This paper aimed to examine the debate over the fertility decline in the German Empire, focusing on the role of the SPD. During the German Empire, the fertility rate dramatically declined and the growing awareness of a continuous decline in the birth rate prompted a massive debate among politicians, doctors, sociologists, and feminist activists. The fertility decline was negatively evaluated and generated consciousness of crisis. However, it was not the only way to face this new phenomenon. Indeed, the use of birth control among the upper class was interpreted as a part of a modernizing process. As the same phenomenon reached the working class, it suddenly became a social problem and was attributed to the SPD. The debate over the fertility decline in imperial German society ridden with a fierce class conflict was developed into a weapon against the SPD. Contrary to the assumption of conservative politicians, the SPD had no clear-cut position on this issue. Except for a few politicians like Kautsky and the doctors who came into frequent contact with the workers, the "birth strike" was not listed as the main interest of the SPD. Even Clara Zetkin, the leader of the Social Democratic women's organization viewed it as a concern of the individual person which could not be incorporated in the party program. The women's organization of the SPD put priority on class conflict rather than issues specific to women. As a result, the debate over the birth rate decline within the SPD was not led by the women themselves. There could have been various means to stimulate the birth rate. Improvement in the welfare system, such as tax relief for large families, better housing conditions, and substantial maternity protection, could have been feasible solutions to the demographic crisis. However, Germany chose to respond to this crisis by imposing legal sanctions against birth control. In addition to paragraphs 218-220 of the German criminal law enacted in 1872 which prescribed penal servitude for anyone who had an abortion or people who helped to practice it, Paragraph 184.3 of the civil code was enacted in order to outlaw the advertising, display, and publicizing of contraceptives with an 'indecent' intention, although selling or manufacturing contraceptives was not forbidden. Such a punitive approach was especially preferred by the government and conservative parties because it was easy to implement and "cheap" in comparison with the comprehensive social welfare program. What made the SPD different from other conservative parties was the fact that the SPD opposed the government's attempt to prohibit contraception by means of strengthening a penal code. According to the SPD, it was not only morally unacceptable, but also technically impossible for the government to intervene in family limitation. Moreover, politicians from the SPD criticized that such a punitive policy targeted the working class because the upper echelon of the society could easily evade the ban on contraceptives. However, the SPD did not proceed to draft comprehensive social welfare measures in order to fight the fertility decline. The miserable condition of working class women remained as an invisible social phenomenon even within the SPD. The German women who could not find the proper means to practice contraception were driven to have abortions. Annually, hundreds of the women were accused of practicing abortion and imprisoned. In sum, German society ran about in confusion and did not know how to properly respond to the unprecedented decline in fertility. By defining the fertility decline just as a social disease due to moral decay and influence of socialism, German society lost a chance to rationalize itself. Given that women, the main actors, had no way to take part in the debate over this issue, it is not surprising that German society fought against the symptom of the disease, not against its root.
Abortion, Induced/history/legislation & jurisprudence ; *Birth Rate ; Contraception/history ; Family Planning Policy/*history ; Female ; Germany ; History, 19th Century ; History, 20th Century ; Humans ; Politics ; Social Welfare/economics/history

No abstract available.
Peripheral Arterial Disease*

In 1960 Jacobson and Suarez introduced the operating microscope to vascular surgery and demonstrated the superiority of small vessel repair using magnification. The first clinical replantation of an arm in the western world was performed by Malt in 1962, and Komatsu and Tamai reported the successful replantation of a completely amputated thumb in 1965. To perform a digit or hand replantation, microsurgical anastomosis of blood vessels is absolutely essential to revascularize the severed part. Without accurate repair of bone, nerves and tendons in addition to vascular anastomosis, however, it is impossible to gain functional success when replanting a digit or hand. This is a difficult task because all structures must be reconstructed at the same level and time. Even if the repair of some structures has been postponed, the secondary reconstruction may also be troublesome due to circular scarring at the replantation level. Since replantation surgery has been popularized throughout the world in recent years, the replantation sucess rate has increased and the surgeons interest in functional reconstruction of replanted digits or hands has been stimulated. The authors have seen and studied 6 cases of upper Jimb and 20 cases of finger replantation from May, 1980 through January, 1982 at the department of orthopedic surgery, Yonsei University College of Medicine. The results were as follows: I. The average age was 20 years and the male to female sex ratio was 4.5:1. 2, The causes of injury are detailed as follows: electric saw(6); cutting machine(5); roller(4}; presser(2); stone(2); others(3). 3. The level of amputation in 26 replantations was as follows: thumb, 3 cases; index finger, 4 cases; middle finger, 9 cases; ring finger, 4 cases; palm, I case, wrist, 3 cases; forearm, 1 case; upper arm, 1 case. 4. The maximum ischemic times for successtul results were 16 hours in limb replantation and 22 hours in finger replantation. 5. Six limbs, with four complete and two incomplete amputations, have been replanted and all six limbs survived: Twenty digits, with nine complete and eleven incomplete amputations, have also been replanted and 6.5 cases of nine complete amputations and 10 cases ot eleven incomplete amputations survived. A total of 22.5 cases(86.5%) of replanted limbs and digits survived. 6. The results of joint motion, two point discrimination, sensory recovery and status of sweating due to recovery ot sympathetic nervous function following replantation were satisfactory. 7. In the early stage of our series, postoperative systemic heparinization was used in some cases, but recently we have achieved good recults without it. 8. Main causes of reattachment failure were tissue crushing and secondary thrombosis of the anstomosed vessels.
Amputation ; Arm ; Blood Vessels ; Cicatrix ; Clinical Study ; Discrimination (Psychology) ; Extremities ; Female ; Fingers ; Forearm ; Hand ; Heparin ; Humans ; Joints ; Male ; Orthopedics ; Replantation ; Sex Ratio ; Surgeons ; Sweat ; Sweating ; Tendons ; Thrombosis ; Thumb ; Western World ; Wrist

No abstract available in English.
Clinical Study ; Spondylolisthesis

Buerger's disease was first identified in 1908 by Leo Buerger as a distinct clinicopathological entity, which causes severe pain and necrosis on distal parts of the extremities and occurs especially in young male adults. In spite of many treatment modalities, it is not completely cured but results in amputation in the long run. So, we studied a total of 120 cases of Buerger's disease, who were admitted at Yonsei University, Severance Hospital from Jan., 1975 to June, 1985 and we obtained the following results. 1. All the patients were male and majority of them were under 40 years of age (69.2%). 2. 118 cases were smokers and 2 cases were non-smokers. 3. The initial symptoms were resting pain, necrosis, and color change in descending order of frequency. 4. Diagnoses were made mainly by angiogram(75.8%) and most common site of obstruction was popliteal artery (49.4%). 5. After sympathectomy and angioplasty, there was temporary relief of symptoms, but none showed good results after long term follow up. As a result, amputations were performed after sympathectomy in 47 cases(39.2%), of which 36 cases(76.6%) received that surgery within 2 yeas after sympathectomy. 6. The pressure index not only helps diagnose the disease but also is a very useful method to objectively assess the severity of the initial symptoms and postoperative results.
Adult ; Amputation ; Angioplasty ; Clinical Study ; Diagnosis ; Extremities ; Follow-Up Studies ; Humans ; Male ; Methods ; Necrosis ; Popliteal Artery ; Sympathectomy ; Thromboangiitis Obliterans

The spine is the most common site of metastatic cancer in the skeletal system. Managment of the lesion site due to the relation of the spinal cord or nerve root and post-operative treatment present coplicated and difficult problems. One hundred and ninety-three cases of metastatic cancer of the spine were seen and treated during the 5 year period from January 1981 to December 1985 in the Department of Orthopedic Surgery, Severance Hospital Yonsei University, College of Medicine in Seoul, Korea. This study was based on the clinical symtoms, radiological studies, laboratory studies, and tissue pathology of selected cases. Most of cases were treated by chemotherapy, radiation therapy, and hormonal therapy in selected terminal cases. In cases of intractable pain and neurological deficit, surgical intervention is advocated for relief of pain and to improve nursing care and daily activity. Unfortunately in Korea most patients and families refuse surgical intervention, the main reason being that surgery can not cure the disease itself. The results of the study lead us to conclude that; The incidende of spinal metastasis was 31.8% of the metastatic lesions of all skeletal systems, and was almost equally distributed in males and females l. 14: l. The primary site of the tumor was in decreasing order lung (25.9%), breast(9.8%), cervix of the uterus(6.7%), stomach(5.7%), liver(5.3%), kidney(3.7%), thyroid(3.7%), prostate(2.6%), bladder(2.6%), rectum(2.0%), ovary(1.0%), pancreas(1.0%), skin(1.0%), colon(0.5%), larynx(0.5%), and unknown origins (27.5 %). The peak age of the patient was the 7th decade in males and the 6th decade in females. The prominent clinical symtom was diffuse back pain (79.0%) which was characteristically worse in a resting position especially at night. The most significant laboratory finding was an elevated serum alkaline phosphatase in 28% of the cases. The predilection site of metastasis was the thoraco-lumbar junction. Diagnostically a whole body bone scan was more sensitive than a plain film.
Alkaline Phosphatase ; Back Pain ; Cervix Uteri ; Drug Therapy ; Female ; Humans ; Korea ; Lung ; Male ; Neoplasm Metastasis ; Nursing Care ; Orthopedics ; Pain, Intractable ; Pathology ; Seoul ; Spinal Cord ; Spine

Tuberculosis of the bones and joints is not an uncommon condition in Korea, but extraosseous tuberculosis of the soft tissue is relatively rare. A few reports of extraosseous tuberculosis, tuberculous tenosynovitis and bursitis, hsve been published in the literature, but there have been no reports concerning soft tissue tuberculosis in other than the tendon, synovium and bursa. We reviewed 7 cases of soft tissue tuberculosis of the lower back at the Department of Orthopedic Surgery, Yonsei University College of Medicine from Jan. 1984 to Sept. 1986. Five cases had received steroid injection to the lumbosscral region, and two had undergone acupuncture, thus all seven cases had experienced injections to the lumbosacral region. We think that a possible route of infection is the hematogenous one, at an area of decreased local resistance after steroid injection, And that direct inoculation of the tuberculous bacilli was result of artificial injection and acupuncture. But, further studies are needed to support the proposal that the hematogenous route following steroid injection and direct inoculation by artifical puncture is the source of soft tissue tuberculosis. These results indicate that steroid injections into the soft tissue should be performed limitedly under sterile conditions.
Abscess ; Acupuncture ; Bursitis ; Joints ; Korea ; Lumbosacral Region ; Orthopedics ; Punctures ; Synovial Membrane ; Tendons ; Tenosynovitis ; Tuberculosis

Simple bone cyst is a benign bone tumor occurring most frequently in the long bone. The pathogenesis is not yet fully known and there is no established mode of optimal treatment. In 1979, Scaglietti reported favorable results in the treatment of simple bone cyst with steroid injection. We have studied 23 cases of curettage with bone graft and 13 cases of steroid injection in 39 cases of histologically proven simple bone cyst in the department Orthopedic Surgery at College of Medicine Yousei University dating from Jan, 1970 to Jan. 1989. In 1 case out of 23 cases, there was no improvement in curettage with bone graft, and this cases was treated with steroid injection. There were 4 cases which did not receive any treatment except cast immobilization. In this case, the patient refused further treatment. The mean follow up period was 20.1 months and the results and conclusions were as follows:1. The average age of patients was 17.9 years, and incidence under 20 years was 74.4% The male to female ratio was 1.6 to l. 2. Twenty three cases were treated with curettage with bone graft. The average age of patients was 16.1 years, and there were 4 cases of recurrence of simple bone cyst (17.3% ). 3. Thirteen cases were treated with steriod injection. The average age of patient was 12.1 years, and there was 1 case of recurrence of simple bone cyst(7.6%). There were 6 cases who were completely healed after one steroid injection, 3 cases after 3 injections, 1 case after 4 injection, and 3 cases who had a maximun of 5 injections. 4. The difference was statistically significant from equality (p<0.05). The steroid injection method is a more simple and a more safe procedure than curettage with bone graft, and can be done at the Out-Patient Department. Steroid injection may be repeated in persisting and recurrent simple bone cyst.
Bone Cysts ; Curettage ; Female ; Follow-Up Studies ; Humans ; Immobilization ; Incidence ; Male ; Methods ; Orthopedics ; Outpatients ; Recurrence ; Transplants

Because of the extremely limited potential of damaged articular cartilage for either repair or regeneration, and the fact that prosthetic joint replacement is contraindicated for children and young adults due to wear, loosening and mechanical failure of the artificial joint, there is a need for biologieal resurfacing of large, full-thickness defects in diseased or damaged joints by transplantation of a tissue with significant chondrogenic potential. The purpose of this study was to investigate the chondrogenic potential of free intra-articular autografts of the perichondrium or periosteum under the influence of joint motion, to characterize the newly formed cartilage, and to determine which is the more effective method to repair the articular defect. In a rabbit model, rib perichondrium and rib periosteum were used to repair full-thickness defects in the femoral condyle. The newly formed tissue was then evaluated grossly, histologically and histochemically at four, eight and twelve weeks after grafting. Successful grafts of the perichondrium or periosteum proliferate to fill the full-thickness articular cartilage defect with neocartilage which produces glycosaminoglycans in the matrix, as demonstrated by the uptake of saframin O. This production of a large amount of glycosaminoglycans in the reparative tissue is similar to that of hyaline cartilage. Unacceptable results were obtained in 38% of the perichondrial grafts, and in 32% of the periosteal grafts. These failures were due to femoral condyle fractures, and detachment of the grafts or failure of proliferation of the grafts. There was no statistically significant difference between the final results of the perichondrial and periosteal grous(p>0.1). The technique of grafting must be improved to increase the rate of successful grafts in which neocartilage resembling hyaline cartilage fills the articular cartilage defect. The positive results of the present experimental investigation prove that biological resurfacing of full-thickness defects in osteoarthritis, especially of small joints, may be clinically possible through the use of free autogenous perichondrial or periosteal grafts. Such biological resurfacing would be a valuable alternative to prosthetic joint replacement, especially in the treatment of children and young adults.
Autografts ; Cartilage ; Cartilage, Articular ; Child ; Glycosaminoglycans ; Humans ; Hyaline Cartilage ; Joints ; Methods ; Osteoarthritis ; Periosteum ; Regeneration ; Ribs ; Transplants ; Young Adult

OBJECTIVE: Perinatal hemorrhagic stroke (PHS) is common cause of cerebral palsy, congenital hemiparesis, and subsequent behavioral, cognitive, and language problems. Despite of this importance, risk factors for this condition have not been studied. This study was undertaken to survey the clinical features and risk factors of PHS. METHODS: A retrospective study was carried out on 24 newborns with PHS who were admitted to the neonatal intensive care unit (NICU) of Daegu Fatima hospital from January 2004 to July 2009. Cases of PHS in neonates (28 weeks' gestational age through 28 days of life) were identified through neuroimaging studies, clinical findings and chart review. Two controls per case were randomly selected. Risk factors of PHS were assessed and clinical features of PHS were reviewed. RESULTS: We identified 24 cases of PHS (19 intracerebral hemorrhage, 4 intracerebral hemorrhage with subarachnoid hemorrhage, 1 subarachnoid hemorrhage). PHS was more common in male (15 males and 9 females). Case presented with encephalopathy (100%), seizures (20.8%) and cyanosis (4.2%). The neuroimaging findings of PHS were more commonly unilateral (78.3%), and right-hemisphere (73.9%). PHS was most often seen in temporal lobe (38.2%). There were no statistical and significant risk factors of PHS. CONCLUSIONS: Newborns with PHS typically present with encephalopathy (lethargy, hypotonia, apnea, feeding disability) and seizures. The neuroimaging findings were more commonly unifocal, unilateral and seen in temporal lobe. Additional prospective studies are needed to determine the prevalence and risk factors of PHS.
Apnea ; Cerebral Hemorrhage ; Cerebral Palsy ; Cyanosis ; Gestational Age ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn ; Intensive Care, Neonatal ; Male ; Muscle Hypotonia ; Neuroimaging ; Paresis ; Prevalence ; Retrospective Studies ; Risk Factors ; Seizures ; Stroke ; Subarachnoid Hemorrhage ; Temporal Lobe