We describe a case of an acute heart transplant rejection treated with triple immunosuppression and plasmapheresis, resulting in evidence of improved clinical manifestation and hemodynamics. This case suggests that plasmapheresis may be useful in the treatment of possible acute humoral(vascular) rejection in heart transplantation.
Graft Rejection* ; Heart Transplantation ; Heart* ; Hemodynamics ; Immunosuppression ; Plasmapheresis*

No abstract available.
Carcinoma, Squamous Cell ; Esophageal Neoplasms ; Neoplasm Metastasis

Transient hyperkalemia has been reported to occur in eletric burn patients following intravenous administration of succinylcholine. We have studied the origin of the elevated serum K+ concentration after injection of succinylcholine from both the non-burned area and from the burned area in electirc burn patients. Blood samples for serum K+ measurement were drawn 1,2,3,4,5 and 10 minutes after administration of succinylcholine from both the burned are and the non-burned area in 6 electric burn patients. The following results were obtained: 1) Serum K+ levels increased in the burned group in 3 minutes after injection of succinylcholine. 2) The serum K+ concentration of venous samples from the electric burn area were more increased than from the non-burned area injection of succinylcholine.
Administration, Intravenous ; Burns ; Burns, Electric ; Humans ; Hyperkalemia ; Succinylcholine*

Injuries of the posterior cruciate ligament have almost universally been treated nonoperatively in the past due to indignity of this complex structure. Recent studies have shown new informations on the anantomical, histological, biomechanical characteristics of the Posterior cruciate ligament PCL), and thereby interest of reconstruction surgery is increasing. But intraarticular PCL reconstruction still remains one of the most challenging problems in knee surgery. Although, various types of graft and surgical techniques have been used for reconstruction, results of surgery has been variable. In this study, three different methods of graft fixation for PCL reconstruction are evaluated biomechanically to determine the effect on mechanical property of reconstructed PCL using 30 porcine knees. Grafts used in this study were bone-patellar tendon-bone fixed with interference screw and Achilles tendon tied with suture. Additionally, five original PCLs were also tested by Instron universal testing instrument to determine its mechanical proprety. Tensile test was performed at extended knee position. It was demonstrated that mechanical strength of bone-patellar tendon-bone graft is superior to that of Achilles tendon graft. All of the failures of bone-patellar tendon-bone graft and Achilles tendon graft occurred at tibial fixation site whereas original PCLs which failed at proximal midsubstance of ligament. In conclusion, tensile strength of Bone-patellar tendon-bone graft used for PCL reconstruction is higher than that of Achilles tendon but latter can be used in terms of as clinical meanings.
Achilles Tendon ; Bone-Patellar Tendon-Bone Grafts ; Knee ; Ligaments ; Posterior Cruciate Ligament* ; Sutures ; Tensile Strength ; Transplants*

Syphilis was known to be generalized disease and it had been decreased until 1960's. But, it has been increased again recently. The author analysed the 22 cases of congenital syphilis which were treated at department of orthopaedic surgery at Ewha Womans University Hospital from Jan. 1979 to July 1983 and the following results were obtained. 1. There were no significant changes of the number of patient by years. 2. Common symptom and sign were hepatosplenomegaly(84%), fever(62%) and skin changes(50%), and pseudoparalysis was observed in one case. 3. Radiologic bone changes were observed in 11 cases (50%) and the following results were obtained: a. Below the two week old, there was relatively low incidence of bone change with 22%. b. There was high incidence of bone change in prematurity with 75%. c. Common features of bone changes were periosteal reaction, osteochondritis and metaphysitis (91%). Pathologic fracture was observed. in one case. 4. Although we have observed the bone changes only in 50% of cases, all the other reports has reported more than 80% and we thought that radiologic bone change would aid the diagnosis of congenital syphilis.
Clinical Study ; Diagnosis ; Female ; Fractures, Spontaneous ; Humans ; Incidence ; Osteochondritis ; Skin ; Syphilis ; Syphilis, Congenital

No abstract available.
Age of Onset ; Psoriasis

Pulmonary thromboembolism (PTE) is a significant cause of death in the hospitalized patient in the western and developed countries. The development of PTE and venous thrombi is associated with many and various factors, including that physicians fail to provide adequate prophylaxis to the high risk patients. The authors studied 74 legal autopsy cases performed from 1996 to 2000 at the Headquarters of National Institute of Scientific Investigation, Seoul, Korea. We learned that ceasarian section was the most common precedong trauma in PTE death in legal cases. Excluding Ceasarian section cases, major mechanical injuries, male gender and aging were common factors associated with PTE. Obesity was a common factor in all kinds of trauma. Deep vein thrombi were documented in majority cases and ambulation was a critical triggering cause for the thrombi making PTE. Clinical diagnosis was not so satisfactory.
Aging ; Autopsy* ; Cause of Death ; Developed Countries ; Diagnosis ; Humans ; Korea ; Male ; Obesity ; Pulmonary Embolism ; Seoul ; Veins ; Walking

In order to investigate the efficacy and safety of oral fosinopril, a new phosphorus containing angiotensin converting enzyme inhibitor, a single dose of 10 to 20mg was administered in 23 hypertensive patients with diastotic blood pressure above 95mmHg and all other anti-hypertensive agents were not administered during 4 weeks of study. Blood pressure and heart rate were measured on the 2nd and 4th week of therapy. The complete blood count with platelet count, blood chemistry by SMA-12 and serum electrolytes were performed at the begining and 4th week of therapy. The urinalysis and electrocardiography were performed at the beginning and 4th week of therapy. Any kinds of side effects were actively questioned by the examining physicians. The following results were obtained : 1) At the beginning and 4th weeks of therapy, the average systolic and diastolic pressure were 170.0+/-17.6/101.6+/-6.1mmHg, 142.7+/-15.1/87.3+/-6.7mmHg respectively. The systolic and diastolic blood pressure were declined statistically significantly(p<0.05) throughout the period of treatment and diastolic blood pressure of all subjects except 3 patients(86%) was maintained below 90mmHg after 4th week of treatment. 2) There was no significant change in the pulse rate before and after therapy. 3) There were no significant changes in blood chemistry, serum electrolytes, hematologic findings, urinalysis and electrocardiographic findigns. 4) side effect were developed in 5 patients(23%) with dry cough, 3 patients(13%) with headache and 2 patients with facial edema but side effects were mostly mild in nature without potenitally serious episodes. These results suggested that antihypertensive therapy with onec-daily fosinopril was effective and well tolerated in essential hypertensive patients.
Antihypertensive Agents ; Blood Cell Count ; Blood Pressure ; Chemistry ; Cough ; Edema ; Electrocardiography ; Electrolytes ; Fosinopril* ; Headache ; Heart Rate ; Humans ; Hypertension ; Peptidyl-Dipeptidase A ; Phosphorus ; Platelet Count ; Urinalysis

This preliminary study was intended to clarify the effect of intraoperative fluid therapy on Acid-Base balance of the use of Hartmann's solution and 5% Dextrose solution. The arterial carbon dioxide partial pressure and oxygen partial pressure and pH are basic indices of the adequacy of ventilation in anesthetized patients, respiratory care and intensive care. In order to achieve this goal, the data collections were done at the Department of Anesthesia in Hanil Hospital from Mar., 1980 to Aug., 1980. The samplings, 20 cases, were included A.S.A. class I and II. We used 1,500 to 1,800cc/2hrs. of Hartmann's solution and 1,000cc/2hrs, of 5% Dextrose solution each 10 patients through the operative period. Observations were made for the followings; pH, PaCO2HCO-3. From the results of this study, there were no significant relationship between the use of 5% Dextrose solution and Hartmann's solution on Acid-Base balance during the intraoperative period.
Acid-Base Equilibrium* ; Anesthesia ; Carbon Dioxide ; Critical Care ; Fluid Therapy* ; Glucose* ; Humans ; Hydrogen-Ion Concentration ; Intraoperative Period ; Oxygen ; Partial Pressure ; Ventilation

Total hip arthroplasty for ankylosed hip has a higher risk of failure due to the poor condition of the hip abductors and the altered configuration of the bone, which lead to poor positioning or fixation of the prosthesis. Fifty-one hips (42 patients) converted to total hip arthroplasty between March 1983 and March 1994 have been reviewed three to thirteen years six months after operation. The average period of follow-up was four years nine months. Twenty six of the patients were men and sixteen were women. The average age at the time of operation was 40 years old (range,19 to 70 years). Among the 51 hips, bony ankylosis were 27 hips and fibrous ankylosis were 24 hips, spontaneous ankylosis were 40 hips and surgical ankylosis were 11 hips. The duration of hip fusion was 13 years six months in the bony ankylosis and 16 years one month in the fibrous ankylosis. Preoperatively 33 cases had low back pain, ipsilateral or contralateral knee or hip pain. In asymptomatic 18 cases, conversion total hip arthroplasty was also performed for the management of functional disabilities due to severe malpositioned ankylosis. At the time of the last follow-up, 25 cases were free from pain and six patients had a mild degree pain on the hip, knee or thigh. In bony ankylosis, the postoperative average hip motion ranged from 1.1 degrees to 93.2 degrees (average arc of motion of 92.1 degrees). In fibrous ankylosis, the postoperative average hip motion ranged from 1.7 degrees to 96.6 degrees (average arc of motion of 94.9 degrees). The average Harris hip score was improved from 66 to 86.9 in bony ankylosis and from 49 to 89.5 in fibrous anklyosis. The postoperative leg length discrepancy was 1.1 cm in average. The postoperative complications included heterotropic ossification in 25 cases (49%), cup loosening in two cases (3.9%) and stem loosening in three cases (5.6%). As for the clinical results, 24 cases (89%) of bony ankylosis and 23 cases (96%) of fibrous ankylosis had satisfactory functional results at the last follow-up. In conclusion, the conversion total hip arthroplasty could provide functional improvement, pain relief and especially correction of leg length discrepancy in most cases of ankylosed hip.
Adult ; Ankylosis ; Arthroplasty, Replacement, Hip* ; Female ; Follow-Up Studies ; Hip* ; Humans ; Knee ; Leg ; Low Back Pain ; Male ; Postoperative Complications ; Prostheses and Implants ; Thigh