Acetabular bone deficiencies encountered during the revision hip arthroplasties should be recon- structed to provide the implant stability and to restore the normal center of rotation of hip and the leg length. We revised the loosened acetabular cup by grafting fresh-frozen bulk femoral head and inserting uncemented cup in 17 hips of 15 patients. The average follow-up period was 2 years and 3 months. The acetabular bone deficiencies were type 2A in 6 hips, type 2B in 8, type 3A in 1 and type 3B in 2 by Paprosky's classification. Three blocks of femoral head were grafted in 3 type 3 deficiencies, but only one in type 2 deficiencies. The cup-host bone contact was 41% on the average. However, the cup-host bone contact in the zone I was present only in 12 out of 17 hips and its average was 14%. Incorporation of the allograft into the host bone occurred between 5 months and 1 year and 7 months (average, 8,6 months) after revision surgery. Significant radiographic loosening sign was noted only in 2 hips which had not only type 3B bone deficiencies reconstructed with 3 blocks of femoral head allograft but also no cup-host bone contact in zone I . The bulk allograft of fresh-frozen femoral head demonstrated acceptable results in type 2 acetabular bone deficiencies, although the follow-up period was relatively short. Reconstruction of type 3B acetabular bone deficiencies by using multiple blocks of femoral head allograft had been failed. We presumed that the lack of the graft stability and the intimate contact between the grafts and host bone was the cause of failure.
Acetabulum* ; Allografts* ; Arthroplasty ; Classification ; Follow-Up Studies ; Head* ; Hip ; Humans ; Leg ; Transplants

Exercise testing with Thallium imaging is widely used for the noninvasive evaluation of patients suspected of having coronary artery disease. However, many patients referred for stress testing connot exercise adequately for either physical or psychological reasons, and as a result may have nondiagnostic or suboptimal test results. Intravenous dipyridamole in conjunction with Thallium imaging is as effective alternative method without exercise. But, myocardial imaging using the standard scintillation camera technique(planner view) is hampered by superposition of proximal & distal cardial walls and by the segmental nature of myocardial ischemia. For this reason, Single Photon Emission Computed Tomography(SPECT) reslut in high specificity & sensitivity rates for the detection of coronar artery disease compared with conventional technique. So we performed dipyridamole Th-201 myocardial scintigraphy on 25 subjects who have suspicious angina or myocardial infarction instead of exercise Th-201 myocardial scintigraphy, and compared SPECT view with conventional plannar view. The results obtained are as follows : 1) T1-201 scintigraphic findings in 17 patients with suspicious angina were as follows ; redistribution defect was seen in 4 cases in plannar view and 13 cases in SPECT view. 2) T1-201 scintigraphic findings in 8 patients with myocardial infarction were as follows ; in planner view, perfusion defect was seen in all cases and 1 cases of them, redistribution defect was accompained, and in SPECT view, perfusion defect was seen in all cases and 6 cases of them, redistribution defect was accompained. 3) During dipyridamole infusion, the mean systolic & diatolic pressure decreased from 133+/-22.7/86+/-13.5 to 121+/-23.9/78+/-13.1mmHg and the heart rate increased from 68+/-12.4 to 84+/-12.4beats/min. 4) Adverse effects of dipyridamole were noted in 14(56%) of the subjects, but in 12 of these, the symptoms were mild in severity and subsided spontanously. To summarize, Dipyridamole-201 myocardial imaging is a useful and test for coronary artery disease, and the new tomographic technique, SPECT view, is more useful than the conventional plannar view.
Arteries ; Coronary Artery Disease ; Dipyridamole* ; Exercise Test ; Gamma Cameras ; Heart Rate ; Humans ; Myocardial Infarction ; Myocardial Ischemia ; Myocardial Perfusion Imaging ; Perfusion Imaging* ; Perfusion* ; Sensitivity and Specificity ; Thallium* ; Tomography, Emission-Computed, Single-Photon*

We have employed the external akeletal fixation devices, that is Hoffmann apparatus and Pin and Resin fixation method, for the treatment of 44 cases of long bone fractures from Dec. 1978 to Dec. 1981. The following are our impressins. 1. Hoffmann apparatus and Pin and Resin fixation method proved to be effective and useful measure for the management of fractures of long bones, particulary in cases of the open tibial fractures. 2. Employing the Hoffmann apparatus to the tibial model, the possible limit of correction of the fracture alignment was calculated. It was found that the average angle of correction of deformity can be managed up to 20 degrees in varus and valgus deformity, 70 degrees in anterior angulation, 40 degrees in posterior angulation and 70 degrees in rotation. 3. Pin and Resin fixation method is one of effective means in immobilization of long bones. It is simple to apply, easy to manipulate and inexpensive while offering fair fixation without much complications and therefore we recommend the method as the best alternative to expensive Hoffmann apparatus. 4. The complications of Hoffmann apparatus and Pin and Resin fixation method were pin tract infections and ankle stiffness which were generally minor and prevented by more careful aseptic technique and encouraging early joint motion.
Ankle ; Congenital Abnormalities ; Fracture Fixation ; Fractures, Bone ; Immobilization ; Joints ; Methods ; Tibial Fractures

Irreparable obstructive azoospermic patients can be treated successfully with microsurgical epididymal sperm aspiration(MESA) o. testicular sperm extraction (TESE) by intracytoplasmic sperm injection(ICSI). Obstructive azoospermic patients generally have normal spermatogenesis. The aim of this study was to see if any spermatozoa could be retrieved from non-obstructive azoospermia and to assess the efficacy of ICSI with TESE in germinal failure. 42 non-obstructive azoospermic patients revealed no spermatozoa at all in their ejaculates, even after centrifuge. The histology of 42 patients revealed 15 Sertoli cell only Syndrome, 4 maturation arrest and 23 severe hypospermatogenesis. All patients underwent extensive multiple testicular biopsy for sperm retrieval. These patients were scheduled for ICSI using testicular spermatozoa. In 25 out of 42 non-obstructive azoospermic patients, spermatozoa were recovered from multiple testicular biopsy specimen and 11 ongoing pregnancies were achieved. There are usually some tiny foci of spermatogenesis which allow TESE with ICSI in non-obstructive azoospermia. Also these patients may have sufficient sperm in the testes for ICSI, despite extremely high FSH level and small testes.
Azoospermia* ; Biopsy ; Humans ; Male ; Oligospermia ; Pregnancy ; Sertoli Cell-Only Syndrome ; Sperm Injections, Intracytoplasmic ; Sperm Retrieval ; Spermatogenesis ; Spermatozoa ; Testis

We report a case of retroperitoneal hemorrhage and abdominal wall hemorrhage due to spontaneous lumbar artery and inferior epigastric artery rupture, in a patient with chronic renal failure treated with hemodialysis. There was no history of specific trauma. The bleeding was confirmed by CT and angiography, and controlled successfully by selective angiographic embolization. We suggest that a possibility of spontaneous retroperitoneal bleeding should be considered in a case of abdominal pain or mass in a hemodialysis patient.
Abdominal Pain ; Abdominal Wall ; Angiography ; Arteries* ; Epigastric Arteries* ; Hemorrhage ; Humans ; Kidney Failure, Chronic ; Renal Dialysis* ; Rupture ; Rupture, Spontaneous*

OBJECTIVES: The cost of psychiatric service is increasing every year in Korea. The length of inpatient stay (LOS) is an important factor determining in-patient service cost. This study was aimed to find the factors that influence LOS in a psychiatric open ward of a general hospital. METHODS: The study includes 134 inpatients who were consecutively admitted to a psychiatric open ward in a general hospital from January 1st to June 30th in 2001. Demographic data, clinical characteristics on admission and discharge, global functioning, social support levels and life stressors were collected. RESULTS: The mean LOS for the 134 patients was 15.5 days (S.D 9.2). The occupation of housekeeper and those secred high in phobic anxiety subscale on SCL-90-R were statistically significant predictor for longer LOS in the univariate analysis. No significant differences in LOS were found by diagnostic groups and social support. In multiple regression analysis, the scores of phobic anxiety subscale, occupation and presence of physical illness were statistically significant predictor for LOS. CONCLUSION: This study failed to find the significant variables to account for substantial proportion of variance for LOS.
Anxiety ; Diagnosis ; Hospitals, General* ; Humans ; Inpatients ; Korea ; Length of Stay* ; Occupations

In contrast to the child with a solitary juvenile polyp, generalized gastrointestinal juvenile polyposis have a much different clinical course. In generalized juvenile polyposis blood loss can be considerable and iron-deficiency anemia is a common observation. Although it is usually regarded as a benign condition, juvenile polyposis may predispose to cancer of the gastrointestinal tract. We experienced a case of nonfamilial generalized gastrointestinal juvenile polyposis with pancytopenia in a 15 year-old male patient who had hospitalized because of intermittent rectal bleeding with anemia for three years. Histological examination of polyps from affected patient revealed a spectrum of change from juvenile polyps, to juvenile polyps with adenomatous changes. Subtotal colectomy, rectal mucosectomy, and endorectal pull-through procedure were successfully performed. No complication has occured since the discharge. A brief review of related literatures is also presented.
Adolescent ; Anemia ; Anemia, Iron-Deficiency ; Child ; Colectomy ; Gastrointestinal Neoplasms ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Male ; Pancytopenia* ; Polyps

Chyloperitoneum, also called chylous ascites, is a rarely reported complication of abdominal surgery. In most cases, the diagnosis and treatment is not difficult. The characteristic milky colored odorless fluid is easily detected by drainage or aspiration. With the help of diagnostic radiology and laboratory tests, it has become easier to detect the chyloperitoneum. Chyloperitoneum subsides spontaneously or responds well to medical treatment. Death from chyloperitoneum is extremely rare. However, 3 cases of medically intractable chyloperitoneum were encountered at our hospital after curative surgery for gastrointestinal malignancies (two colorectal cancers and one gastric cancer). Herein, the authors report these case and discuss their treatments.
Chylous Ascites* ; Colorectal Neoplasms ; Diagnosis ; Drainage

No abstract available.
Trisomy* ; Ultrasonography*

For more than 20 years, many cytologic techniques have been developed for endometrial sampling such as Gravlee jet aspirator, Isaacs cell sampler, Vabra aspirator, Pipelle, etc. But none of the techniques received general acceptanee as a replacement for dilatation and curettage. Hence dilatation and curettage is still used to evaluate women at high risk for endometrial cancer and infertility, to manage abnormal uterine bleeding and to follow womeh on hormone replacement therapy, But biopsy methods produce enough pain to lower patients acceptance, Z-sarnpler is a new simple plastic endornetrial suction curette that provides a histologic diagnosis like Pippelle, This study compared the clinical usability of the Z-sampler to that of endometrial biopsy by dilatation and eurettage. The Z-sampler obtained sufficient tissues for histologic diagnosis in 45 cases(45/50, 90.0%), it was lower than that of end.ometrial biopsy(49/50, 98,0%), But the accuracy of tissue diagnosis was almost equal to that of endometrial biopsy. In addition. Z-sempler cau less pain(94.1%) and the duration of this procdure was shorter than that of endometrial biopsy by dilatation and curettage. These results suggest that the Z-sampler may be efficieot technique in endometrial tissue diagnosi, like dilatation and curettage and it has greater patient acceptability due to less pain, less bleeding and shorter duration of procedure.
Biopsy ; Diagnosis ; Dilatation and Curettage* ; Dilatation* ; Endometrial Neoplasms ; Female ; Hemorrhage ; Hormone Replacement Therapy ; Humans ; Infertility ; Plastics ; Suction ; Uterine Hemorrhage