LONG-TERM FOLLOW-UP OF TOTAL HIP REPLACEMENT. Kenichi ANDO, Yo NOZUE, Kikuzo OKADA, Yoshiaki TOYAMA and Shuichi SOEDA

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1 used in 34.8% of the patient undergoing adenoidectomy, in 83.3% of those undergoing tonsillectomy and in 100% of those undergoing both operations. This means that in most of the patients the volume of epinephrine solution exceeded the safe dose suggested by Johnstone and Kats as concurrently usable in general anesthesia with halothane. Recovery of consciousness and reflex after anesthesia were rapid, thereby permitting early removal of the endotracheal tube. In summary, combination of inhalation anesthesia consisting of GO-pancuronium with regional anesthesia consisting of 0.5% lidocaine containing 1:100,000 epinephrine is considered to be useful for tonsillectomy and adenoidectomy in infants. The reasons are 1) epinephrine can be used concurrently with general anesthesia. 2) analgesia can be brought to the operative site by local anesthesia, 3) the respiratory tract can be maintained by endotracheal intubation during anesthesia, and by rapid recovery of consciousness and reflex activity after operation. LONG-TERM FOLLOW-UP OF TOTAL HIP REPLACEMENT Kenichi ANDO, Yo NOZUE, Kikuzo OKADA, Yoshiaki TOYAMA and Shuichi SOEDA (The 2nd Tokyo National Hospital, Tokyo) Over 5 years follow-up study was made on 29 THR, 19 for osteoarthritis, 8 for intracapsular femoral neck fracture, 1 for the failed replacement of the femoral head and 1 for the central fracture-dislocation of the hip. As much as 64% of the total cases were determined as poor in overall results under the evaluation standards of Japanese Orthopaedic Association. Conclusions drawn from these findings are that skillful and precise techniques are essential for this operation and that the indication for THR has to be strict. FEMORAL NECK FRACTURES COMPLICATED IN HEMIPLEGIC PATIENT Yoshihiro SATO, Zenshiro MIZUMOTO and Miki SHIDARA (Nishi-Sapporo-Byoin National Sanatorium, Hokkaido) Numerous problems have been reported on the hemiplegic patients who are complicated with the femoral neck fracture. Recent studies have shown that the prognosis of these cases are grave, not only the walking, but the life. The following results were obtained by us with 41 cases of these patients including out-

2 patients. 1. The incidence increases markedly in the latter half of the sixth decade in women. 2. In many cases, the fracture occured accidentally by the falling down on the floor, during their hospitalization. 3. For the prognosis of walking, there was no differences between the types of the fracture (trochanteric or intracapsular), among 33 cases, who were able to walk before the accident. For the treatment, it is suggested that the walking prognosis of the open reduction is better than that of the traction method. MENTAL HEALTH CARE IN YAEYAMA DISTRICT OF OKINAWA PREFECTURE -THROUGH A SURVEY OF THE CLINICAL CHARTS KEPT AT YAEYAMA HOSPITAL- Hidetoshi KODAMA, Setsuji KUBO and Nobutada OMORI (Kamo-Byoin National Sanatorium, Hiroshima) An attempt was made to analyse the situation of the mental health care in the southernmost islands, "Yaeyama District", of Okinawa prefecture. The major source of information was 1249 sheets of the clinical chart which had been recorded during the period from 1962 to 1979 and kept at the psychiatric clinic of prefectural Yaeyama Hospital. The data obtained were summarized as follows 1. The psychiatrist was first send to this area (Yaeyama) for a short term in 1966, and the clinic was officially opened two years later. In 1972 the psychiatric ward has started with a full-time psychiatrist (who came in Feb. of the following year) and other medical staffs. 2. The crude distribution of mental illnesses according to those clinical charts were; 27.3% of all patients were schizophrenics, 2.6% manic-depressives, 19.2% neurotics, 15.7% epileptics, 8.2% mentally retarded, 5.2% psychic disorders in the elderly, and 17.3% miscellaneous groups, respectively. 3. These figures were found to be quite similar to those in the neiboring islands "Miyako Jima". However, the prevalences of schizophrenics, epilepsy and neuroses except for that of mental retardation were exceedingly higher in our present survey at Yaeyama, as compared to those of the nation-wide Mental Hygiene Survey performed in 1963.

3 Zenshiro MIZUMOTO Miki SHIDARA (Femoral Neck Fractures Complicated in Hemiplegic Patient)

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7 1) Abramson, A. S. & Delagi, E. F.:Influence of weight-bearing and muscle on disuse osteoporosis, Arch. Phys. Med., 42, , ) Geiser, M. & Trueta, J.:Muscle action, bone rarefaction and bone formation. J. Bone Jt. Surg., 40-B, , ) Perry, J.:The mechanism of walking in hemiplegia, Clin. Orthop., 63, 23-26, ) Stevens, J., Freeman, P. A., Nordin, B. E. C. & Barnett, E.:The incidence of osteoporosis in patients with femoral neck fracture, J. Bone Jt. Surg., 44-B, , 1962