Measurement of bone mineral density(BMD) of the spine may be affected by the presence of various factors such as osteophytes, osteosclerosis and spinal deformity, particularly in elderly persons. Therefore the accurate evaluation for osteoporosis is difficult in osteoarthritic spine and until now no technique can evaluate true mineral density of the osteoarthritic spine. So we performed this study to evaluate the effect of osteoarthritic changes of the spine on the BMD and various BMD values such as young-adult% and age-matched%. Additionally we evaluated the diagnostic value of the Singhs index in the advanced osteoporotic spine. We reviewed 50 patients with advanced osteoporosis of the spine retrospectively and they were divided into two groups; one consisted of 22 patients with osteoporosis alone and the other consisted of 28 patients with osteoporosis and osteoarthritic change on the spine. The measured mean BMD value in AP plane and that expressed in relation to reference data for young adults(young-adult%) of the patients with arthritic and osteoporotic spine were significantly higher than those of the patients with osteoporosis alone. On the other hand, values expressed in relation to the age and sex matched mean reference data(age-matched%) were not significantly higher in group of patients with osteoporosis and osteoarthritic change, and Singh s index was not diagnostic for the osteoporosis of the spine. But young-adult% were significantly lower than agematched% even in the osteoarthritic group. We concluded that young-adult% is mare useful value for diagnosis of the advanced osteoporosis in the osteoarthritic spine.
Aged ; Bone Density* ; Congenital Abnormalities ; Diagnosis ; Hand ; Humans ; Osteoarthritis* ; Osteophyte ; Osteoporosis ; Osteosclerosis ; Retrospective Studies ; Spine*

Capsule contraction syndrome is severe constriction of the anterior capsular opening and equatorial capsular bag diameter after extracapsular cataract surgery. It is relatively common in patients with continuous curvilinear capsulorhexis, but rarely in can-opener capsulotomy or anterior radial capsular tears. It is due to capsular bag contraction from fibrous dysplasia of residual lens epithelial cells with weakened zonular resistance. We experienced a case of capsule contraction syndrome in a 72-year old woman with retinitis pigmentosa, who had phacoemulsification following an intact 5.0mm-continuous curvilinear capsulorhexis 4 months before. After successful YAG laser radial anterior relaxing capsulotomy, her visual acuity restored to 0.3, limited by cystoid macular edema.
Aged ; Capsulorhexis* ; Cataract ; Constriction ; Epithelial Cells ; Female ; Humans ; Lasers, Solid-State ; Macular Edema ; Phacoemulsification ; Retinitis Pigmentosa ; Visual Acuity

To evaluate the effect of tibial cut with posterior slope in total knee arthroplasty(TKA) surgery on the flexion of the knee, 41 knees(32 patients) with varying degree of the posterior slope were retrospectively reviewed at more than 1 year after operation. Does sloping the tibial cut iurface rnore posteriorly promote increasing of maximal flexion of the knee by elimination of excessive tenaion of the posterior cruciate liga ment The degree of the posterior slope was radiographically measured, awi the change of the degree of the maximal flexion between preoperative and postoperative period was clinimlly measured with a goniometer at the latest follow up more than 1 year after operation. Comparison of the results demonstrated significantly larger degree of rqaximal flexion for the knees that had tibial cut with the degree of the posterior slope, 5 degrees or rnore (p<0.05). We concluded that 5 degrees or more posterior slope in proxirnal tibial cut is one of the important fact()r which could achieve increased flexion of the knee after TKA operation.
Arthroplasty* ; Follow-Up Studies ; Knee Joint ; Knee* ; Postoperative Period ; Retrospective Studies

Cytomegalovirus (CMV) is potentially the most important pathogen affecting organ transplant recipients. The overall incidence of documented CMV infection after liver transplantation ranges from 23% to 85%. Approximately 15~40% of infected patients develop CMV disease such as pneumonia, hepatitis, gastrointestinal involvement, central nervous system involvement, retinitis, or nephritis. The gastrointestinal tract is one of the least common sites of CMV disease and usually presents as fever, diarrhea, and abdominal pain. We report a case of a 45-year-old man with end-stage liver disease who developed CMV colitis 6 weeks after deceased donor whole liver transplantation with a review of the relevant literature.
Abdominal Pain ; Central Nervous System ; Colitis* ; Cytomegalovirus* ; Diarrhea ; Fever ; Gastrointestinal Tract ; Hepatitis ; Humans ; Incidence ; Liver Diseases ; Liver Transplantation* ; Liver* ; Middle Aged ; Nephritis ; Pneumonia ; Retinitis ; Tissue Donors ; Transplants

BACKGROUND: A new technique resecting the hepatic parenchyma without inflow occlusion using a Cavitron Ultrasonic Surgical Aspirator (CUSA(R) ) reduces intraoperative blood loss and perioperative morbidity. This study was designed to identify the incidence and severity of venous air embolism (VAE) using transesophaseal echocardiography (TEE) in hepatic resection using CUSA(R) . METHODS: Forty patients undergoing hepatic resection using CUSA(R) of ASA class 1 and 2 were selected. After insertion of an epidural catheter for postoperative analgesia, all patients were anesthetized with sevoflurane in 50% air/O2. After the induction of anesthesia, A TEE probe was inserted into the esophagus. Blood pressure, heart rate, central venous pressure, end tidal CO2, and arterial carbon dioxide tension were recorded after induction, and during and after hepatic resection. During hepatic resection, an anesthesiologist evaluated the degree of VAE by transesophageal echocardiography in the 4-chamber view. RESULTS: The mean time of using CUSA(R) was 65.3 +/- 24.4 minutes. Of 40 patients, 9 had VAE grade I, 14 grade II, 14 grade III, and 3 grade IV. However, no significant difference was observed in hemodynamics or PaCO2 after induction, or during or after hepatic resection. The mean amount of blood loss was 887.0 ml +/- 598.8 ml and the mean transfused amount was 123.1 +/- 351.3 ml. CONCLUSIONS: All patients showed air embolism during hepatic resection with CUSA(R) . Serious complications associated with air embolism would occur in patients with an undiagnosed intracardiac right to left shunt. Therefore, meticulous monitoring by transesophageal echocardiography might be recommended in hepatic resection with CUSA(R) .
Analgesia ; Anesthesia ; Blood Pressure ; Carbon Dioxide ; Catheters ; Central Venous Pressure ; Echocardiography* ; Echocardiography, Transesophageal ; Embolism, Air* ; Esophagus ; Heart Rate ; Hemodynamics ; Humans ; Incidence* ; Ultrasonics*

Fibronectin(FN), a glycoprotein present in plasma and extracellular matrix, has been reported to be effective on various corneal disorders such as persistent epithelial defect, corneal trophic ulcer, herpetic keratitis, etc. We performed the study of the preparation of purified FN from 35 persons' plasma(male: 19, female: 16)by the use of Sepharose 48 Affinity Chromatography and Gel filtration. The prepared FN was pure electrophoretically, and no other plasma proteins were contaminated, and confirmed as pure by multiple methods such as SDS-P AGE, Ouchterlony double gel diffusion and immunoelectro phoresis. Only 40 minutes was taken for preparation. The result showed that FN concentrations in plasma and in prepared solution were 288.9 +/- 72.8 microgram/ml and 294.3 +/- 41.4 microgram/ml respectively. FN concentrations in plasma and FN eyedrops showed no difference between sex, but increased their level with age(p<0.05). The biological activity was better preserved at 4 degrees C(in the refrigerator) than at room temperature till about 4 weeks after preparation. Applicability of this method as a useful preparation of purified FN is recommendable.
Blood Proteins ; Chromatography, Affinity ; Chromatography, Gel ; Diffusion ; Extracellular Matrix ; Female ; Fibronectins* ; Glycoproteins ; Humans* ; Keratitis, Herpetic ; Ophthalmic Solutions ; Plasma* ; Sepharose ; Ulcer

BACKGROUND AND OBJECTIVES: To evaluate the feasibility and the short- and mid-term follow-up outcomes of endovascular stent-graft implantation in patients with Stanford type B aortic dissection. SUBJECTS AND METHODS: Twenty-eight patients with Stanford type B aortic dissection were evaluated. An aortogram was performed immediately after the procedure and a follow-up computed tomography (CT) scan was performed within one week, between 3 and 6 months, and annually thereafter. Clinical status was also evaluated at the same time. RESULTS: Endovascular stent-graft implantation at the target site was successful in 27 patients (96.4%). There were primary endoleaks in 6 patients and one case of procedure failure owing to migration of the stent-graft; and no procedure-related mortality. The number of patients with early complications requiring treatment was 2 (2/27, 4%). Fourteen patients experienced postimplantation syndrome (14/27, 52%). The average follow-up period was 22.1+/-17.5 months. Complete resolution or thrombosis of the false lumen was achieved in 14 patients and partial thrombosis was achieved in 10 patients. Operative treatments were required in three patients due to a progressing dissection or new dissection. There were no deaths and no instances of aneurysm or aortic rupture during the follow-up period. CONCLUSION: Endovascular stent-graft implantation for Stanford type B aortic dissection is a feasible, safe, and effective treatment modality. All patients who underwent surgery had a persisting leak. Therefore, regular evaluation of the aortic dissection and management of endoleaks were crucial for a favorable outcome in endovascular stent-graft implantation for a Stanford type B aortic dissection.
Aneurysm ; Aortic Rupture ; Endoleak ; Follow-Up Studies ; Humans ; Mortality ; Thrombosis

The iliopsoas bursa is a normal anatomical structure that lies deep to the iliopsoas tendon in the region of the hip joint. Iliopsoas bursitis is a relatively rare condition, so it is often overlooked as a cause of signs and symptoms involving the inguinal area and lower extremity. The clinical manifestation related to iliopsoas bursitis can vary due to compression of the adjacent structures such as the common and superficial femoral vessels, nerve, and bladder. We report here on rare cases of iliopsoas bursitis with compression of the superficial femoral artery and common femoral vein.
Bursitis* ; Femoral Artery ; Femoral Vein ; Hip Joint ; Lower Extremity ; Tendons ; Urinary Bladder

The iliopsoas bursa is a normal anatomical structure that lies deep to the iliopsoas tendon in the region of the hip joint. Iliopsoas bursitis is a relatively rare condition, so it is often overlooked as a cause of signs and symptoms involving the inguinal area and lower extremity. The clinical manifestation related to iliopsoas bursitis can vary due to compression of the adjacent structures such as the common and superficial femoral vessels, nerve, and bladder. We report here on rare cases of iliopsoas bursitis with compression of the superficial femoral artery and common femoral vein.
Bursitis* ; Femoral Artery ; Femoral Vein ; Hip Joint ; Lower Extremity ; Tendons ; Urinary Bladder

PURPOSE: We have studied the result of a modified Weaver-Dunn technique using absorbable sutures and imbrication of deltotrapezial fascia for the treatment of the dislocation of acromioclavicular joints. MATERIALS AND METHODS: Seventeen dislocations treated with the operative technique. Followed-up after at least 18 months postoperatively were retrospectively analyzed using the UCLA rating scale score, radiological films and occurrence of postoperative complications. RESULTS: Overall results were excellent in 7 (41%), good in 8 (47%) and poor in 2 cases (12%) according to UCLA rating system. The effect of age on the outcome was not significant but the result was better for early operations than late operations. Forward elevation loss was found in the group that was older than 39 years. The clavicle was anatomically reduced and maintained in 13 cases (76%). CONCLUSION: Modified Weaver-Dunn technique using absorbable sutures is a good treatment for acromioclavicular dislocations and imbrication of deltotrapezial fascia is important in stabilizing the joint.
Acromioclavicular Joint* ; Clavicle ; Dislocations ; Fascia ; Joints ; Postoperative Complications ; Retrospective Studies ; Sutures*