The arthrodesis of the hip is the only certain method for eliminating pain and providing stability in young and middle aged adults. The first used arthrodesis in old congenital dislocation was reported by Heusner, Lampugnani, and Alert as early as 1885 according to Nove-Josserand. The various papers published on this operation appear to be concerned mainly with surgical methods and the frequency of bone healing, rather than with loss of function and its causes. The purpose of this study is to evaluate function of the arthrodesed hip especially the relationship between position of the hip and its daily use. The author studied arthrodesis of the hip clinically in 89 cases of arthrodesed patients, admitted to the Orthopedic Department of Severance Hospital during the 14 years from June 1957 until May 1970. The auther also studied 40 cases which confirmed sound bony ankylosis of the hip by X-ray examination. The follow-up included a careful inquiry into the patients ability to use the fixed hip in various functions of daily life. The results are as follows. 1. The average age of the patients at the time of operation was 16.9 years and tuberculosis of the hip was the most common cause 83(93%) of arthrodesis. 2. The most common type of operation in this series was intraarticular arthrodesis 67(75.3%), and the fusion rate was relatively good in intra & extraarticular arthrodesis 20(85.5%). 3. The average length of follow-up was 3.9 years. The average position of the arthrodesed hip was 37.7 degrees of flexion, 9.1 degrees of abduction and neutral rotation. Actual shortening of the leg averaged 3.8cm. 4. The gait was poor in the group which had 5cm shortening of the leg and was in 43 degrees of flexion for the arthrodesed hip. 5. The ability to sit and defecate in the ordinary toilet was satisfactory when there was 39 degrees of flexion or more for the arhrodesed hip. 6. 10 patients (25%) had back pain and 12 patients (30%) had mild scoliosis. Average Ferguson angle was 47.8 degrees and the Line of Weight Thrust showed over 40 degrees. 7. The ideal hip position of arthrodiesis in Koreans was assumed to be under 40 degrees of flexion, some degrees of abduction and no rotation.
Adult ; Ankylosis ; Arthrodesis ; Back Pain ; Dislocations ; Follow-Up Studies ; Gait ; Hip ; Humans ; Leg ; Methods ; Middle Aged ; Orthopedics ; Scoliosis ; Tuberculosis

No abstract available.
Blood Group Incompatibility* ; Bromelains*

BACKGROUND: Autoimmune hemolytic anemias are characterized by autoantibodies recognizing antigens on the Individual's own red blood cells, resulting in immune- mediated hemolysis. Blood transfusions have been regarded as hazardous in patients with autoimmune hemolytic anemia (AIHA) because of potential intensification of hemolysis and a presumed high incidence of alloimmunization. METHODS: We examined the pretransfusion and posttransfusion hemoglobin levels in 6 patients with autoantibodies in their sera, which showed panagglutinations with all bloods tested in the compatibility testing. They received 'least' incompatible blood because of inability to find compatible blood. RESULTS: When we compared pretransfusion hemoglobin level with posttransfusion hemoglobin level, in 5 of 6 patients with AIHA, the hemoglobin levels were increased after red cell transfusion. 4 patient who did not respond to transfusion therapy initially had an increase in hemoglobin level after steroid treatment. Any signs or symptoms indicating hemolytic transfusion reaction were not observed ducting the transfusion period in all patients. CONCLUSIONS: The decision to transfuse in AIHA should consider multiple factors including the patient's clinical status, the potential benefit of transfusion, the potential response to other therapeutic modalities, but must never be regarded as contraindicated, even though the compatibility test may be strongly incompatible.
Anemia, Hemolytic* ; Anemia, Hemolytic, Autoimmune ; Autoantibodies ; Blood Group Incompatibility ; Blood Transfusion ; Erythrocyte Transfusion* ; Erythrocytes* ; Hemolysis ; Humans ; Incidence

BACKGROUND: Autoimmune hemolytic anemias are characterized by autoantibodies recognizing antigens on the Individual's own red blood cells, resulting in immune- mediated hemolysis. Blood transfusions have been regarded as hazardous in patients with autoimmune hemolytic anemia (AIHA) because of potential intensification of hemolysis and a presumed high incidence of alloimmunization. METHODS: We examined the pretransfusion and posttransfusion hemoglobin levels in 6 patients with autoantibodies in their sera, which showed panagglutinations with all bloods tested in the compatibility testing. They received 'least' incompatible blood because of inability to find compatible blood. RESULTS: When we compared pretransfusion hemoglobin level with posttransfusion hemoglobin level, in 5 of 6 patients with AIHA, the hemoglobin levels were increased after red cell transfusion. 4 patient who did not respond to transfusion therapy initially had an increase in hemoglobin level after steroid treatment. Any signs or symptoms indicating hemolytic transfusion reaction were not observed ducting the transfusion period in all patients. CONCLUSIONS: The decision to transfuse in AIHA should consider multiple factors including the patient's clinical status, the potential benefit of transfusion, the potential response to other therapeutic modalities, but must never be regarded as contraindicated, even though the compatibility test may be strongly incompatible.
Anemia, Hemolytic* ; Anemia, Hemolytic, Autoimmune ; Autoantibodies ; Blood Group Incompatibility ; Blood Transfusion ; Erythrocyte Transfusion* ; Erythrocytes* ; Hemolysis ; Humans ; Incidence

No abstract available.
Anemia, Megaloblastic* ; Humans ; Megaloblasts* ; Methotrexate*

No abstract available.
Pregnancy*

This study was performed for the patients with benign prostatic hyperplasia who had underlying diseases which increase the risk of spinal or general anesthesia. Standard transurethral resections of prostate were done on patients with prostatic hyperplasia under local anesthesia. The selection criteria were urinary retention or below 10 ml/sec of maximum flow rate, coexist with medical problems which increase the risk of spinal and general anesthesia. Local infiltrations of 1% lidocaine were done at penoscrotal junction on each side of the corpus spongiosum, the lateral portion of the prostate and the bladder neck. This anesthesia was supplemented usually by modest dose of intravenous tranquilizers and analgesics under the continuous monitoring by an anesthesiologist. The Visual Pain Analogue Scale(VAS) was used for the evaluation of intraoperative and postoperative pain. The mean operating time, amount of the resected tissues and intraoperative and postoperative visual analogue scale were 50.2 min, 16 grams. 2.7 and 2.0. We thought that this type of anesthesia was a safe, simple and effective procedure.
Analgesics ; Anesthesia ; Anesthesia, General ; Anesthesia, Local* ; Humans ; Lidocaine ; Neck ; Pain, Postoperative ; Patient Selection ; Prostate ; Prostatic Hyperplasia* ; Transurethral Resection of Prostate* ; Urinary Bladder ; Urinary Retention

Among the causes of pure red cell aplasia, human parvovirus B19 has been shown to be cytotoxic to erythroid progenitor cells in the bone marrow associated with chronic hemolytic anemia with rapidly dividing erythroids and persistently to be suppression of erythropoiesis in immunocompromised individuals related with failure to produce neutralizing antibody to the virus. In a patient with hereditary spherocytosis presenting acute onset of reticulocytopenia during hospitalization, who had shown severe anemia and prodromal symptoms including fever, fatigue and dizziness, infection of parvovirus Bl9 was proven by the presence of IgM and IgG antibodies to parvovirus Bl9, the detection of viral DNA using PCR technique in her serum and the decreased erythroid cells, especially late normoblasts in bone marrow, Also in the other who was diagnosed as hereditary elliptocytosis and complained of fever, headache, abdominal pain and diarrhea, an episode of reticulocytopenia and the nearly absence of late normoblasts in the bone marrow were observed. IgM antibodies to parvovirus Bl9 and the viral DNA were detected in her serum, too.
Abdominal Pain ; Anemia ; Anemia, Hemolytic ; Antibodies ; Antibodies, Neutralizing ; Bone Marrow ; Diarrhea ; Dizziness ; DNA, Viral ; Elliptocytosis, Hereditary* ; Erythroblasts ; Erythroid Cells ; Erythroid Precursor Cells ; Erythropoiesis ; Fatigue ; Fever ; Headache ; Hospitalization ; Humans* ; Immunoglobulin G ; Immunoglobulin M ; Parvovirus B19, Human ; Parvovirus* ; Polymerase Chain Reaction ; Prodromal Symptoms ; Red-Cell Aplasia, Pure

Among the causes of pure red cell aplasia, human parvovirus B19 has been shown to be cytotoxic to erythroid progenitor cells in the bone marrow associated with chronic hemolytic anemia with rapidly dividing erythroids and persistently to be suppression of erythropoiesis in immunocompromised individuals related with failure to produce neutralizing antibody to the virus. In a patient with hereditary spherocytosis presenting acute onset of reticulocytopenia during hospitalization, who had shown severe anemia and prodromal symptoms including fever, fatigue and dizziness, infection of parvovirus Bl9 was proven by the presence of IgM and IgG antibodies to parvovirus Bl9, the detection of viral DNA using PCR technique in her serum and the decreased erythroid cells, especially late normoblasts in bone marrow, Also in the other who was diagnosed as hereditary elliptocytosis and complained of fever, headache, abdominal pain and diarrhea, an episode of reticulocytopenia and the nearly absence of late normoblasts in the bone marrow were observed. IgM antibodies to parvovirus Bl9 and the viral DNA were detected in her serum, too.
Abdominal Pain ; Anemia ; Anemia, Hemolytic ; Antibodies ; Antibodies, Neutralizing ; Bone Marrow ; Diarrhea ; Dizziness ; DNA, Viral ; Elliptocytosis, Hereditary* ; Erythroblasts ; Erythroid Cells ; Erythroid Precursor Cells ; Erythropoiesis ; Fatigue ; Fever ; Headache ; Hospitalization ; Humans* ; Immunoglobulin G ; Immunoglobulin M ; Parvovirus B19, Human ; Parvovirus* ; Polymerase Chain Reaction ; Prodromal Symptoms ; Red-Cell Aplasia, Pure

Recently, the bcl-2 and p53 protein have been recognized as important factors that is contributed to programmed cell death. The objective of this study was to evaluate the prognostic significance of bcl-2 and p53 protein expression in uterine cervical carcinoma. The expression of bcl-2 and p53 in 59 cases of uterine cervical carcinoma (stage IB to IIB) were surgically treated from January 1993 to June 1994. The expression of bcl-2 and p53 was examined by immunohistochemical method using formalin fixed paraffin embedded tissue specimens. The 48 cases were squamous cell carcinoma and 11 cases were adenocarcinoma. The results were as follows: 1. The expression rate of bcl-2 protein was 28.8%(17/59) and there was no significant correlaltion between the expression of bcl-2 protein and the clinicopathologic parameters (histologic type, grade, FIGO stage, cervical invasion depth, lymph node metastasis, parametrial invasion, tumor size, neoadjuvant chemotherapy response, recurrence, survival). 2. The expression rate of p53 protein was 32.2%(19/59) and there was no significant correlation between expression of p53 protein and the clinicopathologic parameters. 3. There was significant correlation between and expression of bcl-2 and p53 protein (P 0.05). In conclusion, bcl-2 and p53 protein are thought to be possible factors in the carcinogenesis of uterine cervical carcinoma and correlate with progression of it. But further study will be required to clarify the role of bcl-2 and p53 in carcinogenesis of the uterine cervix.
Adenocarcinoma ; Carcinogenesis ; Carcinoma, Squamous Cell ; Cell Death ; Cervix Uteri ; Drug Therapy ; Female ; Formaldehyde ; Lymph Nodes ; Neoplasm Metastasis ; Paraffin ; Recurrence ; Uterine Cervical Neoplasms*