult genitalia (SMR 5) was observed from 14 to 18.2 with a mean age of 16.1 years. SMR 2 of pubic hair was at a mean age of 13.2 years, and SMR 3,4, and 5 were 14.4+/-1.4, 15.6+/-1.2, 16.0+/-1.0 years of age, respectively. In girls, the mean age for breast budding (SMR 2) was 11.0 years with a range of 8.9 years to 13.1 years for 95% of them. SMR 3,4, and 5 for breast were 12.6+/-1.4, 14.2+/-1.5, 15.7+/-1.1 years of age, respectively. SMR 2,3,4, and 5 for pubic hair were 12.9+/-1.8, 14.5+/-1.5, 15.1+/-1.3, 16.0+/-1.0 years of age, respectively. Tanner stages for breast and pubic hair in girls, and genitalia and pubic in boys did not agree well within one ordinal rank. Average length of time from SMR 2 to 5 was 3.3 years for boys and 5.0 years for girls. Mean age of menarche was 12.8 years (from 10.8 to 14.8 years of age for 95% of them). Mean of menarcheal age was significantly different, geographically (12.6 years Seoul, 12.9 medium-sized city, and 12.9 rural area) (P<.0001). Menarche occurred 1.7% on breast SMR 2, 41.5% on SMR 3, 85.9% on SMR 4, 99.3% on SMR 5. In conclusion, this findings might be interpreted as providing averages of SMR for Korean girls and boys in adolescence.
Adolescent* ; Adult ; Breast ; Cross-Sectional Studies ; Female* ; Genitalia ; Hair ; Humans ; Korea* ; Menarche ; Physical Examination ; Surveys and Questionnaires ; Seoul ; Sexual Maturation ; Testis ; Weights and Measures

We performed total hip arthroplasty on a young male adult with paralytic dislocation of the hip due to poliomyelitis. Because of extreme shortening, as well as instability and weakness, the patient was unable to bear weight on the limb. Pastoperative course was complicated by ectopic ossification that compromised the hip and knee motion. Another young male adult with severe spastic cerebral palsy underwent total hip arthroplasty because of an intractable pain due to degenerative arthritis. Initial attempt coupled with adductor tenotomy and obtuator neurectomy ended in gross loosening and acetabular protrusion. Revision consisted of extensive soft tissue release and bone grafting of acetabular defect and use of a protrusion cup and an extra-long stem. Postoperative course was complicated by long-standing serous aseptic discharge from the wound which was controlled by antibiotics and prolonged recumbency. Indications for total hip arthroplasty in paralytic hips are rare and should be reserved for the most crippling conditions and one must be prepared fvr technical difficulties and a variety of complications with a prospecs for less than optimum results.
Acetabulum ; Adult ; Anti-Bacterial Agents ; Arthroplasty, Replacement, Hip ; Bone Transplantation ; Cerebral Palsy ; Dislocations ; Extremities ; Hip ; Humans ; Knee ; Male ; Ossification, Heterotopic ; Osteoarthritis ; Pain, Intractable ; Poliomyelitis ; Spectinomycin ; Tenotomy ; Wounds and Injuries

Neurofibromatosis is a disease which involves both neuroectodermal and mesodermal tissue, and is characterized by cafe-au-lait spot, multiple subcutaneous neurofibromas, elephantiasis neuromatosa, a positive family history, and specific dystrophic osseous changes such as scoliosis, penciling of ribs, vertebral scalloping, a paravertebral soft tissue tumor, and congenital pseudarthrosis. The classic type of scoliosis in neurofibromatosis was known as a sharp localized short curve that is often rapidly progressive and produces severe deformity with dystrophic changes, but another form with long gentle curve is reported. Since conservative treatment is usually unsuccessful, posterior fusion with or without Harrington instrumentation is the treatment of choice even in young age when the curve is progressive. This paper was aimed to review our experience with 11 patients having neurofibromatosis and scoliosis, who were treated with posterior fusion and Harrington instrumentation from Jan. 1971 to Dec. 1980, and the results were as follows: 1. The average age that spinal deformity was observed was 7.7 years old, but the average age at treatment was 14.4. 2. Cafe-au-lait spot was observed in all cases, subcutaneous nodule in 7 cases, local gigantism in 2 cases, and positive family history in 3 cases. 2 cases were combined with congenital spinal anormalies. 3. Specific pattern in spinal deformity was not significant. There were 7 short curves less than 5 vertebrae involved and 6 long curves more than 6 vertebrae involved. 4. There were 5 kyphosis which had more than 50°, and those were usually combined with severe scoliosis. 5. Preoperative average degree of scoliosis was 93.8, and the final correction was 41.2° (43.9%) with loss of correction 5.3°(5.7%) after 3.2 year follow-up in average. 6. It shouid be educated for early detection at home and school, and for the importance of early treatment for the scoliosis, to prevent rapid increase of scoliosis in neurofibromatosis.
Cafe-au-Lait Spots ; Congenital Abnormalities ; Elephantiasis ; Follow-Up Studies ; Gigantism ; Humans ; Kyphosis ; Mesoderm ; Neural Plate ; Neurofibroma ; Neurofibromatoses ; Neurofibromatosis 1 ; Pectinidae ; Pseudarthrosis ; Ribs ; Scoliosis ; Spine

No abstract available.
Lung Neoplasms* ; Lung*