In the orthopaedic field, some elective surgeries such as joint replacement, spinal surgery and limb salvage procedures for musculoskeletal tumors frequently need various amounts of blood transfusions. However, homologous transfusion occasionally results in various side effects, such as allergic reaction, febrile reaction, and the transmission of infectious diseases such as syphilis, hepatitis and AIDS, ctc. Recently, these complications especially in elective surgery might result in medicolegal or social problems. Risks from transfusions in elective surgery can be minimized with prebanked autologous transfusion. To evaluate the necessity of prehanked autogenous transfusion, fifty five patients who had unilateral hybrid total knee arthroplasty (noncemented at the femoral side and cemented at the tibial and patellar sides) were operated on by the same surgeon from April 199S to July 1997 and had autogenous shed blood transfusion were evaluated for postoperative blood loss, amount of autogenous shed blood, amount of transfusion, hemoglobin and hematocrit. The results were as follows: 1. The distribution of preoperative hemoglobin was from 9.6g/dL to 16.5g/dL (average: 1.8g/dL). 2. The distribution of the amount of blood loss for three days postoperatively was from 156ml to 2001 ml (average: 798ml). 3. The distrihution of the amount of transfusion of autogenous shed blood was from 30ml to 600ml (average: 448ml). 4. There were two patients who had febrile reactions above 38 after transfusion of autogenous shed blood. 5. Forty-six patient(84%) had a homologous transfusion and the average amount of transfusion was 1.9 pint. 6. Total amount of homologous transfusion was decreased according to the increased amount of hemoglobin and the amount of transfusion was statistically decreased above the level of I 3g/dL(Students t-test, P=0.0005). 7. There were no significant differences in the amount of homologous transfusion between age, sex, type of disease, type of implants. In conclusion, most of our patients(84%) needed homologous blood transfusion in unilateral hyhrid total knee arthroplasty and the amount of transfusion decreased in patients who had hemoglobin above 13.0g/dL. So we recommend preparing banked autogenous hlood preoperatively in patients who have a lower hemoglobin level in unilateral hyhrid total knee arthroplasty.
Arthroplasty* ; Blood Transfusion* ; Communicable Diseases ; Hematocrit ; Hepatitis ; Humans ; Hypersensitivity ; Joints ; Knee* ; Limb Salvage ; Postoperative Hemorrhage ; Social Problems ; Syphilis

Synovial cysts are uncommon lesions that may occur within the spinal canal. Most commonly synovial cysts arise from degenerative apophyseal joints, in particular at the L4-5 level, and are associated with spondylolisthesis. We present one case of lumbar synovial cyst located both intraspinally and extraspinally and originated from the defect of the pars interarticularis. The content of the synovial cyst was infected. The patient progressively developed low back pain and fever. The lesion was diag nosed by computed tomography and a magnetic resonance imaging. The synovial cyst was presented a huge lobulacted intraspinal and extraspinal mass and connected with the L4-5 facet joint on the right side. The dural sac was displaced by the intraspinal mass. Relieve of symptoms was achieved with decompressive laminectomy and removal of the mass. The content of the synovial cyst was infected with Staphylococcus aureus confirmed by the synovial fluid culture. The reasons for our report are to describe the previously unreported appearance of this lesion that was huge lobulated intraspinal and extraspinal mass with infected fluid content originated from the defect of the pars interarticularis.
Fever ; Humans ; Joints ; Laminectomy ; Low Back Pain ; Magnetic Resonance Imaging ; Nose ; Spinal Canal ; Spine* ; Spondylolisthesis ; Staphylococcus aureus ; Synovial Cyst* ; Synovial Fluid ; Zygapophyseal Joint

Bilateral jumped facets dislocation in upper thoracic spine is rare injury because the thoracic spine is relatively immobile structure. We experienced a case of T2-3 dislocation without fracture and successfully reduced the dislocation after partial resection of the superior articular process of the third thoracic spine and performed fixation and fusion from T1 to T4 with pedicle screw system.
Dislocations* ; Spine

No abstract available.
Anaphase-Promoting Complex-Cyclosome ; Neoplasms ; Cell Nucleus ; Colorectal Neoplasms ; Anaplasia ; Aneuploidy

No abstract available.
Colorectal Neoplasms*

No abstract available.
Female ; Obstetric Labor, Premature* ; Pregnancy ; Ritodrine* ; Tocolytic Agents*

Pigmented villonodular synovitis and synovial chondromatosis are known as a poup of interrelated tumorous disorders that involve the lining of the joints, hursa and tendon sheath. Pigmented villonodular synovitis consists of proliferatin synovia1 tissue containing histiocytes, librohlasts, multinucleated giant cells, and capillaries that can destroy dense fihrous tissue, form soft tissue masses, and invade bone. Synovial chondromatosis consists of hyaline cartilage nodules within the synovium and synovial joint cavities, develop multiple loose fragments of cartilage within the joint. They may represent a reactive inflammatory process or henign neoplasm and usually occur in latge synovial joints, including the knee, hip and ankle. There are some reports stating that pigmented villonodular synovitis has coexisted with synovial chondromatosis. but none have reported that they occurred simultaneously in a large single joint. This is a report on a diagnosed and arthroscopicully treated pigmented villonodular synovitis and synovial chondromatosis that occurred simultaneously in the same ankle joint.
Ankle Joint* ; Ankle* ; Capillaries ; Cartilage ; Chondromatosis, Synovial* ; Giant Cells ; Hip ; Histiocytes ; Hyaline Cartilage ; Joints ; Knee ; Synovial Membrane ; Synovitis, Pigmented Villonodular* ; Tendons

PURPOSE: This study was to identify symptoms and provided services of home-based cancer patients in J province. METHODS: 1,350 data poins for 167 home-based cancer patients were analyzed retrospectively. 13 symptoms and 39 service items were measured by tools for home-based cancer patients suggested by the Ministry for Health, Welfare and Family Affairs. RESULTS: The mean number of provided services was 7.4+/-9.1. The most common symptoms were fatigue, anorexia, and pain. Patients whose duration after diagnosis was over 6 years, who had metastasis, or who underwent terminal care had more symptoms. Patient education, emotional and spiritual support, and basic assessment and services were provided most often. Frequency of provided services in patients whose duration after diagnosis was over 6 years or who had metastasis was higher. Services such as symptom and pain control, or death of the patient/the bereaved were provided with more support with patients who underwent terminal care. CONCLUSION: There were some differences in provided services according to medical characteristics. Patients experienced diverse symptoms, but services regarding these symptoms seemed to be insufficient. For more effective services, cooperation between organizations for home-based cancer patients is needed to form a better management model based on the merit of each facility or patient characteristics.
Anorexia ; Fatigue ; Home Care Services ; Humans ; Neoplasm Metastasis ; Nursing Services ; Patient Education as Topic ; Retrospective Studies ; Terminal Care

Repairing of lacrimal canalicular laceration has some controversies on the golden time of surgery, the suture method, and the materials for stent. Recently, intubation of silicone tubes has become popular for repair of lacrimal canalicular injuries. Thirty-two cases of injured lacrimal canaliculi were repaired with use of silicone tube stents. The surgery can be done with monocanalicular(10 patients) or bicanalicular(22 patient) methods. The follow-up period was from two to eighteen months(mean ten months). Seven cases using the monocanalicular method and nineteen cases using the bicanalicular method were successful. Three cases of monocanalicular method had epiphora with canalicular obstruction due to early loss of the silicone tube. In monocanalicular method, postoperative complications were punctal granuloma(1 case), punctal slits(2 cases), and early loss of the silicone tube(3 cases). In bicanalicular method, postoperative complications were persistent epiphora during the period of intubaion(4 cases), conjunctival irritation sign(3 cases) and loop retraction(1 case). In conclusion, the success rate of bicanalicular stents were higher than that of monocanalicular stents for canalicular laceration. But the bicanalicular stent had some complications including cosmetic problem, possibility of injuries to the normal canaliculus during intubation, conjuntival irritation sign, and loop retraction.
Follow-Up Studies ; Intubation* ; Lacerations ; Lacrimal Apparatus Diseases ; Postoperative Complications ; Silicones* ; Stents ; Sutures

Purpose: To retrospectively compare the fixation methods for reattaching a trochanteric fragment in a pertrochanteric fracture treated with bipolar hemiarthroplasty. Materials and methods: Forty cases of an unstable femur pertrochanteric fracture were analyzed and followed up for average of 19(6~40) months. There were 18 cases fixed with tension band wiring (group 1), 7 cases treated using modified tension band wiring with K-wires (group 2) and 15 cases treated with the GTRD (Greater Trochanteric Reattachment Device) (group 3). Result: Group 1 was treated with simple a surgical procedure and the results were good. The second group had firm fixation postoperatively but required additional surgery in two cases to remove the K-wires because of wire migration after ambulation. Group 3 had relatively good results but required more dissection and a longer operating time. Conclusion: Tension band wiring or GTRD are good fixation methods for reattaching trochanteric fragments in pertrochanteric fractures. Moreover, tension band wiring is recommended for old osteoporotic patients due to a simple procedure and firm fixation. The use of modified tension band wiring using K-wire or a Steinmann-pin should not be used due to the possibility of distant migration.
Femur* ; Hemiarthroplasty* ; Humans ; Retrospective Studies ; Walking