Late aseptic loosening of the acetabular component following total hip arthroplasty become increasing frequently after about 10 years and has become a more severe problem both in frequency and severity than femoral component loosening. The complexity of acetabular revision depends largely on the reconstruction required to restore normal anatomy due to acetabular bone loss. The clinical and radiologic results of acetabular revision using a porocoated acetabular component fixed to the pelvis with screws were studied in 36 patients (40 hips) who had moderate or severe acetabular loss. Acetabular revision in patients whose bone stock had already been destroyed provied more formidable problems at revision surgery. The mean Harris hip score was improved 46 to 84. Bone graft union was achieved by 7.4 months and incorporated by 16 months. The graft bone resorption was noted minor degree lateral to the cup. Of 40 cases, 2 cases required re-revision of acetabular cup for identifiable failure of fixation and one was showed probable loosening. The results of the present study suggest that revision of the acetabulum with use of a hemispherical cementless component stabilized with multiple screws and morselized bone grafts filling bone defects appears to be successful in restoring bone stock and providing a stable, pain-free reconstruction.
Acetabulum* ; Arthroplasty, Replacement, Hip ; Bone Resorption ; Hip ; Humans ; Pelvis ; Transplants

Fournier described five patients with gangrene of male external genitalia in 1883 and emphasized three characteristics: (1) abrupt onset in young healthy male, (2) rapid progression to gangrene,(3) absence of discernible cause. But more recent reports described genital gangrene as occurring in any age group and 4 patients in our cases, the mean age was 46 years with an age range of 31 to 59 years. Predisposing causes were as follows: case 1. prostatic calculi, Buerger's disease, case 2, perianal abscess, case 3, diabetes mellitus, case 4, tuberculous spondylitis accompanied by paraplegia and bed sores, liver cirrhosis. The duration of symptoms prior to the development of gangrene varied between 4 to 10 days. The cultured organisms were as follows : case 1. Alpha-hemolytic streptococcus, case 2. E. coli, Alpha-hemolytic streptococcus case 3. Alpha-hemolytic streptococcus, case 4, Mycobacterium tuberculosis, proteus species. Reconstructive surgery of defected scrotum was performed postoperative 8 to 41 days (mean 28.7) and total admission period was 25 to 83 days (mean 46 days).
Abscess ; Calculi ; Diabetes Mellitus ; Fournier Gangrene* ; Gangrene ; Genitalia ; Humans ; Liver Cirrhosis ; Male ; Mycobacterium tuberculosis ; Paraplegia ; Pressure Ulcer ; Proteus ; Scrotum ; Spondylitis ; Streptococcus ; Thromboangiitis Obliterans

Meningioma en plaque are extremely rare, not only dose it form a thin layer on the inside of the dura but also infiltrates it an invades the adjacent bone. Painless, slowly developing exophthalmos with palpable swelling in the ipsilateral temporal region, and later impairment of vision and ocular motility indicate menigioma "en plaque" in the temporal region. The authors report a case of meningioma "en plaque" arisen from the outer third of sphenoid ridge.
Exophthalmos ; Meningioma*

Ultrasonograms of proven liver abscesses in 44 patients were analysed. In ulltrasonography prior to otherdiagnostic approach, 38 patients(86.4%) were accurately diagnosed as liver abscess with correlation of clinicalsymptoms. The outline of abscess is smoothly defined. oval and round in 19 patients, irregularly and ill-definedin 25 patients. Only in 5 patients echogenic capsules are demonstrated. The internal echogenecity is variable;they are predominantly echo-free in 14, predominantly low-echo in 25 and predominantly echogenic, similar to solidtumor in 2 patients . 36 patients who were treated by medication only and combined needle aspiration had follow-up ultrasonography within 3 weeks since initial treatment. 33 patients were ultrasonically and clinically improved.Only one patients died of sepsis after needle aspiration and 2 patients were discharged without any sign ofimprovement.
Abscess ; Capsules ; Follow-Up Studies ; Humans ; Liver Abscess ; Liver ; Needles ; Sepsis ; Ultrasonography

The incidences of posttraumatic avascular necrosis of the femoral head were variably reported. In 1980, Calandruccio reported its incidence of 14% in nondisplaced femoral neck fracture and 50% in displaced ones. In general, the prophylactic methods, such as core decompression, bone graft and trochanteric osteotomy were recommended for the treatment of early stages of femoral head avascular necrosis(Ficat-Arlet stage 1 or 2), while the primary replacement surgery for the advanced ones (Ficat-Arlet stage 3 or 4). One of our authors(Y.K. Chung) has performed five cases of corticocancellous bone grafts using combined autogenous free fibular graft and iliac cancellous bone graft, for the post-traumatic femoral head AVN from January 1985 to December 1989 at our hospital, and the following results are obtained: 1. Among the forty nine displaced adult femoral neck fractures, there were five eases of avascular necrosis(10. 2%). 2. There were three male patients and two female ones, and the average age of injury was 48 years old(30 to 57). 3. According to the type of fractures, there were four cases of subcapital fracture and one of transcervical fracture. All of the patients were performed closed reduction and internal fixation with compression hip screw system, including additional Knowles pinning in two cases. 4. Histological study with the excised femoral head, showed that there was no bony union between the grafted cancellous bone and the necrotic head, and the grafted bone has been changed to amorphous necrotic tissue. However, we found a solid consolidation of the grafted bone and the femoral neck portion.
Adult ; Decompression ; Female ; Femoral Neck Fractures ; Femur ; Femur Neck ; Head ; Hip ; Humans ; Incidence ; Male ; Necrosis ; Osteotomy ; Transplants

No abstract available.
Hemangiosarcoma*

BACKGROUND: The aim of this study is to analyze the clinical significance of preoperative renal dysfunction in patients with living donor liver transplant (LDLT). METHODS: We analyzed data collected retrospectively from 327 consecutive LDLT performed at Department of Surgery, Catholic University of Korea from Jan. 2000 to Dec. 2007. Based on creatinine clearance rate (CCR) calculated before LDLT, the patients were classified in three groups: normal renal function(CCR > or =70 ml/min, 273 patients, 83.5%), mild renal dysfunction (CCR<70 ml/min and CCR > or =40 ml/min, 38 patients, 11.6%) and severe renal dysfunction (CCR<40 ml/min, 16 patients, 4.9%). The mean follow up period was 47.5 months. RESULTS: The patient with severe renal dysfunction had higher incidence of postoperative dialysis and longer hospital stay (P<0.001). During the 3 months follow up period, the mean serum creatinine level in patients with severe renal dysfunction were not normalized and the incidence of renal dysfunction (serum creatinine, >1.5 mg/dl) was up to 46.2%. Even in patient with normal renal function, the incidence of postoperative hemodialysis and renal dysfunction 3 months postoperatively was about 5%. Multivariate analysis showed that preoperative serum creatinine, MELD score and postoperative diabetes predicted postoperative renal dysfunction. There was no statistical difference in survival curve between normal and mild renal dysfunction group but the patient with severe renal dysfunction showed worse survival compare with other groups (P < 0.001). CONCLUSIONS: Our data suggested that the patient with preoperative severe renal dysfunction have had poor recovery of renal dysfunction and high incidence of hemodialysis postoperatively and showed worse survival rate after transplantation.
Adult ; Creatinine ; Dialysis ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Length of Stay ; Liver ; Living Donors ; Multivariate Analysis ; Renal Dialysis ; Retrospective Studies ; Survival Rate ; Transplants

OBJECTIVE: To evaluate the effects of the reactive oxygen species (ROS) generated with a xanthine(X) and xanthine oxidase (XO) system on sperm function, the change of sperm characteristics, lipid peroxidation, and DNA fragmentation in bovine spermatozoa. MATERIALS AND METHODS: ROS were produced using a combination of 100 micrometer X and 50 mU/ml XO. The ROS scavengers: superoxide dismutase (SOD)(200mu/ml) and catalase (500mu/ml) were also tested. Spermatozoa were incubated for 2 hours in BWW medium with a combination of X-XO supplemented with or without ROS scavengers at 37degrees C under 5% CO2 incubator. Sperm movement characteristics by CASA (computer-aided sperm analysis), HOST (hypoosmotic swelling test), Ca-ionophore induced acrosome reaction, malondialdehyde formation for the analysis of lipid peroxidation, the percentage of DNA fragmentation using the method of TdT-mediated nick end labelling (TUNEL) by flow cytometry were determined after 2 hours incubation. RESULTS: The action of ROS on bovine spermatozoa resulted in a decreased in capacity for sperm motility, Ca-ionophore induced acrosome reaction and membrane integrity, an increased in malondialdehyde formation and the percentage of sperm with DNA fragmentation. In the effects of antioxidant, catalase completely alleviated the toxic effects induced by the ROS in terms of sperm function and characteristics, however SOD exhibited no capacity to reduce the toxic effects. CONCLUSION: The ROS can induce significant damages to sperm functions and characteristics. The useful ROS scavengers can minimized the defects of sperm function and various damages of spermatozoa.
Acrosome Reaction ; Catalase ; DNA Fragmentation* ; DNA* ; Flow Cytometry ; Incubators ; Lipid Peroxidation* ; Malondialdehyde ; Membranes ; Reactive Oxygen Species* ; Sperm Motility ; Spermatozoa* ; Superoxide Dismutase ; Xanthine Oxidase

Malignant peripheral nerve tumors are very rare and derived from the neurofibromatosis in about 13%. There are two classes of malignant tumors in the peripheral nerve, one those of mesoblastic origin, is far most common and made up of malignant neurofibroma and much common fibrosarcoma, and metastasis in 20% of fibrosarcoma, and the other is neuroepithelial origin. These are characterized by increased cellularity, atypical form of cells, mitoses and invasiveness. The choice treatment is radical removal of the tumor, and not affected the prognosis by radiation or chemotherapy. We have been recently experienced of one case of malignant schwannoma on the cervical roots in a case of von Recklinhausen's disease.
Drug Therapy ; Fibrosarcoma ; Mitosis ; Neoplasm Metastasis ; Neurilemmoma* ; Neurofibroma ; Neurofibromatoses ; Peripheral Nerves ; Peripheral Nervous System Neoplasms ; Prognosis

We report a case of acute interstitial nephritis associated with carbamazepine in a 45-year-old woman who developed acute renal failure. The patient has been taken valproic acid and carbamazepine to control the recurrent episodes of seizure after the surgery for meningioma. The patient developed acute renal failure with fever and skin rash. The patient stopped all medications except valproic acid, and was examined by ultrasonography, gallium scan and renal biopsy. Renal biopsy revealed severe interstitial infiltration of neutrophils in glomeruli without inflammation. After discontinuation of carbamazepine, acute renal failure of the patient improved and serum creatinine returned to normal.
Acute Kidney Injury ; Biopsy ; Carbamazepine ; Creatinine ; Exanthema ; Female ; Fever ; Gallium ; Humans ; Inflammation ; Meningioma ; Middle Aged ; Nephritis, Interstitial* ; Neutrophils ; Seizures ; Ultrasonography ; Valproic Acid