In several pathologic conditions of the joints, it is rather frequent to find a swollen joint. The authors performed an analysis of the joint fluid proteins from 20 cases of rheumatoid arthrit is and 20 normal Kore an adults with the object of evaluating the significance of it s clinical application. The study was done with Beckman Model R System, Durrum type cell, and scanned with Model RB Analytrol. Scheicher and Schuell 2043-A paper was used with diethyl barbituric acid-sodium diethyl barbituratebuffer, pH 8.6, ionic strenght 0.075 and stianed with 0.1% bromphenol blue. The results obtained were as follows: 1) The amount of total protein was significantly increased with average of 4.80 + 1.249gm% in comparison with 2.34 + 0.553gm% in normal group. 2) Albumin fraction showed the average of 41.86 + 6.219% in comparison with 64.85 + 5.288% in normal group. 3) Alpha 2 globulin fraction disclosed the average of 10.19 + 3.379% in comparison with 4.24 + 1.158% in normal group, which was significantly increased one. 4) Gammaglobulin fraction was also significantly elevated with the average of 21.51 + 8.942% in comparison with 11.70 + 1.923% in normal group. 5) There was noted a decreased A/G ratio, the average of 0.74 + 0.196, in comparison with 1.911 + 0.430 in normal group.
Adult ; Arthritis, Rheumatoid ; Bromphenol Blue ; Humans ; Hydrogen-Ion Concentration ; Joints

Nine hips in eight patients had development of femoral endosteal cortical erosion after a cementless total hip arthroplasty. Serial anteroposterior and lateral radiographs of all of the affected femora were reviewed to determine the interval between the operation and the first recognition of the osteolytic lesion or lesion, as well as to evaluate the radiographic appearance and progression of the lesions. We reviewed the one hundred twenty hips in one hundred eleven patients had a cementless total hip arthroplsty at the department of Orthopaedic Surgery, Pusan National University Hospital from January 1985 to December 1991. The mean average follow up period was forty five months (twenty four to one hundred nine months). Osteolysis was first noted radiographically at forty four to eighty five months(mean, sixty three months) postoperatively; it occurred most frequently around the distal portion of the prosthetic stem. Three of the femoral components were shown to be loose. The remaining six hips had been judged to be stable when the endosteal erosion had first been identified. The osteolysis was more severe in the femora in which the component was loose than in those in which it was stable. Of the six stable hips and two unstable hips except revised one hip, who were followed, four hips had an increase in the size of osteolytic lesion with time. All two unstable hips and two stable hips among six stable hips had an increase in the size of osteolytic lesion with time. Therefore, close follow up in necessary for patients in whom osteolysis develops in association with a stable cementless femoral component.
Arthroplasty, Replacement, Hip ; Busan ; Femur ; Follow-Up Studies ; Hip ; Humans ; Osteolysis

PURPOSE: To analyze complications and their effects on prognoses of children hip fractures. MATERIALS AND METHODS: 26 childhood hip fractures (6 type I, 7 type II, 10 type III, 3 type IV) were studied for 11 years (1986-1997) . We analyzed factors possibly related to complications and their effects on prognoses, especially avascular necrosis (AVN) of the femoral head. RESULTS: Of 26 patients, there were 7 AVN (27%) , 2 nonunions (8%) , 3 coxa vara (12%) , 9 premature epiphyseal closures (35%) , and 2 infections (8%) . Of 7 patients with AVN, 3 patients had type I fracture and 4 patients had type II fracture. No AVN developed in type III and IV fractures. Of 2 patients who had type I fracture with dislocation, all patients had AVN (100%) . Four of 14 patients who had displacement of the fracture site and one in 10 patients who had non-displacement fracture developed AVN. In our study of the incidence of AVN according to surgical reduction time after injury, 3 (60%) of 5 patients who were treated by surgical reduction within 6 hours and 4 (19%) out of 21 patients who were treated by surgical reduction after 6 hours developed AVN. CONCLUSION: In childhood hip fracture, surgical reduction time after trauma (<6 hours) did not seem to be a critical factor in preventing AVN. Force of injury and level of fracture site which jeopardize the blood supply to the femoral head were important factors. Age at time of injury was also important. Containment treatment of younger children (<10 years) and surgical treatment of older children (>10 years) were found to be an effective treatment of AVN. AVN concomitant with pyogenic infection had the worst prognosis.
Child* ; Containment of Biohazards ; Coxa Vara ; Dislocations ; Head ; Hip Fractures ; Hip* ; Humans ; Incidence ; Necrosis ; Prognosis

Crohn's disease is a rare inflammatory bowel disease in Korea which requires a differential diagnosis with intestinal tuberculosis. In the early stages of Crohn's diseaae, the combiation of bowel wall edema and spasm produces intermittent obstructive manifestations, so the usual subjective symptoms were appeared long standing diarrhea, low grade fever and abdominal pain and distension. We recently experienced a case of Crohn's colitis with repeated bowel obstruction in female adult who underwent surgical resection.
Abdominal Pain ; Adult ; Colitis ; Crohn Disease* ; Diagnosis, Differential ; Diarrhea ; Edema ; Female ; Fever ; Humans ; Inflammatory Bowel Diseases ; Korea ; Spasm ; Tuberculosis

Crohn's disease is a rare inflammatory bowel disease in Korea which requires a differential diagnosis with intestinal tuberculosis. In the early stages of Crohn's diseaae, the combiation of bowel wall edema and spasm produces intermittent obstructive manifestations, so the usual subjective symptoms were appeared long standing diarrhea, low grade fever and abdominal pain and distension. We recently experienced a case of Crohn's colitis with repeated bowel obstruction in female adult who underwent surgical resection.
Abdominal Pain ; Adult ; Colitis ; Crohn Disease* ; Diagnosis, Differential ; Diarrhea ; Edema ; Female ; Fever ; Humans ; Inflammatory Bowel Diseases ; Korea ; Spasm ; Tuberculosis

A prominent cause of death in patients with advanced gastric cancer is peritoneal metastasis or recurrence. There is no definite preventive surgery or treatment in such cases. Cancer tissue is more heat labile than normal tissue, and the administration of anticancer drugs interacts synergically with hyperthermia. The ability of anticancer drugs to eradicate the malignant cells is dependent not only on the dose of the antineoplastic drug but also on the number of tumor cells. Therefore, for success, the combination therapy of cytoreductive surgery and IPHC may be necessary in advanced gastric cancer. We performed this study to evaluate the toxicity and the clinical efficacy of IPHC in far-advanced gastric cancer and to assess the concentration of CDDP. Twenty one patients (11 females and 10 males) with gross serosal invasion (with or without peritoneal metastasis) underwent cytoreductive surgery and were treated with IPHC via hyperex-GHT-cpl (Green Cross Med. Corp. Korea) before closure of the abdominal wound. The IPHC was done using CDDP (200~400 mg/m2) and MMC (30~50 mg/m2) with 10 liters of normal saline as the perfusate. The peritoneal temperature during the IPHC was maintained at 42oC for 60 minutes. We used a modified peritoneal cavity expander to achieve free flow of the perfusate. The concentrations of the plasma and the perfusate were measured by atomic absorption spectrometry (Varian 300 A). Sixteen patients were stage IV, 3 were IIIb, and 2 were IIIa. The plasma concentraton of CDDP was 1.8 ug/ml at 10 minutes after perfusion and reached a maximal concentration (MXC) of 3.6 ug/ml. The area under the time-concentration curve (AUC) of the plasma at the 48th hour after perfusion was 3031.1 ug.min/ml. At the 24th hour, the maximum concentration of CDDP in the perfusate was 16.2 ug/ml. The AUC of the perfusate was 1703.3 ug min/ml at the 24th hour and 1817.7 ug min/ml at the 48th hour. The ratio of AUC of perfusate and the AUC of the plasma were 0.92 at the 24th hour and 0.59 at the 48th hour. The postoperative compllications were lymphatic leakage (2), pneumonia (1), and paralytic ileus (1). The most common drug-related complications of IPHC were anemia (WHO grade I), hematuria, leukopenia, jaundice, and thrombocytopenia in such order. These side effects were eliminated by conservative treatment within 4 weeks postoperatively. We could not determine the long term survival rate because of the short follow up period. However, the mean survival of the cases was about 12.0 months. The three deaths among the resected cases were due to extraperitoneal recurrences. The combination therapy of IPHC and cytoreductive is available for clinical use with a high AUC, high intraperitoneal CDDP concentration with a reasonable plasma concentration and has no threatening complications or mortality.
Absorption ; Anemia ; Area Under Curve ; Cause of Death ; Female ; Fever ; Follow-Up Studies ; Hematuria ; Hot Temperature ; Humans ; Intestinal Pseudo-Obstruction ; Jaundice ; Leukopenia ; Mortality ; Neoplasm Metastasis ; Perfusion ; Peritoneal Cavity ; Plasma ; Pneumonia ; Recurrence ; Spectrum Analysis ; Stomach Neoplasms* ; Survival Rate ; Thrombocytopenia ; Wounds and Injuries

An anomalous systemic arterial supply to the normal basal segments of the left lower lobe without sequestration is a rare congenital anomaly. It differs from classical bronchopulmonary sequestration in that the involver lung retains a normal connection to the bronchial tree, although some place this entity exists within the broad framework of pulmonary sequestration. We experienced a case of a woman who presented with a nodular lesion on a chest X-ray. Contrast-enhanced CT diagnosed her as having an anomalous systemic arterial supply to the normal basal segments of the left lower lobe. This case is reported with a brief literature review.
Bronchopulmonary Sequestration ; Female ; Humans ; Lung* ; Thorax ; Tomography, X-Ray Computed ; Trees

Paralytic pontine extropia(PPE) is a exotropia in contralateral eye of lesion side, associated with one-and- a-half syndrome in acute phase of brainstem infarction and after then, often followed by non-paralytic pontine extropia(NPPE) and medial longitudinal fasciculus (MLF) syndrome in each clinical improvement. NPPE is pontine exotropia without lateral gaze palsy to ipsilateral side and is considered to be due to partial impairment of the unilateral paramedian pontine reticular formation(PPRF). We reported a case, 75 yearold man, of brainstem infarction who initially presented NPPE in acute phase, followed by ipsialteral MLF syndrome after 5th days.
Brain Stem Infarctions* ; Brain Stem* ; Brain* ; Exotropia* ; Paralysis

BACKGROUND: Pulmonary Langerhans cell histiocytosis forms part of a spectrum of diseases that are characterized by a monoclonal proliferation and infiltration of organs by Langerhans cells. Several organ systems may be involved in Langerhans cell histiocytosis, including the lungs, bone, skin, pituitary gland, liver, lymph nodes and thyroid. Pulmonary histiocytosis X represents 2.8% of interstitial lung disease. Here we present the clinical, radiological, therapeutic aspects of pulmonary histiocytosis X. METHOD: Fourteen cases of biopsy-proven pulmonary histiocytosis X patients who were diagnosed in Seoul National University Hospital during the period from January 1990 to December 1998 were analyzed retrospectively. RESULT: There were 12 men and 2 women in this study. The initial presenting symptoms were dyspnea, cough, chest pain, which was associated with the pneumothorax, and chest radiography abnormalities. Only 8 patients (57%) were smokers. There were 5 patients with extra-pulmonary histiocytosis (pituitary, bone, skin). Eight patients had received the chemotherapy. There were no mortalities and only one patient experienced an aggravation of symptom during the follow-up period. CONCLUSION: In contrast to previous reports from other countries, the patients with pulmonary histiocytosis X in this study presented with several different clinical characteristics, such as a male predominance, relatively low smoker's rate, and a better prognosis.
Chest Pain ; Cough ; Drug Therapy ; Dyspnea ; Female ; Follow-Up Studies ; Histiocytosis ; Histiocytosis, Langerhans-Cell* ; Humans ; Langerhans Cells ; Liver ; Lung ; Lung Diseases, Interstitial ; Lymph Nodes ; Male ; Mortality ; Pituitary Gland ; Pneumothorax ; Prognosis ; Radiography ; Retrospective Studies ; Seoul ; Skin ; Thorax ; Thyroid Gland

No abstract available.
Buthionine Sulfoximine* ; Cell Line* ; Cisplatin* ; Humans* ; Lung Neoplasms* ; Lung* ; Stomach*