Extensive knowlege of the characteristics of synovial fluid has been available for at least the past 30 years, when a Monograph on the subject by Kling first appeared in 1938. Since that time, Ropes, Bauer(1953) and Hollander (1960, 1961, 1965) have published classic. Monographs on their extensive studies and findings of synovial fluid. Specific laboratory tests for diagnosis of various forms of arthritis are usually lacking. For example, the test for the rheumatoid factor in serum may be helpful in establishing the diagnosis of rheumatoid arthritis, but these are often negative in early cases and L. E. phenomenon is often negative in the early stage or between severe exacerbations of the Systemic lupus erythematosus. It has become increasingly clear during the past 10 years that synovial fluid analysis is both the most valuable and yet the most neglected differential diagnostic test for arthritis. Studies of synovial fluid have presented a virtually unexplored frontier in the investigation of arthritis. So, we studied the synovial fluid from 100 cases of various forms of arthritis in the Department of Orthopedic Surgery, Severance Hospital from May, 1968 to May, 1969. 100 cases of arthritis are; 30 cases of Osteoarthritis, 20 cases of Traumatic athritis, 25 cases of Rheumatoid arthritis, 10 cases of Septic arthritis, 5 cases of Tuberculous arthritis, and 10 cases of Non-specific bursitis. The synovial fluid were aspirated from the involved joints in aseptic conditions and follwing studies were done. 1) General appearance. 2) Mucin content by Acetic acid PPT. or Ropes test. 3) Viscosity by Drop test. 4) Cell count by Wright s stain. WBC: Total and differential count. RBC count. 5) Synovial sugar by Folin Wu method. 6) Fasting blood sugar by Folin Wu method. 7) Sugar difference between synovial sugar and Fasting blood sugar. 8) Total protein by Kingsley s Biuret method. 9) Bacterial culture in Septic arthritis. 10) Microscopic examination. RA cells by Sternheimer-Malbin stain in Rheumatoid arthritis. Cartilage fragments with simple wet preparations in Osteoarthritis. 6 kinds of arthritides were grouped into 3 categories based on the degree of inflammation of the synovial membrane as reflected by synovial fluid changes according to Ropes and Bauer s classification(1953). The first group, consisting of Osteoarthritis and Traumatic arthritis, was associated with mild inflammatory reactions and increased amount of fluid, but no significant changes in the number of WBC, sugar concentration, or quality of mucin. The second group was characterized by more sever inflammation of the synovial membrane and included Rheumatoid arthritis, Septic arthritis and Tuberculous arthritis. The second group was associated with decreased mucin content, increased WBC, polymorphonuclear leucocytes, RBC and protein and decreased amount of synovial sugar. RA cells were found in all cases of Rheumatoid arthritis and cartilage fragments in Osteoarthritis under the light microscope. The third group, an intermediate group-Non specific bursitis might have some distinguishing characteristics of synovial fluid but these were not usually diagnostic.
Acetic Acid ; Arthritis ; Arthritis, Infectious ; Arthritis, Rheumatoid ; Biuret ; Blood Glucose ; Bursitis ; Cartilage ; Cell Count ; Diagnosis ; Diagnostic Tests, Routine ; Fasting ; Inflammation ; Joints ; Lupus Erythematosus, Systemic ; Methods ; Mucins ; Netherlands ; Orthopedics ; Osteoarthritis ; Rheumatoid Factor ; Synovial Fluid ; Synovial Membrane ; Viscosity

No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Humans ; Statistics as Topic*

BACKGROUND: To evaluate the efficacy of Fibrin glue to decrease recurrence in video-assisted thoracoscopic surgery(VATS) for a treatment of spontaneous penumothorax. MATERIAL AND METHOD: All medical records of 17 patients who underwent a thoracoscopic wedge resections of bullae with stapling device with Fibrin glue in our institute between May 1998 and December 1999 were reviewed. variables analyzed include affected sites primary indication of VATS. duration from admission to discharge duration of postoperative stay duration of chest tube drainage recurrence and complication. There were 16 men and 1 woman. RESULT: There was no evidence of hemodynamic instability or arterial blood gas abnormalities encountered during the procedure. Mean age at the time of the VATS was 26.9 years (range 15 to 61 years) The mean duration from admission to discharge was 7.8 days and mean postoperative stay was 5.1days mean chest tube indwelling period was 4..0 days. There was no recurrence of pneumothorx. CONCLUSION: Thoracoscopic wedge resections with introduction of fibrin glue are safe and effective and requires only a short hospital stay. We believe that this thoracoscopic technique will further simplify the surgical treatment of pneumothorax.
Chest Tubes ; Drainage ; Female ; Fibrin Tissue Adhesive* ; Fibrin* ; Hemodynamics ; Humans ; Length of Stay ; Male ; Medical Records ; Pneumothorax* ; Recurrence ; Thoracic Surgery, Video-Assisted

No abstract available.
Bronchoalveolar Lavage Fluid* ; Bronchoalveolar Lavage* ; Silicosis*

No abstract available.
Femoral Fractures*

PURPOSE: As Korea has been rapidly transformed to be a multicultural society, it becomes essential for nurses to develop cultural competency. The purpose of this descriptive study was to assess the cultural competency level of general hospital nurses and to examine its contributing factors adopting ecological model. METHOD: A convenience sample of 327 nurses from six general hospitals in Seoul metropolitan area was recruited between November 14 to 28, 2011. Cultural competency was measured using the Korean version of the Caffrey Cultural Competence in Healthcare Scale (CCCHS) and Cultural Competence Assessment(CCA). Hierarchical multiple regression analysis was performed to assess the influence of intrapersonal, cultural-experience, and organizational factors on cultural competency. RESULTS: Mean cultural competency in this study was 2.57(+/-0.43). Cultural competency was associated with job position (p=.044) at the intrapersonal level. At the cultural experience level, foreign language classes experience (p=.005), fluency in a foreign language (p=.000), experience of working with foreign health care professionals (p=.000) were associated cultural competency. At the organizational level, training program (p=.000), job description (p=.002), health education materials (p=.016), insufficient job control (p=.000), and interpersonal conflicts (p=.011) showed significant difference. Foreign language class experience, foreign language fluency, experience of working with foreign health care professionals, and job control were the most consistent predictors of cultural competence and explained 20.4% of the total variance in the proposed ecological model. CONCLUSIONS: The findings suggest that to enhance cultural competency in general hospital nurses, cultural experience and organizational factors need to be more fully considered than intrapersonal factors.
Cultural Competency ; Delivery of Health Care ; Health Education ; Hospitals, General ; Job Description ; Korea

PURPOSE: The purpose of this study was to explore the relationships of family strain, perceived social support, family hardiness, and family adaptation and identify the family resiliency factors for the adaptation of families who have a child with congenital heart disease. METHOD: The sample consisted of 90 families who had a child diagnosed with congenital heart disease and completed surgical treatment. Data was collected from parents using a questionnaire. RESULTS: Results from path analyses revealed that family strain had a direct effect on both perceived social support and family hardiness, and an indirect effect on family adaptation. Also, the findings revealed that perceived social support had a direct effect on both family hardiness and family adaptation, and family hardiness had a direct effect on family adaptation. Thus, these results indicated that perceived social support and family hardiness had a mediating effect on family strain. CONCLUSION: Findings provide the evidence for the theoretical and empirical significance of perceived social support and family hardiness as family resiliency factors for family adaptation. Clinical implications of these findings might be discussed in terms of family-centered nursing interventions for the families who have a child with congenital heart disease based on an understanding of family resiliency for adaptation.
*Adaptation, Psychological ; Child ; Family/*psychology ; Female ; Heart Defects, Congenital/*psychology/surgery ; Humans ; Male ; Questionnaires ; Social Support

Caudal analgesia is a widely accepted technique for providing pain relief. However, both permanent and transient neurologic complications, including paraplegia, have been reported. We report on a patient who developed paraplegia following a caudal block for an epidural mass. The cause of the paraplegia was unknown, but possibly spinal angioma may have taken part in the onset and progression of the paralysis. A mechanism is proposed by which the caudal injection may have caused a change in blood flow through the spinal angioma resulting in cord ischemia.
Analgesia* ; Hemangioma ; Humans ; Ischemia ; Paralysis ; Paraplegia*

Reye syndrome is a rapidly progressive encephalopathy with hepatic dysfunction, which often begins several days after apparent recovery from a viral illness, especially varicella or influenza A or B. Salicylate use was identified as a major precipitating factor for the development of Reye syndrome. With the recommendation to avoid use of salicylates in children, Reye syndrome has virtually disappeared in recent years. We report a case of Reye syndrome in a 5-month-old infant who had been treated with intravenous immunoglobulin and aspirin under the diagnosis of Kawasaki disease, and showed symptoms of sudden onset of irritability, rigidity, decreased activity, vomiting, poor appetite, lethargy, liver dysfunction without jaundice, coagulopathy, and hyperammonemia.
Appetite ; Aspirin ; Chickenpox ; Child ; Humans ; Hyperammonemia ; Immunoglobulins ; Infant ; Influenza, Human ; Jaundice ; Lethargy ; Liver Diseases ; Mucocutaneous Lymph Node Syndrome ; Precipitating Factors ; Reye Syndrome ; Salicylates ; Vomiting

To evaluate characteristic CT findings of orbital pseudotumor and to define differentialpoints from other pathology, the authors retrospectively reviewed CT of 19 patients who were prooen to have orbital pseudotumor by clinical course and, in some cases, biopsy. A variety of CT findings including extraocular muscle thickening(11 cases), streaky infiltration of retroorbital fat(11 cases), mass formation(10 cases), optic nerve thickening (6 cases), conjunctival thickening (5 cases), scleral thickening(4cases), enlarged lacrimal gland(4 cases) and destruction of orbital bone (2 cases) were observed. Thickening of the anterior portion and irregular margin were characteristic findings of extraocular muscle and optic nerve lesions. Mass formation predominantly occurs in the anterior portion of the orbit. In most cases more than two orbital structures are involved by lesion.
Biopsy ; Humans ; Optic Nerve ; Orbit* ; Orbital Pseudotumor* ; Pathology ; Retrospective Studies