No abstract available.
Brain Injuries* ; Brain* ; Disability Evaluation* ; Humans ; Perfusion* ; Technetium Tc 99m Exametazime* ; Tomography, Emission-Computed, Single-Photon*

The changes in the surface of articular cartilage of femoral condyle from rabbits were evaluated after degenerative changes were made by the technique advocated by Hulth. The medial collateral and both cruciate ligaments were excised, and a medial menisectomy was done. Then the right knee joint was injected with 1 ml of Na-hyaluronate gel every two weeks. The animals were sacrificed at two, four, six, eight, or sixteen weeks postoperatively. After sacrifice, the medial femoral condyle was excised and prepared for the light microscopic and scanning electron microscopic study. At eight to sixteen weeks, there were chondrocyte clones with clefts to the radial zone and increased loss of the height of articular cartilage on the control side; but, on theexperimental side there was a significant delay and lessening of the arthriticresponse. The biocompatibility and the protective effect of joint degeneration of this device make this material a valuable adjuvant in the treatment ofosteoarthritis and the traumatized joints.
Animals ; Cartilage, Articular/drug effects/ultrastructure ; Disease Models, Animal ; Gels ; Hyaluronic Acid/*therapeutic use ; Knee Joint/drug effects/ultrastructure ; Microscopy, Electron, Scanning ; Osteoarthritis/*prevention & control ; Rabbits ; Support, Non-U.S. Gov't

No abstract available.
Osteogenesis Imperfecta* ; Osteogenesis*

No abstract available.
Genes, myc* ; Neuroblastoma* ; Polymerase Chain Reaction*

Purpose: The results of a more than 10-year follow-up after total hip arthroplasties with circumferential and proximal porous-coated femoral stems were evaluated. Materials and Methods: Seventy-six patients (80 hips), who were operated on between Aug. 1991 and July 1994, were followed for more than 10 years after primary total hip arthroplasties using Multilock stems. The mean age at the time of the operations was 47.3 years old and the mean duration of follow-up was 12.3 years. The clinical results and radiological findings were evaluated. Results: The mean Harris hip scores improved from 54.7 points to 88.5 points at the time of the 10-year follow up. On the last follow-up radiograph, endosteal bone formation was observed in 70 hips (90%) and all femoral stems were biologically stable. Femoral osteolysis, which was linear in Gruen zone I and VII and mostly restricted to the proximal zones, was observed in 67 hips (84%), and no hip had distal osteolysis in the femur. There was no loosening, migration, or revisions of the stems. Conclusion: Total hip arthroplasties using circumferential and proximal porous coated Multilock femoral stems demonstrated stable osseous fixation and no distal osteolysis for a minimum 10-year follow-up; therefore, all stems were reported to have satisfactory outcomes. With improvement of cup design and liner wear, circumferential and proximal porous coating designs of femoral stems can be an alternative answer to mechanical failure due to aseptic loosening.
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Femur ; Follow-Up Studies* ; Hip ; Humans ; Osteogenesis ; Osteolysis

The successful development of reliable total hip arthroplasties for the treatment of several diseased hips has led to it increasing application in this country. As with any mode of therapy, the more frequent its use, the greater chance of complication or failure. Infection and loosening of component which is mainly due to improper surgical and cementing technique are the most frequent of these complication and has been increased the incidence of revision, too. We have experienced 96 hips of total hip replacement in 90 patients from February 1980 to July 1986. Among them, 14 hips who had been undertaken revisional arthroplasty were followed-up for average 27 months, and the following results were obtained. 1. Average patients age was 50.5 years, and time from previous total hip replacement to revisional arthroplasty was 3 years in 11 cases of loosening but only 3 weeks in 3 cases of surgieal error, and the post-revision follow-up was average 27 months. The main cause of the revisional surgery in this study were aseptic loosening in 9 csses (64.3%), surgical error in 3 cases(21.4%) and septic loosening in 2 cases(14.3%). 2. Cementless total hip replacement seems to be more prefer in an attempt to in initial total and even in revisional hip replacement to prevent loosening. 3. There are three cases of surgical error with the fracture and penetrating the tip of femoral stem into the proximal femur. Their causes of initial hip arthroplasty wss dysplastic hip in one and two cases of secondary osteosrthritis due to late sequelae of Legg-Calve-Perthes disease with moderate degree of anteversion of femoral head. These patients were younger than most who require usually total hip replscement and therefore their bone was harder and the medullary canal was nsrrow. These surgical complications are initiated because any attempt to correct these anteversion of femoral head was not given preoperatively. These kinds of surgical error in total hip replacement can be prevented by careful anstomicsl and radiological analysis of proximsl femur preoperatively, and X-rays or viewing with the T-V image intensifier for the proximal femur during the operation.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Femur ; Follow-Up Studies ; Head ; Hip ; Humans ; Incidence ; Legg-Calve-Perthes Disease ; Medical Errors

OBJECTIVE: This study was to define clinical characteristics and formulate the management strategies of the patients with posterior cerebral artery (PCA) aneurysms. PATIENTS AND METHOD: The authors reviewed the database and imaging studies as sources for identification and analysis. During the past 14 years, 16 consecutive patients with PCA aneurysms were treated either by surgery or neurointervention. RESULTS: Ten patients had ruptured PCA aneurysms: 4 patients were Hunt and Hess Grade I, 1 Grade II, 4 Grade III, and 1 Grade IV. Six patients had unruptured PCA aneurysms: one patient was Grade 1, and the other patient was Grade IV due to ruptured multiple aneurysms. Seven aneurysms were small, 9 (56.2%) were large or giant. Thirteen aneurysms were saccular, 2 were fusiform, and 1 was serpentine. Seven of the 16 patients (43.7%) had multiple aneurysms. Pterional (8) or subtemporal (5) approach was done in 13 patients. The obliteration methods of the aneurysms were neck clipping in 10 patients, and trapping in 3 patients. Endovascular treatment was performed in 3 patients. Five patients showed transient oculomotor nerve palsy and contralateral hemiparesis after the surgery. Persisting oculomotor nerve palsy occurred in one patient. All patients showed favorable outcome (food recovery 14, moderate disability 2). CONCLUSIONS: As a result, PCA aneurysms were characterized by high frequency of non - saccular shape, large or giant size with mass effect, and multiple aneurysms. Surgical treatment was necessary for large or giant aneurysm of the distal PCA to decompress midbrain. Wrapping and clipping technique were useful for treatment of fusiform aneurysms. Although ultimate management outcome of the patients with PCA aneurysms were better than the patients with aneurysms of the other location, intra-aneurysmal treatment with Guglielmi detachable coil would be useful for the proximal PCA aneurysms to avoid surgical injury of the P1 perforator or the oculomotor nerve.
Aneurysm ; Humans ; Intracranial Aneurysm* ; Intraoperative Complications ; Mesencephalon ; Neck ; Oculomotor Nerve ; Oculomotor Nerve Diseases ; Paresis ; Passive Cutaneous Anaphylaxis ; Posterior Cerebral Artery*

PURPOSE: Several analgesic techniques are available for pain management after a major operation. MATERIALS AND METHODS: From December 2005 to February 2006, a prospective, double-blind study was performed involving 90 patients who had undergone a total knee arthroplasty. Patients were randomly divided into three equal groups (n=30). Demographic data, including age, height, weight, knee score, visual analogue scale (VAS), and range of flexion were evaluated preoperatively. Before wound closure, patients were given intra-synovial injections of the following solutions: patients in group I received 40mL of 300mg ropivacaine with 1:200,000 epinephrine and 5mg morphine; patients in Group II received 40mL of 300mg ropivacaine with epinephrine; and patients in Group III received 50mL normal saline as a control. All patients received an epidural patient-controlled analgesia (PCA) for 24 postoperative hours. Analgesic efficacy was evaluated using the VAS at intervals of 2, 4, 6, 12, 24, 32, 40, and 48 hours postoperatively. During this period, the side effects, the dosage of rescue analgesia required, and the range of knee flexion were recorded for each group. RESULTS: There were no significant differences among the three groups with regards to the VAS and the required dose of rescue analgesia (p > 0.05). None of the groups demonstrated significant differences in the range of knee flexion and the incidence of postoperative nausea and emesis (p > 0.05). CONCLUSION: Therefore, we found that ropivacaine, alone or with morphine, injected into the synovial tissue, along with an epidural PCA has no additional benefits in pain control after a total knee arthroplasty.
Synovial Membrane ; Range of Motion, Articular ; Postoperative Complications/*prevention & control ; Pain, Postoperative/*drug therapy ; Osteoarthritis/surgery ; Morphine/administration & dosage/*therapeutic use ; Middle Aged ; Male ; Knee Prosthesis/*adverse effects ; Humans ; Female ; Double-Blind Method ; Arthritis, Rheumatoid/surgery ; Anesthetics, Local/administration & dosage/*therapeutic use ; Anesthesia, Epidural ; Analysis of Variance ; Analgesia ; Amides/administration & dosage/*therapeutic use ; Aged

No abstract available.
Automation, Laboratory/*methods ; Culture Media/*classification ; Female ; Humans ; Male ; Sputum/*microbiology ; Tuberculosis, Pleural/*diagnosis

OBJECTIVE: The purpose of this study is to determine whether patients with alcohol dependence do have brain dysfunction by auditory event related potential P300, EEG, and neuro-cognitive function test or not. METHODS: Subjects were composed of patients with alcohol dependence (N=33) and normal controls (N=67). P300 was determined by conventional method, Global Field Power method, and modified method. Also Korea Wechsler Intelligence Scale, Wechsler Memory Scale, and Trail Making B were tested. Spectral EEG was analyzed by the ranges of Hz, delta (delta, 1-3.5Hz), theta (theta, 4-7.5Hz), alpha(alpha, 8-13Hz), and beta(beta, 13.5-18Hz), and compared by relative power. RESULTS: In patients with alcohol dependence, P300 was smaller and later, and there was no difference between the measurement methods of P300. Lower IQ score was shown in patients with alcohol dependence, but it did not affect the P300 results. It took more time to perform Trail Making B test in patients with alcohol dependence, but there was no difference between groups in Wechsler Memory Scale. Spectrum EEG was shown as similar patterns. CONCLUSION: It suggests that patients with alcohol dependence have brain dysfunction in some neurophysiological aspects, regardless of intelligence. And frontal lobe dysfunction might be more severe than temporal one in patients with alcohol dependence.
Alcoholism* ; Brain ; Electroencephalography* ; Frontal Lobe ; Humans ; Intelligence ; Korea ; Memory