No abstract available.
Arthroplasty* ; Knee* ; Reoperation*

No abstract available.

Survivorship analysis is a useful way of expressing the long term results of joint replacement. With the increase of follow up period in total knee replacement, it has became possible to predict the survival rate of implants in total knee replacement. The survivorship of total knee replacement in 145 consecutive patients(209 knees) between 1982 and 1988 with follow-up period of up to 10 years was estimated by Dobbs' method(1980), and we analyzed, clinically and radiologically, 116 patients(177 knees) which were followed up more than 2 years(from 2 years to 10 years, average 6 years and 4 months). Also, we evaluated the knee function according to the functional knee scores of Hospital for Special Surgery. 1. The average age at operation was 55.6 years(from 19 years to 75 years). Male was 12 patients and female was 104 patients. 2. There were osteoarthritis in 83 knees(46.5%), rheumatoid arthritis in 71 knees(40.0%), secondary osteoarthritis in 18 knees(10.0%), tuberculous arthritis in 3 knees (2.0%), and Charcot joint in 2 knees(1.5%). 3. The Hospital for Special Surgery functional knee and pain scores was improved from average 43 points preoperatively to average 84 points postoperatively. The results were satisfactory in 162 knees(91.4%, excellent in 64.0% and good in 27.4%). 4. Revision surgery was performed in 15 knees of the 209 knees(7.2%), due to aseptic loosening in 9 knees(4.3%) and septic loosening in 6 knees(2.9%). 5. Survival rate of total knee replacement with reliability was 87.7%, 8 years after operation for 145 patients, 209 knees. In summary, total knee replacement is a relatively satisfying and predictable procedure which can obtain the relief of pain, restoration of function, and long term survivorship.
Arthritis ; Arthritis, Rheumatoid ; Arthropathy, Neurogenic ; Arthroplasty, Replacement, Knee ; Female ; Follow-Up Studies ; Humans ; Joints ; Knee ; Male ; Osteoarthritis ; Survival Rate

No abstract available.
Bone Marrow* ; Head* ; Neck*

About one tenth of all CNS neoplasms involves the brain. Due to their location in the ventricles they often present similar nonspecific clinical manifestation. Localization and differential diagnosis are dependent on radiological investigation. For the identification of specific CT characteristics of the intraventricular tumors and the differental diagnosis, we retrospectively analyzed 22 pathologically proved cases seen on CT. Important differential features included age and sex of the patient, the location within the ventricle, and the morpholgic appearance of the mass and density on CT before and after intravenous administration of contrast material. Meningiomas (4 cases) and a germinoma showed increased density on the precontrast CT scans, and demonstrated dense uniform enhancement of the postenhanced scan. Choroid plexus papillomas (3 cases) showed dense uniform contrast enhancement. Intraventricular neurocytomas (3 cases) demonstrated characteristic attachment to the septum pellucidum, confinement of the lateral and third ventricle, and calcification within the mass Colloid cysts (2 cases) showed characteristic location of anterosuperior aspect of the third ventricle. In conclusion, CT findings of intraventricular tumors are usually nonspecific. The location of the mass and the patient's age are the most helpful information in the differential diagnosis.
Administration, Intravenous ; Brain ; Colloid Cysts ; Diagnosis ; Diagnosis, Differential ; Germinoma ; Humans ; Meningioma ; Neurocytoma ; Papilloma, Choroid Plexus ; Retrospective Studies ; Septum Pellucidum ; Third Ventricle ; Tomography, X-Ray Computed

PURPOSE: To evaluate the specif!c radiologic findings of the dysgenesis of corpus callosum(CCD) on CT and/or MR images. MATERIALS AND METHODS: The authors reviewed retrospectively CT and/or MR images of 10 patients with CCD. After classifying CCD into partial and total type according to the degree of its development, we investigated structural abnormalities on CT and/or MR images resulting from or related to CCD and then associated anomaly. RESULTS: The most common findings of CCD on axial planes of CT and/or MR images were dilatation of posterior part of the lateral ventricles(8/10) and feature of the bodies of the both lateral ventricles(8/10) in parallel. Sagittal and coronal planes of MR demonstrated exact extent of dysgenesis of the corpus callosum(5/5) and radiating pattern of gyri in medial surface of cerebral hemisphere extending to the 3rd ventricle without interruption by cingulate sulcus(4/5). CONCLUSION:MR image of mid-sagittal plane appeared most useful in diagnosis of CCD because of its direct depiction of the whole length of corpus callosum. In most cases, however, CCD can be easily diagnosed with CT scan by characteristic findings of dilatation of the posterior part of lateral ventricles and paralleling of the lateral ventricles.
Cerebrum ; Corpus Callosum ; Diagnosis ; Dilatation ; Humans ; Lateral Ventricles ; Retrospective Studies ; Tomography, X-Ray Computed

BACKGROUND: In recent years, the incidence of obesity increased in Koreans. The main cause suggested is the diet style of Korean changed to that of Western. It has been proved that obesity is a risk factor or an aggravating factor of hypertension and diabetes mellitus, cardiovascular disease, etc. Primary physician has been interested in the correlation of blood pressure with relative body weight and aging. The purpose of this study was to focus on the influence of age and relative body weight on blood pressure. METHODS: Subjects were collected from 2,068 adults who had received Adult Health Examination. That subjects were divided according to age, relative body weight and then the relation of blood pressure with age according to relative body weight and relation with relative body weight according to age were investigated. RESULTS: Systolic blood pressure increased significantly according to age in all male and female three weight groups and then increased significantly according to relative body weight in all male and female three age groups except male seventh decade group. Diastolic blood pressure increased significantly according to age in all male and female three weight groups except male obesity group and then increased significantly according to the relative body weight in all male and female three age groups except male and female seventh decade groups. Systolic blood pressure has higher correlation with age than relative body weight and diastolic blood pressure has higher correlation with relative body weight in male. In female, systolic and diastolic blood pressure have higher correlations with age. CONCLUSIONS: It can be suggested that blood pressure increase significantly according to aging process and relative body weight. These two factors have a little different effects to systolic and diastolic blood pressure according to sex. Relative body weight has more effect to diastolic blood pressure than systolic blood pressure in male.
Adult ; Aging ; Blood Pressure* ; Body Weight ; Cardiovascular Diseases ; Diabetes Mellitus ; Diet ; Female ; Humans ; Hypertension ; Incidence ; Male ; Obesity* ; Risk Factors

PURPOSE: Intraductal papilloma (IDP) is a benign breast disease with malignant potential, for which complete surgical excision is usually recommended. The aim of the present study was to investigate predictive factors for upgrading patients with a benign papillary lesion (BPL). METHODS: This study was an observational study using a prospectively collected cohort. In total, 13,049 patients who underwent a core needle biopsy (CNB) for a breast lesion between January 2009 and May 2015 were enrolled. We reviewed all patients with pathologically confirmed BPL from a CNB. RESULTS: Surgical treatment was performed for 363 out of a total of 592 lesions. According to the pathological differences, the lowest upgrade rate was shown in IDP without atypia (without atypia, 6.0%; with atypia, 26.8%; papillary neoplasm, 31.5%; p<0.001). The univariate analysis showed that, in IDP without atypia, the age at diagnosis, size of BPL on ultrasonography, and density on mammography were associated with upgrading. The multivariate analysis revealed that age >54 years and lesion size >1 cm were significantly associated with upgrade to malignancy (odds ratio [OR]=4.351, p=0.005 and OR=4.236, p=0.001, respectively). CONCLUSION: The indications for surgical treatment can be defined as age >54 years and mass size >1 cm, even in IDP without atypia in the CNB results; this also includes cases of IDP with atypia or papillary neoplasm. Therefore, we suggest that close observation without surgery is sufficient for younger women with a small IDP without atypia.
Biopsy ; Biopsy, Large-Core Needle* ; Breast Diseases ; Breast Neoplasms ; Breast* ; Cohort Studies ; Diagnosis ; Female ; Humans ; Mammography ; Multivariate Analysis ; Observational Study ; Papilloma, Intraductal ; Prospective Studies ; Ultrasonography

The National Teacher Training Center for Health Personnel (NTTC) / Korea, administrated jointly by Seoul National University College of Medicine, is a resource to conduct programs on fundamental and applied problems in Korean medical education, to assist faculty of health professions to gain increased knowledge of the methods of teaching, educational evaluation and curriculum planning. Of varieties of educational services given for health profession faculty since its establishment in 1975, faculty development program has been one of the major activities to provide educational experiences to the faculty members to improve their teaching effectiveness by conducting workshops, seminars and conferences. A total of 30 short-term educational workshop programs, designed for newly appointed medical school faculty members were implemented during a period from 1981 to 1989, and their postworkshop questionnaires were analysed together with summary reports from convertors in view of evaluating immediate effectiveness. The number of participants was 655 from 27 out of 31 medical schools. They attended a 3-day promotional workshop under the same workshop objectives and format with a class size of no more than 30/workshop. The selection procedure was mostly relied on the recommendation through the dean's office. The workshop format was generally well accepted among the participants as a necessary mechanism for reclarification of the faculty roles in teaching-learning process, especially in professional educational programs. Teaching strategies including small group discussions and various group dynamics techniques were the integral parts of the workshop format aiming for the active participation throughout the educational activities in development of lecturing and test-item construction skills. Impeding and enhancing factors identified during the workshop were listed and recommendations to NTTC, medical schools and related organizations were made with regard to further improvement in faculty development programs.
Congresses as Topic ; Curriculum ; Education* ; Education, Medical ; Health Occupations ; Health Personnel ; Humans ; Korea ; Research Report ; Schools, Medical* ; Seoul ; Surveys and Questionnaires

Background: and Purpose: Many elderly patients are unable to actively stand up by themselves and have contraindications to performing the head-up tilt test (HUTT). We aimed to develop screening algorithms for diagnosing orthostatic hypotension (OH) before performing the HUTT. Methods: This study recruited 663 patients with orthostatic intolerance (78 with and 585 without OH, as confirmed by the HUTT) and compared their clinical characteristics. Univariate and multivariate analyses were performed to investigate potential predictors of an OH diagnosis. Machine-learning algorithms were applied to determine whether the accuracy of OH prediction could be used for screening OH without performing the HUTT. Results: Differences between expiration and inspiration (E-I differences), expiration:inspiration ratios (E:I ratios), and Valsalva ratios were smaller in patients with OH than in those without OH. The univariate analysis showed that increased age and baseline systolic blood pressure (BP) as well as decreased E-I difference, E:I ratio, and Valsalva ratio were correlated with OH. In the multivariate analysis, increased baseline systolic BP and decreased Valsalva ratio were found to be independent predictors of OH. Using those variables as input features, the classification accuracies of the support vector machine, k-nearest neighbors, and random forest methods were 84.4%, 84.4%, and 90.6%, respectively. Conclusions We have identified clinical parameters that are strongly associated with OH. Machine-learning analysis using those parameters was highly accurate in differentiating OH from non-OH patients. These parameters could be useful screening factors for OH in patients who are unable to perform the HUTT.