As the number of primary total knee arthroplasties (TKA) have increased, there has been a corresponding increase in the number of revision TKAs. The purpose of the this study is to report on the follow-up results of 50 revision TKAs, and to assess their clinical outcome. From January 1990 to December 1995, 50 revision TKAs were perfomed in 43 patients, by one surgeon. Mean follow up time was 2.5 years (range, 1 to 6 years). The mean interval from the initial arthroplasty to revision was 4.6 years (range, 3 months-12.6 years). The causes of the revision were wear of polyethylene in 29 joints (58%), infection in seven (14%) and aseptic loosening in six. The revision components were fixed with cement in all cases. Additional fixations were obtained with modular stems (femoral 11 cases, tibial 13 cases), 9 tibial metal wedges, 7 femoral augmentations, and 12 allografts. The Knee Rating Scale of Hospital for Special Surgery was used for clinical assessment. The mean flexion contracture and further flexion of knee joint were 8.8degrees (range, 0-70degrees), 98.5degrees (range, 5-135degrees) preoperatively, and 3.7degrees (range, 0-15degrees), 112degrees (range, 75-135degrees) postoperatively. The Knee Rating Scale improved from 66.5 points (range, 15-83) to 87.5 points (range, 79-98). There were two cases of complications, dislocation of patella and superficial wound problem in each case. In conclusion, wear was the most common cause of failure of primary TKA. The results of revision in infected TKA were less favorable than that of wear and loosening. The prosthetic design and thickness of polyethylene were the most important factors related to wear. The tibial component of PCA and patellar component of Miller-Galante had significant wear problems.
Allografts ; Arthroplasty* ; Contracture ; Dislocations ; Follow-Up Studies ; Humans ; Joints ; Knee Joint ; Knee* ; Passive Cutaneous Anaphylaxis ; Patella ; Polyethylene ; Wounds and Injuries

Objective: The patient with electrically injured myelopathy showed mild motor weakness without somatosensory pathway abnormalities. Few reports have been reported on the pathophysiological mechanisms of electrically injured myelopathy, and there is controversy about the exact pathological causes. This study aimed to investigate the ultrastructural changes in the electron microscopic findings of electrical spinal cord injury. Methods: Nine rats were used in this study. We performed 7 electrical shocks (frequency, 120 Hz; pulse width, 0.9 ms; duration, 3 seconds; current, 99 mA) using an electroconvulsive therapy (ECT) apparatus (57800 ECT unit; UGO BASILE). We used one ear and one contralateral hind limb as entry and exit sites, respectively. We only enrolled rats with hind limb weakness and performed electron microscopy evaluations of the spinal cord on the first day and 4 weeks after injury. Results: On the first day after injury, an electron microscopic examination showed a directly damaged area that appeared to be torn as physical damage, damaged myelin sheath, vacuolated axons in the myelin sheath, swollen Golgi apparatus, and injured mitochondria.Looking at changes in motor and sensory nerves, the sensory neurons showed recovered mitochondria and Golgi apparatus 4 weeks after injury; however, motor neurons still showed injured mitochondria, swollen Golgi apparatus, and endoplasmic reticulum. Conclusion This study showed that recovery from ultrastructural injury was more rapid in sensory neurons than in motor neurons.

PURPOSE: Over the past several decades, the survival rates of low birth weight(LBW; birth weight <2,500 g) infants have been improving. Many of these infants have had bronchial asthma(BA) at childhood and aldolescence. The aim of this study is to investigate whether LBW influenced the severity of BA in prealdolescent children and aldolescence by a retrospective case control study. METHODS: 15 LBW children(1,500 gDae-dong hospital as the case group were compared with 2 BA children to each case as the control group(total 30 children) on the basis of following criteria:the same age, he/she attended Dae-Dong hospital or local medical center after 8 years old, birth weight was more than 2,500 g. Asthma severity was modified from 2003 Guideline for management of childhood asthma at The Korean Academy of Pediatric Allergy and Respiratory Disease. PFT(Pulmonary function test) were measured using a portable spirometer. The value are expressed as percentage predicted using standard reference values. Total IgE and specific IgE Ab. were assessed by the PRIST method and MAST Allergy Test. Methacholine challenge test and PC20 was assessed by the Masterlab. RESULTS: LBW group had:a significantly more severe symptoms between 8 year-old and 18 year-old than control group.(P=0.015) A significantly more used to ICSs(Inhaled corticosteroids) and add-on therapy than control group.(P=0.009)(P=0.0001) There were no significant differences in the PFT and PC20 and specific IgE Ab. between LBW group and control group. But, total IgE level is higher in the control group than in the LBW group. CONCLUSION: These results suggest that LBW is a risk factor for the severity of BA. We suggest that infants with birth weight of less than 2,500 g have a more severe risk of asthma during prealdolescent children and aldolescence than who were birth weight of more than 2,500 g.
Adolescent ; Asthma* ; Birth Weight ; Case-Control Studies ; Child* ; Humans ; Hypersensitivity ; Immunoglobulin E ; Infant ; Infant, Low Birth Weight* ; Infant, Newborn ; Methacholine Chloride ; Parturition ; Reference Values ; Retrospective Studies ; Risk Factors ; Survival Rate

In glaucoma filtering surgery, we conducted subconjunctival injection of Mitomycin-C(MMC) 12 hours before and after surgery, and examined histologic findings of the filtering bleb, and condition of the anterior chamber which ensued after the injection. We divided 15 full-grown rabbits into three groups, and for each group, administered subconjunctivally 0.1cc of 0.002%, 0.004%, and 0.008% MMC, respectively. The subconjunctival injection of MMC before surgery was given to the right eye and post-surgical injection to the left, and we examined the results 1, 2, 4, 7, and 14 days after the administration.In conclusion, subconjunctival injection of MMC 12 hours before glaucoma filtering surgery is shown to be more effective than the injection after the surgery.
Anterior Chamber ; Blister* ; Filtering Surgery* ; Glaucoma* ; Mitomycin* ; Rabbits

A comparison betwen electrocardiographic and echocardiographic criteria of Lt. atrial enlargement was made in 40 cases who demonstrated left atrial enlargement either electrocardiographically or echocardiographically. 1) There were 20 cases with Lt. atrial enlargement by electrocardiographic criteria and echocardiographic criteria and 30 cases by echocardiographic criteria 2) Of 40 subjects, 19 cases were found to satisfy both electrocardiographic and echocardiographic critera of Lt. atrial enlargement at the same time. 3) 10 cases were consistent only with electrocardiographic criteria of Lt. atrial enlargement, but not with echocardiographic criteria 4) On the other hand, 11 cases of Lt. atrial enlargement consistent with echocardiographic criteria did not meet the electrocardiographic criteria 5) The respective predictive indices of electrocardiographic and echocardiographic criteria of Lt. atrial enlargement were: Electrocardiographic criteria; positive: 65.52%, Negative: 79.9%. Echocardiographic criteria; Positive: 63.3%, Negative: 89.13%.
Echocardiography* ; Electrocardiography* ; Hand

Limb salvage operations for osteosarcoma of the extremity usually consist of wide excision and skeletal reconstruction. Most osteosarcoma patients are anemic prior to the surgery as majority of them undergo preoperative neo-adjuvant chemotherapy; thus, it is necessary to treat anemia before and after the surgery since limb salvage operation tends to accompany significant blood loss. Despite the fact that blood transfusion has bad influence on prognosis, complication, and postoperative outcome of cancer patients, it is still considered as a standard management to fix anemia for limb salvage operations. We would like to present a case report in which the authors succeeded in performing limb salvage operations on patients with distal femur osteosarcoma without transfusion.
Anemia ; Blood Transfusion* ; Drug Therapy ; Extremities ; Femur* ; Humans ; Limb Salvage* ; Osteosarcoma* ; Prognosis

No abstract available.
Female ; Nifedipine* ; Obstetric Labor, Premature* ; Pregnancy ; Ritodrine*

We studied 193 Diabetics without any symptoms of coronary artery disease and 39 Normal healthy subjects as Control group, using treadmill exercise test and obtained following results. 1) The positive rate was significantly higher in Diabetics(19.4% in Normal ECG groups and 25.4% in total Diabetics)than Control groups(5.1%)(0.010.05). 5) There was no difference in HbAIC, Total cholesterol and Triglyceride between positive and negative groups(P>0.05). In summary, with exercise test, the positive rate was higher in Diabetics than in Normal control groups and it seemed to be treadmill exercise test is a useful screening method for evaluation of coronary artery disease as well as for assesment of treatment and follow up care.
Blood Pressure ; Cholesterol ; Coronary Artery Disease ; Diabetes Mellitus* ; Electrocardiography ; Equidae ; Exercise Test* ; Heart Rate ; Mass Screening ; Triglycerides

No abstract available.
Giant Cell Tumors* ; Giant Cells*

Peritrochanteric fractures are common in the elderly, and the mortaliy and morbidity rates after conservative treatment of the fractures are usually high. In these fractures the internal fixation now allows the patient more rapid functional gain. It has been known that for stabilization of fracture the sliding hip screw is superior to other fixation devices. To investigate the biomechanical difference between two different materials of dynamic hip screw, eight intertrochateric and eight subtrochanteric femur fractures were artificially induced in human cadavers. Two femurs were used as the control. In eight cadaver intertrochanteric fractures (Group I), four of them were treated with stainless steel compression hip screw and four were treated with titanium compression hip screw. Eight cadaver subtrochanteric fractures (Group II) were divided by two groups as equal number. One group was treated with stainless steel compression hip screw and the other was treated with titanium compression hip screw with plate. Each femur was secured in a fixation device of the Instron and loaded in a vertical compression. Collapse or fixation failure during vertical compression were observed and recorded continuously in slow speed with deformation rate of 3mm/min. Biomechanical analysis of maximal loading force in the control and experimental two groups were performed. The results were as follows; 1. The mean maximal loading force was 625 kp in control group. 2. The mean maximal loading force in each 4 intertrochanteric fractures fixed with stainless steel DHS (dynamic hip screw) and plate was 92.59 kp, and with titanium DHS and plate was 71.57 kp. There was no statistical significance between stainless steel DHS and plate fixation and titanium DHS and plate fixation. (p>0.05) 3. The mean maximal loading force in each 4 subtrochanteric fractures fixed with stainless DHS and plate was 140.12 kp, and with titanium DHS with plate was 169.4 kp. There was no statistical significance between stainless steel DHS and plate fixation and titanium DHS and plate fixation. (p>0.05) 4. The breakage of metal implant was not occurred at the maximal loading force 600 kp in both group. There was no difference of fixability and stability according to the metal quality, as the results of the experiment of compression loading force to the stainless steel DHS and titanium DHS fixation on intertrochanteric and subtrochanteric fractures in cadaverous femurs.
Aged ; Cadaver ; Femur* ; Hip Fractures ; Hip* ; Humans ; Internal Fixators ; Stainless Steel* ; Titanium*