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: 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 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: 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

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

BACKGROUND AND OBJECTIVES: Psychological distress may develop from tinnitus, or that recognition of tinnitus may even be greater during exposure to environmental stress. So, patients with tinnitus need to consider the psychologic aspect in their diagnosis and treatment. The aim of this study is to evaluate the degree and characteristics of the psychologic factors associated in patients undergoing tinnitus retraining therapy. MATERIALS AND METHOD: 119 patients with tinnitus who received the Symptom Check List-90-Revision (SCL-90-R) and a control group without tinnitus were compared first; and then 92 out of 119 patients performed the follow up study after three months of tinnitus retraining therapy. RESULTS: The results were as follows. 1. The tinnitus group scored higher than the control group in somatization, anxiety, phobic anxiety (p<0.05). 2. The gender difference, age, duration, position, hearing, and Feldmann masking curve of tinnitus were not related to the psychologic status of patients with tinnitus (p>0.05). 3. The psychologic aspect of patients with tinnitus were related to loudness, pitch, annoyance (p<0.05). 4. The follow-up study of 3 months on patients who underwent tinnitus retraining therapy showed diminished score in all components of SCL-90-R, except phobic anxiety, and paranoid (p<0.05). CONCLUSION: This study indicated that the compliant behaviour of tinnitus is related closely with intrinsic psychodynamic mechanism.
Anxiety ; Diagnosis ; Follow-Up Studies ; Hearing ; Humans ; Masks ; Psychology ; Surveys and Questionnaires ; Tinnitus*

PURPOSE: This study retrospectively reviewed the results of a closed reduction and internal fixation with cannulated screws for a displaced femoral neck fracture. MATERIALS AND METHODS: Among 631 patients between January 1991 and December 2000, 27 patients classified as Garden stage III or IV were treated with a closed reduction and internal fixation with cannulated screws. The mean follow-up duration was 4.5 years. The mean age of the patients was 56.5 years. RESULTS: Union and the restoration of function was observed in 15 cases (55.6%), and failure occurred in 12 cases (44.4%). The cause of failure was early stage reduction loss due to a failure to obtain anatomical reduction on the surgical field in 4 cases, reduction loss and displacement during the follow up period after an appropriate reduction at surgery in 4 cases and avascular necrosis in 4 cases. Seven cases were converted to a total hip arthroplasty, 4 cases were converted to bipolar hemiarthroplasty and 1 case is currently being followed up. CONCLUSION: A closed reduction and internal fixation for displaced femoral neck fracture showed a high failure rate. Therefore, an accurate anatomical reduction, firm internal fixation and efforts to prevent further unnecessary vascular injury will be needed to reduce the high failure rate and complications.
Arthroplasty, Replacement, Hip ; Femoral Neck Fractures* ; Femur Neck* ; Follow-Up Studies ; Hemiarthroplasty ; Humans ; Necrosis ; Retrospective Studies ; Vascular System Injuries

PURPOSE: To evaluate the clinical and radiologic result of total knee arthroplasty using Scorpio. total knee system retrospectively. MATERIALS AND METHODS: Between January 1999 and December 2001, 71 knees in 51 patients who had been followed up mean 3.6 years (minimum 3.0 years) after total knee arthroplasty with Scorpio(R) system (posterior substitution type) were evaluated retrospectively for clinical result, active range of motion, flexion contracture and radiologic result. RESULTS: The average active range of motion increased from 108degrees (75-144degrees) preoperatively to 120degrees(90-144degrees) at last follow up. The average flexion contracture improved from 12degrees(0-30degrees) preoperatively to 2degrees(0-13degrees) at last follow up. The average HSS knee score was measured 54 preoperatively and was measured 88 postoperatively. There was no difference in clinical result, active range of motion and flexion contracture between resurfaced patella group and nonresurfaced patella group. Radiologic evaluation revealed radiolucency rate of 11% in Tibia anteroposterior view and 10% in femur. Complications were periprostheitc fracture in one case, deep infection in one case and peroneal nerve palsy in one case. In one case, femoral and tibial component migration due to aseptic loosening was noted. Revision of tibial and femoral component was done. CONCLUSION: The 3.6 years follow up results of Scorpio(R) system (posterior substitution type) were excellent in range of motion and function. There was no difference between resurfaced patella group and nonresurfaced patella group in clinical result.
Arthroplasty* ; Contracture ; Femur ; Follow-Up Studies ; Humans ; Knee* ; Paralysis ; Patella ; Peroneal Nerve ; Range of Motion, Articular ; Retrospective Studies ; Tibia

PURPOSE: To evaluate the medium-term clinical and radiographic results of uncemented total hip arthroplasty with ceramic-on-ceramic articulation. MATERIALS AND METHODS: From February 1999 to August 2000, fifty-two primary total hip arthroplasties were performed on forty-two patients using a ceramic-on-ceramic bearing implant. The mean follow-up period was 5.4 years (range, 5-6.6 years) and the mean age at surgery was 43.2 years (range, 19-66 years). The clinical results were evaluated using the Harris hip score. The radiographic evaluations were carried out in terms of the stability of the components, the prevalence of osteolysis and wear. RESULTS: At the most recent follow-up, the mean preoperative Harris hip score improved from 63 points (range, 26-93 points) to 97 points (range, 82-100 points). The Harris hip score showed excellent results in 49 hips (94%) and good results in 3 hips (6%). Fixation by bone ingrowth was noted in all cases and there was no case with osteolysis or a deep infection. Ceramic wear was not detectable on the plain radiograph. Complications included one case of dislocation, one case of a fracture of the ceramic femoral head and one case of an intraoperative periprosthetic proximal femoral crack. CONCLUSION: Ceramic-on-ceramic articulation showed excellent clinical and radiographic results in terms of wear, osteolysis and loosening. A further follow-up study should be performed to evaluate the long-term clinical and radiographic results with special focus on the fracture of the ceramic material.
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Ceramics ; Dislocations ; Follow-Up Studies* ; Head ; Hip ; Humans ; Osteolysis ; Prevalence