PURPOSE: The purpose of this study was to examine the effects of change of polyethylene resin type and manufacturing method on the wear of polyethylene tibial component. MATERIALS AND METHODS: Thirteen MG I and 10 MG II components were retrieved at revision surgery. Each polyethylene tibial component was graded for surface wear damage. Density profiles of the polyethylene were measured to examine the extent of oxidative degradation of the polyethylene. RESULTS: The primary damage mode of the MG I retrievals was scratching and metallic debris, but the primary damage mode of the MG II was delamination (P<0.05). For the implants with implantation time of 5 years or more, the MG II polyethylene had a higher density value (0.959+/-0.002 g/cc, n=7) compared with the MG I (0.948+/-0.004 g/cc, n=11). Both delamination and polyethylene degradation increased with length of implantation time for the MG II components (P<0.01). Even after gamma sterilization, the directly molded 1900 MG I components experienced significantly less delamination and degradation than the machined GUR 415 MG II tibial components. CONCLUSIONS: This study suggests that delamination of polyethylene tibial components is influenced by resin type and/or manufacturing method
Fungi ; Polyethylene* ; Sterilization

No abstract available.
Esophagectomy* ; Stomach*

BACKGROUND: This study examined the efficacy of patient-controlled epidural analgesia (PCEA) for post-cesarean section pain control and compared the suitability of four different volumes of continuous background infusion (CBI). METHODS: Sixty patients were received 0.125% bupivacaine with 5 g/ml fentanyl by PCEA (2 ml of demand dose and 10 minutes of lockout interval) and CBI. Experimental groups were divided four groups according to the volumes of CBI; 1 ml/hr, 2 ml.hr, 3 ml/hr and 4 ml/hr of CBI during 48 hours postoperatively. RESULTS: Total amount of fentanyl and bupivacaine consumption was significantly higher in 1ml/hr of CBI group than 2 ml/hr of CBI group during first 24 hours, and in 4 ml/hr of CBI group than 1 ml/hr and 3 ml/hr of CBI group during second 24 hours. CBI/maximum hourly demand dose was 15~23%. There is no significant difference between the groups in pain score, side effects and patient's satisfaction. CONCLUSIONS: This study suggests that two or three ml/hr of CBI can provide the most effective postoperative analgesia and the optimal ratio of CBI/maximum hourly demand dose is about 20%.
Analgesia ; Analgesia, Epidural* ; Bupivacaine ; Fentanyl ; Humans

Uterine sarcomas are relatively rare tumors of mesodermal origin that constitute 2-6% of uterine malignancies. Uterine sarcomas include endometrial stromal sarcoma (ESS), leiomyosarcoma (LMS), malignant mixed m llerian tumor (MMMT) of both homologous and heterologous type, pure heterologous sarcomas, blood vessel sarcomas, and lymphoma. Endometrial stromal tumors are divided into three types: 1) endometrial stromal nodule, 2) low-grade stromal sarcoma or endolymphatic stromal myosis, and 3) endometrial stromal sarcoma. The low grade endometrial stromal sarcoma is very rare. It shows occasional local recurrence, which might arise from endometrial stroma, from adenomyosis, and rarely from endometriosis. We have experienced a case of low grade endometrial stromal sarcoma of the uterus in a 54-year-old woman, which is presented with a review of literatures.
Adenomyosis ; Blood Vessels ; Endometrial Stromal Tumors ; Endometriosis ; Female ; Humans ; Leiomyosarcoma ; Lymphoma ; Mesoderm ; Middle Aged ; Recurrence ; Sarcoma ; Sarcoma, Endometrial Stromal* ; Uterus*

Cystic nephroma (CN) is a benign cystic neoplasm composed of mixed epithelial and stromal elements. Less than 200 cases have been reported. We had a patient, a 41-year-old woman, who had a huge typical CN. The patient was admitted for a right renal mass that was found incidentally. On laparaoscopic right nephrectomy, there was an encapsulated 7 cm multilocular cystic mass at the upper pole. Microscopically, the cystic wall was lined by a single layer of low cuboidal or hobnail epithelium without a solid area. The thin septa were composed of bland, ovarian type spindle cells. The main differential diagnoses were mixed epithelial and stromal tumor (MEST), low grade multilocular renal cell carcinoma, and tubulocystic carcinoma. The results of immunohistochemical staining were cytokeratin 7/19(+/+) and CD10(-) in lining epithelium, estrogen receptor/progesterone receptor(+/+) in stromal cells. After surgery, she was free of recurrence for 10 months. We report this rare case and compare it with other cystic renal tumors, especially MEST.
Adult ; Carcinoma, Renal Cell ; Diagnosis, Differential ; Epithelium ; Estrogens ; Female ; Humans ; Keratins ; Kidney ; Nephrectomy ; Receptors, Estrogen ; Recurrence ; Stromal Cells

BACKGROUND: Ondansetron, a 5-HT3 (hydroxytryptamine receptor 3) receptor antagonist, is effective for prevention and treatment of postoperative nausea and vomiting. This study is to evaluate the intraoperative and postoperative efficacy of prophylactic ondansetron and droperidol in preventing nausea and vomiting in cesarean section patients under epidural anesthesia. METHODS: Sixty ASA physical status I-II parturients undergoing elective cesarean section under epidural anesthesia were allocated to 3 groups received intravenous ondansetron 4 mg (Group O), droperidol 1.25 mg (Group D) and normal saline 1 ml (Group N) after delivery of baby. The intra and postoperative incidence and severity of nausea and vomiting were recorded using 4 point scale (0: none, 1 : mild, 2: moderate, 3: severe). RESULTS: There were significantly lower incidence and severity of nausea and vomiting in Group O and Group D than in Group N during intra and postoperative 24 hours (p<0.05). CONCLUSIONS: Prophylactic ondansetron and droperidol had antiemetic effect in cesarean section patients under epidural anesthesia and these effect was observed long after the normal expected duration.
Anesthesia, Epidural* ; Antiemetics ; Cesarean Section ; Droperidol* ; Female ; Humans ; Incidence ; Nausea ; Ondansetron* ; Postoperative Nausea and Vomiting ; Pregnancy ; Vomiting

No abstract available.

No abstract available.

BACKGROUND: Continuous epidural morphine administration (CEM) is a common method to treat the pain of terminal cancer patients, but this could produce many side effects/ such as pruritus, nausea, vomiting, constipation and urinary retention. The purpose of this study was to determine the optimal epidural butorphanol dosage to prevent side effects of CEM in terminal cancer patients. METHODS: Thirty terminal cancer patients were randomly assigned to one of three groups. After insertion of epidural catheter, morphine 2 mg and butorphanol 1 mg were injected epidurally for a loading dose and a 2 Day Infusor (2 ml/hr)(Home Pump(R) , I-Flow, Lake Forest, USA) containing morphine 8 mg with butorphanol 2 mg (B2 group, n = 10), 4 mg (B4 group, n = 10) or 6 mg (B6 group, n = 10) mixed with 5% D/W (total 100 ml) was connected. Severity of pain, nausea and vomiting, and pruritus were evaluated using VAS score at 1, 6, 12, 24, 36 and 48 hr after epidural infusion. RESULTS: Severity of pain, nausea and vomiting, and pruritus were significantly decreased in the B6 group as comparable to the other two groups (p < 0.05). CONCLUSIONS: The addition of butorphanol 3 mg to morphine 4 mg in CEM in terminal cancer patients reduced nausea, vomiting and pruritus and improved the pain control effect.
Butorphanol* ; Catheters ; Constipation ; Humans ; Infusion Pumps ; Lakes ; Morphine* ; Nausea ; Pruritus ; Urinary Retention ; Vomiting

Sex cord-stromal tumors of the ovary are the third most common types of neoplasms that develop in the ovary and account for about 5-8% of all ovarian malignancies. This group of ovarian neoplasms is derived from the sex cords and the ovarian stroma or mesenchyme. Granulosa-stromal cell tumors include granulosa cell tumor, thecoma and fibroma. The granulosa cell tumor is a low-grade malignancy and accounts for about 2-3% of all ovarian malignancies. Granulosa cell tumors have a prolonged natural history and tendency toward late relapse, reflecting their low grade biology. We present a case of juvenile granulosa cell tumor of the ovary with brief review of literature,
Biology ; Female ; Fibroma ; Granulosa Cell Tumor* ; Granulosa Cells* ; Mesoderm ; Natural History ; Ovarian Neoplasms ; Ovary* ; Recurrence ; Sex Cord-Gonadal Stromal Tumors ; Thecoma