Thirty years ago a major arterial laceration was devasting injury, threatening survival of the limb in almost every case. Increased awareness of vascular injuries and of feasibility of immediate and more advanced arterial repair techmique reduced the amputation rate. The authors reviewed 163 patients of vascular injuries in extremities, who were admitted to Severence Hospital of the Yonsei University College of Medicine from January, 1979 to December, 1986. The results were follows : 1. Among the 163 patients, 146 patients were male patients. 2. Most of the victims were in their twenties. 3. The most common cause in the upper extremity was glass injury. The most common cause in the lower extremity was being struck by moving vehicles. 4. More complications in vascular injuries were associated with severe soft tissue crushing and comminuted fracture of the bone. 5. More favorable results can be gained through the use of microvascular techniques than through conventional techniques in vascular reconstruction.
Amputation ; Clinical Study ; Extremities ; Fractures, Comminuted ; Glass ; Humans ; Lacerations ; Lower Extremity ; Male ; Upper Extremity ; Vascular System Injuries

Purpose: The purpose of this study was to evaluate the clinical and radiological results of total hip arthroplasty using a proximal modular femoral stem in patients who had secondary coxarthrosis associated with a deformed femur. Materials and Methods: Forty-two patients (45 hips) with secondary coxarthrosis were evaluated after primary total hip arthroplasty using an S-ROM proximal modular femoral stem, between January 2001 and March 2004. The average follow-up was 44 months (range, 24 to 60 months). The mean age of the patients was 48.5 years old and there was a predominance of female patients (65.5%). The preoperative diagnoses included 26 cases of developmental dysplasia of the hip, 13 cases of sequalae of LCP, 2 cases of epiphyseal dysplasia, 3 cases of sequalae of pyogenic arthritis, and 1 case of congenital coxa vara. Results: The average Harris hip score improved from 52.2 points to 85.5 points. All the femoral stems demosntrated stable fixation, which included 37 cases by bony ingrowth and 8 cases by stable fibrous ingrowth. Neither osteolysis nor progressive radiolucent lines around the femoral stems were found at the latest follow-up. Postoperative complications included: 2 cases of hip dislocations, 1 case of periprosthetic fracture, 1 case of infected cup loosening, and 1 case of sciatic nerve palsy. Overall, forty-one hips (91.9%) exhibited excellent or good clinical results at the most recent follow-up. Conclusion: For advanced secondary coxarthrosis, total hip arthroplasty with use of a proximal modular femoral stem yielded good mid-term results based on clinical and radiological criteria.
Arthritis ; Arthroplasty, Replacement, Hip* ; Coxa Vara ; Diagnosis ; Female ; Femur* ; Follow-Up Studies ; Hip Dislocation ; Hip* ; Humans ; Osteoarthritis, Hip* ; Osteolysis ; Periprosthetic Fractures ; Postoperative Complications ; Sciatic Neuropathy

No abstract available.
Acetabulum* ; Osteotomy*

Treatment modalities for herniated lumbar intervertebral disc are the conservative method, chemonucleolysis, percutaneous diskectomy and operation. Conservative treatment is effective in 70–80% of the acute stage and the other 20% requires chemonucleolysis, percutaneous diskectomy or operation. Indications for operation are cases not improved after conservative treatment, recurrent cases and cauda equina syndrome. Mixter and Barr(1934) demonstrated that laminectomy and surgical removal of disc material could relieve symptoms, but spinal segmental instability, incomplete removal of the disc and postoperative adhesion of the nerve root caused low back pain after long-term follow up. Thus, the authors evaluated the plain X-ray and computed tomographic findings in 21 cases of failed laminectomy to determine the cause of failure. The results were as follows ; 1. Among 21 cases, 18 cases complained of low back pain with sciatica and 3 cases complained of low back pain. 2. In all cases, disc space narrowing was detected on plain X-ray. Total laminectomy and diskectomy promote insufficiency and instability of the lumbar and lumbosacral spine. Whenever one attempts to do total laminectomy and diskectomy, it is recommended that spine fusion be performed in same operating field. 3. Several findings were detected on CT scan : 8 disc protrusions in the operation site, 6 disc protrusions in the operation site and spinal stenosis, 4 extradural scars, 1 extradural scar and other site disc protrusion and 2 cases of spinal stenosis and spondyloisthesis. 4. Computed tomography in cases of failed laminectomy offers more information than has been available by any other imaging method.
Cicatrix ; Diskectomy ; Diskectomy, Percutaneous ; Follow-Up Studies ; Intervertebral Disc ; Intervertebral Disc Chemolysis ; Laminectomy ; Low Back Pain ; Methods ; Polyradiculopathy ; Sciatica ; Spinal Stenosis ; Spine ; Tomography, X-Ray Computed

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but potentially fatal drug-induced systemic hypersensitivity response characterized by erythematous eruption, fever, leukocytosis with eosinophilia, and internal organ involvement. Antitubercular agents are potential causative agents for DRESS syndrome but difficult to verify as a culprit drug, since antitubercular agents are coadministered as a combination regimen. A 42-year-old female with endobronchial tuberculosis was diagnosed with DRESS syndrome after 4-week treatment of isoniazid, rifampicin, ethambutol, and pyrazinamide with prednisolone 50 mg. All the antitubercular agents were stopped and replaced with levofloxacin, cycloserine, p-aminosalicylic acid, and kanamycin. However, severe exacerbation of DRESS syndrome compelled the patient to discontinue the administration of the second-line antitubercular agents. Two months later, the patient underwent a patch test for all the antitubercular agents which had been used, and the results showed positivity to isoniazid and cycloserine. We report a rare case of DRESS syndrome that reacted to cycloserine as well as isoniazid. Development of coreactivity to other drugs should be differentiated with a flare-up reaction in the management of DRESS syndrome.
Adult ; Aminosalicylic Acid ; Antitubercular Agents ; Cycloserine ; Drug Hypersensitivity Syndrome ; Eosinophilia* ; Ethambutol ; Female ; Fever ; Humans ; Hypersensitivity ; Isoniazid ; Kanamycin ; Leukocytosis ; Levofloxacin ; Patch Tests ; Prednisolone ; Pyrazinamide ; Rifampin ; Tuberculosis

In this paper, some parts of Fig. 1 and dose information of methylprednisolone on page 113 were misprinted.

No abstract available.
Aneurysm* ; Hydrocephalus* ; Hypothalamus* ; Subarachnoid Hemorrhage*

There were many controversies in the cause and progress of tumorigenesis. Recently, studies on the mutation of genes related to the tumor have extensively been performed due to development of molecular biology. Structural and morphological changes of chromosomes, which are related to the abnormal activation of oncogenes or inactivation of tumor suppressor genes, transform the normal cells into the tumor cells. p53 and Rb are well known tumor suppressor genes, while oncogenes include c-myc, bcl-2 and ras, etc. When exposed to cell damaging agents, p53 inhibits cell growth by inducing transcription of p21. Especially p73, which is homo-logy of p53, frequently deleted in melanoma, neuroblastoma, colon cancer, and breast cancer. when over produced, p73 activates the transcription of p21, bax-1 and inhibits cell growth by inducing apoptosis. For study on mRNA expression of p21 and p73, normal oral keratinocytes, and cell lines of primary and metastatic oral squamous cell carcinomas were cultured and then electrophoresis and RT-PCR(reverse transcription-polymerase chain reaction) were performed. 1. The mRNA of p21 and p73 in normal oral keratinocyte expressed lower level than that of primary oral squamous cell carcinoma. 2. The mRNA of p21 in metastatic oral squamous carcinoma cell lines was expressed as various patterns compared with that of normal oral keratinocyte. 3. In the metastatic oral squamous cell lines, the mRNA of HN8 expressed higher than that of HN12 or HN19. 4. The mRNA of p73 in primary oral squamous cell lines expressed 4-5 times higher than that of normal oral keratinocyte. 5. In metastatic oral squamous cell lines, there was no significant expression of p73 mRNA compared with that of normal oral keratinocyte. From the results obtained in this study, mRNA expression of p73 in primary oral squamous cell lines was remarkable, while mRNA expression of p21 and p73 in metastatic oral squamous cell lines were statistically insignificant.
Apoptosis ; Breast Neoplasms ; Carcinogenesis ; Carcinoma, Squamous Cell* ; Cell Line* ; Colonic Neoplasms ; Electrophoresis ; Genes, Tumor Suppressor ; Keratinocytes ; Melanoma ; Molecular Biology ; Neuroblastoma ; Oncogenes ; RNA, Messenger*

No abstract available.
Acute Kidney Injury* ; Edema* ; Hemofiltration*

No abstract available.
Acute Kidney Injury* ; Edema* ; Hemofiltration*