A total of 15 revision total knee arthroplasties in infected cases had been followed for an average 31.4 moths(ranging between 1 year 4 months and 10 years) from 1983 to 1992 at Kyung Hee University Hospital. Average age of the patients was 60 years old (ranging between 27 and 80 years). Of the total 15 infected total knee arthroplasties, original diagnosis was osteoarthritis in 11 patients, rheumat,oid arthritis in three patients, and tuberculosis in one patient. In nine of 15 patients, causative orgamisms were not found. But such clinical evidences as increased erythrocyte sedimentation rate, draining sinus, local heating, intraoperative findings, and pathologic findings demonstrated the infection of total knee arthroplasty. In 15 cases, seven cases were early infection and eight were late infection. Two cases of tuberculosis were diagnosed with intraoperative pathology. The majority of prosthetic loosening was found on the tibial side. Several methods of treatment were applied to the infected cases. One-stage or two-stage reimplantation were used in seven cases, knee fusion in six cases, and conservative treatment was used in two cases. Average period from initial total knee arthroplasty to prosthesis removal of fusion is 20. 3 months(ranging between 11 months and 64 months). In cases of two stage reimplantation, antibiotic-mixed bone cement was implanted after removal of prosthesis to increase the local concentration of antibiotics. The average interval from prosthesis removal to revision in 4 cases of two stage reimplantation was 9.9 weeks(ranging between 43 days and 122 days). All patients were evaluated according to the knee rating Scale of Hospital for Special Surgery. Prior to revision operation in 7 reimplantation cases, the average knee score was 50.1 points, and the average range of motion was 70°. After revision, the average knee score was 81. 1 points. The average range of motion was 98°. Complete union was obtained in all cases of knee fusion. Even though at the time of follow up there has been no recurrence of infection after revision or fusion, long term follow up is needed. Interrmittent knee joint swelling and pus drainage were observed in conservatively treated cases.
Anti-Bacterial Agents ; Arthritis ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Blood Sedimentation ; Diagnosis ; Drainage ; Follow-Up Studies ; Heating ; Hot Temperature ; Humans ; Knee ; Knee Joint ; Osteoarthritis ; Pathology ; Prostheses and Implants ; Range of Motion, Articular ; Recurrence ; Replantation ; Suppuration ; Tuberculosis

To know the amplification pattern according to relative concentration ratio in mixed samples, two STRloci, vwF locus and MBP locus and two VNTR loci, D1S80 locus and d17S5 locus were amplified in DNA with various concentration of two individuals were easily identified. But when the concentration of one person were lowered to 1/20-1/40 of the other's the intensity of product bands diminshed and hardly discernible. Also different amplification efficiency according to the template length was noted, especially in VNTR loci. Using automatic sequencer and RFLP scan program, the intensity OD of each PCR product band could be calculated, and this correlates the felative amplification efficiency of each allele. By using this we could construct quantitative PCR for the mixed samples. This could be used in practical case work for forensic purpose, and also be a valuable candidate for 'chimerism detection' in case of bone marrow transplatation.
Alleles ; Bone Marrow ; DNA ; Humans ; Minisatellite Repeats ; Polymerase Chain Reaction* ; Polymorphism, Restriction Fragment Length

No abstract available.
Aneurysm* ; Renal Artery*

We evaluated the results of twelve total elbow arthroplasties that had been performed from Feb. 1986 to Mar. 1993 in ten patients. The duration of follow-up averaged three years two months(range, one year to seven years one month). There were six females and four males. Two females had bilateral procedures. The average age at the time of the operation was 35.3 years(range, 22 to 53). Five patients had severe rheumatoid arthritis, four patients had fracture sequelae around elbows and one patient had sequele of tuberculous arthritis. Total elbow arthroplasty had been performed for improving the range of motion and relief of pain. Total elbow arthroplasties had been performed in six cases of total ankylotic elbows and in six cases who complained severe painful limitation of motion of the elbow joints. Preoperatively, ankylotic group were fixed by 30 degrees of flexion on an average. In painful elbow group, the average total range of motion was 68 degrees. The prosthesis which were used in total elbow arthroplasties were semiconstrained type in nine cases and noncostrained in three cases. Most of the patients had relief of pain. Postoperative complications were permanent ulnar nerve palsy in one case, superficial infection in one case and dislocation in one case. Total gain of range of motion(ROM) was 17 degrees in painful elbow group and 102 degrees in ankylotic elbows. Total elbow arthroplasty was effective method for improvement of range of motion in ankylotic elbows and relief of pain in elbows which had painful limitation of motion.
Ankylosis ; Arthritis ; Arthritis, Rheumatoid ; Arthroplasty ; Dislocations ; Elbow Joint ; Elbow ; Female ; Follow-Up Studies ; Humans ; Male ; Methods ; Postoperative Complications ; Prostheses and Implants ; Range of Motion, Articular ; Ulnar Neuropathies

Mitochondrial DNA (mt DNA) and the non-recombining region of the Y chromosome are passed down, unaltered, from generation to generation, matrilineally and patrilineally, respectively. Therefore, the Y-chromosome DNA and mtDNA are known as lineage markers, and they play important roles in studies based on human migration and evolutionary history. Y-chromosome DNA is used in forensic analysis to identify individuals involved in cases of sexual assault. In this paper, we review the methods of statistical evaluation of lineage markers used in forensic identification. We also review the combined approach of autosomal and lineage marker evidence.
DNA ; DNA, Mitochondrial ; Human Migration ; Y Chromosome

We report a case of Rasmussen aneurysm diagnosed by helical CT that well shows vascular imaging. Coil embolization of Rasmussen aneurysm stopped the bleeding successfully.
Aneurysm* ; Embolization, Therapeutic* ; Hemorrhage ; Tomography, Spiral Computed*

[Background] Over the last thirty years, majority of researches on clinical effectiveness of acupuncture have been explanatory (or experimental) randomized controlled trial. The benefits of acupuncture in clinical trials are stillcontroversial and most studies concluded that further control studies were required. Standardized combinations of acupuncture points for all the experimental subjects in various past studies have been criticized because such treatments do not reflect current routine clinical treatment.
[Objective] This paper aims to review pragmatic clinical trials on the effect of acupuncture treatment and to develop the ideal clinical research methodology of acupuncture study.
[Method] Clinical studies of acupuncture relevant with pragmatic or individualized trials were searched mainly in Pubmed and Science direct databases. All articles were fully reviewed by researchers, and data were evaluated by usage of a standardized form.
[Results & Suggestion] Pragmatic acupuncture researches were tried for various symptoms (eg. low back pain, hypertension, depression during pregnancy, sleep quality in HIV disease, chronic poststroke leg spasticity, headache, etc). Individualized acupuncture treatments based on oriental disease pattern diagnosis reflexes practical treatments which is more effective than unified and fixed acupuncture treatments without any theoretical basis of oriental medical philosophy.
[Conclusion] To overcome the controversies and limitations of past explanatory acupuncture trials, more individualized and tailored acupuncture trials with the theoretical basis of oriental medical diagnosis is highly recommended. Also clear definition and categorization of pattern identification should be established for further active clinical researches and applications of acupuncture.

The field of forensic DNA requires not only genetic typing but also social systems. The systems include the establishment of Korean guidelines for DNA typing. There were some publications relating DNA typing guidelines in 2001 and 2002, but the works could not be sustained. Although KOLAS and KIGTE are operating now, we can hardly say that these are optimal for forensic purposes. There also have been foreign publications about the DNA typing guidelines. Considering various differences among nationality, however, we need to establish suitable guidelines for Korean. Therefore, expert members in forensic society should be concern about Korean guidelines for DNA typing and participate in this work.
DNA ; DNA Fingerprinting ; Ethnic Groups ; Humans

In pediatric dentistry, chloral hydrate is habitually selected for sedation of uncooperative children. Although chloral hydrate has been used for decades, various adverse effects are reported and necessity for new alternative drugs has increased. Dexmedetomidine was approved by FDA for sedation at intensive care units (ICU) in 1999. Compared to conventional sedative drugs, dexmedetomidine has not only analgesic and sedative effects but also it barely suppresses the respiratory system. Due to these characteristics, dexmedetomidine is known as safe sedative drug for children and elderly patients. Furthermore, approved by KFDA in 2010 in Korea, the frequency of sedation using dexmedetomidine is increasing. However, due to its intravenous administration method, it was difficult to apply in pediatric dentistry. Recently, intranasal administration method was introduced which might be a new possible alternative of oral sedation. In this study, we compare the mechanisms, pros and cons of chloral hydrate and dexmedetomidine, introducing new possibilities.
Administration, Intranasal ; Administration, Intravenous ; Aged ; Child ; Chloral Hydrate ; Dental Care* ; Dexmedetomidine ; Humans ; Hypnotics and Sedatives ; Intensive Care Units ; Korea ; Methods ; Pediatric Dentistry ; Respiratory System

We experienced a case of transient right-sided heart failure after angioplasty of membranous obstruction of the inferior vena cava confirmed by sonography and an inferior vena cavogram. Angioplasty involved the use of a self-expandable metallic stent, but after successful recanalization of the obstruction , the patient became dyspneic. Chest radiography revealed mild cardiomegaly with pulmonary congestion, but this was resolved spontaneously. For the prevention of serious heart failure, we recommend preprocedural evaluation of cardiac function.
Angioplasty* ; Cardiomegaly ; Estrogens, Conjugated (USP) ; Heart Failure* ; Humans ; Radiography ; Stents ; Thorax ; Vena Cava, Inferior*