No abstract available.
Hip* ; Natural History* ; Technetium Tc 99m Medronate*

PURPOSE: Pain control after total knee arthroplasty reduces total admission days and is important in improving post operative range of motion. This study evaluates the efficacy of intrasynovial injection of morphine and ropivacaine after total knee arthroplasty. MATERIALS AND METHODS: A prospective, double blinded and randomized study was performed in thirty two patients with American society of anesthesiology stage I or II who underwent one staged total knee arthroplasty for both knees simultaneously under spinal anesthesia. Demographic data (age, height, weight, gender distribution, Hospital for Special Surgery knee score, Knee society score, visual analogue scores (VAS) and range of motion were evaluated in all patients preoperatively. Before closure of the joint capsule, a local injective analgesia of 50mL including 0.5 ml 5 mg of HCL morphine, 40 mL 0.6% 300 mg ropivacaine and 0.25 mL of 1:200,000 epinephrine was injected into the synovium of one knee and 50 mL of normal saline was injected into the synovium of the opposite knee. Analgesic efficacy was evaluated by visual analogue scores (VAS) at intervals of 2, 4, 6, 12, 24, 32, 40 and 48 hours after operation. During this period, the amount of postoperative bleeding and range of motion were compared between both knees in the same patient. RESULTS: There were no statistically significant differences among both knees in regard to VAS at intervals of 2, 4, 6, 12, 24, 32, 40 and 48 hours after surgery (p>0.05). There were no statistically significant differences between the range of motion among both knees (p>0.05). CONCLUSION: On the basis of the results of this study, we do not recommend the routine use of postoperative intrasy-novial ropivacaine and morphine injection for the purpose of reducing pain in patients undergoing knee arthroplasty under spinal anesthesia with epidural patient controlled anesthesia.
Analgesia ; Anesthesia ; Anesthesia, Spinal ; Anesthesiology ; Arthroplasty* ; Epinephrine ; Hemorrhage ; Humans ; Joint Capsule ; Knee* ; Morphine* ; Pain, Postoperative* ; Prospective Studies ; Range of Motion, Articular ; Synovial Membrane

BACKGROUND AND OBJECTIVES: Rhinoplasty has been frequently performed for correction of injured nose or cosmetic reasons. Korean standard values are insufficient, and most reference values are based on Caucasian ones. We measured Korean values of external nose with photographs according to sex and age. MATERIALS AND METHODS: Three hundred forty seven subjects without past history of operation or trauma were included in this study. With scaled instrument for head fixation, frontal and profile views were taken. On frontal view, physiognomic face height and nasal width were measured. On profile view, midface height, nasal height, alar height, glabellar depth, nasion depth, nasal dorsum depth, nasal tip depth, nasal depth, nasofrontal angle and nasolabial angle were measured. And location of nasion and shape of nasal dorsum were also classified. RESULT: Physiognomic face height decreased with age in both men and women groups. Nasofrontal angle increased with age in men. Nasion was located between upper end of upper eyelid and lateral canthus in most cases. On classifying the shape of nasal dorsum, straight type was the most in both men and women groups. CONCLUSION: We could know average measurements of external nose and differences of those according to sex and age in Korean adults. And it is thought that these data will be useful to facial plastic surgery including rhinoplasty.
Adult ; Cosmetics ; Eyelids ; Female ; Head ; Humans ; Male ; Nose ; Reference Values ; Rhinoplasty ; Succinates ; Surgery, Plastic

BACKGROUND: Alpha-1-antitrypsin (A1AT) deficiency is the only established genetic resk factor for emphysema. This study was undertaken to investigate the prevalence of the genotypes of A1AT genotypes in healthy Koreans. METHOD: The study population consisted of 380 healthy Koreans enrolled at the Health Promotion Center in Kyungpook National University Hospital. The polymerase chain reaction (PCR) and restriction fragment length polymorphim (RFLP) for detecting the A1AT variants M1(Ala), M1(Val), M2, S and Z were used. RESULTS: The genotypes of subjects were as follows : M1(Val)/M1(Val), 254(66.8%) ; M1(Val)/M2, 105(27.6%) ; M2/M2, 19 (5.0%) ; and M1(Val)/M1(Ala), 2 (0.5%). There was no case with 'deficiency' alleles such as S and Z found in this study. CONCLUSION: These results suggest that A1AT deficient alleles are either extremely rare or not present in Koreans.
Alleles ; Emphysema ; Genotype* ; Gyeongsangbuk-do ; Health Promotion ; Polymerase Chain Reaction ; Prevalence*

BACKGROUND: Primary lymphoma of bone is a rare disease. There is yet no systematical evaluation of primary lymphoma of bone in Korea. Here we report our experience of sixteen cases with primary lymphoma of bone focusing on the survival. METHODS: Sixteen cases, collected for 13 years, were evaluated on the clinical presentation, histologic subtype, stage and treatment outcomes of the primary bone lymphoma. RESULTS: The most common presenting complaint was bone pain. Malignant lymphoma of bone involved a wide variety of sites, the most prevalent site of which in this study was the spine. Most of the cases were in the diffuse large B-cell category. The clinical stage of lymphoma was IEA in two cases, IIEA in three cases, IVEA in five cases and IVEB in three cases. All treated cases received systemic chemotherapy and ten cases among them were treated with combined modality therapy. Median overall survival was not reached after median follow-up period of 28 months and five-year overall survival rate was 54%. CONCLUSION: More promising therapeutic strategies are needed for survival improvement on more accumulated cases.
Adolescent ; Adult ; Aged ; Bone Neoplasms/*mortality/pathology/therapy ; Child ; Child, Preschool ; Female ; Human ; Infant ; Korea/epidemiology ; Lymphoma/*mortality/pathology/therapy ; Male ; Middle Age ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Survival Rate

OBJECTIVE: To analyze morphologic differences between only spondylolysis group and mild spondylolisthesis one in young-aged persons and to find useful parameters for radiological assessment of mild spondylolisthesis. METHOD: Twenty patients with only lumbar spondylolysis, 18 patients with mild lumbar spondylolisthesis and 19 normal subjects were recruited in this study. Their radiological findings were examined. The films of subjects were evaluated with respect to variables describing wedging of the spondylolytic vertebra, relative thickness and lengths of the transverse processes. The evaluation was made with attention to possible signs which could mean vertebral slipping. The lumbar index reflects the degree of wedge deformity of the spondylolytic vertebra. RESULTS: Lumbar index was significantly lower in spondylolisthesis group than only spondylolysis group. There was no significant difference in relative thickness of L5 transverse process between two groups. The incidence of a midline lumbar or sacral defect in the spondylolisthesis group was higher than other groups. CONCLUSION: Our results support the usefulness of lumbar index as a supplement parameter for radiological assessment of mild spondylolisthesis.
Congenital Abnormalities ; Humans ; Incidence ; Spine ; Spondylolisthesis* ; Spondylolysis

Carcinoma ex pleomorphic adenoma is a rare neoplasm of the salivary gland. It has been reported that the most frequently affected site is the parotid gland, while the incidence rates in palatal minor salivary gland are much lower. Misdiagnosis is common, because the residual mixed tumor component may be small, and various carcinoma subtypes are possible. Clinical manifestations are mostly asymptomatic and have space occupying lesion sometimes. The recommended treatment is surgical excision with wide margins and subsequent radiation therapy. The author recently experienced a carcinoma ex pleomorphic adenoma of hard palate in a 62-year-old female with palatal mass. We treated with total excision with wide margins and there was no recurrence during the follow-up period of 2 years until now. We report this case with review of the literature.
Adenoma, Pleomorphic* ; Diagnostic Errors ; Female ; Follow-Up Studies ; Humans ; Incidence ; Middle Aged ; Palate, Hard* ; Parotid Gland ; Recurrence ; Salivary Glands ; Salivary Glands, Minor

Angiosarcoma is an exceedingly rare and highly malignant neoplasm which develops from the endothelium of blood vessels. Only a few cases of primary angiosarcoma of the non-irradiated parotid gland have been reported. In this case, we report a primary angiosarcoma of the parotid gland in a 64-year-old man without prior irradiation of the head and neck region. MRI finding revealed a 3.9x2.7 cm sized mass located in the right parotid gland with unhomogenous enhancement in T2 weighted image. The patient underwent a total parotidectomy and radical neck dissection. The histologic diagnosis was high-grade angiosarcoma showing pleomorphic spindle or epithelioid tumor cells growing as solid infiltrative pattern or slit-like irregular vascular lumina formation. Despite postoperative radiation therapy, the patient died of lung metastasis with hemorrhage 3 months later.
Blood Vessels ; Endothelium ; Head ; Hemangiosarcoma ; Hemorrhage ; Humans ; Lung ; Middle Aged ; Neck ; Neck Dissection ; Neoplasm Metastasis ; Parotid Gland

PURPOSE: To evaluate the results of open or arthroscopic debridememt with a retention of the components for acute deep infected total knee arthroplasty. MATERIALS AND METHODS: From January 1991 to December 2005, among 1282 patients, 1457 TKAs, 8 cases of acute deep infected total knee arthroplasty was retrospectively reviewd. A radiologic and clinical assessment were performed to analyze the treatment results. The mean age was 63.9 (57-77) years. One patient was male, and 7 were female. RESULTS: The acute infection rate was 0.55% and the mean follow-up period was 41 months ( range, 30 months to 62 months). Using the Segawa classification, 3 cases were Type 2, and five cases were Type 3. Six cases were treated with arthroscopic debridement and antibiotic therapy. Two cases were treated with open debridement and antibiotic therapy. Intravenous antibiotic therapy was administered over a 3 week period. There were 2 cases of recurred infection. In synovial fluid culture, 4 cases were positive to S. aureus, 2 cases were positive to S. epidermidis and no bacteria was found in 2 cases. At the last follow-up, the mean Knee Society Score was 86.4 points. There were no chronic infection, loosening or osteolytic changes in the implants. CONCLUSION: If an early diagnosis is made, open or arthroscopic debridememt with a retention of the components is a useful method for acute deep infected total knee arthroplasty.
Arthroplasty* ; Bacteria ; Classification ; Debridement ; Early Diagnosis ; Female ; Follow-Up Studies ; Humans ; Knee* ; Male ; Retrospective Studies ; Synovial Fluid

The patient with pulsatile tinnitus can bo annoying and the tinnitus can be the only clue to a potentially devastating and life-threatening disease, too. This tinnitus may originate from the arterial, arteriovenous, venous vessels and the myoclonus. Occasionally it is the cause of underlying condition in increased flow volume such as anemia, hyperthyroidism, pregnancy, medication or increased intracranial pressure. And then control of these underlying condition is important treatment in those occasions. If anyone suffered from venous pulsatile tinnitus, then simple ligation of the internal jugular vein could be the simplest treatment. Recently the authors experienced a case of 28-year-old woman with left pulsatile tinnitus originating from venous hum. The tinnitus had developed at fourth month of pregnancy and persisted after 20 months of delivery. The patient was treated by ligation of the internal jugular vein in local anesthesia. The proper ligation site was decided by angiography. She remains free of symptoms and complications 7 months after treatment.
Adult ; Anemia ; Anesthesia, Local ; Angiography ; Female ; Humans ; Hyperthyroidism ; Intracranial Pressure ; Jugular Veins* ; Ligation* ; Myoclonus ; Pregnancy* ; Tinnitus ; Veins