Purpose: This study examined the changes in the body mass index (BMI) and the effects of BMI on the knee function and risk factors for an increase in BMI after total knee arthroplasty (TKA) in Asians. Materials and Methods: A prospective observational study was conducted on 100 cases of TKA performed by one surgeon. Obesity was defined as BMI ≥25 kg/m 2 . The BMI and Knee Society Score, consisting of the Knee Score and Function Score, were measured on the day before surgery and one year after surgery. Results: The BMI decreased or was maintained in 34 cases (34%) and increased in 66 cases (66%) one year after surgery. An increase in BMI of 5% or more was considered a clinically significant increase in BMI and occurred in 28 cases (28%). The patients with an increased BMI by more than 5% showed a significantly lower knee function score. The age and preoperative function score were significantly associated with an increased BMI by more than 5%. As the age increased by one year, the odds ratio at which the BMI would increase by more than 5% one year after surgery was 0.905. Moreover, as the preoperative function score increased by one point, the odds ratio that the BMI would increase by 5% one year after surgery was 0.902. In other words, a younger preoperative age and a lower preoperative function score mean a higher risk of a more than 5% postoperative increase in BMI. Conclusion The BMI increased by more than 5% one year after surgery in 28% of the TKA patients examined. They had a lower functional score. The risk factors for a more than 5% increase in BMI after TKA were young age and a low preoperative function score. Therefore, surgeons should educate patients, particularly those who are young or have a low preoperative function score, so that the patient’s BMI would not increase after surgery.

No abstract available.
Gonadotropins* ; Humans*

No abstract available.
Cryptococcosis*

Ossifying fibroma is not a well recognized entity, and only rarely affects the long bones. The main differential diagnosis is with fibrous dysplasia and with adamantinoma, non-ossifying fibroma of the long bone. Ossifying fibroma seldom has even a moderate tendency to progress during childhood, but it recurs frequently after curettage or subperiosteal resection. Any progression of the lesion comes to an end after puberty. So, surgery should be delayed as long as possible. But, if the lesion is rapidly progressive, or if a patient has repeated fractures, it would be necessary to resort to wide extraperiosteal resection. We have experienced 7 cases of ossifying fibroma from Octover 1979 to November 1988. The results were as follows; 1. The male and female ratio, was 5 to 2 and six patients were at their first decade, and one patient was 13 years old. 2. The lesion site was six cases in the tibia, one case in the fibula. 3. In six patients, we had done wide resection with free-vasculaized fibular graft in five cases and wide resection of the distal one-third of the fibula in one case. Two patients among them had recurrence. One case of recurrence was performed incomplete wide resection with free vascularized fibular graft because the lesion was too close to the distal epiphysis of the tibia.
Adamantinoma ; Adolescent ; Curettage ; Diagnosis, Differential ; Epiphyses ; Female ; Fibroma ; Fibroma, Ossifying ; Fibula ; Health Resorts ; Humans ; Male ; Puberty ; Recurrence ; Tibia ; Transplants

Cystic mesothelioma of the peritoneum is a very rare tumor which has a clinically and histologically benign nature. It occurs predominantly in young to middle-ged women and tends to recur locally. It affects chiefly the pelvic peritoneum-articularly the cul-e-ac, uterus, and rectum. We report a case of cystic mesothelioma of the visceral peritoneum which was located anterior to the ascending colon. A 54-ear-ld female patient visited our hospital with a palpable tender mass in the right flank. A computed tomographic scan of the abdomen showed a multicystic mass with an enhancing wall and septum in front of the ascending colon. The patient underwent a right hemicolectomy, and the mass was completely removed. Grossly, the tumor consisted of a multilocular cyst containing clear, serous, or gelatinous fluid and partially solid areas. Microscopically, the solid areas were composed of fibrous tissue, and the lining cells varied from flattened to cuboidal cells with a strong positive reactivity for cytokeratin and mild positive reactivity for epithelial membrane antigen on immunohistochemical staining. These findings suggest that the tumor was mesothelial in origin.
Abdomen ; Colon* ; Colon, Ascending ; Female ; Gelatin ; Humans ; Keratins ; Mesothelioma, Cystic* ; Mucin-1 ; Peritoneal Neoplasms ; Peritoneum ; Rectum ; Uterus

BACKGROUND: Antibiotics are often indiscriminately prescribed for respiratory tract infections. This study was conducted to describe the prescription pattern of family physicians for respiratory tract infections. METHODS: In each clinic of 50 representative family practitioners, about 20 consecutive patients with diagnosis of respiratory tract infection were enrolled into the study. The data were collected by questionnaire to physicians just after patient interview. RESULTS: The number of study subjects was 1020, of which 55.7% was less than 15 year old. Antibiotics were prescribed to 73.9% of total subjects. According to diagnosis, the antibiotic prescription rate was 51.5% in common cold, 86.0% in pharyngitis, 88.6% in bronchitis, 98.9% in sinusitis, and 100% in otitis media. In common cold, the factors which significantly increased the antibiotic prescription were 1)patient age less than 15 year old (OR=1.70, CI=1.06-2.73), 2)more than two visits during the same episode(OR=1.95, CI=1.27-2.99), 3)yellow and thick rhinorrhea(OR=2.22, CI=1.16-4.25), 4)yellow and thick sputum(OR=3.31, CI=1.34-8.19), and 5)throat injection(OR=2.50, CI=1.42-4.39). Among patients to whom antibiotics were prescribed, 48.7% of patients were given the antibiotics by intramuscular injection. The most frequently prescribed antibiotics were penicillin and macroride among per-oral medicine and ribostamycin and lincomycin among intramuscular medicine. The reason for antibiotic prescription were 1)posssibility of bacterial infection(43.4%), 2)prevention of bacterial complication(23.7%), and 3)definite evidence of bacterial infection(22.5%). CONCLUSION: Family practitioners prescribe antibiotics indiscriminately for the respiratory tract infection. The prescription was influence by patient's age, number of clinic-visit, and clinical symptoms and signs.
Adolescent ; Anti-Bacterial Agents* ; Bronchitis ; Common Cold ; Diagnosis ; Humans ; Injections, Intramuscular ; Lincomycin ; Otitis Media ; Penicillins ; Pharyngitis ; Physicians, Family ; Prescriptions* ; Respiratory System* ; Respiratory Tract Infections* ; Ribostamycin ; Sinusitis ; Surveys and Questionnaires

Malakoplakia is an uncommon but distinctive type of chronic granulomatous inflammation that occurs most commonly in the genitourinary tract, especially the urinary bladder. Most patients have associated conditions characterized by some degree of immunosuppression, as seen in solid-organ transplants, autoimmune diseases requiring steroid use, chemotherapy, chronic systemic diseases, alcohol abuse and poorly controlled diabetes. We report an unusual case of the renal malakoplakia that involved the perirenal space, extending to the descending colon in a 65-year-old Korean woman with secondary adrenal insufficiency and diabetes mellitus.
Adrenal Insufficiency ; Aged ; Alcoholism ; Autoimmune Diseases ; Colon, Descending ; Diabetes Mellitus ; Female ; Humans ; Immunosuppression ; Inflammation ; Kidney ; Korea ; Malacoplakia ; Transplants ; Urinary Bladder

Cosmetic lateral canthoplasty, in which the size of the eye is increased by extending the palpebral fissure and decreasing the degree of the eye slant, has become a prevalent procedure for East Asians. However, it is not uncommon for there to be complications or unfavorable results after the surgery. With this in mind, the authors have designed a surgical method to reduce complications in cosmetic lateral canthoplasty by preserving the lateral canthal angle. We discuss here the anatomy required for surgery, the surgical methods, and methods for reducing complications during cosmetic lateral canthoplasty.
Asian Continental Ancestry Group ; Humans ; Lacrimal Apparatus ; Methods

Churg-Strauss syndrome is a rare primary vasculitis called allergic granulomatosis angiitis. There is a substantial overlap of symptoms or signs between different vasculitides, so that a diagnosis of any vasculitis can be determined by a combination of clinical symptoms and laboratory tests. We report a case of a 54-year-old woman who had bronchial asthma, eosinophilia, peripheral polyneuropathy, pulmonary infiltrate, maxillary sinusitis, and extravascular eosinophilic infiltration on skin biopsy. So she was diagnosed as having Churg-Strauss syndrome, but she was antineutrophil cytoplasmic antibodies-negative on immunologic study. She had fever and showed cardiac involvement that was presented as cardiomegaly and pulmonary edema at chest radiography and left ventricular hypertrophy on electrocardiography. After steroid therapy, general condition and skin manifestation were rapidly improved.
Antibodies, Antineutrophil Cytoplasmic ; Asthma ; Biopsy ; Cardiomegaly ; Churg-Strauss Syndrome ; Cytoplasm ; Electrocardiography ; Eosinophilia ; Eosinophils ; Female ; Fever ; Humans ; Hypertrophy, Left Ventricular ; Maxillary Sinus ; Maxillary Sinusitis ; Middle Aged ; Polyneuropathies ; Pulmonary Edema ; Skin ; Skin Manifestations ; Thorax ; Vasculitis

No abstract available.
Smoking* ; Tobacco Products*