Rheumatoid patients have poor bone quality and also have an increased incidence of sepsis, delayed wound healing, and general overall complications. It is the purpose of this paper to assess the clinical and roentgenographic results of ABG total hip replacement in rheumatoid arthritis. Twenty-six total hip arthroplasties done in seventeen patients with rheumatoid arthritis were studied prospectively. The average follow-up was 3 years and 4 months, with a minimum follow-up of 2 years and 7 months. The average age of the patients was 49.7 years (range 36-63) and there were sixteen females and one male. All patients fulfilled the 1987 revised criteria and there were eleven cases of protrusio acetabuli. All patients except two were taking oral steroids, nineteen cases were classed as Singhs index 1, five cases as Singhs index 2, and two cases as Singhs index 3. The Charnley approach with a trochanteric osteotomy was employed in all patients. Cup fixation was achieved with two spikes in twenty-one cases, two spikes and one screw in five cases, and in all cases the acetabular cup was angled at less than 45 from the horizontal. There was a gap between the acetabular cup and the acetabulum at DeLee and Charnley zone 1 in three cases, and at zone 2 in six cases. At 2 years, there was no radiolucency, reactive line or any sign of bone resorption. The development of cancellous and cortical densification was seen in Gruen's zone 2 and 6 for the first time in the 1 year radiographs. It became more prominent in the 2 year radiographs. The reactive bone line first became visible at the 6 month follow-up in the Gruen's zone 3 and 5. These lines extended more proximally, but it did not involve the proximal HA coated portion. Cortical hypertrophy of diaphysis was seen at Gruen's zone 3 and 5 in five cases. Rounding off of calcar was visible at zone 7 in six cases. There were no radiological changes of the femoral side in fourteen cases and the acetabular side in seven cases. There was one case of wire breakage, one case of trochanteric separation, and one case of intraoperative splitting of calcar. The result of the study indicated that the development of osseointegration in rheumatoid arthritis might be slow, but the clinical and radiological results were satisfactory. Further prospective follow up is necessary to determine whether the favorable early result of HA coated implant are maintained over longer periods.
Acetabulum ; Arthritis, Rheumatoid* ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Bone Resorption ; Diaphyses ; Durapatite* ; Female ; Femur ; Follow-Up Studies ; Hip ; Humans ; Hypertrophy ; Incidence ; Male ; Osseointegration ; Osteotomy ; Prospective Studies ; Sepsis ; Steroids ; Wound Healing

For many years, members of medical profession have believed that the shorter symptoms to diagnosis interval(SDI) might be related to early stages and that the prompt treatments might improve survival rates in cancer patients. But this notion has been challenged by many researches for many years. This study was conducted to investigate the effects of SDI on the cancer survival for 221 stomach cancer cases, 106 lung cancer cases, 74 liver cancer cases and 59 cervix cancer cases. These cancer cases are registered ones in Kanghwa Cancer Registery Program from 1987 to 1991. Relationships among SDI, stages of cancers, operation rates, and survival were analysed. Results are as follows: 1. SDI was not related to stages of cancer. There were no difference in the distribution of stages among five SDI subgroups. 2. This data did not support that SDI affects the survival of stomach cancer patients. The cancer stages did affect survival in stomach cancer patients though. 3. Our data did not support that SDI affects cancer survival. A Cox proportional hazard model showed that SDI does not play a important role in cancer survival controlling age, gender, stage and other variables in the model. Further studies are highly expected to clarify the relationships between SDI and cancer survivals. Researches with bigger sample size and more sophisticated variables would be needed.
Diagnosis* ; Humans ; Liver Neoplasms ; Lung Neoplasms ; Proportional Hazards Models ; Sample Size ; Stomach Neoplasms ; Survival Rate ; Uterine Cervical Neoplasms

Four children, with histopathologically confirmed posterior fossa primitive neuroectoderrnal tumors, were examined by plain radiography, computed tomography (CT) and cerebral angiography. The homogeneously well enhanced solid mass in the midline of the posterior fossa and hydrocephalus of various degree were seen on all CT scans. One case had calcifications and another case had low density areas in the tumor mass. Three cerebral angiograms showed vascular displacement without tumor vascularities. Unfortunately, these CT and angiography findings are and other tumors. when a well enhanced solid mass in the midline posterior fossa is seen on CT scan in children.
Angiography ; Cerebral Angiography ; Child ; Humans ; Hydrocephalus ; Medulloblastoma* ; Neuroectodermal Tumors, Primitive* ; Pathology* ; Radiography ; Tomography, X-Ray Computed

PURPOSE: To evaluate the feasibility and accuracy of the simple robotic surgical system to rasp the femoral canal in total hip arthroplasty, we investagated the fitness error and alignment error. MATERIALS AND METHODS: Femoral canals of six human cadaveric bones, 12 pig bones, and 18 sawbones were reamed using the author's robot system. Radiographs and axial CT images were obtained after the operation. The fitness error(gap between the femoral stem and the surface of the femoral canal) and the alignment error(the angle between the longitudinal axis of femoral canal and the distal part of the stem) were measured. The anteversion was measured in axial view of CT scan. RESULTS: The errors were measured at 3 levels; level A, in the upper third, level B, in the middle third and level C, in the lower third of the proximal part of the stem. The mean value of fitness error was 0.12 mm at level A, 0.20 mm at level B, and 0.29 mm at level C. In cadaveric femurs, the average alignment errors were 0.02 degrees in anteversion, 0.98 degrees of valgus in coronal plane, and 0.51 degrees of flexion in sagittal plane. The errors were -0.03 degrees, 0.31 degrees, and -0.36 degrees respectively in pig bones. The errors were 0.13 degrees, 0.14 degrees, and -0.27 degrees respectively in sawbones. CONCLUSIONS: This robot system is relatively simple and cheap compared with ROBODOC system. It can be utilized for the rasping of the femoral canal during total hip arthroplasty.
Arthroplasty, Replacement, Hip* ; Axis, Cervical Vertebra ; Cadaver ; Femur ; Humans ; Tomography, X-Ray Computed

Despite of high recurrenre rate of oerebrovascular accidents(CVA), little attntion had been given to the features of its' recurrence. Of 167 patients with recurrent CVA between March, 1985 and Febnuary, 198.103 patients wer included in this study. Sixty of them were men and 43 of them were women, Their ages ranged from 29 to 8 years(mean. 6.5 ears), with the peak inidence in the sixth and seventh decades .The mean interval between first and second CVA was 23.4 months(range, 1to 144 months) Eighty-one patients had at least more tha one of isk factors, but onl 3 had been received proper treatment. There were tendencies to recur same type and site with the first attack, The patient with history of heart disase. Abnormal eletrocardiographic features, increased fasting bloo sugar(p<0.01), high diastolic bloo pressres (p<0.05)had poo prognois And, the patients ith embolism or hemorrhage revealed poo prognosis than the patients with trombosis(p<.05).
Embolism ; Fasting ; Female ; Heart ; Hemorrhage ; Humans ; Male ; Prognosis ; Recurrence ; Stroke*

PURPOSE: This study was performed to evaluate chromatin condensation of morphologically mature sperm using a modified aniline blue-eosin (AB-E) staining method in azoospermia. MATERIALS AND METHODS: Chromatin condensation was analyzed using an AB-E staining method in 61 cases (50 patients) of TESE or testicular biopsy with the patient's own sperm. Obstructive azoospermia (OA) was present in 48 cases in 39 patients and non-obstructive azoospermia (NOA) was present in 13 cases in 11 patients, respectively. Immature sperm heads were stained dark blue, whereas mature sperm were stained red-pink by the eosin. The percentage of sperm chromatin condensation was calculated from the ratio of the number of red-pink sperm to the total number of sperm analyzed. RESULTS: The percentage of chromatin maturity was 37.7% vs. 30.3% in OA and NOA, respectively, of the total sperm cell count. The maturity of fresh testicular sperm was 38.3% and 36.3% in OA and NOA, respectively. Also, the maturity of thawed testicular sperm was 34.5% and 10.3% (p<0.05) in OA and NOA, respectively. The maturity of fresh and thawed testicular sperm was 36.3% and 10.3% (p<0.05), respectively, in NOA. These results suggest that chromatin condensation is less stable in sperm of NOA and freezing and thawing procedures may impair sperm chromatin condensation. CONCLUSIONS: In our results, the aniline blue-eosin staining method improved the visualization of excessive histones in sperm and the diagnosis of sperm immaturity in morphologically normal testicular sperm. We found that AB-E staining method can be an effective method for analyzing testicular sperm chromatin condensation in azoospermia.
Aniline Compounds ; Azoospermia ; Biopsy ; Cell Count ; Chromatin ; Eosine Yellowish-(YS) ; Freezing ; Histones ; Humans ; Sperm Head ; Spermatozoa

Purpose: This study was conducted in order to examine the usefulness of osteoconductive bone substitutes with zeta potential control (geneX® ds; Biocomposites, England) by comparing the complications and radiographic evaluation with or without geneX® ds augmentation for internal fixation with proximal femur nail antirotation (PFNA) for treatment of osteoporotic unstable intertrochanteric fractures. Materials and Methods: A retrospective study of 101 patients who underwent fixation with PFNA in osteoporotic unstable intertrochanteric fractures was conducted from December 2015 to August 2020. The radiographic evaluation and complication rates were compared between patients with geneX® ds (Group A: 41 cases) and those without geneX® ds (Group B: 60 cases). Results: In radiological valuation, the degree of blade sliding from the time immediately after surgery to one year after surgery was 1.4±1.2 mm and 5.8±2.7 mm in Group A and Group B, respectively (P<0.001). During the same time frame, a significant difference of 2.3±2.2° and 7.4±3.1° , respectively (P<0.001), in varus collapse, was observed for Group A and Group B. Conclusion Among patients fixed with PFNA for treatment of unstable intertrochanteric fractures, less blade sliding and varus collapse was observed for those with geneX® ds augmentation compared to those without it. In addition, there was no increase in the incidence of complications. The authors believe it can be regarded as a safe and effective additive for intramedullary fixation for treatment of unstable intertrochanteric fractures.

Pnuemocystis jirovecii pneumonia (PJP) is one of leading causes of acute respiratory failure in patients infected with human immunodeficiency virus (HIV), and the mortality rate remains high in mechanically ventilated HIV patients with PJP. There are several reported cases who received extracorporeal membrane oxygenation (ECMO) treatment for respiratory failure associated with severe PJP in HIV-infected patients. We report a patient who was newly diagnosed with HIV and PJP whose condition worsened after highly active antiretroviral therapy (HAART) initiation and progressed to acute respiratory distress syndrome requiring veno-venous ECMO. The patient recovered from PJP and is undergoing treatment with HAART. ECMO support can be an effective life-saving salvage therapy for acute respiratory failure refractory to mechanical ventilation following HAART in HIV-infected patients with severe PJP.
Antiretroviral Therapy, Highly Active* ; Extracorporeal Membrane Oxygenation* ; HIV ; Humans ; Mortality ; Pneumocystis jirovecii* ; Pneumocystis* ; Pneumonia* ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult* ; Respiratory Insufficiency ; Salvage Therapy

BACKGROUND: In recent years, lung cancer has been one of most common cause of death in Korea. Despite many physician's high degree of pessimism about the gains made in treatments progressive improvement in the survival of lung cancer by treatment has occurred, particulary in the early stages of the disease. However, a lot of patients refuse treatment or give up in the fight against the disease. This study was done to evaluate factors ifluencing the compliance to therapy and to lead in the establishment of special programs to enhance compliance in patients with lung cancer. METHODS: The medical records of 903 patients, whose ECOG(Eastern Cooperative Oncology Group) performance status was 3 or less and whose medical record was relatively satisfactory, among 1141 patients diagnosed with lung cancer between January 1989 and December 1996 were reviewed retrospectively. Compliance was classified into three groups based on the degree of compliance with physicians practice guideline : (a) complaints ; (b) patients who initially complied but gave up of themselves midway during the course of treatment ; (c) noncompliants who refused the treatment. RESULTS: The overall compliance rats was 63.9%, which was progressively increased from 57.3-61.3% in 1989 and 1990 to 64.2-67.5% in 1995 and 1996. Age, education level and occupation of patients bore statistically significant relationship with the compliance but sell marital status and smoking history did not. The compliance was significantly higher in patients without symptoms than with, and was also significantly higher in patients with good performance status. The compliance was significantly high in patients with NSCLC(non-small cell lung cancer) compared to SCLC(small cell lung cancer), but after exclusion of stage l and ll, among NSCLC, which had higher compliance to surgery there was no significant difference of compliance by histology. The compliance was significantly lower in advanced stage. CONCLUSION: To enhance the compliance, special care including education programs about therapy including complicantion and prognosis are necessary, especially for educationally and economically disadvantaged patients.
Animals ; Cause of Death ; Compliance* ; Education ; Humans ; Korea ; Lung Neoplasms* ; Lung* ; Marital Status ; Medical Records ; Occupations ; Prognosis ; Rats ; Retrospective Studies ; Smoke ; Smoking ; Vulnerable Populations

PURPOSE: The gastric cancer is most frequent malignant disease in Korea. With increase of GNP and social welfare, lot of people pay attention to that. But many of gastric cancer patients who were diagnosed, are advanced -stage III or more- case and produces poor result of treatment. Nowadays many surgeons report that the resection of cancer mass and radical lymph node dissection, which called systematic lymph node dissection, can increase the longterm survival rate and curability of patients. For this purpose Maruyama and his colleagues made a program to predict the 5 year survival rate, cause of death, and the status of lymph node metastases. We put the basic datas of pateints in AGC into Maruyama's program and compare its result to final histologic reports. We would check sesitivity, specificity, positive predictive value, negative predictive values between Maruyamas program and hitologic reports. MATERIALS AND METHODS: From Sep. 1995 to Sep. 1996, We operated 55 patients with gastric cancer with this program in GNUH. We checked the histopathologic reports and put the data into the prediction program. The datas were sex, age, maximal size of tumor, differentiation, gross type and location. We compared status of lymph node metastases, TNM stages between the reports of histopathology and that of predictive program. RESULTS: In early stages the sensitivity and specificity of the program showed poor result but in advanced stages did not. The distribution of lymph node metastasis showed a same pattern. The patterns of perigastric lymph node metastasis were somewhat different according to the location of tumor. But its significance was not confirmed. We analysed the metastaic rate between lymph node groups and compared with the results between two reports. The sensitivity, and negative predictive value were 100% in each groups, and positive predictive value was also high. CONCLUSION: The systematic lymph node dissection is an effective and safe procedure in the surgical treatment of gastric cancer. We suggest that the techniques should be standardized and popularized in Korea. This procedure will improve the survival rate of gastric cancer patients and decrease the local recurrence of gastric cancer.
Cause of Death ; Humans ; Korea ; Lymph Node Excision ; Lymph Nodes* ; Neoplasm Metastasis* ; Recurrence ; Sensitivity and Specificity ; Social Welfare ; Stomach Neoplasms* ; Survival Rate