BACKGROUND: Esmolol is a short acting sympathetic beta receptor antagonist, and it was successfully applied to induced hypotension. Esmolol lowers blood pressure by decreasing cardiac output, and does not cause vasodilation. This property of esmolol may help to decrease bleeding during induced hypotension. In this study, we tried to elucidate the effect of esmolol on induced hypotension for total hip arthroplasty. METHOD: Twenty patients receiving total hip arthroplasty were randomly divided to two groups. Esmolol group (10 patients) received esmolol as a hypotensive agent, and sodium nitroprusside (SNP) group (10 patients) received SNP as a hypotensive agent. We measured arterial blood gas analysis, vital sign, amounts of bleeding, amounts of transfusion and administered fluid, and various laboratory findings. RESULTS: Induced hypotension was successfully performed in either esmolol and SNP group. Heart rate increased by SNP, and decreased by esmolol. There were no statistically significant differences between the two groups in amounts of bleeding, amounts of transfusion or administered fluid, and laboratory findings. Arterial oxygen tension was relatively constant in esmolol group, but decreased in SNP group. CONCLUSION: Esmolol can be used as a single hypotensive agent during induced hypotension without significant side effects during total hip arthroplasty.
Arthroplasty, Replacement, Hip* ; Blood Gas Analysis ; Blood Pressure ; Cardiac Output ; Heart Rate ; Hemorrhage ; Humans ; Hypotension* ; Nitroprusside* ; Oxygen ; Sodium* ; Vasodilation ; Vital Signs

PURPOSE: We investigated the efficacy of transurethral needle ablation (TUNA) of prostate for benign prostatic hyperplasia (BPH) in patients with low compliance to medical therapy and high risk operative morbidity and mortality. MATERIALS AND METHODS: Total 38 patients with BPH and low compliance to medical therapy and high risk operative morbidity and mortality were treated with TUNA under the local anesthesia and evaluated prospectively using the international prostate symtom score (IPSS), Qmax, satisfaction score and postvoid residuals (PVRs), and followed for 3 months after treatment. RESULTS: The mean pretreatment symptom score was 24.82+/-5.76. At 1 and 3 months after treatment, the mean symptom score was decreased to 13.63+/-7.07 and 9.21+/-6.28, respectively (p<0.01). The mean pretreatment satisfaction score was 4.63+/-0.85. It was decreased to 2.84+/-1.26, 1.92+/-1.34 at 1, 3 months (p<0.01). The mean pretreatment Qmax was 5.26+/-3.37mL/s. It was increased to 9.53+/-4.54mL/s, 11.97+/-4.52mL/s at 1, 3 months (p<0.01). The mean pretreatment PVRs were 131.85+/-123.05mL. It was decreased to 49.68+/-38.28mL, 26.77+/-17.92mL at 1, 3 months (p<0.01). CONCLUSIONS: TUNA treatment in the management of BPH improved symptom scores, peak flow rates with lower morbidity. TUNA appears to be a useful alternative treatment for BPH in patients with low compliance to medical therapy and high risk operative morbidity and mortality.
Anesthesia, Local ; Compliance* ; Humans ; Mortality* ; Needles* ; Prospective Studies ; Prostate ; Prostatic Hyperplasia* ; Tuna

No abstract available.
Knee*

From Jan. of 1990 to Dec. of 1992, we have experienced three cases of multiple primary malignant neoplasms originated from different histogenesis, in the Department of Orthopedic Surgery of Korea Cancer Center Hospital. Liposarcomas, malignant fibrous histiocytoma were combined with renal cell carcinoma, mucinous cystadenocarcinoma of ovary or prostatic cancer. With Moertel's classification, synchronous tumors were found in 2 cases and metachronous in 1 case. Synchronous tumors were 2 liposarcomas-renal cell carcinoma or mucinous cystadenocarcinoma of ovary. Metachronous tumors were malignant fibrous histiocytoma-prostate cancer. We couldn t find any family history among them. The causes of these multiple malignancies were considered as the individual predilrection to tumors.
Carcinoma, Renal Cell ; Classification ; Cystadenocarcinoma, Mucinous ; Female ; Histiocytoma, Malignant Fibrous ; Humans ; Korea ; Liposarcoma ; Orthopedics ; Ovary ; Prostatic Neoplasms

ESWL is an effective treatment for renal and ureteral calculi with few serious side effects. Most complications are related to an obstruction from stone fragments lodged within the ureter with an accompanying colic and/or infection and subcapsular or perirenal hematoma. Here we report a patient with a protein S deficiency sustaining a deep vein thrombosis following an ESWL for a mid ureter stone.
Colic ; Hematoma ; Humans ; Protein S Deficiency* ; Protein S* ; Thrombosis ; Ureter ; Ureteral Calculi ; Veins ; Venous Thrombosis*

ESWL is an effective treatment for renal and ureteral calculi with few serious side effects. Most complications are related to an obstruction from stone fragments lodged within the ureter with an accompanying colic and/or infection and subcapsular or perirenal hematoma. Here we report a patient with a protein S deficiency sustaining a deep vein thrombosis following an ESWL for a mid ureter stone.
Colic ; Hematoma ; Humans ; Protein S Deficiency* ; Protein S* ; Thrombosis ; Ureter ; Ureteral Calculi ; Veins ; Venous Thrombosis*

PURPOSE: We evaluated the early outcomes of Gortex patch sling operation in the management of women with intrinsic sphincter deficiency(ISD). MATERIALS AND METHODS: 20 women underwent Gortex patch sling operation to treat genuine stress urinary incontinence and all patients had ISD. Patients were interviewed by telephone for incontinence, self-catheterization, and voiding symptoms at a mean of 16.6 months(range 6-35) after surgery. RESULTS: The mean age of the patients was 54.2 years and mean parity was 2. Mean operation time was 55 minutes(range 45-90) and mean duration of postoperative catheterization was 7.0 days(range 5-12). Success rate(complete dry) was 90% and de novo urge incontinence occurred in 3(15%). CONCLUSIONS: Gortex patch sling operation is a safe, simple and effective procedure for the treatment of stress incontinence due to ISD. However, further follow-up of longterm results is needed.
Catheterization ; Catheters ; Female ; Follow-Up Studies ; Humans ; Parity ; Telephone ; Urinary Incontinence ; Urinary Incontinence, Urge

Frontal fibrosing alopecia (FFA) is one of the primary cicatricial alopecia and is considered a variant of lichen planopilaris. This condition is characterized by a progressive recession of the frontal and temporal hairline, primarily in postmenopausal women. Only two cases have been reported in premenopausal woman worldwide. We report a case of FFA in a 45-year-old female in her premenopausal age, who presented with multiple, small, bald spots on the bilateral frontotemporal area. Microscopically the lesion consisted of the inflammatory stage of lichen planopilaris and its cicatricial stage showing replacement of hair follicles by fibrous tissue. This was an additional case of frontal fibrosing alopecia in a premenopausal woman.
Alopecia* ; Female ; Hair Follicle ; Humans ; Lichens ; Middle Aged

OBJECTIVE: The ubiquitous human polyomavirus, JC virus(JCV) is the etiologic agent of the fatal demyelinating central nervous system(CNS) disease, progressive multifocal leukoencephalopathy(PML). Recent studies have reported the detection of the JCV in samples derived from several type of human neural tumors and suggested the possible association of JCV with CNS tumors. Here we report for the first time, the presence of JCV in Korean glioblastoma multiforme(GM) patients. METHODS: Two Korean GM patients were assayed for JCV. To detect JCV, we performed immunohistochemical analysis using anti-JCV and anti-glial fibrillary acidic protein(GFAP) serum and polymerase chain reaction(PCR) using primers. RESULTS: JCV antigen was detected in cytoplasm abundantly in cells of this tumor case. Also, GFAP immunoreactivity was predominantly observed in cytoplasm of the cells that were morphologically bizarred appearing astrocytes in GM. In addition, both of the large T antigen gene and the VP1 gene were detected and this result correspond with previous result of immunohistochemistry. CONCLUSION: Although it is not certain that GM is associated with the JCV, we are attempted to elucidate the possible implication of JCV in the tumorigenesis of certain human malignant gliomas.
Antigens, Viral, Tumor ; Astrocytes ; Brain* ; Carcinogenesis ; Cytoplasm ; Glioblastoma* ; Glioma ; Humans ; Immunohistochemistry ; JC Virus*

Osteoporosis imperfecta (OI) is a genetic disorder characterized by fragility of bone, deafness, blue sclerae; and laxity of joints. Four types of OI are distinguished by clinical findings. Although mutations affecting collagen I are responsible for the disease in the most patients, the mechanism by which the genetic defects cause abnormal bone development has not been well established. Therefore we evaluated static and dynamic bone histomorphometry of type I OI in the case study of a 15 year old boy with OI who had blue sclerae, a history of frequent fracture and a familial history of blue sclerae. Biopsy of the ilium showed loss of connection between the cortical bone and trabecular bones. The Harversian system in the cortical bone was poorly developed. In the trabecular bones, the lamellar pattern was poorly developed. Mineral apposition rate of the cortical bone was 1.0 m/day and of the trabecular bone was 0.79 m/day. Thus OI might be regard as a disease whereby abnormal collagen synthesis interferes with bone strength by multiple mechanisms.
Adolescent ; Biopsy ; Bone Development ; Collagen ; Deafness ; Humans ; Ilium ; Joints ; Male ; Osteogenesis Imperfecta* ; Osteogenesis* ; Osteoporosis ; Sclera