Hemophilia, a genetically determined disorder, can be divided into hemophilia A and hemophilia B. Hemophilia A, defined as a sex-linked recessive trait hemorrhagic disease of males characterized by a deficiency of factor VIII occurs about seven times more frequently than hemophilia B which is characterized by a deficiency of factor IX. The complications resulting from hemophilia occurs in virtually every system. This paper is concerned with a rare complication of hemophilia, iliacus hematoma with femoral neuropathy. On case of spontaneous hemorrhage of iliacus muscle with femoral neuropathy in hemophilia was decompressed through a small incision with sump drainage under cover of AHF(Anti-hemophilic factor) concentrated plasma cryoperecipitate followed AHF replacement therapy.
Drainage ; Factor IX ; Factor VIII ; Femoral Neuropathy ; Hematoma ; Hemophilia A ; Hemophilia B ; Hemorrhage ; Humans ; Male ; Plasma

No abstract available.
Bone Density* ; Female ; Lactation* ; Postpartum Period*

PURPOSE: To investigate the characteristics of cultured rabbit corneal keratocytes in vitro and evaluate the possibility of differentiation of mesenchymal stem cells to keratocytes using the keratocyte conditioned medium (KCM). METHODS: Isolated keratocytes were seeded on the stromal side of amniotic membranes (AM) or plastic dishes, and morphologic changes were evaluated. Rabbit mesenchymal stem cells were cultured on AM with alpha-MEM (minimum essential medium alpha) and KCM. The gene expression patterns of specific keratocyte markers (keratocan, lumican, and aldehyde dehydrogenase family, member A1 (ALDH1A1)) of cultured cells were evaluated by RT-PCR. RESULTS: Keratocytes on AM showed dendritic morphology with slow proliferation in contrast, cells on dishes were stellate in shape with fast proliferation. Cultured keratocytes on AM maintained the expression of keratocan, lumican and ALDH1A1 while keratocytes on plastic dishes steadily lost their keratocyte marker gene expression. Additionally, mesenchymal stem cells cultured with KCM on AM induced expression of keratocan and ALDH1A1. CONCLUSIONS: Keratocytes cultured on AM stromal matrix maintained their characteristic morphology and marker gene expression. Morphology changes and marker gene expressions of mesenchymal stem cells suggest an ability to differentiate into keratocytes when grown on AM with KCM.
Aldehyde Dehydrogenase ; Amnion ; Cells, Cultured ; Chondroitin Sulfate Proteoglycans ; Corneal Keratocytes ; Culture Media, Conditioned ; Gene Expression ; Humans ; Keratan Sulfate ; Mesenchymal Stromal Cells ; Organic Chemicals ; Plastics ; Seeds

Chondromyxoid fibroma is the least common benign bone tumor, accounting for less than 1% of all bone tumors. Pathologically, it is composed of varying proportions of chondroid, myxoid and fibrous elements. The most common anatomical site is the metaphyseal region of the long bone, and the typical radiologic appear-ance is a cortical expansile osteolytic lesion with a lobulated sclerotic margin, and septa. We report the plain and MRI findings of a relatively typical chondromyxoid fibroma occuring in the proximal fibula.
Bone Neoplasms ; Fibroma* ; Fibula* ; Magnetic Resonance Imaging

BACKGROUND: Prolonged extracorporeal circulation entails tremendous threats of red cell lysis, severe bleeding problems due to platelet injury and activation, and endothelial damages by sequestered leukocytes. In consideration of these problems, a new centrifugal pump was developed and tested clinically to evaluate its effectiveness. METHODS: We compared the effects of a centrifugal pump with those of a roller pump on hematological responses during cardiopulmonary bypass (CPB) in 20 coronary artery bypass surgery patients. The patients were divided into two groups of 10 each. The studied parameters included WBC counts, platelet counts, plasma Hb and D-dimer. Blood samples were taken after sternotomy, at 60 min, 120 min and 180 min after CPB start, and at 2 hr after CPB stop. RESULTS: No differences between the groups were found in bypass time, aortic cross clamp time, extracorporeal circulation flow and hematocrit. The centrifugal pump group demonstrated less platelet depletion (p<0.05), hemolysis (plasma Hb, p<0.05) and fibrinolysis (D-dimer, p<0.05). These differences were CPB time dependent and became statistically significant after 120 min bypass. CONCLUSION: We conclude that roller pump still can be safely used for standard cardiac procedures with bypass time less than 120 minutes and the centrifugal pump has significant potential to be safely applied to CPB for long ypass time in order to avoid postperfusion syndrome.
Blood Platelets ; Cardiopulmonary Bypass* ; Coronary Artery Bypass ; Extracorporeal Circulation ; Fibrinolysis ; Hematocrit ; Hemolysis ; Hemorrhage ; Humans ; Leukocytes ; Plasma ; Platelet Count ; Sternotomy

Ambulstory surgery in a hospital-based setting has been practiced at Yongdong Severance Hospital since August 1983. Several factors favor ambulatory surgery over the inpatient approach, first, hospital costs are decreased, second, it is less disruptive to the patient's personal life and the risk of hospital-acquired infection can be significantly decreased. The charts of 1913 patients who were anesthetized for ambulatory surgery were analyzed retrospectively to obtain better guidance for anesthetic management in ambulatory surgical patients. The results are as follows: 1) The number of patients has been increasing since 1983. 2) A total of 1913 patients were evaluated, including 660 males and 1253 females, ranging in age from 5 months to 80 years and averaging 26 years. 3) The operations performed were grouped into: gynecologic(33.9% of the cases), otolaryngologic(33.7%), orthopaedic(10.4%), etc. The most frequent procedures were diagnostic dilation and curettage(23.7%) and excision(17.6%). 4) General anesthesia was performed for 852 patients(44.5%) and the anesthetic agents administered were intravenous narcotics in 360 cases, halothane-N2O-O2 in 289 cases, enflurane-N2O-O2 in 67 cases, etc. Nongeneral anesthesia was included regional nerve block in 76 cases(4.0%) and local infiltration in 985 cases(51.5%). 5) Anesthesia lasted less than one hour in 79.2% of the cases. Recovery time lasted less than one hour in 88.0% of the cases. 6) Only one patient was admitted for an anesthetic reason which was aspiration pneumonia. Seventeen patients were admitted for surgical reasons such as fever, bleeding, etc. From the above results, we believe that anesthetic care for ambulatory surgical patients can be provided safely and cost saving. Safety is an attitude, and when good practice is followed in selection of patients with careful preanesthetic evaluation and careful anesthetic technique, there is no reason to expect more complication than under the circumstance of hospitalization.
Ambulatory Surgical Procedures ; Anesthesia ; Anesthesia, General ; Anesthetics ; Cost Savings ; Female ; Fever ; Hemorrhage ; Hospital Costs ; Hospitalization ; Humans ; Inpatients ; Male ; Narcotics ; Nerve Block ; Pneumonia, Aspiration ; Retrospective Studies

Gastric teratoma is an extremely rare tumor that accounts for less than 1% of all teratomas. Gastric teratoma is mostly presented as a palpable abdominal mass, and is rarely accompanied with gastrointestinal bleeding such as melena or hematemesis. A 5-month-old male infant was brought with a history of pale facial color and dark-colored stool. The hemoglobin level was at 6.1 g/dL, with melena having begun 1 month previous. Upper gastrointestinal endoscopy revealed a polypoid mass with bleeding at the upper body and lesser curvature of the stomach. Wedge resection of the stomach was performed and histopathological analysis confirmed the mass to be a mature cystic teratoma. There was no recurrence after the operation during follow-up.
Endoscopy, Gastrointestinal ; Follow-Up Studies ; Hematemesis ; Hemorrhage* ; Humans ; Infant* ; Male ; Melena ; Recurrence ; Stomach ; Teratoma*

There is some controversy regarding the effect of general inhalation anesthesia on platelet function. In 20 patients undergoing long operations over 3 hours, and anesthetized with either nitrous oxide-oxygen and enflurane (A group) or nitrous oxide-oxygen and halothane (B group), we could not find any clinically significant impairment of coagulation. Platelet functions were consecutively evaluated on the samples collected at preinduction, during anesthesia (3 hours) and at postoperation (24 hours) using an aggregometer and several aggregating agents including ADP, epinephrine, collagen and ristocetin. There were no statistically significant changes between the maximum aggregation rate of preinduction and that duirng anesthesia in either group.
Adenosine Diphosphate ; Anesthesia ; Anesthesia, Inhalation ; Anesthetics, Inhalation* ; Blood Platelets* ; Collagen ; Enflurane ; Epinephrine ; Halothane ; Humans ; Inhalation* ; Ristocetin

OBJECTIVES: The aim of this work is to use a 3D solid model to predict the mechanical loads of human bone fracture risk associated with bone disease conditions according to biomechanical engineering parameters. METHODS: We used special image processing tools for image segmentation and three-dimensional (3D) reconstruction to generate meshes, which are necessary for the production of a solid model with a 3D printer from computed tomography (CT) images of the human tibia's trabecular and cortical bones. We examined the defects of the mechanism for the tibia's trabecular bones. RESULTS: Image processing tools and segmentation techniques were used to analyze bone structures and produce a solid model with a 3D printer. CONCLUSIONS: These days, bio-imaging (CT and magnetic resonance imaging) devices are able to display and reconstruct 3D anatomical details, and diagnostics are becoming increasingly vital to the quality of patient treatment planning and clinical treatment. Furthermore, radiographic images are being used to study biomechanical systems with several aims, namely, to describe and simulate the mechanical behavior of certain anatomical systems, to analyze pathological bone conditions, to study tissues structure and properties, and to create a solid model using a 3D printer to support surgical planning and reduce experimental costs. These days, research using image processing tools and segmentation techniques to analyze bone structures to produce a solid model with a 3D printer is rapidly becoming very important.
Bone Diseases ; Computer-Aided Design ; Fractures, Bone ; Humans ; Tibia*

PURPOSE: The purpose of this study was to conceptualize and clarify a concept of "preparatory grief" in terminal cancer patients. METHOD: A hybrid model of concept development was applied to develop a concept of preparatory grief, which included a field study carried out in Busan, Korea. Participants of this study were 8 cancer patients. RESULTS: On the basis of our literature, research and clinical experience, the concept of preparatory grief emerged as a complex phenomenon playing an important role in five areas; physical, emotional, interpersonal, religious, and transcendental dimensions. Two new attributes were defined through a field phase; trust of the post-mortal world and a serene state of mind. Indicators reflected attitudes of sadness, worry, regret, capability to adapt and hope. The results of preparatory grief were loss of energy and interest, emotional chaos, contemplation, taciturnity and restoration. CONCLUSIONS: Differentiating among preparatory grief and other symptoms in cancer patients is essential because of therapeutic implications. Understanding preparatory grief is necessary in order to manage cancer patients for promoting quality of life so that its application may have a positive impact on the patient's life.
Adaptation, Psychological ; Aged ; *Concept Formation ; Counseling/*methods ; Female ; *Grief ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Neoplasms/nursing/*psychology ; Quality of Life ; *Terminal Care