No abstract available.
Hyperparathyroidism, Primary*

The cement-free hip prosthesis coated with hydroxyapatite was developed to obtain primary firm fixation by an enhanced anatomic design and secondary biologic stable fixation by hydroxyapatite which is bioactive and has the same chemical and structural components with those of human bone tissue in total hip arthroplasty. Between January 1992 and June 1994, we used ABG cement free hip prosthesis (Anatomique Benoist Giraud, Howmedica Europe, Staines, England) in 28 hips (avascular necrosis of femoral head; 17, osteoarthritis; 6, posttraumatic arthritis; 3, rheumatoid arthritis; 2) of 25 patients in Pusan National University Hospital. Those cases had a minimum of two years and maximum of four years and five months (average three years and six months) of follow up, including analysis of the clinical and radiological data. The results were obtained as follows: 1. The average Modified Harris Hip Score increased from 51 points preoperatively to 96 points at last follow up. Almost all cases (97%) were excellent or good results in Modified Harris Hip Score. 2. In radiologic results, no migration of the cup, no change in the inclination of the cup, ar.d no oste-olysis around the cup and the stem were observed. Endosteal bone apposition around the cup was found in 54% of the cases and subcortical cancellous densification around the stem was found in 89%. This results indicate that we obtained direct and biologic firm fixation without fibrous tissue interposition between bone and metallic component by inducing on-growth of bone. 3. In the radiologic follow up according to the initial bone quality, it was demonstrated that the incidences of cortical hypertrophy, calcar resorption, and radiolucent line in type B and type C were higher than those in type A. The early clinical and radiological results of the cement-free hip prosthesis coated with hydroxyapatite are encouraging, although a longer follow up period is necessary.
Arthritis ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Hip* ; Bone and Bones ; Busan ; Durapatite* ; Europe ; Follow-Up Studies ; Head ; Hip ; Hip Prosthesis ; Humans ; Hypertrophy ; Incidence ; Necrosis ; Osteoarthritis

No abstract available.

BACKGROUND: Early diagnosis and proper therapy of malfunctioning prosthetic heart valves remain a challange. Transthoracic echocardiography(TTE) is the diagnostic procedure of choice for the evaluation of malfunctioning prosthetic heart valves. Howerver, TTE may be limited owing to poor acoustic windows. Some of these limitations can be overcome by transesophageal echocardiography(TTE). METHODS: The study comprised 33 consecutive patients(20 male and 13 famale patients, age range 20 to 59) in congestive heart failure after remote mitral valve replacement with bioprosthesis. The patients were examined between 1987 and 1994. All the 33 patients were studied by TTE and 19 patients among these patients furthermore by TEE. The morphology of the explanted bioprosthesis was confirmed by surgery in all cases. RESULTS: The abnormalities of the bioprosthesis were diagnosed correctly by TTE in 32 cases. The more detailed morphology of the valves could be observed by TEE(19 cases). Only in one case a small thrombus in left atrium was overlooked in TTE examination, on the otherhand it was detectedd by TEE. The severity grade of mitral regurgitation was estimatedca. I' severer by TEE in 8 cases. In all TEE examination spontaneous echocontrast was observed in left atrium. The bioprostheses from CE(Carpentier-Edwards) showed higher tendency to cuspal tearing and perforation. CONCLUSION: TTE is the diagnostic procedure of choice on patients with bioprosthetic mitral valve replacement. TTE examination confirms immediately clinical diagnosis of bioprosthetic failure. The transesophageal approach promises more detailed informations about lesions of the degenerated bioprosthetic valves and left atrium.
Acoustics ; Bioprosthesis ; Diagnosis* ; Early Diagnosis ; Echocardiography, Transesophageal* ; Estrogens, Conjugated (USP)* ; Heart Atria ; Heart Failure* ; Heart Valves ; Humans ; Male ; Mitral Valve Insufficiency ; Mitral Valve* ; Thrombosis

It has been widely accepted that complete surgical resection of hepatoblastoma is essential for long-term survival. But unfortunately less that 50% of hepatic tumors in children can be totally removed at the time of diagnosis. This report is to present the experience of successful resection of hepatoblastoma after concurrent radiotherapy with transarterial chemoinfusion in a child. We believe this modality of treatment enables complete resection of unresectable hepatoblastoma, which is resistant to the systemic chemotherapy.
Child ; Diagnosis ; Drug Therapy ; Hepatoblastoma* ; Humans ; Radiotherapy*

Transhiatal gastric transpositions were performed in two case of long gap esophageal atresia without tracheoesophageal fistula. The patients were a 12 months old female and an 18 months old male. Stamm type gastrostomies were performed at other hospitals in both cases. The stomach was mobilized preserving the right gastric artery, the right gastroepiploic artery and spleen. The proximal and distal esophageal pouches were excised by transcervical and transhiatal route, respectively. The mobilized stomach was pulled up to the neck through esophageal hiatus and posterior mediastinal route. The esophagogastrostomy, the only one anastomosis of this procedure, was performed in the neck. There was no clinical evidence of anastomotic leakage, stricture, regurgitation, difficulty of gastric emptying, hoarseness or respiratory problem. Transhiatal gastric transposition seems to be a safe and easy alternative surgical procedure for esophageal replacement in long gap esophageal atresia.
Anastomotic Leak ; Arteries ; Constriction, Pathologic ; Esophageal Atresia* ; Female ; Gastric Emptying ; Gastroepiploic Artery ; Gastrostomy ; Hoarseness ; Humans ; Infant ; Male ; Neck ; Spleen ; Stomach ; Tracheoesophageal Fistula

Hemolytic disease of newborn due to Rhesus incompatibility occurs mostly by anti-Rh(D) antibodies. But recently, because of Rh(D) immune globuin prophylaxis, Rh(D) incompatibility is decreased and importance of minor group incompatibility is increasing. The majority of minor blood group incompatibilities are anti-c, anti-E or anti-Kell, but hemolytic diseases caused by combination of these antibodies are relatively rare. The 21 day-old male neonate was admitted because of pallor and poor feeding for 2 days. Laboratory data showed severe normochromic and normocytic anemia with increased reticulocyte and bilirubin. Patient's and his mothers blood type was B, Rh(D) positive. Minor blood groups of mother's and sons were different and anti-c and anti-E antibody were detected in mother's serum. After transfusions of two times with anti-c and anti-E free B, Rh(D) positive blood, the baby was discharged at 11th hospital day with good general condition.
Anemia ; Antibodies ; Bilirubin ; Blood Group Antigens ; Blood Group Incompatibility ; Erythroblastosis, Fetal ; Humans ; Infant, Newborn* ; Male ; Mothers ; Pallor ; Reticulocytes

BACKGROUND: Antihypertensive effect and safety of the newer, long acting, nonsulfhydryl angiotensin converting enzyme inhibitor, lisinopril, were studied. METHODS: Twenty eight patients of mild to moderate essential hypertension were administered 10-20mg of lisinopril once daily for ten weeks. Patients were evaluated every two weeks concerning the changes of blood pressure and pulse rate in the sitting position and also any untoward sumptoms and signs attributable to the side effect. Chest X-rey, ECG and laboratory examination were performed in principle two times before and after the completion of medication. RESULTS: The blood pressure declined from 165.4/107.6mmHg to 141.3/92.4mmHg at the end of ten weeks of medication, thus the reduction of 24.1mmHg of systolic pressure and 15.2mmHg of diastolic pressure were observed and the overall effective rate was 85.7%. The pulse rate and laboratory findings were not sigificantly changed before and after the administration of lisinopril. The side effects were observed in 2 cases(7.1%) of mild dry cough and in 2 cases(7.1%) of transitory mild headache and in 1 case(3.6%) of dizziness but no one discontinued medication due to adverse effects. CONCLUSION: Lisinopril proved effective and safe in the treatment of mild to moderate essential hypertension.
Blood Pressure ; Cough ; Dizziness ; Electrocardiography ; Headache ; Heart Rate ; Humans ; Hypertension* ; Lisinopril* ; Peptidyl-Dipeptidase A ; Thorax

Scapular fractures are being seen with increasing frequency in our mechanized society, specially in patients who have multiple injuries. Most of the scapular fractures have been treated non-operatively, with early mobilization of the shoulder. The result of such functional treatment have been predictably good. However, this non-operative approach may not yield such good results in patients who have a fracture of the scapular neck in association with the ipsilateral clavicular fracture or other double disruptions of the superior shoulder suspensory complex. Ipsilateral fractures of the scapular neck and clavicle disrupt the suspensory mechanism of the shoulder resulting in fuctional loss and deformity. From January 1989 to June 1995, twelve patients were identified with this specific pattern of injury. The follow up period was 39.2 months in average. Seven patients were treated operatively using 3.5mm DCP or reconstruction plate, and five patients were performed K-wire fixation or wiring. Upon review all were healed radiographically. According to the scoring system of Rowe, five patients had an excellent fuctional result, five had a good result, and two had a fare result. The average score for the twelve patients was 85 points. The results of our retrospective study show that operative treatment for these complex fractures is safe and that functional recovery is predictably good.
Clavicle* ; Congenital Abnormalities ; Early Ambulation ; Follow-Up Studies ; Humans ; Multiple Trauma ; Neck* ; Retrospective Studies ; Shoulder

PURPOSE: The megacolon after repairing an anorectal malformation is not a rare complication, and there is much controversiy on the causes, the treatment of choice and the results after a longterm follow-up. We present 5 cases of a megacolon after the repair of an anorectal malformation, which were controlled with either a surgical resection or conservative treatment. METHODS: Five patients with a megacolon after the repair of an anorectal malformation were studied. A retrospective chart review was done and fecal continence was evaluated with an individual interview. RESULTS: All five patients initially underwent conservative treatment with laxatives and/or enemas. One Patient responded well to conservative treatment and the diameter of the bowel reduced to normal size. Another patient responded to conservative treatment after correcting the location of the anus. Three patients needed a surgical resection and one of those needed a further procedure to correct the anal location. After the surgical resection of the megacolon and/or correction of the anus (one out of the three patients), they soon reported an almost normal bowel habit. CONCLUSION: The first step in treating a megacolon after repairing an anorectal malformation was conservative treatment. However patients without an adequate response to conservative treatment are best managed with a surgical resection. The cause of the megacolon is now under investigation and the lack of adequate management after repair is one of the subjects.
Anal Canal ; Enema ; Follow-Up Studies ; Humans ; Laxatives ; Megacolon* ; Retrospective Studies