Purpose: The results of a more than 10-year follow-up after total hip arthroplasties with circumferential and proximal porous-coated femoral stems were evaluated. Materials and Methods: Seventy-six patients (80 hips), who were operated on between Aug. 1991 and July 1994, were followed for more than 10 years after primary total hip arthroplasties using Multilock stems. The mean age at the time of the operations was 47.3 years old and the mean duration of follow-up was 12.3 years. The clinical results and radiological findings were evaluated. Results: The mean Harris hip scores improved from 54.7 points to 88.5 points at the time of the 10-year follow up. On the last follow-up radiograph, endosteal bone formation was observed in 70 hips (90%) and all femoral stems were biologically stable. Femoral osteolysis, which was linear in Gruen zone I and VII and mostly restricted to the proximal zones, was observed in 67 hips (84%), and no hip had distal osteolysis in the femur. There was no loosening, migration, or revisions of the stems. Conclusion: Total hip arthroplasties using circumferential and proximal porous coated Multilock femoral stems demonstrated stable osseous fixation and no distal osteolysis for a minimum 10-year follow-up; therefore, all stems were reported to have satisfactory outcomes. With improvement of cup design and liner wear, circumferential and proximal porous coating designs of femoral stems can be an alternative answer to mechanical failure due to aseptic loosening.
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Femur ; Follow-Up Studies* ; Hip ; Humans ; Osteogenesis ; Osteolysis

We treated 160 patients with ureteral stones using extracorporeal shock wave lithotripsy (Siemens Lithostar, Germany) and evaluated many factors which influence the results of ESWL such as stone size, location, degree of ureteral obstruction. duration of impaction and adjuvant procedure. Our results showed that. in case of large stones (more than 1 cm in diameter), mid-ureteral stones, long-standing impacted stones or in-situ treatment, the success rates of ESWL were relatively poor. Therefore in cases accompanying the above-mentioned factors, in is necestary to recognize that the patients may be required to repeat ESWL. The results also suggest that the use of an ureteral catheter or stent may contribute to a slightly higher success rate. But we prefer in-situ extracorporeal shock wave lithotripsy to an ureteral stent because it is an invasive procedure.
Humans ; Lithotripsy* ; Shock* ; Stents ; Ureter* ; Ureteral Obstruction ; Urinary Catheters

No abstract available.
Mucocutaneous Lymph Node Syndrome*

No abstract available.
Neuroblastoma*

Four newborn infants with hyperbilirubinemia, caused by ABO blood group incompatibility, were treated with high-dose intravenous immune globulin(IVIG). As soon as the diagnosis was clinically suspected, these infants received conventional treatment including phototherapy and were monitored closely for bilirubin levels. When bilirubin concentrations reached the risk point in spite of phototherapy, IVIG was given at a dose of 1g/kg for 6 hours. In all cases, bilirubin levels declined within 12 hours after LVIG therapy, and to rebound effect was seen, No side effects of IVIG treatment were observed. We suggest that high-dose IVIG therapy may be useful in the treatment of hyperbilirubinemia due to ABO incompatibility, and reduce the need for exchange transfusion.
Bilirubin ; Blood Group Incompatibility ; Diagnosis ; Humans ; Hyperbilirubinemia* ; Hyperbilirubinemia, Neonatal ; Immunoglobulins, Intravenous* ; Infant ; Infant, Newborn ; Phototherapy

PURPOSE: We report on minimum 10-year follow-up results of total hip arthroplasties with hydroxyapatite (HA)-coated cementless acetabular cups. MATERIALS AND METHODS: From January 1992 to October 1994, we performed one-hundred eight primary total hip replacements in ninety-seven patients using HA-coated cementless acetabular cup. Eighty-four cases in seventy-seven patients were followed-up for a minimum of 10 years. RESULTS: The mean Harris score was 54.7 (range, 0 to 77.2) points preoperatively and 88.5 (range, 27.1 to 100) points at the most recent follow-up. Revision procedures were required on twenty-eight (33.3%) hips. Thirteen (15.5%) cups were revised because of loosening. Seven (9.5%) hips among the eight that revealed excessive polyethylene wear and osteolysis were revised and one hip is waiting for the revision procedure. In seven (8.3%) cases, only a polyethylene liner exchange was performed because of excessive liner wear without osteolysis. The mean linear polyethylene wear was 2.74 mm. The mean linear wear rate was 0.28 mm per year and the corresponding estimate of volumetric wear was 1689.15 mm3. The mean linear polyethylene wear and linear wear rate in revised hips was 3.05 mm and 0.33 mm per year, respectively. The estimated volumetric wear in the revised group was 1882.27 mm3. CONCLUSION: HA-coated cementless acetabular cup (Atoll(R)) demonstrated a high rate of loosening and poor results in wear and osteolysis. Further studies are needed to promote the design of acetabular cups and the technique of HA coating.
Acetabulum* ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Durapatite ; Follow-Up Studies* ; Hip ; Hip Joint ; Humans ; Osteolysis ; Polyethylene

PURPOSE: We report the minimum 5-year follow-up results of total knee arthroplasty with anteroposterior glide LCS(R) CompleteTM. MATERIALS AND METHODS: From June 1999 to June 2000, we performed sixty-two primary total knee replacements with the anteroposterior glide LCS(R) CompleteTM. Fifty-eight cases were followed-up for a minimum of 5 years. The posterior cruciate ligaments were preserved in all the cases. RESULTS: The mean Hospital for Special Surgery Knee Score increased from 62.9 points preoperatively to 88.6 points at the most recent follow-up. The mean knee score of the American Knee Society increased from 56.9 points preoperatively to 90.8 points and the functional score increased from 39.8 points to 76.8 points at the most recent follow-up. The mean flexion contracture decreased from 11.5 degrees preoperatively to 1.6 degrees and the range of motion with flexion increased from 103.5 degrees to 112.2 degrees. There was no loosening, osteolysis, or measurable polyethylene wear in any of the cases. We experienced dislocation of the polyethylene liner and guide arm in one case, but there was no revision surgery performed due to loosening or infection. CONCLUSION: Anteroposterior glide LCS(R) CompleteTM demonstrated excellent clinical and radiological results in polyethylene wear and osteolysis; but there was no increased benefit in ranges of motion compared with fixed-bearing implants. Further follow-up is needed to obtain long-term clinical and radiological results.
Arm ; Arthroplasty* ; Arthroplasty, Replacement, Knee ; Contracture ; Dislocations ; Follow-Up Studies* ; Knee Joint ; Knee* ; Osteolysis ; Polyethylene ; Posterior Cruciate Ligament ; Range of Motion, Articular

PURPOSE: To evaluate the results of revision total hip arthroplasty using a Wagner SL revision stem. MATERIALS AND METHODS: This study reviewed 56 revisions of the femoral component performed using a Wagner stem in 55 patients between 1992 and 2001. The mean age of the patients at the time of the revision was 50 years. The mean follow up duration was 8.4 years (range, 5 to 12.5 years). The indication for revision was aseptic loosening in fifty-two hips, septic loosening in two and periprosthetic fractures in two. The pre-revisional femoral defects were classified according to the Paprosky classification system. A clinical evaluation and radiological assessment were performed. RESULTS: The mean Harris hip score improved from 47 points preoperatively to 87 points at the latest follow-up. There were 5, 20, 22 and 9 hips of type I, II, IIIA and IIIB according to the Paprosky classification system. Fifty two hips (93%) showed stable stems at the latest follow-up radiographs. The mean vertical subsidence of the stem was 6.2 mm (range, 0 to 21 mm). Severe progressive vertical subsidence in three hips and an infection in one occurred requiring repeat revision. CONCLUSION: For severe proximal femoral bone loss, the conical femoral revision stem with a fully grit-blasted surface produced satisfactory results with distal press-fit fixation. We can expect a decrease in the rate of mechanical failure rate of the stem by reducing the subsidence derived from the stem design itself.

Abdominal pregnancy is a very rare and life threatening varient of ectopic pregnancy with high maternal mortality and perinatal mortality. A 26-year-old woman, gravida 2, para 0, abortion 2, visited our emergency department for amenorrhea for 11 weeks and lower abdominal pain. Diagnostic transvaginal ultrasonographic finding suggested ruptured ectopic pregnancy. Serum Hemoglobin level was 8.1 mg/dL, and Hematocrit value was 25.2%. On laparatomy about 2.000 mL of blood was filled in the abdomen and severe adhesion was found on right adnexa, posterior cul-de-sac and omentum. A live fetus was attached to uterus. After adhesiolysis, we removed conceptus from uterine surface. We performed subtotal hysterectomy and excised right fallopian tube. 10 pints of packed red blood cell and 3 pints of fresh frozen plasma were given to the patient during and after the operation. Patient recovered postoperatively without any complications and discharged at postoperative seventh day. We experienced a case of first trimester secondary abdominal pregnancy after tubal reanastomosis and reported it with brief of a literature review.
Abdomen ; Abdominal Pain ; Adult ; Amenorrhea ; Emergency Service, Hospital ; Erythrocytes ; Fallopian Tubes ; Female ; Fetus ; Hematocrit ; Humans ; Hysterectomy ; Maternal Mortality ; Omentum ; Perinatal Mortality ; Plasma ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy, Abdominal* ; Pregnancy, Ectopic ; Sterilization Reversal* ; Uterus

For the past two years, nephropexy using PCN was underwent in 9 cases of nephroptosis (8 patients) with variable degrees of flank pain. All were female and 6 on right, 1 on left and 1 on bilateral. All patients had a very mobile kidney and exact distance of movement measured on the film was greater than 6cm (6 to 15 cm). After this operation, 14-20 Fr. nephrostomy catheter was indwelled for about two weeks. All patients were followed at least 3 months(3 to 32, median 17 months). We followed the patients with symptom relief and IVP after 3 months. Nephropexy was regarded as success if she remained asymptomatic for more than 3 months. Five cases were successful and four cases felt recurrent flank pain within 1 month after the surgery. Among four cases of recurrence, one had repeated PCN and got successful result, another had open nephropexy and the others have been followed so far So overall success rate was 67% (6/9). In conclusion, nephropexy using PCN is less invasive, needs shorter period of admission and leaves ignorable scars postoperatively. Furthermore it can be repeated even in the case of failure or recurrence, which would make this new technique available as the first step for the surgical treatment of nephroptosis. And the success rate could be increased if the nephrostomy tract is dilated upto 30 Fr. and the PCN catheter is placed about 4 weeks.
Catheters ; Cicatrix ; Female ; Flank Pain ; Humans ; Kidney ; Nephrostomy, Percutaneous* ; Pregnenolone Carbonitrile ; Recurrence