Femoral fracture, dislocation of the hip, or tasumatic amputation of the ipsilateral lower extremity is a rare injury. There has been only a few reports describing their managements. All amputated limbs are vulnerable to fracture, which occur frequently around the hip. Conservative treatments are not always adequate for the managements of fracture and dislocation of the hip and operative procedures are needed in almost patients. Among various operative measures, prosthetic replacement surgery may be indicated in cases of non-united fracture of the femoral neck, avascular necrosis of the femoral head, pathological fracture, or osteoporosis. We performed two cases of total hip replacement for the non-united fracture of the femoral neck(case 1) and the avascular necrosis of the femoral head(case 2) in the ipsilateral lower limb amputees, each. The early results were known to be very satisfactory postoperatively. The first patient was followed for 17 months and the second patient for 22 months. 1. P.C.A. femoral stems and acetabular cups were used without cement in both cases. A operative time was 2 hours and 22 minutes in the first case, 1 hour 45 minutes. in the second case. 2. There were no significant intraoperative or postoperative complications. 3. The functions of each hip were evaluated postoperatively by the method of Jesse and showed satisfactory results. 4. During the follow-up period, roentgenogram showed no significant bony changes around the femoral stems and acetabular cups. 5. The prosthetic replacement is also valuable for the treatment of the fracture-dislocation of the hip in the lower limb amputee.
Acetabulum ; Amputation ; Amputees ; Arthroplasty, Replacement, Hip ; Dislocations ; Extremities ; Femoral Fractures ; Femur Neck ; Follow-Up Studies ; Fractures, Spontaneous ; Head ; Hip ; Humans ; Lower Extremity ; Methods ; Necrosis ; Operative Time ; Osteoporosis ; Postoperative Complications ; Surgical Procedures, Operative

This is a follow-up study of 88 cases of cementless total hip replacement in 77 patients(59 males and 18 female), using AML, PCA and HGP prostheses, performed at the Department of Orthopaedic Surgery, Yonsei University Wonju College of Medicine, between September 1984 and December 1987. The follow-up period ranged from 18 to 56 months, the average being 34 months. The youngest patient was 21 and the oldest one was 79, the average being 47 years. The results were as follows:1. The average of Harris hip score was 89.7 points(Preop, 55.4 pints) at one year for 77 patients and 91.4 points at two years for 68 patients. 2. Radiographic analysis. a. Radiodense line:10 cases(11.4%) around the acetabular cup. 20 cases(22.7%) around the femoral stem. b. Calcar resorption:4 cases with AML stem(4/30), 2 cases with HGP stem(2/7). c. Subsidence:5 cases in PCA group(5/51).d. Radiological loosening:1 cases in PCA stem(1/51). 3. Intraoperative complications a. Femur neck fracture:15 cases(17%);5 cases in PCA group(5/51), 8 cases in AML group (8/31), and 2 cases in HGP group(2/7). b. Lateral collateral ligament tear:One case in PCA prosthesis(1/51). 4. Postoperative complications a. Prosthetic joint dislocation occured in 3 cases:1 case, closed reduction after tight adductor release:2 cases, cup reinsertion due to poor cup position. 5. Heterotopic ossification developed in 5 cases(5.7%) without significant loss of ROM. 6. Postoperative infection developed in 2 cases(2.3%):One superficial and the other deep. All were treated successfully with systemic antibiotics after irrigation and debridement.
Acetabulum ; Anti-Bacterial Agents ; Arthroplasty, Replacement, Hip ; Debridement ; Dislocations ; Femur Neck ; Follow-Up Studies ; Gangwon-do ; Hip ; Humans ; Intraoperative Complications ; Joints ; Lateral Ligament, Ankle ; Male ; Ossification, Heterotopic ; Passive Cutaneous Anaphylaxis ; Postoperative Complications ; Prostheses and Implants

In the past two decades, the incidence of rubella infection has decreased due to a nation-wide rubella vaccination program. Therefore the rate of rubella Ig G antibody has decreased. This means an increasing vulnerability to rubella infection among the group, with negative Ig G antibodies. The study was conducted in January of 1992 to April of 1996. The subjects were 1,010 fertile women(ages 20/45 years). The study was performed at Park Women`s Clinic to investigate the status of rubella antibody in Korean fertile women. The results were as follows. 1. The positive rate of rubella Ig G and Ig M antibody were 80.5% and 1.5%, respectively. 2. The mean age of positive rubella Ig G group was 28.5+/-3.6 years. The positive rate of rubella Ig G antibody was decreased by an increase in age with a significant level at p < 0.05. 3. The positive rate of rubella Ig G antibody was 63.3% in 1992, 71.3% in 1993, 87.5% in 1994, 81.1% in 1995 and 83.8% in 1996. The increase in the positive rate of rubella Ig G antibody by year for 5 years was statistically significant at p < 0.05. 4. The positive rubella Ig M antibody was noted in 15 women. Among them, one woman was tested in 1993, 5 women in 1995 and 9 women in 1996. The incidence of rubella infection had increased by years, and was statistically significant at p < 0.05. 5. The mean titer of rubella Ig G antibody was 47.18+/-50.04 IU/ml. The titer of rubella Ig G antibody was decreased by the increased in at age(p < 0.05). We observed a low positive rate of rubella Ig G antibody as compaired with other studies that were performed before 1990. Therefore, to prevent sporadic rubella infections, rubella vaccinations should be given to unmarried women.
Antibodies ; Female ; Humans ; Incidence ; Rubella* ; Single Person ; Vaccination

Alveolar macrophages participate in the host defense against P. carinii, but the mechanisms in degradation and clearance of the organism from lung has not been well established. We observed the transmission and scanning electron microscopic features and evaluated the expression of TNF-alpha and Surfactant-D in the interaction of P. carinii with alveolar macrophages. Expression of TNF-alpha and Surfactant-D in the experimentally induced P. carinii pneumonia in rat was examined by immunohistochemistry and immunoelectron microscopy. Electron microscopically, the alveolar macrophages phagocytized trophozoites and cysts of P. carinii micro-organisms. Immunohistochemically TNF-alpha was strongly expressed in the cytoplasms of alveolar macrophages. Postembedding immunogold labeling for Surfactant-D protein was expressed on the pellicles of trophozoites and cysts, P. carinii micro-organisms in the cytoplasms of macrophages, free floating surfactant materials and multilamellar bodies of type II epithelial cells. We conclude that alveolar macrophages interacted with P. carinii micro-organisms respond with increased expression of TNF-alpha. TNF-alpha may bind to P. carinii and exert a direct toxic effect upon the micro-organisms. Surfactant-D protein may augment binding of P. carinii to the alveolar macrophages and enhance the clearance of the micro-organisms.
Animals ; Cytoplasm ; Epithelial Cells ; Immunohistochemistry ; Lung ; Macrophages ; Macrophages, Alveolar* ; Microscopy, Immunoelectron ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia ; Pneumonia, Pneumocystis* ; Rats ; Trophozoites ; Tumor Necrosis Factor-alpha*

Tsutsugamushi disease is an acute febrile disease caused by Rickettsia tsutsugamushi, and which has been reported with increasing frequency thorough the nation since 1986. We experienced 21 cases of Tsutsugamushi Disease diagnosed with serologic test occurring in Taegu city and Kyungpook province during October-November, 1989. The results of survey are as follow. 1) Of 21 cases, 12 (57%) were males and 9 (43%) were females, and the peak incidence was the 4th decade. 2) The outbreak was in October to November and the peak incidence was in October. 3) The most frequent symptoms were fever and chill (100%), myalgia (95%), headache (90%), Eschar and rash were observed in 18 patients (86%) and the eschar was detected in all over the body, especially thorax (33%) and lower extremity (22%). 4) Laboratory features were SGOT elevation (83%), SGPT elevation (61%), LDH elevation (67%), leukocytosis (38%). 5) Indirect immunofluorescent antibody test was done in 18 patients and the antibody titer was above 1:320 in all patients. 6) The chloramphenicol, tetracycline or doxycycline regimens were very effective and mean duration of defervescence from initiation of therapy was 1.3 days. 7) The complication such as meningitis or shock, was not seen.
Alanine Transaminase ; Aspartate Aminotransferases ; Chloramphenicol ; Daegu ; Doxycycline ; Exanthema ; Female ; Fever ; Gyeongsangbuk-do ; Headache ; Humans ; Incidence ; Leukocytosis ; Lower Extremity ; Male ; Meningitis ; Myalgia ; Orientia tsutsugamushi ; Scrub Typhus* ; Serologic Tests* ; Shock ; Tetracycline ; Thorax

No abstract available.
Amyloidosis*

In urologic surgery, especially in intrascrotal surgery, spermatic cord block has been used as the primary anesthesia on patients with intrascrotal diseases, who were admitted to the Department of Urology in Jeonbug National University Hospital during 6 months ranged from March, 1983 to August, 1983. This technique has not severe anesthetic Complications and is easy to master and cost effective. The anesthesia o[ 0.5 per cent bupivacaine hydrochloride with epinephrine or lidocaine with epinephrine was made by injection through the spermatic cord approximately I cm below and medial to the pubic tubercle. Overlying skin was infiltrated with bupivacaine or lidocaine. We made a clinical study on 19 cases of intrascrotal diseases and report with review of literatures.
Anesthesia ; Bupivacaine ; Epinephrine ; Humans ; Jeollabuk-do ; Lidocaine ; Skin ; Spermatic Cord* ; Urology

No abstract available.
Hemolytic-Uremic Syndrome*

Megaureter is a relatively rare disease, and first described by Caulk in 1923. Authors report a case of huge primary megaureter misdiagnosed as an ovarian cyst preoperatively in a 20 year-old female patient with brief review of literatures.
Female ; Humans ; Ovarian Cysts* ; Rare Diseases ; Young Adult

This study was carried out to investigate the light and electron microscopic findings of the livers of rats after an intraperitoneal injection of cadmium chloride. The Sprague-Dawley rats were intraperitoneally injected with cadmium chloride dissolved in water, once a day for three days. These animals were sacrificed at 1, 3, 8, and 24 hr after the last injection. Control groups of the rats were also sacrificed in the same manner. The liver was extirpated and examined by both light and electron microscopy. The results obtained are as follows: The parenchyma of the liver shows focal neutrophilic infiltration and spotty necrosis. The hepatocytes show fatty change, ballooning degeneration, swelling of the endoplasmic reticulum and mitochondria, increase numbers of secondary lysosomes and residual bodies. Focal patic venules and sinusoids of the liver are congested. The Kupffer cells are increase in number. Therefore, it can be concluded that the cadmium is directly acted to hepatocytes resulting in cellular injuries and deposits in the fat droplets of the cytoplasm of the hepatocytes, not Ito cells as previously suggeted.
Rats ; Animals