A follow-up study was made of 26 knees of 21 patients who underwent arthroscopic synovectomy between October 1982 and August 1983 in Catholic Medical College and Center. The patient's ages ranged from 3 to 66 years of age. There were 14 female patients and 7 male patients in this series. The follow-up period of all patients was a minimum of twelve months to a maximum of 20 months. The average follow-up of the whole group was 16.8 months. The abnormal findings were rated from 0 to 4 according to Marmors rating system. Final clinical evaluations of the patients were done according to the modified criteria of Sledge et al. The results were as follows; 1. Rheumatoid Arthritis Of 14 knees, 3 joints(21.4%) were rated “excellent”, 6(42.9%) were “good”, and 5(35.7%) were “fair”. There was no case of “unimproved”. 2. Juvenile Rheumatoid Arthritis The results of all 5 knees were satisfactory. Of 5 knees, 4 joints(80%) were rated excellent and one joint (20%) was good. 3. There were 3 knees of osteoarthritis, 3 knees of chronic synovitis and one knee of pigmented villonodular synovitis. Their final results were all satisfactory. Three joints were rated excellent and the other 3 joints were good. 4. Of 26 knees, as a whole, 10 joints (38.5%) were rated “excellent”, 11 joints (42.3%) were “good”, 5 joints (19.2%) were “fair” and no joint was “unimproved”. There were 5 recurrences of active synovial disease in this series, and these patients all were “classic” rheumatoid arthritis. But surprisingly the average patient in this group of recurrence did well even after recurrence. These patients all had less pain and effusion than before operation. 5. The major cause of unsatisfactory results other than recurrence of synovitis were articular degeneration (joint space narrowing) and patellofemoral osteoarthritis (4 knees). 6. A good range of motion with the shortest rehabilitation period can be expected if alternate flexion and extension splints are applied on alternate days for less than a week following the surgery. In conclusion, one may state that the arthroscopic synovectomy is worth considering for the treatment of various kinds of synovitis of the knee joint and when the rheumatoid process follows a favourahle course.
Arthritis, Juvenile ; Arthritis, Rheumatoid ; Female ; Follow-Up Studies ; Humans ; Joints ; Knee Joint ; Knee ; Male ; Osteoarthritis ; Range of Motion, Articular ; Recurrence ; Rehabilitation ; Splints ; Synovitis ; Synovitis, Pigmented Villonodular

Dislocation involving tarsal navicular is a extremely rare injury compare to dislocation of other tarsal bone. One case of the tarsal navicular dislocation associated with subluxation of the midtarsal joint treated by open reduction and arthrodesis was reported.
Arthrodesis ; Dislocations ; Joints ; Tarsal Bones

No abstract available.
Hair ; Humans ; Siblings

No abstract available.
Fetal Death*

No abstract available.
Hydronephrosis*

The spinal motonucleus of the genitofemoral nerve regulating scrotal temperature can also be related to prenatal and neonatal testicular descent by gubernacular change in rats, and a sexually dimorphic-like bulbocavernosus/dorsolateral motonucleus. There is a hypothesis that neonatal androgen affects these motonuclei, and induces development of sexual organs through neural stimulation. Until now, the accumulation of isotope-labelled androgen and the immuno-reactivity of androgen receptor protein in each sexually-dimorphic spinal motonucleus have been revealed in adult rats but they have not been established in rats during neonatal periods. To investigate the presence of the androgen receptor in spinal sexually-dimorphic motonuclei in the neonatal period, we evaluated the androgen receptor immunoreactivity of these motonuclei. In Sprague-Dawley male rats, the lumbar spinal cords were resected at postnatal days 3, 10 and 30, and stained immunohistochemically using polyclonal antibody of androgen receptor protein. The immunoreactivity of androgen receptor protein was observed in the cells of the genitofemoral motonucleus from the 13th thoracic to the 2nd lumbar spinal cord and the bulbocavernosus/dorsolateral motonucleus was observed from the 4th to 5th lumbar spinal cord in all age groups. The proportional areas of both motonuclei at days 3 and 10 on cross-section were larger than at day 30. The motonuclei at days 3 and 10 were similar in all age groups. With the above results, the presence of androgen receptor protein was confirmed in the genitofemoral and bulbocavernosus/dorsolateral motonucleus from neonate to day 30. The larger proportional area of these motonuclei in neonates may indicate an active role for these motonuclei during the neonatal period. Although the immunoreactivity does not directly imply the presence of a functional receptor, neonatal androgen could be responsible for the development of sexual organs through the spinal motonucleus.
Animal ; Animals, Newborn ; Male ; Rats ; Rats, Sprague-Dawley ; Receptors, Androgen/immunology ; Receptors, Androgen/analysis* ; Sex Characteristics* ; Spinal Cord/chemistry*

Ceftriaxone is a commonly used antibiotic due to some of its advantages. Reversible gallbladder (GB) sludge or stone has been reported after ceftriaxone therapy. Most of these patients have no symptom, but the GB sludge or stone can sometimes cause cholecystitis. We experienced two patients who had newly developed GB stones after ceftriaxone therapy for diverticulitis and pneumonia, and this resolved spontaneously 1 month after discontinuation of the drug. Awareness of this complication could help to prevent unnecessary cholecystectomy.
Ceftriaxone ; Cholecystectomy ; Cholecystitis ; Cholecystolithiasis ; Diverticulitis ; Gallbladder ; Gallstones ; Humans ; Pneumonia ; Sewage ; Young Adult

BACKGROUND: Many patients received transfusion in emergency department because of blood loss. There are few studies on massive transfusion for non-traumatic patients. This study investigated mortality and risk factor for non-traumatic bleeding patients who received transfusion. METHODS: Non-trauma patients who received transfusion at the emergency department for 3 years from March 2009 to February 2011 were enrolled. The patients who are younger than 15 years, trauma patients, and transfused FFP or platelet alone are excluded. Medical records was investigated retrospectively. We investigated predictive factors for MT on non-trauma patients and predictive factors for mortality on MT patients. RESULTS: Among 1655 non-trauma patients, 150 patients (9.24%) received MT. The age of MT group was younger than that of non-MT group and systolic bloor pressure, diastolic blood pressure, mean arterial pressure were significantly lower. Base excess, pH, lactate levels were significantly different between MT and non-MT group. Intensive care unit length of stay was longer, mortality of 24 hours was higher and survival discharge was lower than non-MT group. Mortality rate of MT group was 20.7% which was significantly higher than non-MT group's 9.3%. FFP:RBC ratio was higher in MT group than non-MT group. Among the MT group, non-survival group used higher FFP:RBC ratio product than survival group. On multivariate analysis, sBP, MAP, lactate, pH, BE were significant as predictors of MT. CONCLUSION: For non-trauma patients in emergency department, if sBP, MAP, lactate, pH, BE are abnormal, massive transfusion could be expected. Like trauma patients, basic scoring system that can predict MT would be necessary and useful.
Arterial Pressure ; Blood Platelets ; Blood Pressure ; Blood Transfusion* ; Emergencies* ; Hemorrhage ; Humans ; Hydrogen-Ion Concentration ; Intensive Care Units ; Lactic Acid ; Length of Stay ; Medical Records ; Mortality ; Multivariate Analysis ; Retrospective Studies ; Risk Factors

BACKGROUND: End-stage renal disease (ESRD) is accompanied by various skin manifestations, and recently, the survival time of patients is increasing owing to the development of dialysis treatment, and skin manifestations are on the rise. OBJECTIVE: The objective of this study is to investigate the differences in skin changes, according to the dialysis method and period in ESRD patients, and to verify whether a correlation exists between the factors that affect pruritus. METHODS: Various kinds of skin manifestations were identified by examining and asking 80 outpatients detailed questions and the difference was examined by classifying them into groups, according to the dialysis method and period. RESULTS: The most common symptoms were xerosis (91%) and pruritus (85%). The study showed that most symptoms occurred more frequently in the peritoneal dialysis group than the hemodialysis, and among these, the change of sweating had a significant difference (p=0.043). As the dialysis period got longer, skin manifestation generally showed a higher frequency, and the particular bleeding tendencies and nail abnormalities showed an obvious difference. Results considering the relation of severity of pruritus and xerosis with the dialysis method and period showed a significant increase only in pruritus, according to the dialysis period (p=0.003). CONCLUSION: Skin changes showed a high frequency in peritoneal dialysis, but it didn't show a significant difference. Bleeding tendencies, changes of sweating, and nail abnormalities, according to the dialysis period, showed a significant difference. Factors causing pruritus were more related with xerosis than blood levels showing a renal function.
Dialysis ; Hemorrhage ; Humans ; Kidney Failure, Chronic ; Nails, Malformed ; Outpatients ; Peritoneal Dialysis ; Pruritus ; Renal Dialysis ; Skin ; Skin Manifestations ; Sweat ; Sweating

BACKGROUND: End-stage renal disease (ESRD) is accompanied by various skin manifestations, and recently, the survival time of patients is increasing owing to the development of dialysis treatment, and skin manifestations are on the rise. OBJECTIVE: The objective of this study is to investigate the differences in skin changes, according to the dialysis method and period in ESRD patients, and to verify whether a correlation exists between the factors that affect pruritus. METHODS: Various kinds of skin manifestations were identified by examining and asking 80 outpatients detailed questions and the difference was examined by classifying them into groups, according to the dialysis method and period. RESULTS: The most common symptoms were xerosis (91%) and pruritus (85%). The study showed that most symptoms occurred more frequently in the peritoneal dialysis group than the hemodialysis, and among these, the change of sweating had a significant difference (p=0.043). As the dialysis period got longer, skin manifestation generally showed a higher frequency, and the particular bleeding tendencies and nail abnormalities showed an obvious difference. Results considering the relation of severity of pruritus and xerosis with the dialysis method and period showed a significant increase only in pruritus, according to the dialysis period (p=0.003). CONCLUSION: Skin changes showed a high frequency in peritoneal dialysis, but it didn't show a significant difference. Bleeding tendencies, changes of sweating, and nail abnormalities, according to the dialysis period, showed a significant difference. Factors causing pruritus were more related with xerosis than blood levels showing a renal function.
Dialysis ; Hemorrhage ; Humans ; Kidney Failure, Chronic ; Nails, Malformed ; Outpatients ; Peritoneal Dialysis ; Pruritus ; Renal Dialysis ; Skin ; Skin Manifestations ; Sweat ; Sweating