No abstract available.
Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis, Tuberculous*

No abstract available.
Purpura, Thrombocytopenic, Idiopathic*

No abstract available.
Suicide, Attempted*

No abstract available.
Blood Platelets* ; Diagnosis* ; Flow Cytometry* ; Integrin beta3* ; Thrombasthenia*

The surgical intervention for secondary developmental cervical spinal stenosis that results in myelopathy and radiculopathy has been modified by technical improvement to obtain more reliable enlargement of the cervical spinal canal. The authours have experienced good results with the modified open door expansive laminoplasty, so we report this article. The patients were treated by surgical intervention during the period from October 1989 to February 1991. The results obtained were as follows : 1) The average age was 54.7 years, and the sex distribution ratio of female to male was 2 : 8. 2) In clinical symptoms and symptoms of both myelopathy and radiculopathy. 3) In morphological analysis of lesions, all patients except one case had lesions over 3 levels, The lesions were spondylosis, spondylosis combined with soft disc herniation, spondylosis combined with OPLL, spondylosis combined with OPLL and soft disc herniation, OPLL and OYL in the order of frequency. 4) The operation method was as follows : after the patient was positioned in modified Concorde position, open door lamina was anchored to faced joint capsule and surrounding tissue with nylon sutures. And then the raw epidural space was covered with Lyodura by the modified Hirabayashi method. By this method, reclosure of widened spinal canal was prevented. 5) The outcomes were evaluated by JOA score difference between preoperation and post operation times. The outcome of recovery rate was 100% in five cases. Therewere no aggravated or unimproved cases. The results were excellent 8 cases, good 1 case, unchanged 0 case, poor 0 case and expired 1 case.
Epidural Space ; Female ; Humans ; Joint Capsule ; Male ; Nylons ; Radiculopathy ; Sex Distribution ; Spinal Canal ; Spinal Cord Diseases ; Spinal Stenosis* ; Spondylosis ; Sutures

The shoulder fusion is one of the good method to relieve pain, improve the function and stabilize the flail shoulder joint. But recent advance of arthroplasty, the procedure is less popular. Authors studied and analized 23 patients who received shoulder arthrodesis from Aug. 1978 to Aug. 1986 and reported functional outcome after shoulder arthrodesis. Among twenty three patients, brachial plexus palsy were eighteen, upper extremity residual poliomyelitis in three and shoulder joint turberculosis in two respectively. Postoperative follow up was 12 months to 9 years and 6 months, average being 2 years and 6 months. It took 14.4 weeks in average for shoulder arthrodesis. The postoperative abduction fusion angle was 33.8 degrees in average(20 degrees to 50 degrees). The active abduction after shoulder fusion was mean 51.8 degrees(20 degrees to 85 degrees). The abduction fusion angle between 20 degrees and 40 degrees was presented satisfactory results in the point of pain relief, functional assessment and patients satisfaction. High abduction fusion angle(more than 40 degrees) revealed pain around the fused shoulder area. The combined extra and intraarticular arthrodesis revealed better results. The Saber-cut approach was more valuable for secondary elbow reconstruction than Henry approach.
Arthrodesis ; Arthroplasty ; Brachial Plexus ; Elbow ; Follow-Up Studies ; Humans ; Methods ; Paralysis ; Poliomyelitis ; Shoulder Joint ; Shoulder ; Upper Extremity

In the treatment of fractures of the thoracolumbar junctiion area, surgical intervention was performed when posterior part of veretbral body, posterior structure supporting ligaments were involved and body compression more than 40%. Number of cases satisfying above criteria were seven between Aug. 1990 and Jun. 1991. Age distribution ranged from 15 to 57 years. Sex ratio was 4:3(F:M). Four patients presented with nerve root sign, one patient with cauda equina signs, and two patients were normal neurologically. In all cases, spinal canal decompression, internal instrument fixation, and bone fusion with iliac bone were performed via anterolateral approach. After surgical treatment, neurological deficits disappeared and kyphotic angle returned to normal range of thoracolumbar junction area in all cases. Percentage of body compression was improved from preop. 55% to postop. 21% in average. According to above results, we concluded that anterior instrumental fixation combined with bone fusion using iliac bone was supperior to posterior approach in providing biomechanical stability and decompression of protruding ventral bone fragments.
Age Distribution ; Cauda Equina ; Decompression ; Humans ; Ligaments ; Reference Values ; Sex Ratio ; Spinal Canal

No abstract available.
Child* ; Humans ; Male ; Penis* ; Replantation*

PURPOSE: Although intraoperative radiotherapy (IORT) is known to be a method that can reduce local recurrence in locally advanced colorectal cancer, it is not widely used. The aim of this study was to report our experience with IORT for locally advanced rectal cancer. METHODS: From 1991 to 1994, nine patients with locally advanced rectal cancer received IORT. External beam radiotherapy was given postoperatively in five patients and preoperatively in three. Seven patients received chemotherapy. IORT was done with 6-MeV or 9-MeV electrons, and 12 Gy was irradiated at the tumor bed. The median follow-up period was 84 months (range, 15 to 208 months). RESULTS: The median age of patients was 51 years (range, 42 to 73 years). All patients had advanced clinical T-stage (cT3/4) cancer. The overall and the disease-free survival rates were 66.7% and 66.7% at 5 years, respectively. One patient developed a local recurrence near the anastomosis site, which was out of the IORT field. Four patients died before the last follow-up; three from distant metastasis and one from secondary primary cancer. Adverse effects related to IORT did not occur. CONCLUSION: Although the number of patients was small in this study, IORT is thought to be safe and effective in reducing local recurrence in locally advanced rectal cancer. However, the role of IORT should be refined in the era of preoperative radio-chemotherapy followed by total mesorectal excision.
Colorectal Neoplasms ; Disease-Free Survival ; Electrons ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Rectal Neoplasms ; Recurrence

BACKGROUND AND OBJECTIVES: This examined the association of cognitive function with self-care and major adverse cardiac events (MACE) among heart failure (HF) patients. SUBJECTS AND METHODS: In this prospective study, 86 outpatients with HF completed face-to-face interviews including neuropsychological testing to evaluate cognitive function and the use of the Self-Care of Heart Failure Index to measure self-care. Functional status was assessed with the New York Heart Association (NYHA) classification. Follow-up data on MACE were obtained at 24 months after enrollment. RESULTS: Compared with the Korean norm values, more than half of the HF patients had cognitive deficits in global function (33.0%), immediate recall (65.1%), delayed recall memory (65.1%), and executive function (60.5%). Patients with symptomatic HF (> or =NYHA class II) had the higher risk for substantially poor cognitive function in all areas of cognitive function than asymptomatic HF patients (NYHA class I, p<0.05). Most patients demonstrated poor self-care adequacy in maintenance (84.9%), management of symptoms (100%), and confidence (86.0%). After adjustment for age and gender, memory function was significantly associated with self-care confidence (odds ratio 1.41, 95% confidence interval 1.03-1.92, p=0.033). No relationship was found between cognition and self-care maintenance. There were 19 MACE's during the 24-month follow-up. Patients without MACE had a significantly higher global cognitive function (p=0.024), while no cognitive domains were significant predictors of MACE when adjusted for age and gender. CONCLUSION: HF patients with memory loss have poorer self-care confidence. Studies are warranted to examine the functional implication of cognitive deficits and adverse outcomes in a larger sample.
Classification ; Cognition ; Executive Function ; Follow-Up Studies ; Heart ; Heart Failure* ; Humans ; Memory ; Memory Disorders ; Memory, Short-Term ; Neuropsychological Tests ; Outpatients ; Prospective Studies ; Self Care*