In these days, there are two main ways in the treatment of the avascular necrosis of the femoral head in adult by prosthetic replscement; total hip replacement and bipolar endoprosthesis. So far, no study has been performed on the post-operative functional evaluation of them. Therefore it is difficult to decide which one is preferred to the other in the treatment of avascular necrosis of the femoral head in adult. In order to evaluate the functions of the prosthetic joints, the authors reviewed the results of 18 cases of cementless bipolar endoprosthesis(abbreviated as CBE) and 22 csses of cementless total hip replscement arthroplasty(abbreviated as CTHRA), performed at the Department of Orthopedic Surgery, Seoul National University Hospital, during the period from February, 1984 to May, 1986. The following results were obtained. 1. The average ages of CBE and CTHRA groups at the time of operation were 48.5 years and 37.5 years, respectively. 2. The average follow-ups of CBE and CTHRA were 15.7 months and 30.5 months, respectively. 3. By Meyer's modification of Marcus and Enneking classification, the sverage stages of CBE and CTHRA groups were 3.7 and 4.4 respectively. 4. According to Harris hip rating score system, Harris scores were increased as much as 30.5 in CBE group and 30.6 in CTHRA group. 5. In the aspects of functional improvement and relief of pain, the two groups showed no significant difference. However, the operation was essier, and the damage to the acetabular bone was less in CBE group. For these reasons, CBE was believed to be the preferred choice of treatment of avascular necrosis of femoral head in adult.
Acetabulum ; Adult ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Classification ; Follow-Up Studies ; Head ; Hip ; Humans ; Joints ; Necrosis ; Orthopedics ; Seoul

Herein we report a 51-year-old male with angioimmunoblastic lymphadenopathy who had developed rnaculopapular eruptions after the administration of crystalline penicillin, acetylsalicylic acid and sulpyrine. Skin biopsy showed mild lyrnphohistiocytic infiltration and extravasated RBCs around the blood vessels in the upper dermis. He had run a progressively downhill course in spite of vigorous chemotherapy and ultimately died.
Aspirin ; Biopsy ; Blood Vessels ; Crystallins ; Dermis ; Dipyrone ; Drug Therapy ; Humans ; Immunoblastic Lymphadenopathy ; Lymphatic Diseases* ; Male ; Middle Aged ; Penicillins ; Skin

No abstract available.
Nevus, Pigmented* ; Vitiligo*

The authors have analysed 39 rheumatoid wrists in 25 rheumatoid patients, who underwent vsrious surgeries including arthroscopic and open synovectomy, partial and total arthrodesis and total wrist arthroplasty at the department of orthopaedic surgery, St. Mary's Hospital from November 1985 to April 1988, and the effect of eaeh surgery on the wrist function and proper time of operation are discussed. The results were as follows; 1. The patients who were classified as a classical rheumatoid arthritis according to the ARA criteria were four males and twenty-one females, with a mean age of 43 yesrs, and the functional capacity of the patients before operation was graded in III for twenty-threeand in IV for two patients. 2. Out of 25 patients (39 wrists), 14 patients are in bilateral and II patients in unilateral involvement. The synovectomy in 13 wrists, arthrodesis in 24 wrists and total joint replacement in 2 wrists were performed and followed them for average 17 months after operation. 3. The synovectomy were done for 13 wrists in grade II and III according to the classification of rheumstoid arthritis by radiology(3). There were two cases of recurrence in the cases of synovectomy, but not in replacement and arthrodesis. 4. The arthrodesis of wrist was performed for 24 wrists-bilateral arthrodesis in 3 patient (6 wrists) and unilateral fusion in 18 patients. For 4 cases out of 24 cases of wrist arthrodesis, the second and third carpo-metacsrpal joints were fused simultaneously. 5. Protek total wrist arthroplasty was done in 2 cases snd followed them for more than9 months with relatively good clinical results. Finally, it is our beliefs for rheumatoid wrists that surgery is often indicated to control the various wrist problems, early synovectomy is strongly indicated, and partial wrist fusion has proven to be effective in patients with moderate destruction, deformity and pain, but the total wrist arthrodesis and arthroplasty is still in controversy. The proper surgery for rheumatoid wrist should be determined by the clinical severity of disease and radiological changes of wrist.
Arthritis ; Arthritis, Rheumatoid ; Arthrodesis ; Arthroplasty ; Classification ; Congenital Abnormalities ; Female ; Humans ; Joints ; Male ; Recurrence ; Wrist

BACKGROUND: The aim of this study was to investigate the effect of doxapram on recovery following propofol-remifentanil anesthesia. METHODS: Forty patients scheduled for gastrectomy were randomly allocated to receive either doxapram 1 mg/kg or normal saline at the end of surgery under propofol-remifentanil anesthesia. Clinical recovery from anesthesia was assessed by times to spontaneous breathing, eye opening on verbal command, extubation, and discharge from the postanesthetic care unit (PACU). Bispectral index (BIS) values, blood pressure, and heart rate were recorded every 2 min for 16 min after the administration of doxapram or saline. The incidences of side effects were checked in the recovery room. RESULTS: Spontaneous breathing was recovered after 6.2 +/- 1.1 minutes in the Doxapram group versus 9.2 +/- 1.8 minutes in the normal saline group (P < 0.001). Times to eye and extubation were also shorter in the Doxapram patients than in the normal saline patients (6.9 +/- 1.0 and 8.1 +/- 1.7 min versus 10.4 +/- 2.0 and 12.0 +/- 2.6 min, respectively) (P < 0.001). However, the times to PACU discharge were not different between the two groups (46.9 +/- 4.9 min versus 47.0 +/- 6.0 min, respectively). The patients in the Doxapram group showed higher mean BIS values compared with the normal saline group during emergence, but there were no differences in arterial blood pressure, heart rate and incidences of side effects between the two groups. CONCLUSIONS: Doxapram 1 mg/kg hastens early recovery from TIVA with propofol and remifentanil, and this emergence effect correlates with higher BIS values. Doxapram, however, does not affect the discharge time from the PACU and incidences of side effects.
Anesthesia ; Anesthesia, Intravenous ; Arterial Pressure ; Blood Pressure ; Doxapram ; Eye ; Gastrectomy ; Heart Rate ; Humans ; Incidence ; Piperidines ; Propofol ; Recovery Room ; Respiration

BACKGROUND: The aim of this study was to investigate the effect of doxapram on recovery following propofol-remifentanil anesthesia. METHODS: Forty patients scheduled for gastrectomy were randomly allocated to receive either doxapram 1 mg/kg or normal saline at the end of surgery under propofol-remifentanil anesthesia. Clinical recovery from anesthesia was assessed by times to spontaneous breathing, eye opening on verbal command, extubation, and discharge from the postanesthetic care unit (PACU). Bispectral index (BIS) values, blood pressure, and heart rate were recorded every 2 min for 16 min after the administration of doxapram or saline. The incidences of side effects were checked in the recovery room. RESULTS: Spontaneous breathing was recovered after 6.2 +/- 1.1 minutes in the Doxapram group versus 9.2 +/- 1.8 minutes in the normal saline group (P < 0.001). Times to eye and extubation were also shorter in the Doxapram patients than in the normal saline patients (6.9 +/- 1.0 and 8.1 +/- 1.7 min versus 10.4 +/- 2.0 and 12.0 +/- 2.6 min, respectively) (P < 0.001). However, the times to PACU discharge were not different between the two groups (46.9 +/- 4.9 min versus 47.0 +/- 6.0 min, respectively). The patients in the Doxapram group showed higher mean BIS values compared with the normal saline group during emergence, but there were no differences in arterial blood pressure, heart rate and incidences of side effects between the two groups. CONCLUSIONS: Doxapram 1 mg/kg hastens early recovery from TIVA with propofol and remifentanil, and this emergence effect correlates with higher BIS values. Doxapram, however, does not affect the discharge time from the PACU and incidences of side effects.
Anesthesia ; Anesthesia, Intravenous ; Arterial Pressure ; Blood Pressure ; Doxapram ; Eye ; Gastrectomy ; Heart Rate ; Humans ; Incidence ; Piperidines ; Propofol ; Recovery Room ; Respiration

BACKGROUND: Reactive oxygen species (ROS) induce lipid peroxidation and tissue damage in the isolated rabbit thoracic aorta. The aim of this study was to explore the influence of the propofol and midazolam against ROS in the isolated rabbit thoracic aortic endothelium. METHODS: Eighteen white male rabbits (weighing 2.0-2.5 kg) were used. The thoracic aorta was dissected free and cut into rings (3-4 mm) and then suspended in a organ bath filled with 10 ml Krebs solution bubbled with 5% CO2 95% O2 at 37 degrees C. Aortic rings were then equilibrated for 90 min, and a resting tension of 1.5 g was applied. The Krebs solution was changed every 15 min. Isometric tension was recorded with transducer coupled to a data acqusition system (Biopac Inc. USA) on a PC. After precontraction with norepinephrine (NE, 10(-6)M), changes in tension were measured following the cumulative administration of acetylcholine (ACh 3x10(-7), 10(-6) and 3x10(-6)M) and nitroglycerin (NTG, 10(-5)M). Data are expressed as percentage of the 10 5 M NTG-induced relaxation (ACh/NTG). The ACh/NTG, before and after electrolysis were defined as the control and the experimental groups. The aortic rings were pretreated with propofol (3x10(-5), 10(-4), 3x10(-4) and 5.7x10(-4) M, n = 8, 10, 15, 13), midazolam (10(-4)M, n = 7), catalase (1,000 U/ml, n = 12), mannitol (3x10(-4)M, n = 5) or not pretreated group (Free, n = 6). After 30 minutes, the aortic rings were exposed to ROS generated by electrolysis (DC 9 V, 20 mA, aortic rings 1 cm away from electrode) in Krebs solution for 2 minutes, which was then changed for physiologic buffered salt solution. The aortic rings were precontracted with NE and vasorelaxation was induced with ACh and NTG at the above mentioned concentrations. RESULTS: Propofol produced vasorelaxation of NE-precontracted thoracic aorta in a dose-dependent fashion in all groups of propofol (3x10(-5), 10(-4), 3x10(-4) and 5.7x10(-4)M) even after ROS attack (P < 0.05 vs control value). Catalase produced vasorelaxation after ROS attack (P < 0.05 vs control value).On the other hand, ACh-induced significant endothelium-dependent vasorelaxation were not observed in the midazolam or mannitol pretreated group or the non-pretreated group (P <0.05 vs control group). CONCLUSIONS: These findings suggest that propofol and catalase preserve ACh induced endothelium-dependent vasorelaxation and that propofol has a concentration dependent ROS scavenging effect like catalase.
Acetylcholine ; Aorta, Thoracic ; Baths ; Catalase ; Electrolysis ; Endothelium ; Hand ; Humans ; Lipid Peroxidation ; Male ; Mannitol ; Midazolam ; Nitroglycerin ; Norepinephrine ; Propofol* ; Rabbits ; Reactive Oxygen Species* ; Relaxation ; Transducers ; Vasodilation

No abstract available.
Leiomyoma*

No abstract available.
Anus, Imperforate*

Endodermal sinus tumors are an uncommon malignancy in children and occur most often in the gonads and sacrococcygeal region. In these locations, thy are found as primary tumors ; in teratoma they form part of the malignant component. We present CT and MR imaging findings in two cases of endodermal sinus tumor occurring after the resection of a mature benign cystic sacrococcygeal teratoma during the neonatal period. Awareness of the transformation of a benign cystic teratoma to a different type of malignant germ cell tumor may be helpful in the evaluation of sacrococcygeal masses.
Child ; Endoderm* ; Endodermal Sinus Tumor* ; Gonads ; Humans ; Magnetic Resonance Imaging ; Neoplasms, Germ Cell and Embryonal ; Sacrococcygeal Region ; Teratoma*