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

Objectives: The goals of this study are to exploring critical factors and methods to improve Korean Community Care through the cases of GyeongsangNamdo. Methods: For this study, we performed in-depth interviews with 90 people involved in Community Care services of 6 regions, and the collected data were analyzed. The collected data were analyzed utilizing NVivo12. In the end, we reconfirmed the process through Topic Modeling analysis. Results: We conducted descriptive statistics and qualitative data analysis collected through surveys and in-depth interviews. In the case of qualitative analysis, we extracted principle codes (Need, Lack, Absence), and sorted the contents into sub-categories. The response rate of ‘Need to strengthen capabilities’ was the highest, ‘Need to communicate and share information’ was the second, and ‘Need for integrated operation and a control tower’ was the third. Conclusion As a result, we find the critical factors to improve Community Care. Based on them, we should conduct follow-up researches to propose concrete methods to apply to diverse regions.

Rupture of Achilles tendon was first reported by Pare, 1575 and thereafter the cause and the diagnostic and therapeutic methods of the ruptured tendon have been described by many workers. Rupture of the Achilles tendon is often wrongly diagnosed and inadequately treated by the doctor who first sees it, with consequent problems of treatment and prognosis. In this paper 24 patients(25 cases)
Achilles Tendon ; Female ; Follow-Up Studies ; Humans ; Male ; Methods ; Prognosis ; Rupture ; Tendons

No abstract available.

No abstract available.
Neuroblastoma* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*

We compared the prophylactic efficacy of intravesical mitomycin C with bacillus Calmette-Guerin instillation in the high risk superficial bladder tumor patients. Recurrent, grade III multiple (more than 3) or large(more than 3 cm) stage Ta or T1 tumors were included. Thirty patients were treated with 8 weekly instillation of 40mg of mitomycin C and 31 with 6 weekly instillation of 120mg or BCG. Thirty six patients were selected as a control Group. The mean follow-up period was 31.3 months in BCG, 27.7 months in mitomycin C and 23.2 months in control group. The overall one and two year recurrence rate was 52% and 62% in BCG, 70% and 80% in mitomycin C and 74% and 82% in control group. which was not statistically different(p>0.05) and the recurrence free pattern among three groups was not different statistically. But the mean time for recurrence and time for recurrence of 50 percent of the patients was 24.55 and 13 months in BCG group, which were longer than 14.2 and 5 months in mitomycin C and 12.72 and 7 months in control group. The tumor grade and number were lowered in the 20 recurrent tumors after BCG treatment with statistical significance. The overall 2 year recurrence rate was not significantly improved, BCG instillation resulted in improvement in grade, decrease in the number of the tumor and delay in time for recurrence in patients with high risk superficial bladder tumors. Although prophylactic efficacy of the BCG instillation is not complete, it would be provide reasonable benefit to the patients and is apparently superior to mitomycin C.
Bacillus* ; Follow-Up Studies ; Humans ; Mitomycin* ; Mycobacterium bovis ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder*

OBJECTIVE: Radiation injury includes radiation necrosis and apoptosis. The purpose of this study is whether steroids and calcium channel blockers are effective for the prevention of single high dose irradiation-induced apoptosis in the rat brain. METHODS: Eighty Sprague-Dawley rats were divided into four experimental groups: Control(nontreated, n=20), Dexamethasone-treated(0.1mg/kg, n=20), Prednisolone-treated(2mg/kg, n=20), Nimodipine-treated (0.5mg/kg, n=20). After drug was administered, the right hemisphere of rat's brain was exposed to a single 10Gy dose of gamma rays using Ir-192. All brains underwent histological examination at 1 week, 2 weeks, 4 weeks, and 8 weeks after irradiation to evaluate cortical thickness and number of apoptotic cells. Apoptotic cells were detected by TUNEL assay. RESULTS: In nimodipine-treated group, apoptotic cell count was reduced significantly, compared to that of control(non treated) group at 4 and 8 weeks after irradiation(p<0.05). The decrease of cortical thickness was reduced significantly in nimodipine-treated group, compared to that of control group(p<0.05). There was no significant changes in the number of apoptotic cells and cortical thickness in prednisolone and dexamethasone-treated groups compared with those of control. CONCLUSION: These results suggest that nimodipine treatment may have effects on the prevention of radiation-induced apoptosis. If it could be established that calcium channel blockers inhibit radiation injury, they might be useful in radiation therapy. Further investigation of calcium channel blockers including dosage effectiveness, intracellular calcium ion concentration and effects on tumor tissue are necessary to clarify the usefulness of nimodipine.
Animals ; Apoptosis* ; Brain* ; Calcium Channel Blockers ; Calcium Channels* ; Calcium* ; Cell Count ; Dexamethasone ; Gamma Rays ; In Situ Nick-End Labeling ; Necrosis ; Nimodipine ; Prednisolone ; Radiation Injuries ; Rats* ; Rats, Sprague-Dawley ; Steroids

Tyrosine kinases have been implicated in vascular smooth muscle cell proliferation and contraction. The involvement of tyrosine kinases in 5-hydroxytryptamine (5-HT)-induced contractile response of the isolated aorta was examined in two-kidney, one clip (2K1C) hypertensive rats, 2141C hypertension was made by constricting the left renal artery and age-matched control rat received sham treatment. Thoracic aortic rings denuded of endotheliurn were mounted in tissue bath, for measurement of isometric contractile force. The putative tyrosine kinase inhibitor, genistein, shifted concentration-response curves to 5-HT toward the right in control rats The isometric force generation induced by 5-HT was also inhibited by genistein in aortic rings from 2K1C: hypertensivc rats, however genistein did not affect on the high concentration of 5-HT in hypertensive rat ;. Genistein-induced relaxations were more attenuated in aortae from hypertensive rats than those from control Genistein had no effect on contrartcion elicited by the direct protein kinase C activator, phorbol 12, 13 dibutyrate (PDBu) either in 2KlC hypertensive or in control Group. These findings indicate that genistein-sensitive tyrosine kinases paeticipate in 5-HT-induced contraction of rat aortic smooth muscle, of which role is apparent in 2K1C: hypertension.
Animals ; Aorta ; Baths ; Cell Proliferation ; Genistein ; Hypertension ; Muscle, Smooth ; Muscle, Smooth, Vascular ; Phosphotransferases* ; Placebos ; Protein Kinase C ; Protein-Tyrosine Kinases ; Rats* ; Relaxation ; Renal Artery ; Serotonin ; Tyrosine*

Experinece in the management of 74 patients with delayed traumatic intracranial hemorrhage(DTICH) of 474 head injury from January 1996 to December 1996 is poresented with emphasis on the incidence, occurring time, risk factors and outcome. The incidence of DTICH was 15.6% of all hospitalized head-injury patients. After an injury, every patient had an immediate computerized tomography(CT) scan to diagnose intracranial pathology and then CT follow-up was carried out according to intial CT finding and reurological deficit. The lesion was almost occurred in patients with initial abnormal CT finding(85.1%). 82.4% of DTICH were noted within 72 hours after injury. The delayed epidural hematoma and intracerebral hemorrhage were almost noted in first 72 hours(>90%), but the delayed subdural hemorrhage was found after a time interval varying from 6 hours to 10 days. So we strongly recommend CT follow-up in 4-8hour, 24-72hour, and then 7th day after head injury, especially in patients with initial abnormal CT findings. The risk factor of the delayed lesion was not hypotension, hypoxia, and consciousness level, but age of patients and the initial CT finding. The development of DTICH was not heralded by neurological deterioration. The prognosis of DTICH was not worse than non-DTICH. The patient with delayed subdural hemorrhage was better than the patient with non-delayed lesion(including hemorrhage and normal CT finding).
Anoxia ; Cerebral Hemorrhage ; Consciousness ; Craniocerebral Trauma* ; Follow-Up Studies ; Head* ; Hematoma ; Hematoma, Subdural ; Hemorrhage ; Humans ; Hypotension ; Incidence ; Intracranial Hemorrhages* ; Pathology ; Prognosis ; Risk Factors

OBJECTIVEL: Anterior cervical discectomy and fusion has been successfully performed for many years using a variety of techniques. Recently, the concept of internal fixation has been applied to the lower cervical lesions. The need for postoperative immobilization, usually required to stabilize the patient while the fusion mass heals, is decreased or negated by internal fixation. In order to determine the effects of plate stabilization on maintenance of interspace height during postoperative period, we assessed the potential differences between anterior interbody fusion without plate and fusion with plate in patients with lower cervical lesions. PATIENTS AND METHODS: The authors analyzed the results of 76 patients with lower cervical lesions, who underwent anterior interbody fusion between May, 1991 and December, 1997. Of these, 36 underwent only anterior interbody bony fusion and 40 underwent bony fusion plus interbody fixation with plate system. RESULTS: In order to compare the difference of two groups, we investigated the pre- and postoperative interspace height, clinical outcomes, and radiographic fusion success rates. Anterior interbody fusion with plate was found to be superior to anterior interbody fusion without plate after anterior cervical decompression procedures with respect to maintenance of cervical interspace height(p<0.01), and radiographic and clinical fusion success rates. CONCLUSION: The authors concluded that the use of anterior plate fixation may provide added security to the nervous system before bony fusion occurs, may potentiate the maintenance of interspace height, may increase the probability of successful fusion, and may permit early ambulation.
Decompression ; Diskectomy ; Early Ambulation ; Humans ; Immobilization ; Nervous System ; Postoperative Period