No abstract available.
Transplants* ; Urinary Incontinence*

Subluxation of hip is a disease commonly experienced in orthopaedic field, which is classified into primary subluxation and secondary subluxation. Generally, secondary subluxation of the hip in children who once suffered from infected hips, Legg-Calve-Perths disease and also as sequellae of incompletely treated congenital dislocation of the hip can be often seen in Korea. Especially in Korea, subluxation of the hip with some destruction of the affected femoral head frequently arose from late complication of the tuberculous or septic hip in children. But, no definite treatment for the condition was established and no satisfactory results were obtained with various operative methods. Authors experienced satisfactory result by combining the intertrochanteric varus osteotomy and administration of crystalline glucosamine sulphate (Viatril, Rotta pharmaceuticals, Italy) in subluxated burnt-out tuberculous hip of 6 years old male.
Child ; Crystallins ; Dislocations ; Glucosamine ; Head ; Hip ; Humans ; Korea ; Male ; Osteotomy ; Tuberculosis

The treatment of acetabular fractures is composed of operative and conservative methods, however, they are still controversial. Generally, because the acetabular fracture involves the joint surface and one sequalae such as post-traumatic arthritis can follow treatment, therefore an accurate reduction and postoperative early mobilization to obtain the prevenation of joint stiffness and arthritis are required. In order to achieve these purposes, we have studied and done a comparative survey between conservative and operative treatment on 55 patients with acetabular fractures, who were treated at our department from Jan. 1982 to Dec. 1988. Results were obtained as follows. 1. The prevalent age was the third decade and the cause of injury was traffic accidents in the majority. 2. The most common type of fracture was a posterior wall by Letournel classification. 3. Satisfactory results of operative treatment were 76% and conservative treatment 47%. 4. The complications were post-traumatic arthritis, ectopic ossification, peroneal nerve palsy and skin infection. 5. In the majority of displaced acetabular fractures, ORIF was recommended.
Accidents, Traffic ; Acetabulum ; Arthritis ; Classification ; Early Ambulation ; Humans ; Joints ; Ossification, Heterotopic ; Paralysis ; Peroneal Nerve ; Skin

Despite the continually improving results of total knee arthroplasty, infection remains the most debilitating complication. The treatments of infected total knee arthroplasty were variable, but initially we removed infected implants and inserted antibiotic containing cemented spacer. Postoperatively, patients were mobilized in a 30 knee flexion state and treated with parenteral antibiotics. After control of infection was clinically and radiologically determined, we inserted PCL substitute total knee prosthesis. Five days postoperatively, patient began touch down standing exercise. We observed two cases in whom infected total knee arthroplasty had been salvaged successfully with two-stage implantation using cement spacers containing antibiotics.
Anti-Bacterial Agents* ; Arthroplasty* ; Humans ; Knee Prosthesis ; Knee* ; Replantation*

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

Patients with severe acetabular bony deficiency in total hip revision arthroplasties need the use of autogenous or allogenic bone grafts. The Authors performed 28 cases of total hip revision arthroplasties between June 1991 and January 1995 with femoral head allograft for acetabular bony deficiencies and evaluated the clinical and radiological results according to AAOS classification. The clinical result was evaluated by D'Aubigne and Postel score. The mean score was improved from 3.9 points to 5.1 points at follow-up. In radiological evaluation, osseous union of graft was achieved within 12 month and rerevision were performed in two cases (92.8% survival rates) but radiological radiolucent line in at least one zone was seen in five hips in two year follow up. In conclusion, the results of hemispherical microporocoat cup with allogenic bone in segmental or cavitary defect using with acetabular reinforcement ring in combined deficiency were encouraging to date. Success rate of allograft reconsruction of the acetabulum results from a variety of acetabular defect. In our studies, only 40% showed stable bony fixation over short period.
Acetabulum* ; Allografts ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Classification ; Follow-Up Studies ; Head ; Hip ; Humans ; Transplants*

No abstract available.

No abstract available.
Child* ; Colon* ; Constipation* ; Enema* ; Fecal Incontinence* ; Humans

BACKGROUND: Controversy exists as to whether or not inhalation anesthetics and intravenous anesthetics impair arterial oxygenation (PaO2) during one lung ventilation (OLV). Accordingly, we examined the effect of enflurane and propofol on PaO2 and pulmonary vascular resistance (PVR) during OLV. METHODS: Forty patients, who had prolonged periods of OLV anesthesia with minimal trauma to the nonventilated lung were studied in a cross over design. Patients were randomized to four groups; Group 1 received 1 MAC of enflurane and oxygen from induction until the first 20 min after complete lung collapse, then were switched to propofol 100 g/kg/min (P100). In group 2, the order of the anesthetics was reversed. Group 3, Group 4 received the same order of the anesthetics as Group 1, Group 2, respectively but received propofol 200 g/kg/min (P200). RESULTS: During OLV, the PaO2 values were lower than those with two lung ventilation (TLV), there were no significant differences among each groups and between propofol and enflurane in PaO2, but in the selected patients (n=10, PaO2<120 mmHg during OLV), PaO2 in propofol group was higher than that of enflurane group (p<0.05). Conversion from TLV to OLV caused a significant increase in PVR, but there were no difference in PVR between propofol and enflurane group. CONCLUSIONS: These results suggest that the usual clinical dose of propofol affords no advantage over 1 MAC of enflurane anesthesia except low PaO2 patients during OLV. Propofol might be of value in risk patients of hypoxemia during thoracic surgery when OLV is planned.
Anesthesia ; Anesthetics ; Anesthetics, Inhalation ; Anesthetics, Intravenous ; Anoxia ; Cross-Over Studies ; Enflurane* ; Humans ; Lung ; One-Lung Ventilation* ; Oxygen* ; Propofol* ; Pulmonary Atelectasis ; Thoracic Surgery ; Vascular Resistance ; Ventilation

This study was carried out to determine the accuracy of Doppler echocardiography for predicting the pulmonary arterial pressure from right ventricular systolic time intervals in 52 patients with ventricular septal defect. The diagnosis of ventricular septal defect was made by cardiac catheterization and angiocardiography at Dong San hospital, Keimyung University during the period of one year from jan. 1988 to Dec. 1988. Doppler measurements of acceleration time (AT), right ventricular ejection time (RVET), right ventricular preejection period (RPEP), AT/RVET, and RPEP/AT were compared with pulmonary arterial pressure (PAP), measured by cardiac catheterization. The patients were divided into 3 groups : PAP< or =30mm Hg, PAP 31-59mm Hg, PAP??0mm Hg. The following results were obtained. 1) In the groups of PAP< or =30mm Hg, AT was 0.12+/-0.01sec, AT/RVET was 0.47+/-0.07 and RPEP/AT was 0.50+/-0.05. 2) In the groups of PAP> or =60mm HG, AT was 0.06+/-0.01sec. AT/RVET was 0.28+/-0.05. RPEP/AR was 1.51+/-0.21. As the level of PAP increased, Doppler AT, AT/RVET and RPEP/AT showed significant change(P<0.001). 3) The Doppler AT showed relative high correlation(r=-0.76) with PAP measured by cardiac catheterization in all group. 4) The Doppler AT/RVET showed correlation(r=-0.70) with PAP. 5) The Doppler RPEP/AT showed high correlation(r=0.91) with PAP. The Doppler echocardiography was easy to apply in all age groups, and was found useful for detecting pulmonary hypertension in ventricular septal defect and for the follow-up check of the patients. It may help to determine the optimal time for surgery and evaluation of the treatment.
Acceleration ; Angiocardiography ; Arterial Pressure* ; Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Echocardiography* ; Echocardiography, Doppler ; Follow-Up Studies ; Heart Septal Defects, Ventricular* ; Humans ; Hypertension, Pulmonary ; Systole