Between Jan. 1971 and Dec. 1985, 102 consecutive patients underwent total cystectomy and urinary diversion for primary carcinoma of the bladder. Among the patients, planned radiation therapy (2,000 rad. for 5 days) followed by operation was done in 18 patients, therapeutic dose of radiation was given postoperatively in 8 patients and 76 patients underwent operation only The postoperative mortality rate was 3.9%. Early complications occurred in 30% of the 102 patients and included wound infection, urine leak, bowel obstruction and medical complication. An increased late complication incidence was noted among 26 patients receiving pre- or postoperative radiation (50%) compared with those not receiving radiation (32%). Staging errors by CT scanning occurred in 37% of patients, overstaging in 8 (33%) and understaging in 1 (4%). Survival was evaluated in 45 patients and the overall 5-yesr survival rate for patients with transitional cell carcinoma was 38%.
Carcinoma, Transitional Cell ; Cystectomy* ; Humans ; Incidence ; Mortality ; Survival Rate ; Tomography, X-Ray Computed ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urinary Diversion ; Wound Infection

No abstract available.
Hepatitis B Surface Antigens* ; Interferons* ; Lymphocytes*

Treatment of femoral shaft fractures in children is varying according to age. Satisfactory results have been obtained with longitudinal skin traction, split Russell traction, ordinary Russell traction, 90-90 skeletal traction, and immediate application of a spica cast(2,4,6,11,15). Most authors use one or more techinques routinely. It is safe and convenient to use single treatment protocol to treat all fractures of same type, Distal femoral skeletal traction with the knee and hip flexed 90 degrees and with the thigh hanging free, using the trunk as counter traction, has been used routinely for femoral shaft fractures in children(age 4-12). We reviewed 30 cases of femoral shaft fractures in children treated with 90-90 skeletal traction. 1. The average age of the patients was 6.8 years(range, 4-12 years), and almost all were caused by pedestrian injury. 2. The average time of traction was 48 days(range, 28-75), and 12 cases(40%) were treated without spica cast application. 3. Four among 30 cases developed angular deformity exceeding acceptable range(15° in AP view, 20° in lateral view), and three of them were proximal third fractures. 4. The older the patient, the longer the duration of limited activity and the more tendency of angular deformity. 5. 90-90 skeletal traction is easy, safe and convenient to treat all femoral shaft fractures of the children between four and ten years old.
Child ; Clinical Protocols ; Congenital Abnormalities ; Hip ; Humans ; Knee ; Skin ; Thigh ; Traction

One hundred and twenty patients with symptomatic lumbar disc herniation were treated with automated percutaneous lumbar discectomy(APLD) from June 1988 to October 1989 in Seoul National University Hospital. Among them, 95 patients were followed up for more than 6 months. Number of male patients was 58 and female 37. Age ranged from 15 to 57 years with average 28 years. L4-L5 was the most commomly involved level comprising 80%, and 2 level involvement was 9%. Average duration of procedure was 38 minutes, and average amount of tissue aspirated was 5.2 grams and average hospital stay was 2.4 days. The average follw up was 10.8 months. Eighty seven percent of patients were satisfactory and 13% unsatisfactory and there was no major complication. There was no significant disc space narrowing in all the cases and the size of herniation revealed no significant change in all the patients, even the patient had a satisfactory result. APLD was compared with chemonucleolysis performed during 1988 in terms of clinical results, disc space narrowing on plain films and herniation size change on follw up CT. Chemonucleolysis also had satisfactory result in 89% with reduction of herniation size in 41% but induced significant disc space narrowing in 84%. Authors experienced some special cases, which are generally considered poor indication for percutaneous discectomy. Those were degenerative, calcified and possibly ruptured discs. Satisfactory results were obtained in 10 of 14 these patients.
Diskectomy ; Diskectomy, Percutaneous ; Female ; Humans ; Intervertebral Disc Chemolysis ; Length of Stay ; Male ; Seoul

No abstract available.
Diagnosis* ; Magnetic Resonance Imaging* ; Spinal Stenosis*

Corneal ulcerations are divided into two morphologic types: central and marginal. Marginal corneal ulcerations are characterized by focal, muItifocal, multifocal or diffuse ulcerative, infiltrative, or vascular involvement of the peripheral cornea, and the exact pathogenesis of these ulcerations is not clearly understood but infectious, toxic or autoimmune factors may be involved. The authors treated one peripheral corneal ulcer patient, no respond to steroid and antibiotic therapy, with lamellar keratoplasty and had a good result.
Cornea ; Corneal Transplantation* ; Corneal Ulcer* ; Humans ; Ulcer

Exploratory analysis was conducted in a health screening data which had been collected in residents of Taegu city in 1986 to seek out items of serum chemistry associated with hypertension. Six-hundred residents mere than 20 years of age were sampled by the multistage cluster sampling method. Because blood sampling and blood pressure measurements were possible in 384 residents of 600, the rest of 216(36%) were replaced with the healthy visitors to the Department of Health checkup, matched with age and sex. Fivehundred eighty subjects were used in the defined above systolic blood pressure 141mmHg and/or diastolic pressure 91mmHg. The most common age group was under 29 years of age in both sexes, with 103(38.3%) in males and 125(40.2%) in females. Mean body weight of males was Hypertensives were 24(8. in males and 21(6.8%) in females. The items of serum chemistry which showed p values less than 0.25 were glucose, albumin, total cholesterol, ALP and AST in males and glucose, creatinine, albumin, total cholesterol, AST and ALT in females. After controlling age and body weight, glucose and AST showed slightly decreased regression coefficients(beta=0.030, S.E.=0.018, beta= 0.021, S.E.=0.012, respectively) and p values 0.09, 0.08 respectively while albumin, total cholesterol and ALP showed substantially larger p values than unadjusted ones in males. After controlling age and body weight, total cholesterol only remained statistically significant (beta=0.015, S. E. =0. 007, p=0.04). These results suggested that certain items of serum chemistry might be associated with hypertension.
Blood Pressure ; Body Weight ; Chemistry* ; Cholesterol ; Creatinine ; Daegu ; Female ; Glucose ; Humans ; Hypertension* ; Male ; Mass Screening

This study was performed to analyze the clinical, radiological results of 70 patients with isthmic spondylolisthesis and 30 patients with degenerative spondylolisthesis who were underwent with wide decompression, reduction with transpedicular screw system and posterolateral fusion from Mar. 1990 to Dec. 1995. In this study we excluded posterior lumbar interbody fusion, circumferential fusion or decompression method for sondylolisthesis. The mean follow up duration was 29 months. The most common level was L5-Sl in isthmic group (36 patients, 51%), and L4-5 in degenerative group (23 patients, 77%). The clinical result were analyzed according to Kirkaldy-Willis criteria. The satisfactory result were obtained 90% in each group. Screw failure occured in unstable level with severe slip angle, so anterior column support may be recommended in this group. Pedicle screw fixation and wide decompression augmented with posterolateral bone graft is a satisfactory alternative method for degenerative and isthmic spondylolisthesis.
Decompression ; Follow-Up Studies ; Humans ; Spondylolisthesis* ; Transplants

No abstract available.
Kyphosis*

Various kinds of bone cements mixed with antibiotics have been widely used for treatment and prevention of infections, especially combined with bone defects. But bone cements have some disadvantages in that they are rather expensive and capable of incurring some complications such ss fibrosis of surrounding soft tissue or local erosion of bone, and furthermore, they must be removed after infection is controlled for bone graft to fill up the defects because they do not have properties of osteoconduction or osteoinduction. So we have come to the idea of using theoretically advantageous plaster of paris to take place of bone cements, and performed in-vitro experiment upon the effectiveness of plaster of paris pellets containing antibiotics, then obtained good results comparable to those from many experimental studies using bone cements. By this, we think that it would be possible in the future to treat and prevent infections supervening bone defects with plaster of paris mixed up with antibiotics. The results are as follows : 1. Sustained release of large amount of antibiotics from plaster of paris enough to exert inhibitory activity on abcterial growth, and there was a direct relationship between concentrations of eluted antibiotics and diameters of inhibitory zones. 2. Tobramycin was capable of inhibiting the growth of S. aureus, E. coli, and Ps. aeruginosa for 7 days at maximum. 3. Cephradine inhibited the growth of S. aureus and E. coli but did not affect that of Ps. aeruginosa. 4. The maximum antibacterial activity wss reached within first 24 hours from the start of elution of antibiotics from plaster of paris.
Anti-Bacterial Agents ; Bone Cements ; Bone Regeneration ; Calcium Sulfate ; Cephradine ; Fibrosis ; Tobramycin ; Transplants