No abstract available.
Ultrasonography*

From 1993 to 1996, we have used a new modular shoulder prosthesis for the treatment of acute complex fracture of the proximal humerus. The purpose of this study is to evaluate function, pain relief, and patient satisfaction after moduiar hemiarthroplasty for proximal humerus fractures. The stucly included 12 patients (J2 shoulders) with an average age of 68.5 years (range, 60 to 84 years). According to the Neer classification system, there were 3 four-part fracture-dislocations, 5 four-part fractures, 3 three-part fractures, and #I head splitting fracture. 'fhe hemiarthroplasty was pert'ormed at an average of 4 days (range, 3 to 10 days) following injury. Deltopectoral approach was used in all patients, and the prostheses were implanted with cement in ten cases. Follow-up evaluation, at an average of 32 months post-surgery, included clinical and radio- graphic examination. Active forward elevation averaged 120 degrees; external rotation, 35 degrees; and internal rotation, to the first lumbar vertebra. All of patients, except two who had poor results, were graded as good or excellent according to UCLA shoulder rating scale. Complications consisted of one tuberosity dispiacement, one peri-operative death and one loosening of uncemented humeral prosthesis. We concluded that Modular hemiarthroplasty for acute complex fracture of the proximal humerus especially in severely osteoporotic elderly patients facilitated the restoration of humeral length, anatomic repositioning of tuberosities, and precise soft tissue balance, thereby allowing earliermotion to prevent the developement of painful shoulder stiffness.
Aged ; Classification ; Follow-Up Studies ; Head ; Hemiarthroplasty* ; Humans ; Humerus* ; Patient Satisfaction ; Prostheses and Implants ; Shoulder ; Spine

OBJECTIVE: To compare the safety and efficacy of intravaginal misoprostol versus intracervical dinoprostone (prostaglandin E2 gel) for cervical ripening and labor induction. METHODS: 60 patients with indication for labor induction and unfavorable cervices were randomly assigned to receive either intravaginal misoprostol or intracervical dinoprostone. 50 microgram tablets of misoprostol were placed in the posterior vaginal fornix every 4 hours for a maximum of 3 doses or dinoprostone 0.5mg was placed into the endocervix every 6 hours for a maximum of 2doses. No more medication was given after either spontaneous rupture of membranes or beginning of active labor. RESULTS: Among 60 patients enrolled, 30 received misoprostol and 30 received dinoprostone. The average interval from start of induction to active labor was shorter in misoprostol group (6.5+/-3.2 hours) than in the dinoprostone group (10.7+/-7.3 hours) (p<0.05). Oxytocin augmentation of labor occurred more often in the dinoprostone group (36.7%) than in the misoprostol group (10.0%) (p<0.05). There was a higher prevalence of fetal distress (23.3% versus 3.3%) and tachysystole (16.6% versus 6.6%) in the misorprostol group than in the dinoprostone group(p<0.05). CONCLUSIONS: Vaginally administered misoprostol is an effective agent for cervical ripening and induction of labor. Furthermore, the cost of misoprostol ( 360/200microgram) is much less than that of dinoprostone ( 42,000/0.5mg). Cost benefits from administration of misoprostol are evident, especially in clinics under system of diagnosis-related group (DRG) : however when given at this dosage, it is associated with a higher prevalence of fetal distress and tachysystole than dinoprostone. Further studies to compare the safety of misoprostole to that of dinoprostone and to delineate an optimal dosing regimen for misoprostol are needed.
Cervical Ripening* ; Cost-Benefit Analysis ; Diagnosis-Related Groups ; Dinoprostone* ; Female ; Fetal Distress ; Humans ; Membranes ; Misoprostol* ; Oxytocin ; Pregnancy ; Prevalence ; Prospective Studies* ; Rupture, Spontaneous ; Tablets

No abstract available.
Hepatitis B Surface Antigens* ; Interferons* ; Lymphocytes*

No abstract available.
Cadherins* ; Carcinogenesis* ; Urinary Bladder*

Nasopharyngeal angiofibroma is a relatively rare, but is a well known tumor that occurs almost in male, most frequently during the adolescent stage. Its character is histologically benign but clinically malignant because of locally invasive character to the adjascent structures, massive bleeding tendency during surgical procedure and high recurrence rate after treatment. Recently many advancements diagnostic method and surgical technique has reached satisfactory result in treating this difficult tumor. The authors present a case of nasopharyngeal angiofibroma in 16 years old male patient, who was received surgical removal of the tumor through the transpalatal approach after full diagnostic evaluation and preoperative hormonal therapy.
Adolescent ; Angiofibroma* ; Hemorrhage ; Humans ; Male ; Methods ; Recurrence

No abstract available.
Ligaments* ; Magnetic Resonance Imaging* ; Tendons* ; Transplants*

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*

Despite continually improving results of total hip arthroplasty, infection remains the major debilitating complication. The treatments of infected total hip arthroplasty were variable. but initially we removed infected implants and inserted antibiotic containing cemented spacer so called PRSTALAC to prevent scar contracture and disuse osteoporosis. After 6 weeks later, control of infection was clinically and radiologically determined, we inserted new prosthesis with cement. Three weeks postoperatively, patient began touch down standing exercise. We observed infected total hip patient in whom hip had been salvaged successfuily with twostage implantation using so called "" PROSTALAC "" which was made with Moore stem.
Arthroplasty, Replacement, Hip* ; Cicatrix ; Contracture ; Hip ; Humans ; Osteoporosis ; Prostheses and Implants ; Replantation*

Supracondylar Fractures of the femur are not as cammon as femoral neck or intertrochanteric fractures, but their treatment may be just as difficult. Few surgeons have had extensive experience with this complex fractures of uncommon frequency. Until a few years ago, conservative treatment was considered superior to internal fixation of supracondylar fractures of the femur in adults. However, the development of new fixation devices and techniques has, according to several investigations, improved the results of the treatment of these fractures. The following clinical results were shown by analysis of 27 cases of femoral supracondylar fractures experienced in the Department of Orthopedic Surgery, Capital Armed Forces General Hospital in the past 3 years from Jan. 1977 to Oec. 1979. 1. The most common cause of these fractures were traffic accidents. 2. Of 27 cases, 11 cases were treated by conservative method, 16 cases were treated by open reduction and internal fixation. 3. Anatomical reduction and rigid internal fixation led to 80% of good to excellent results whereas only 33.4% of good to excellent results were obtained in patients in whom the fixation was not absolutely rigid. 4. In the treatment of supracondylar fractures of the femur, anatomical reduction and rigid internal fixation (80% of good to excellent results) resulted in better functional recovery after union of fractures than conservative treatment (45.5%).
Accidents, Traffic ; Adult ; Arm ; Femur Neck ; Femur ; Hip Fractures ; Hospitals, General ; Humans ; Methods ; Orthopedics ; Surgeons