The complications of Salter's innominate osteotomy in the treatment of congenital dislocation of the hip were avascular necrosis of the femoral head, hematoma, rotation of distal pelvic fragment, infection, fracture of femoral shaft and redislocation. Among them the causes of redislocation were technical failure, immobilization failure and absorption the bone graft, etc. We experienced a case of redislocation after open reduction and Salter s innominate osteotomy in congenital dislocation of the hip which was induced by a foreign body reaction to the suture material.
Absorption ; Dislocations* ; Foreign-Body Reaction ; Head ; Hematoma ; Hip* ; Immobilization ; Necrosis ; Osteotomy* ; Sutures ; Transplants

BACKGROUND: We conducted this study to verify whether a mechanical ventilator is adequate for cardiopulmonary resuscitation (CPR). METHODS: A self-inflating bag resuscitator and a mechanical ventilator were used to test two experimental models: Model 1 (CPR manikin without chest compression) and Model 2 (CPR manikin with chest compression). Model 2 was divided into three subgroups according to ventilator pressure limits (P(limit)). The self-inflating bag resuscitator was set with a ventilation rate of 10 breaths/min with the volume-marked bag-valve procedure. The mode of the mechanical ventilator was set as follows: volume-controlled mandatory ventilation of tidal volume (Vt) 600 mL, an inspiration time of 1.2 seconds, a constant flow pattern, a ventilation rate of 10 breaths/minute, a positive end expiratory pressure of 3 cmH2O and a maximum trigger limit. Peak airway pressure (P(peak)) and Vt were measured by a flow analyzer. Ventilation adequacy was determined at a Vt range of 400-600 mL with a P(peak) of < or = 50 cmH2O. RESULTS: In Model 1, Vt and P(peak) were in the appropriate range in the ventilation equipments. In Model 2, for the self-inflating bag resuscitator, the adequate Vt and P(peak) levels were 17%, and the P(peak) adequacy was 20% and the Vt was 65%. For the mechanical ventilator, the adequate Vt and P(peak) levels were 85%; the P(peak) adequacy was 85%; and the Vt adequacy was 100% at 60 cmH2O of P(limit). CONCLUSIONS: In a manikin model, a mechanical ventilator was superior to self-inflating bag resuscitator for maintaining adequate ventilation during chest compression.
Cardiopulmonary Resuscitation* ; Manikins* ; Models, Theoretical ; Positive-Pressure Respiration ; Thorax ; Tidal Volume ; Ventilation* ; Ventilators, Mechanical*

Histiocytic medullary reticulosis is a rare, uniformly fatal, acute disease of the reticuloendothelial system. The disease is associated with fever, malaise, weakness, weight loss, lymphadenopathy, hepatosplenomegaly, jaundice, and purpura. Common laboratory findings are severe anemia, leukopenia, and thrombocytopenia. A 49-year-old male patient is described who had multiple purple nodules and tumors in the skin. A biopsy taken from a skin lesion showed a diffuse proliferation of atypical histiocytes in the dermis and subcutaneous tissue.However, erythrophagocytosis of these atypical histiocytes was not seen.
Acute Disease ; Anemia ; Biopsy ; Dermis ; Fever ; Histiocytes ; Humans ; Jaundice ; Leukopenia ; Lymphatic Diseases ; Male ; Middle Aged ; Mononuclear Phagocyte System ; Purpura ; Skin ; Thrombocytopenia ; Weight Loss

The appendiceal mucocele is very rare disease of 0.2% incidence. About 24% of patients are asymptomatic and symptomatic patients present with pain in the right lower quadrant of abdomen in 64%, plapable maas in the right lower quadrant of abdomen in 50%, and rarely, melena, hematochezia, anemia, diarrhea, malaise, and abdominal distension. The gastrointestinal bleeding may be presented in the patient with intussusception, but the massive bleeding is generally absent. We report a case of appendiceal mucocele accompanying with gastrointestinal bleeding and review of literature.
Abdomen ; Anemia ; Diarrhea ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Humans ; Incidence ; Intussusception ; Melena ; Mucocele* ; Rare Diseases

Primary gastrointestinal lymphoma primarily confined to gastrointestinal tract is relatively rare diaease. Although the lymphoma primarily involved colorectum or small bowel was commonly reported than primary gastric lymphoma in Korea, the concurrent primary lymphoma of colon and small bowel is very rare in reported cases. We report a case of combined primary malignant lymphoma of the jejunum and cecum, who was admitted due to melena and anemia. She had right hemicolectomy and end-to-side ileotransverse colostomy at 2 months ago, due to primary colon lymphoma. The laparotomy was performed and identified hard, 2 x 3 cm sized masses on distal 25 cm, 80 cm and 150 cm from the Treitz ligament. The histology of these small ma showed histiocytic lymphoma as same as cecal specimen. In general, the small bowel lymphoma shaws poor prognosis than gastric or colorectal lymphoma due to diffieulty in diagnosis and late symptoms, but this problem could be resolved through the knowledge about primary gastrointestinal lymphoma and the development of diagnostic methods.
Anemia ; Cecum ; Colon* ; Colostomy ; Diagnosis ; Gastrointestinal Tract ; Jejunum ; Korea ; Laparotomy ; Ligaments ; Lymphoma* ; Lymphoma, Large B-Cell, Diffuse ; Melena ; Prognosis

Cryptococcosis is an acute, subacute or chronic infectian caused by the encap sulated yeast Cryptococcus neoformans. The case of Cryptococcosis is a 2 5/12 year-old boy with involvement of the skin, lungs, liver, spleen, lymph node and central nervous system is reported. He has suffered from fever, nausea., vomiting and multiple skin lesions for a month. Thcre were various cutaneous lesions consisting of papules, pustules, nodules, crusts and ulcers on the scalp, face, back, buttocks and both extremities. Diagnosis was confirmed by the clinical characteristics, histopathologic findings and culture of the C. neoformans from cerebrospinal fluid and marcerated skin tissue. He was successfully treated with combination of Amphotericin B and 5-fluorocytosine.
Amphotericin B ; Buttocks ; Central Nervous System ; Cerebrospinal Fluid ; Cryptococcosis* ; Cryptococcus neoformans ; Diagnosis ; Extremities ; Fever ; Flucytosine ; Humans ; Liver ; Lung ; Lymph Nodes ; Male ; Nausea ; Scalp ; Skin ; Spleen ; Ulcer ; Vomiting ; Yeasts

No abstract available.
China* ; Depression* ; Republic of Korea*

PURPOSE: The Remeex (Mechanical External Regulation) sling is a mid-urethral sling that allows adjustment of the sling tension in the postoperative period. We evaluated the early outcomes of the procedure in patients in whom the success rate of tension-free slings is low, such as with intrinsic sphincter deficiency (ISD). MATERIALS AND METHODS: We included 17 women with urodynamically proven stress urinary incontinence (SUI) who underwent the Remeex procedure and were followed for at least 12 months. The patients were considered to have ISD on the basis of a Valsalva leak point pressure (VLPP) <60 cmH2O or a maximum urethral closure pressure (MUCP) <20 cmH2O. We analyzed parameters including history taking, urodynamic study (UDS), and postoperative clinical outcomes. Patient's success and satisfaction rates were evaluated after the procedure. Also, we asked about lower urinary tract symptoms (LUTSs) with a questionnaire, and the severity of LUTSs was assessed with the Visual Analog Scale (VAS) before and 12 months after the operation. RESULTS: The patients' mean age was 55.6+/-9.58 years. Four (23.5%) patients had mixed incontinence. Five patients (29.4%) had undergone previous surgery for SUI. At a mean follow-up of 13.3 months (range, 12-16 months), 14 patients (82.3%) were cured and 3 patients (17.6%) were improved. Four patients (23.5%) answered very satisfied and 13 patients (76.4%) answered satisfied on the satisfaction questionnaire. Also, LUTSs were improved except voiding pain (p<0.05). CONCLUSIONS: This procedure provides high cure and satisfaction rates. Our results demonstrate that the Remeex procedure is suitable for women with SUI with ISD.
Female ; Follow-Up Studies ; Humans ; Lower Urinary Tract Symptoms ; Postoperative Period ; Suburethral Slings ; Urinary Incontinence ; Urodynamics

Hepatolithiasis is said to exist when stones are present in the right or the left hepatic ducts or their tributaries. Although it is a pathophysiologically benign disease, it causes frequently serious problems-recurrent cholangitis, liver abscess, obstructive jaundice, liver cirrhosis, and sepsis - and has challenged surgeons. Until recently, its fundamental pathogenetic mechanisms have not been elucidated, but bile duct stenosis, bile stasis, and secondary infection are considered as important pathogenetic factors. Therefore, the ultimate goal of the treatment is directed to the correction of these factors. We were retrospectively reviewed 119 cases of patients with hepatolithiasis treated by various surgical methods from Jul. 1989 to Dec. 1996 at the Department of Surgery of Maryknoll Hospital, Pusan. There were 72 women and 47 men, and the mean age was 45.5 years. Thirty-nine patients (32.8%) had previous histories of operations related to biliary stone diseases - cholecystectomy (n=13), T-tube choledocholithotomy (n=21), choledochoduodenostomy (n=9), Roux-en-Y choledochojejunostomy (n=6), and transduodenal sphincteroplasty (n=1). Operative procedures were 24 (20.2%) lithotomy, 60 (50.4%) drainages, and 35 (29.4%) hepatectomies and determined by the location of the stones, the general condition of the patient, and the anatomical change (stenosis or cystic dilatation) in intrahepatic duct. Postoperative complications occurred in 33 (27.7%) patients : wound infection (n=23), atelectasis (n=5), intra-abdominal bile collection (n=3), choledochocutaneous fistula (n=2), hemobilia (n=1), and adhesive ileus (n=1). Residual stones were detected in 39 (32.7%) patients by T-tube cholangiography, ultrasonography, computed tomography. The instances of residual stones was the lowest (17.1%) for hepatectomy compared to 45.8% for a lithotomy and 39.3% for a drainage. The follow-up study showed symptom improvement in 91.5% of the patients with a hepatectomy compared to 58.3% for a lithotomy and 71.7% for a drainage which was statistically significant(P<0.05). Since incomplete stone removal in hepatolithiasis and presence of stenosis in intrahepatic duct frequently require a repeat operation or other invasive management, the authors conclude that a hepatectomy, as an initial treatment for hepatolithiasis, is a safe, satisfactory treatment where possible.
Adhesives ; Bile ; Bile Ducts ; Busan ; Cholangiography ; Cholangitis ; Cholecystectomy ; Choledochostomy ; Coinfection ; Constriction, Pathologic ; Drainage ; Female ; Fistula ; Follow-Up Studies ; Hemobilia ; Hepatectomy ; Hepatic Duct, Common ; Humans ; Ileus ; Jaundice, Obstructive ; Liver Abscess ; Liver Cirrhosis ; Male ; Postoperative Complications ; Pulmonary Atelectasis ; Retrospective Studies ; Sepsis ; Sphincterotomy, Transhepatic ; Surgical Procedures, Operative ; Ultrasonography ; Wound Infection

Infection in primary total hip arthroplasty may cause catastrophic results and is the major reason for implant failure. The purpose of this study was to evaluate the utility of the hip joint fluid culture as a method of predicting the possibility of a hip joint infection by calculating the sensitivity, specificity and accuracy. We performed 628 primary total hip arthroplasty and aerobic and anaerobic bacterial cultures for hip joint fluid between January 1989 and June 1996. The hip joint fluid culture was routinely performed to evaluate the utility of the femoral head for bone banking. Thirty-two cases out of the 628 hips showed positive intraoperative culture and 596 cases showed negative intraoperative culture. The isolated organisms from 32 positive cultures were 11 for Staphylococcus aureus, eight for Staphylococcus coagulase negative, seven for Enterococcus, three for E.coli and one each for Enterobacter, Acinetobacter and Pseudomonas. Anaerobic culture was negative in all cases. In the positive intraoperative culture cases, none had delayed infection during the follow-up period. But in the negative intraoperative culture cases, one case had acute infection and two cases had delayed infection. In the case with acute infection, Staphylococcus aureus was isolated and on two cases with delayed infection, Enterococcus and Staphylococcus coagulase negative were isolated, respectively. All 32 positive culture cases were fa~lse positive and 595 negative culture cases were true negative and one negative culture case was fa~lse negative. The sensitivity of the hip joint culture was 0%, the specificity was 94.9% and the accuracy was 0%. The specificity of hip joint fluid culture in primary total hip arthroplasty was high, hut the sensitivity score was zero. Therefore, the hip joint fluid culture should not be used for a routine check of infection status in primary total hip arthroplasty. We recommend the hip joint fluid culture in revision arthroplasty or hips in which infection is clinically suspected.
Acinetobacter ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Bone Banks ; Coagulase ; Enterobacter ; Enterococcus ; Follow-Up Studies ; Head ; Hip Joint* ; Hip* ; Pseudomonas ; Sensitivity and Specificity ; Staphylococcus ; Staphylococcus aureus