A clinical study of traumatic amputation by railroad accidents was made an 124 patients with 154 amputee, who had been treated at Department of Orthopaedic Surgery, National Seoul Hospital, during the 4 years period from January 1976 to December 1979. The results of this study are as follows: 1. The ratio of male to female was 9 to 1. The 3rd decade of age group showed the hightest number of accident causalties, as much as 37.1%. 2. Causalties showes a maximum during the sprlng (37.1%) and a minimum during winter. 3. The most common injured sites of the amputee were B–K in 44 cases among 154 cases of the amputee. 4. Considering the number of the multiple amputee in 26 casee among 124 cases, frequently they developed in 2 sites with 22 cases, 3 sites with 4 cases. 5. The frequent fracture sites with combined amputation were 18 cases of the pelvic bone, 12 cases of femur in amputation of the lower extremity. 6. Our methods of treatment were debridement, debridement and primary skin closure, debridement with open amputation, circular amputation, closed amputation with skin graft, and closed amputation. 7. The major complications were phantom limb in 108 cases (70.1%), infection in 44 cases (28.6%). 8. The most frequent infectious agent was pseudomonas (16 cases).
Amputation ; Amputation, Traumatic ; Amputees ; Clinical Study ; Debridement ; Female ; Femur ; Humans ; Lower Extremity ; Male ; Pelvic Bones ; Phantom Limb ; Pseudomonas ; Railroads ; Seoul ; Skin ; Transplants

No abstract available.
Anti-Bacterial Agents* ; Ascorbic Acid* ; beta Carotene* ; Tretinoin*

No abstract available.

One hundred and thirty trimethoprim-resistant R plasmids derived from of Escherichia coli isolated from clinical specimens and feces of healthy collegians were examined for incompatibility, EcoRI endonuclease restriction fragment pattern, and Southern hybridization with DHFR I, II, III, V, and VII probe. 1. Most trimethoprim-resistant R plasmids were resistant to ampicillin, tetracycline, chloramphenicol, gentamicin, and kanamycin, and showed multiple drug resistance and various antimicrobial resistance patterns. 2. Trimethoprim-resistant R plasmids ranged from 90 to 50 kilobase and 42.3% of R plasmids tested were classified to incompatibilty group Inc FI, Inc FII or Inc FIV, 3. Among 48 random selected R plasmids from various origin, 14 R plasmids (including 9 of 14 Inc FII plasmids and 3 of 14 Inc FI plasmids) hybridized with DHFR VII oligonucleotide probe but others did not respond to any of DHFR probes used. 4. Most R plasmids showed various EcoRI endonuclease fragments and different reaction sites by Southern hybridization. Six plasmids showed identical or nearly identical molecular weight, EcoRI endonuclease fragment patterns and different sites of Southern hybridization. But 2 Inc FII plasmids derived from urine and feces showed identical pattern. These findings, if confirmed by further studies, suggest that normal flora E. coli can act as reservoir of resistant genes and, consequently, as a factor in the dissemination of these genes among enteric pathogens and need to be examined further.
Ampicillin ; Chloramphenicol ; Deoxyribonuclease EcoRI ; Drug Resistance, Multiple ; Escherichia coli* ; Escherichia* ; Feces ; Gentamicins ; Immunodeficiency Virus, Feline ; Kanamycin ; Molecular Biology* ; Molecular Weight ; Plasmids ; R Factors ; Tetracycline ; Trimethoprim Resistance* ; Trimethoprim*

Heart transplantation is an accepted procedure for treatment of end-staged cardiac failure. A return to near-normal quality on life can be expected in many patients with a nonrejecting cardiac allograft, and many of these patients will return to the operating room for noncardiac surgical procedures. Anesthesiologists should be alert to recognizing problems caused by the presence of infection in immunosuppressed patients, modes of presentation of rejection phenomena and how transplanted organs, notably significantly denervated ones, may behave and respond under the pathophysiologic circumstance that arise during surgery, resuscitation and intensive care. The use of regional techniques require adequate preloading to avoid exaggerated hypotension and aseptic technique to avoid infection. Hypobaric spinal anesthesia has some benefit. It does not depress cardiovascular and respiratory system and keep adequate venous return by trendelenberg position. We report herein a case of successfully undergone total hip replacement in a patient who had previously undergone orthotopic heart transplantation under hypobaric spinal anesthesia.
Allografts ; Anesthesia, Spinal* ; Arthroplasty, Replacement, Hip ; Heart Failure ; Heart Transplantation ; Heart* ; Humans ; Hypotension ; Critical Care ; Operating Rooms ; Respiratory System ; Resuscitation

No abstract available.
Cognition*

Pigmented villonodular synovitis is a benign proliferative disorder affecting the synovium. In 1941, Jaffe assembled under the common term of pigmented villonodular synovitis dissimilar lesions described by different names, that issuch as giant cell tumors of synovial tendon sheaths, actual pigmented villonodular synovitis, and villonodular bursitis. (Giant cell tumors of tendon sheaths, which may be localized, most often occurring in fingers, flexor tendons or interphalangeal joints, or diffuse, usually arising in the vicinity of large joints.) Involvement of the temporomandibular joint is very rare. (We report a rare case of pigmented villonodular synovitis of the temporomandibular joint that invaded the mandibular condyle. A 34-year-old man had a large left preauricular (parotid) mass for two years that he had focal facial nerve paralysis, temporal and zygomatic branches. The clinical appearance suggested a parotid tumor. At surgical exploration, a tumor was found to be severely adhered sion to the facial nerve and involving the temporomandibular joint. Histologically, Tthe resected specimen histologically was a proliferative lesion composed of epithelioid histiocytes, spindle cells, and multinucleated giant cells.) The appearance was typical of the family of lesions that includes pigmented villonodular synovitis, bursitis, and tenosynovitis . rewritten as follows: (Giant cell tumors of tendon sheaths, which may be localized, most often occurring in fingers, flexor tendons or interphalangeal joints, and spread to other parts after arising in the vicinity of large joints.) rewritten as follows: (A 34-year-old man had a large left preauricular (parotid) mass for two years and showed focal facial nerve paralysis in the temporal and zygomatic branches. The clinical appearance suggested a parotid tumor. Surgical exploration revealed a tumor that was severely connected to the facial nerve involving the temporomandibular joint. Histologically, the resected specimen was a proliferative lesion composed of epithelioid histiocytes, spindle cells, and multinucleated giant cells.)
Adult ; Bursitis ; Facial Nerve ; Fingers ; Giant Cell Tumors ; Histiocytes ; Humans ; Joints ; Mandibular Condyle ; Paralysis ; Synovial Membrane ; Synovitis, Pigmented Villonodular* ; Temporomandibular Joint* ; Tendons ; Tenosynovitis

No abstract available.
Animals ; Listeria* ; Listeriosis* ; Mice*

Ninety-two strains of Serratia marcescens isolated from 5 hospitals were analyzed for plasmid profile, antimicrobial drug resistance pattern, biotyping, and production of pigment. Ninety-three percents of strains were resistant to chloramphenicol (Cm), tetracycline (Tc), sulfisoxazole (Su), cefazolin (Cz), ampicillin (Ap), and rifampin (Rf). A majority of strains were susceptible to amikacin (Ak), ciprofloxacin (Ci), and cefotaxim (Ct). Fifty-four resistance patterns were found in 94 strains and the most prevalent resistance pattern was CmTcSuApCzRf. Seventeen (17.4%) isolates could transfer their partial resistance to E. coli or Klebsiella pneumoniae by conjugation. Twenty-seven plasmid profiles in 54 strains (58.7%) were detected, however no predominant patterns were seen in isolates from each hospital. Eleven biotypes were detected. The common types were A3b (29.4%) and A8b (27.1%), predominant types were found in each hospital. Twenty strains from 4 of 5 hospitals showed consistence of 3 types. These results indicate that plasmid profile analysis, Grimont biotyping, and resistance pattern type of strains in combination are useful as an epidemiological tool for S. marcescens isolates and some of isolates were confirmed as nosocomial strains.
Amikacin ; Ampicillin ; Cefazolin ; Cefotaxime ; Chloramphenicol ; Ciprofloxacin ; Drug Resistance, Microbial ; Epidemiologic Studies* ; Klebsiella pneumoniae ; Plasmids ; Rifampin ; Serratia marcescens* ; Serratia* ; Sulfisoxazole ; Tetracycline

Eighty-nine isolates of Enterobacter spp. from two university hospitals were analyzed by phenotypic and genotypic characteristics for epidemiologic investigation. Most strains were isolated from sputum, urine, wound, pus and catheter tip. Most isolates of Enterobacter spp. were resistant to ampicillin, cefazolin and cefoxitin and 39% of E. cloacae isolates were also resistant to other cephalosporins and aminoglycoside antibiotics except amikacin but all strains were highly susceptible to imipenem and ciprofloxacin. Twenty-six antimicrobial resistance patterns were obtained from E. clacae, but E. aerogenes showed only 4 patterns. Fourty-two plasmid profiles were identified, but plasmid was not detected from 28.4% of E. cloacae and 58% of E. aerogenes. Six biotypes from E. cloacae and three biotypes from E. aerogenes were obtained by carbohydrate metabolism. Fourteen strains of E. cloacae carried conjugative R plasmids and these plasmids were further analyzed. Among them, ten plasmids showed identical antibiogram, molecular weight, and pI value by isoelectric focusing and nearly identical restriction endonuclease fragment pattern. Their parental strains had identical antibiogram, biotype, plasmid profile, and were isolated from 4 different specimens including 6 catheter tips of different patients. But most clinical isolates showed various types of combination and seemed to be different strains. These results indicate that the epidemic strain were present in this hospital and the combination of antibiogram and plasmid analysis can be used to discriminate the epidemic strains of multi-resistant E. cloacae.
Amikacin ; Ampicillin ; Anti-Bacterial Agents ; Carbohydrate Metabolism ; Catheters ; Cefazolin ; Cefoxitin ; Cephalosporins ; Ciprofloxacin ; Cloaca ; DNA Restriction Enzymes ; Enterobacter* ; Hospitals, University ; Humans ; Imipenem ; Isoelectric Focusing ; Microbial Sensitivity Tests ; Molecular Weight ; Parents ; Plasmids ; R Factors ; Sputum ; Suppuration ; Wounds and Injuries