No abstract available.

The utilization of acetate & bicarbonate dialysate and their effects on acid-base balance, blood pressure, pulse rate, serum cholesterol, triglyceride, HDL and free fatty acid were investigated during regular hemodialysis.

Eight patients with chronic renal failure were studied during two successive dialysis treatments for which either acetate or bicarbonate were used as a buffer anion in the dialysate.

The result obtained as follows :

1) There was no significant difference in arterial pH between acetate and bicarbonate hemodialysis patients.

2) Arterial HCO₃ was higher significantly in patients with bicarbonate hemodialysis than acetate hemodialysis from 60 to 240 minutes (p<0.01)

3) Arterial pCO₂ fell significantly from 34.0 mmHg to 31.7 mmHg during acetate hemodialysis patient (p<0.01)

4) Heart rate rose signifificantly from 69 b.p.m to 82 b.p.m. during acetate hemodialysis(p<0.01).

5) Serum fatty acid increased significantly during acetate and bicarbonate hemodialysis, but no difference between two groups.

6) There were no significant changes in systolic and diastolic blood pressure in two groups during hemodialysis.

7) There were no significant changes in serum cholesterol, triglyceride and HDL in two groups during hemodialysis.

We studied prospectively 48 patients with end stage renal disease on chronic dialysis (hemodialysis or chronic ambulatory peritoneal dialysis). Of these 48 patients, 9(19%) had urinary tract infection (UTI), 4(8%) had symptomatic UTI, and 14(29%) had sterile pyuria. Among 16 patient who had documented previous UTI, 8(50%) had repeated UTI at presentation compared to 1 of 32 patients who had not documented previous UTI. Daily urine out put in all patients with sterile pyuria was lesser than 500ml. No significant correlation was seen between frequences of UTI and duration of dialysis therapy. Successful cure with oral antibiotic treatment for 1-2 weeks achieved in 6 of 9 patients with UTI. However, recurrence of infection occurred in 3, one patient was diabetic with neurogenic bladder, another was patient with chronic pyelonephritis who had experienced perinephric abscess. Third was patient with chronic pyelonephritis complicated with chronic UTI, paraplegia, and vesico-renal reflux. This patient was admitted to hospital for intravenous gentamycin therapy.

A consecutive series of fifty-six patients with ruptured aneurysms were operated upon within 24 to 72 hours after subarachnoid hemorrhage (SAH). All operations were performed by the author.

The clinical grading (Hunt and Hess) was I to II in 21, III in 11 and IV to V in 24. In 24 patient the internal carotid complex and in 18 it arose from the middle cerebral artery. The SAH as determined by computerized tomography was minor in 14, moderate in 5 and severe in 24. 15 patients habored intracranial hematomas (subdural, intracerebral or intraventricular hematoma). Of the patients preoperatively grade I or II, 86% had good neurological recovery, of the grade III patients good neurological recovery and of grade IV-V 75% had died. The mortality of the grade I-II patients operated upon within 24 hours, 24~48 hour and 72 hours were 11.1%, nil and 13.3% respectively. These results suggest that acute surgical repair of the ruptured cerebral aneurysms within 3 day of the ruptures in the grade I to III, is useful in preventing recurrence of hemorrhage and vasospasm through the removal of the subarachnoid clot.

Clinical studies have indicated that the non-operative treatment is the best method for clavicle fracture and the operative treatment may contribute to the development of non-union. But some clavicle fractures may be difficult to treat only by non-operative method.

From March, 1980 to May, 1989, 42 patients with clavicle fractures were treated by open reduction and internal fixation with threaded steinmann pin and plate & screws at Department of Orthopaedic Surgery of Ewha Womans University Hospital.

The results were as follows;

1) The avarage duration of union of fracture was 6.7 weeks.

2) By open reduction & internal fixation, gross deformity such as large bone hypertrophy, joint stiffness and shortening was minimized.

3) The plate & screws fixation is more satisfactory result than threaded steinmann pin fixation.

A clinico-statistical analysis was performed on 35 cases of mutational disturbance at Dept. of Otolaryngology of Ewha Womans University Hospital during past 5 years and the following results were obtained.

1) Among 35 cases of mutational disturbance, continuation of mutational disturbance were 11 cases, 9 cases were male(25.7%) and 2 cases were female(5.7%).

2) Among 15 cases of phonasthenia, 5 cases were male(14.3%) and 10 cases were female(28.6%).

3) Among 9 cases of vocal cord atrophy, 6 cases were male(17.1%) and 3 cases were female(8.6%).

4) The age distribution of mutational disturbance in order of frequency were obtained as follows. Among 11 cases of continuation of mutational disturbance, 21~ 25year old group were 5 cases(45.5%), 15-20 and 31~35year old group were 2 cases(18.2%) each. Among 15 cases of phonasthenia, 26~30year old group were 6 cases(40.0%), 31~35year old group were 3 cases(20.0%). Among 9 cases of vocal cord atrophy, 26~30year old group and 31~35year old group were 2 cases(33.3%) each.

5) Duration of visit after voice disturbance in order of frequency were 1~2year group 10 cases(28.6%), 3~5year group 9 cases(25.7%) and 6month~lyear group 4 cases(11.4%).

6) Other symptoms except voice disorder in order of frequency were dry sensation of pharyngolarynx, foreign body sensation of pharyngolarynx, neurasthenia, general fatigue, pain of neck and shoulder area.

The author measured the mental health status of 204 female industrial workers from March 1st, 1988 to June 30th, 1988 using Zung's S.A.S(self-rating anxiety scale) and S.D.S(self-rating depression scale) and compared the results with those of 208 female college students.

The results were as follows :

1) The results showed that there was significant difference in the means of total anxiety and depression scores between the two groups(p<0.01).

2) The anxiety scores in items of insomnia(p<0.001), restlessness(p<0.001), dyspnea, apprehension, face flushing and the depression scores in items of decreased libido, hopelessness, personal devaluation, dissatisfaction(p<0.001), emptiness were relatively high in female industrial workers.

3) As to the subjects who got above 50 scores in the distribution of anxiety and depression scores, the number of female industrial workers was more than that of female college students.

4) As to the female industrial workers, the younger ones, the higher scores in anxiety. The ones without parents, lodgers, or buddhists were higher in anxiety and depression scores. The older ones, catholics, or the ones with 7 to 9 years in the duration of employment were higher in depression scores. As to the female college students, the older ones, the ones without both parents, buddhists, the ones lodging in the relatives, or the students majoring on music, fine arts, physical education were higher in anxiety and depression scores.

Acute poststreptococcal glomerulonephritis (APSGN) is a disease thought to be induced by the renal deposition of circulating immune complexes. Clinical recovery usually ensues more than 80% of children. But the clinical course of acute glomerulonephritis in sporadic occurance and that of adult remain a matter of debate. There are long term follow-up reports in which rare cases of APSGN progressed to rapidly progressive glomerulonephritis and chronic glomerulonephritis.

Recently we have experienced a case of APSGN with long oliguric phase ARF who recovered renal function after 6 months hemodialysis.

The authors report a case of neuroblastoma with metastasis into the throacic spinal canal. It manifested as an extradural mass with spinal cord compression. The clinicopathologic features, radiologic findings & surgical treatment are discussed with brief review of the literatures.

Metastatic tumors of the spine often cause severe pain and paralysis because of deformity and neural encroachment. As oncology now extends the life expectancies of these patients, spinal decompression and stabilization are necessary.

2 patients who had vertebral metastases of hepatocarcinoma were operated on by decompressive corporectomy and firm stabilization. They had significant neural recovery and pain relief immediately.

Now, 2 cases are presented with a brief review of literatures.

We present two cases of childhood dermatomyositis. Case 1 was a 4 year old girl who developed erythematous swelling on the face, violaceous papules on the dorsum of the hands, and progressive muscle weakness which led to walking difficulty. Case 2 was a 11 year old girl who had diffuse erythematous confluent patches with fine scales on the face. Poikilodermatous changes on the whole body and progressive muscle weakness in lower extremities developed. These cases were confirmed by clinical appearance, laboratory findings and histopathologic findings.