No abstract available.
Thrombasthenia*

No abstract available.
Diabetes Insipidus, Nephrogenic* ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

No abstract available.
Family Practice* ; Humans ; Primary Health Care*

No abstract available.
Vascular System Injuries

Eighteen cases of osteonecrosis of the femoral head associated with macromolecular polyvinylpyrrolidone (PVP) deposition were analysed on the basis of clinical, radiologic and pathologic features. The cases were observed during 8 years period from January, 1974 to December, 1981. The pathogenesis of the osteonecrosis of the femoral head due to PVP storage in reticuloendothelial system were discussed in detail. Parenteral administration of high-molecular PVP in repeated, long duration led to osteonecrosis of the femoral head. Storage of PVP in the histiocytes of the bone marrow resulted in osteonecrosis of the femoral head followed by microciculation disturbance. PVP-induced osteonecrosis were manifested as multiple foci of necrosis involving not only the femoral head, other long bones around joints, but also the visceral reticuloendo-thelial system characterized by infiltrates of histiocytes laden with PVP. The patients with PVP induced osteonecrosis complianed multiple joint pain in their early course of the disease. On roentgenogram, osteonecrosis were often noted in the hip, shoulder, knee, and ankle in order or frequency. Foamy histiocytes laden with PVP were characteristic on hematoxylin-eosin stain diagnostic on Weigert's elastica, phosphotungstic acid hematoxylin, and Congo red stains. As far as rationale of the treatment concerning a number of staging systems for Osteonecrosis, the choice of surgical procedures were similar to those given by W.F. Enneking et al. In the series, we have performed two hips in total surface replacement, 26 hips in total hip replacement mostly for 3rd generation-configuration of Charnley prosthesis. In addition, one case for free vascularized fibula graft and trans-trochanteric rotational osteotomy after Sugioka were also included for this study. The result of treatment was rather optimistic. However, complications have occured in 4 hips of 3 patients which required removal of whole prosthetic components. Therefore, we underwent revisional surgery in three out of four hips subsequently during the short post-poerative follow-up. These will be published in the future.
Ankle ; Arthralgia ; Arthroplasty, Replacement, Hip ; Bone Marrow ; Coloring Agents ; Congo Red ; Fibula ; Follow-Up Studies ; Head ; Hematoxylin ; Hip ; Histiocytes ; Humans ; Joints ; Knee ; Mononuclear Phagocyte System ; Necrosis ; Osteonecrosis ; Osteotomy ; Phosphotungstic Acid ; Povidone ; Prostheses and Implants ; Rubber ; Shoulder ; Transplants

Rheumatoid arthritis (RA), which is frequently involved in the articulations of the hands and feet, is known to be related with inheritance. Dermatoglyphics, the patterns of ridges on the skin of the fingertips, palms, and soles, are mostly related with inheritance. The purpose of this study is to verify the possibility that dermatoglyphics are helpful for the diagnosis of RA. We attempted to compare the characteristics of the fingerprints, palmprints, and palm creases in 67 Korean RA patients (RA group) to those in 3, 216 normal Korean persons. In the RA group, the radial loop and whorl were more frequent whereas the arch and ulnar loop were less frequent. The total fingerprint ridges were more numerous and 11 palmprint D type was more frequent in the RA group. Also, the Simian and Sydney creases were more frequent and the total degree of palm crease transversality was lower in the RA group. In addition, a part of the dermatoglyphic characteristics of the Korean RA group were different from those of the Indian RA group. These results suggest that dermatoglyphics may be helpful in the diagnosis of Korean RA patients.
Arthritis, Rheumatoid* ; Dermatoglyphics* ; Diagnosis ; Foot ; Hand ; Humans ; Skin ; Wills

Technological advances that have been achieved over the last two decades in the area of treatment planning and sophisticated and complicated hardware capabilities, such as computer-controlled treatments, multileaf collimators, and incorporating imaging devices into treatment machines, enable clinical implementation of high-precision radiotherapy in field of radiation oncology. High-precision radiotherapy allows the delivery of increased tumor doses with relative sparing of normal tissues compared to 3 -dimensional radiotherapy and conventional techniques. Preliminary clinical experiences of high precision radiation therapy have been encouraging by high rates of local control and decrease of toxicity. This article provides an overview of high precision radiotherapy such as intensity-modulated radiotherapy, stereotactic radiation therapy, image-guided radiotherapy, and charged particle therapy.
Proton Therapy ; Radiation Oncology ; Radiotherapy, Image-Guided ; Radiotherapy, Intensity-Modulated

The purpose of this study was to investigate changes in the shape and ultrastructure of the articular disc of the rat mandibular joint with aging. Mechanical stress applied to the articular disc changes during neonatal, suckling, juvenile, adult and senile stages. Mandibular joints of 6 groups of rats(l-, 7-, 17-, 27-, 55-day and over-1-year groups) were removed en bloc and processed for light and electro microscopic study. The changes in the shape of articular disc were examined by light microscope in each group. Structural and ultrastructural changes in the articular disc were examined by light and electron microscope in each group. The results were as follows : In the 1-day and 7-day groups, the articular disc was long and slender in shape and the articular disc was not fitted with the shape of the mandibular fossa and condyle. However, after that time, the anterior and posterior portions of the articular disc were more bulged and the middle portion was shorter and biconcave. Thus the articular disc was well fitted with the shape of the mandibular fossa and condyle. The cell density decreased with aging. In the 1-day and 7-day groups, the Golgi apparatus, rough endoplasmic reticulum and free ribosome, which are involved in the synthesis of intracellular and extracellular matrix, were developed. In the 17-day, 27-day and 55-day groups, not only the cell organelles involved in the synthesis of the intracellular and extracellular matrix but also the cell organelles involved in the remodeling of the extracellular matrix(i.e., finger-like cell process, lysosome and mitochondria)were well developed. With advancing age, intracytoplasmic microfilaments were more accumulated and condroid cells increased. In the over-1-year group, the majority of cells of the articular disc were chondroid cells. The majority of cytoplasmic compartment were filled with intracytoplasmic microfilaments and cell organelles were not developed. Therefore, metabolic activities of the cell was markedly reduced and cells contained structures enduring mechanical stress, and cells which were in the process of degeneration were observed occasionally.
Actin Cytoskeleton ; Adult ; Aging* ; Animals ; Cell Count ; Cytoplasm ; Endoplasmic Reticulum, Rough ; Extracellular Matrix ; Golgi Apparatus ; Humans ; Joints* ; Lysosomes ; Organelles ; Rats* ; Ribosomes ; Stress, Mechanical

Objective: The purpose of this study is to report the activities of Disaster Medical Assistance Team and national emergency medical center in the fire at a women’s hospital on December 14, 2019, and to suggest an improvement plan for the special disastrous situation. Methods: We reviewed the transfer records of national emergency medical center, medical records of regional emergency medical center, and records of each patient’s prognosis of the women’s hospital, retrospectively. Triage of casualties was conducted according to SALT (Sort, Assess, Lifesaving Interventions, Treatment/Transport) method. Results: The fire was extinguished early and there was no victim with significant carbon monoxide intoxication. Among 228 casualties, there were 143 patients of the women’s hospital. Two patients were classified as immediate, 55 patients including pregnant women, newborns, and mothers were classified as delayed, and 171 casualties including newborns and mothers were classified as minimal. Among 66 newborns, 40 newborns were transferred to the regional Emergency Medical Center, and a second triage was conducted by doctors there. Conclusion Although there was no significant victim, physically and socially susceptible people such as pregnant women, newborns, and mothers were included in this accident. We recommend establishing a standard of disaster response for special population and improving our capability at a national level.

PURPOSE: Planning target volume (PTV) for tumors in abdomen or thorax includes enough margin for breathing-related movement of tumor volumes during treatment. Depending on the location of the tumor, the magnitude of PTV margin extends from 10 mm to 30 mm, which increases substantial volume of the irradiated normal tissue hence, resulting in increase of normal tissue complication probability (NTCP). We developed a simple and handy method which can reduce PTV margins in patients with liver tumors, respiratory motion reduction device (RRD). MATERIALS AND METHODS: For 10 liver cancer patients, the data of internal organ motion were obtained by examining the diaphragm motion under fluoroscope. It was tested for both supine and prone position. A RRD was made using MeV-Green and Styrofoam panels and then applied to the patients. By analyzing the diaphragm movement from patients with RRD, the magnitude of PTV margin was determined and dose volume histogram (DVH) was computed using AcQ-Plan, a treatment planning software. Dose to normal tissue between patients with RRD and without RRD was analyzed by comparing the fraction of the normal liver receiving to 50% of the isocenter dose. DVH and NTCP for normal liver and adjacent organs were also evaluated. RESULTS: When patients breathed freely, average movement of diaphragm was 12+/-1.9 mm in prone position in contrast to 16+/-1.9 mm in supine position. In prone position, difference in diaphragm movement with and without RRD was 3+/-0.9 mm and 12 mm, respectively, showing that PTV margins could be reduced to as much as 9 mm. With RRD, volume of the irradiated normal liver reduced up to 22.7% in DVH analysis. CONCLUSION: Internal organ motion due to breathing can be reduced using RRD, which is simple and easy to use in clinical setting. It can reduce the organ motion-related PTV margin, thereby decrease volume of the irradiated normal tissue.
Abdomen ; Carcinoma, Hepatocellular* ; Diaphragm ; Humans ; Liver ; Liver Neoplasms ; Prone Position ; Respiration ; Supine Position ; Thorax