No abstract available.
Anti-Bacterial Agents* ; Prevalence* ; Shigella*

Wolf-Hirschhorn syndrome (WHS) is a malformation associated with a hemizygous deletion of the distal short arm of chromosome 4. Herein we report a fetal autopsy case of WHS. A male fetus was therapeutically aborted at 17(+0) weeks gestational age, due to complex anomaly and intrauterine growth retardation, which were found in prenatal ultrasonography. His birth weight was 65 g. Mild craniofacial dysmorphism, club feet, bilateral renal hypoplasia, edematous neck, and left diaphragmatic hernia of Bochdalek were found on gross examination. On GTG-banding, the fetus revealed 46,XY,add(4p) karyotype and the mother revealed 46,XX,t(4;18)(p16;q21.1), with normal karyotype of the father. Array comparative genomic hybridization performed on the autopsied lung tissue revealed loss of 4p16.2-->4pter and gain of 18q21.1-->18qter, suggesting 46,XY,der(4)t(4;18)(p16.2;q21.1)mat of fetal karyotype. This suggested deletion of 4p, compatible with WHS inherited from the mal-segregation of a maternal translocation t(4;18)(p16.2;21.1). Therefore, our fetus was both genotypically and phenotypically compatible with WHS.
Arm ; Autopsy ; Birth Weight ; Chromosomes, Human, Pair 4 ; Comparative Genomic Hybridization ; Fathers ; Fetal Growth Retardation ; Fetus ; Foot ; Gestational Age ; Hernia, Diaphragmatic ; Humans ; Karyotype ; Karyotyping ; Lung ; Male ; Mothers ; Neck ; Ultrasonography, Prenatal ; Wolf-Hirschhorn Syndrome

Displaced acetabular fractures have given rise to difficulty to the management, It has been unique diagnostic and operative challanges for the surgeon. We made a retrospective study of hip arthroplasty in fourteen patients who had a history of previous acetabular fracture. The most of patients was sutfered from traumatic osteoarthritis, We performed two bipolar hemiarthroplasty, eleven non-cement cup and one case Charnley cup replacement were done. The purpose of this stady was to determine the outcome long-term cup. The clinical results showed that pain was most improved at foliow-up, but the incidence of radiographic loosening and revisions were higher 42.8% within 10 years. We conclude that a history of prior acetahular fracture has a significant adverse impact on the long term out come of acetabular cup in total hip arthroplasty.
Acetabulum* ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Hemiarthroplasty ; Hip ; Humans ; Incidence ; Osteoarthritis ; Retrospective Studies

Previously severe multiple injuries associating the segmental fractures of the femurs were reported to be rare, and as a rule were fatal when surgeons did not immediately give or provide excellent care. Recently many patients having those injuries are quite often encountered at the clinic. The reason is high incidence of the mass casualties by road accidents, mine accidents and accidents at the industrial complexes. Also as the other reason, the advanced resuscitative measures which could do many of these patients to survive can be listed. For those severely injured patients associating segmental fracture of the femur, the more positive and efficient diagnostic and therapeutic measures have to be sought. Authors analyzed the 18 cases of segmental fractures of the femurs who were treated at the Orthopedic department of Catholic Medical College & Center from Jan., 1974 to Dec., 1979. The results obtained were as follows: 1. The male patients outnumbered the female in ratio of 13/5, and the most were at their 4th and 5th decade of age. 2. Traffic accident was the main cause of the injury; 13 out of 18 cases. Remaining 5 cases sustained injury by industrial accident. 3. All but one were closed fracture, and segmental shaft fracture was the commonest type of them; 10 out of 18 cases. 4. Thirteen patients accompanied significant injuries to other vital organ and/or other musculoskeletal system. 5. In entire cases the average union time in the proximal fracture was 28.9 weeks, and in the distal one 17.5 weeks. 6. Fractures regardless of their group that needed late bone grafting procedure numbered 7; 6 in the proximal shaft fracture and one in the distal fracture. 7. In 10 cases of the segmental shaft fracture (Group III fracture), bony union in the proximal fracture was obtained at 29.6 weeks in average. Proximal fractures in 4 cases in this group needed late bone grafting. Through these results it is suggested that in the treatment of segmental fracture of the femur, primary bone grafting at the proximal fracture site is beneficial to promote fracture healing or to prevent delayed union or nonunion especially when the proximal fracture is located across mainly the cortical part of the bone. Methods of treatment necessarily have to be selected according to the site and shape of the fracture, and in cases of segmental shaft fracture Kuntscher nailing is preferably recommended although the distal fracture site is not ideal one for the Kiintscher nail fixation.
Accidents, Occupational ; Accidents, Traffic ; Bone Transplantation ; Female ; Femur ; Fracture Healing ; Fractures, Closed ; Humans ; Incidence ; Male ; Mass Casualty Incidents ; Multiple Trauma ; Musculoskeletal System ; Orthopedics ; Surgeons

As increasing demands for CCC (Continuous Curvilinear Capsulorhexis) fincreases, the incidence of capsule contraction syndrome is also increasing in cataract surgery. We tried to classify and treat this syndrome with 44 eyes who have capsule contraction. It is known that the basic mechanism of capsule contraction is fibrotic dysplasia of anterior capsule, and we found that capsular contraction can arise with glaucoma, diabetes mellitus, uveitis, retinitis pigmentosa, psuedoexfoliation syndrome and old aged group as ordered. It can also be frequently can be found in age 50 to 60. In order to decrease the complication of capsule contraction(IOL dislocation, retinal detachment, etc.), we incised the anterial capsule with Nd:Yag laser at the time of fibrotic change. For the case of weak zonules, we made a radial incision in the 12 o'clock direction after IOL insertion.
Cataract ; Diabetes Mellitus ; Dislocations ; Glaucoma ; Incidence ; Retinal Detachment ; Retinitis Pigmentosa ; Uveitis

The Saville's index of the lumbar spine and the Singh's index of the femoral neck is very simple method to measure degree of osteoporosis. Authors compared Singh's index and Savilles index with Dual Photon Absorptiometry(D.P.X.) and studied the reliability and clinical usefulness of two indices. We took the D.P.X. and simple L-spine lateral view in 103 patients in same time and also performed D.P.X. and both hips A-P view in 70 patients, then analyzed and compared each two indices with D.P.X. The Singh's index had less interpersonal difference and intrapersonal difference compared with Saville's spine index. There was some confidence of Singh's index and Saville's spine index compared with the D.P.X., but the relationship between Saville's spine index and D.P.X. was less promising than that of Singh's index. Authors suggest that the Saville's spine index has less clinical usefulness than Singh's index in measurement of osteoporosis.
Femur Neck ; Hip ; Humans ; Methods ; Osteoporosis ; Spine

Twelve cases with paralytic elbow due to a traumatic lesion of the brachial plexus (eleven cases) and to poliomyelitis (one case) were treated by elbow flexorplasty from April, 1978 to February, 1984 Seven cases with available muscle for transfer were treated by muscle transfer, three cases withwhole arm type brachial plexus injury were treated by gracilis muscle transplantation, and two relatively fresh cases by neurotization. The three operated groups were assessed in range of active elbow motion, muscle power testing, and electromyography at final follow-up. In eight cases, the elbow flexorplasty were augmented by shoulder arthrodesis. The mean length of follow-up was twenty two months. The mean arc of restored active elbow motion was 93 degrees following muscle transfer, 100 degrees following gracilis muscle transplatation, and 35 degrees following neurotization. The overall mean arc of active elbow motion was 77.5 degrees. In the muscle testing, the mean scores of the elbow flexor power were 3+, 4−, and 3− following muscle transfer, grcilis muscle transplantation, and neurotization respectively. The overall mean score of restored elbow flexor power was 3− . The electromyographic findings also revealed corresponding restoration of the action potential in the flexor muscle in the three groups. One case of the transfer group failed after sternocleidomastiod muscle transfer, who subsequently received gracilis muscle transplantation with satisfactory result.
Action Potentials ; Arm ; Arthrodesis ; Brachial Plexus ; Elbow ; Electromyography ; Follow-Up Studies ; Nerve Transfer ; Poliomyelitis ; Shoulder

About 5% of patients with SCLC have the ectopic production of ACTH. Ectopic ACTH production of SCLC is suspected when patients of SCLC have unexplained metabolic alkalosis and hypokalemia. Most patients lack the classic feature of Cushing's syndrome. According to the recent report, they have poor prognosis, which median survival is less than 4 months and associated with a high rate of complication during chemotherapy. Also a case of paraneoplastic CRH production with SCLC can mimic the ectopic ACTH syndrome hut it can be distinguished by immunohistochemistry or direct measurement of serum CRH level. We report here a case of small cell lung cancer associated with Cushing's syndrome of ectopic ACTH production. That is immunohistochemically provened by staining with ACTH.
ACTH Syndrome, Ectopic ; Adrenocorticotropic Hormone* ; Alkalosis ; Cushing Syndrome* ; Drug Therapy ; Humans ; Hypokalemia ; Immunohistochemistry ; Lung Neoplasms* ; Lung* ; Prognosis ; Small Cell Lung Carcinoma

The purpose of this study is to compare the quality of intraoperative salvaged blood with that of Citrate Phosphate Dextrose(CPD) stored blood in 32 patients having cardiac surgery involving cardiopulmonary bypass. 20 patients in the control group received one week cild CPD stored blood and 12 patients received autologous intraoperative salvaged blood which prepared and processed with the Hemonetics Cell Saver Plus autotransfusion device. 1) Salvaged blood had a higher hemoglobin concentration(l7.6 vs 13.1 g/dl, P<0.005), a higher 2.3-diphosphoglycerate concentration(3.1 vs 0.6 mmol/L, P<0.005), higher pH(7.6 vs 6.8, P<0.005) than CPD stored blood group. Salvaged blood had a lower ATP concentration was(47.7 vs 67.7 pmol/dl, P<0.005) than stored blood group. 2) Platelet count was l3.4 X 10(9)/L and WBC count was 5.09 X 10(9)/L in salvaged blood. 3) Salvaged blood volume was 1411+/-487.9 ml(range 580 to 2325 ml). Intraoperative salvaged blood had a superior oxygen carrying and delivery capacity, but modification of washing is required to lessen the platelet and white blood cell count in the salvaged blood.
2,3-Diphosphoglycerate* ; Adenosine Triphosphate* ; Blood Platelets ; Blood Transfusion, Autologous ; Blood Volume ; Cardiopulmonary Bypass ; Citric Acid ; Erythrocytes* ; Humans ; Leukocyte Count ; Oxygen ; Platelet Count ; Thoracic Surgery

No abstract available.
Bacterial Infections* ; C-Reactive Protein*