PURPOSE: To investigate the clinical and radiological results after primary or revision total knee arthroplasty using fresh frozen femoral head strut allograft for severe bone defect. SUBJECTS AND METHODS: Seventeen patients (18 cases) with severe bone defect were taken primary or revision TKA from 1997 to 2001 using fresh frozen femoral head allograft. 12 cases of revision TKA and 6 of primary TKA were conducted. The average age was 66 years old(55~74) and the follow up period was 29 months(12~63 months). Bone defects were found at proximal tibia in 10 cases, distal femur in 2 and both sites in 6 cases. PCL substituting TKA with extension rod were 15, and PCL retaining TKA were 3. The clinical result was assessed with the knee score of Hospital for Special Surgery(HSS) and for assessment of allograft, simple X-ray film was employed. RESULTS: Average range of motion was increased from 71 degrees to 103 degrees and HSS score was increased from 46(18 ~68) to 83(68 ~91). With 17 of 18 femoral head strut allograft, union was seen and no clinical collapse was present. In one, partial allograft absorption was occured. The preoperative alignment was an average of 7 degrees varus(range 5 degrees~15 degrees) and postoperative alignment was averaged 6.1 degrees valgus(range 3 degrees ~7 degrees). No radiolucent lines were 2 mm or more in width, and there was no case of infection or fracture of allograft. CONCLUSIONS: Femoral head strut allograft was a satisfactory method of managing severe bone defect in primary or revision TKA.
Absorption ; Allografts* ; Arthroplasty* ; Femur ; Follow-Up Studies ; Head* ; Humans ; Knee* ; Range of Motion, Articular ; Tibia ; X-Ray Film

BACKGROUND: Non-ablative dermal remodeling and ablative skin resurfacing are currently well-established skin treatment modalities. Fractional laser was recently introduced as a new concept for laser skin rejuvenation, and is characterized by creation of a dense pattern of epidermal and dermal microthermal treatment zones (MTZs). However, the precise mechanisms of dermal remodeling by Er:glass fractional laser treatment are largely unknown. OBJECTIVE: The purpose of this study was to investigate the effect of 1,550 nm Er:glass fractional laser treatment on dermal collagen synthesis and expression of TGF-beta1, a potent cytokine involved in collagen synthesis. METHODS: We treated hairless mice with several power densities (5 W 5 mJ~20 W 20 mJ), and examined the tissue samples on days 1, 30, and 90 after treatment. We analyzed the penetrating depth of laser treatment by determining dermal response through assessment of type I collagen synthesis and TGF-beta1 expression by H&E, Masson-trichrome staining, western blot analysis and immunohistochemistry staining. RESULTS: We observed, through H&E staining, that increasing the pulse energy of fractional laser treatment correlated with increasing depth of MTZ. Also, fractional laser treatment increased type 1 collagen synthesis on days 30 and 90, energy dependently. Immunohistochemical study showed that fractional laser treatment increased expression of type I collagen and TGF-beta1, energy dependently, with TGF-beta1 expression peaking on day 1. In addition, according to western blot analysis, expressions of TGF-beta1 and type I collagen were up-regulated in an energy- dependent manner. CONCLUSION: Er:glass fractional laser induced dermal remodeling by up-regulation of TGF-beta1 and type I collagen synthesis, and may be a promising modality for skin rejuvenation.
Animals ; Blotting, Western ; Collagen ; Collagen Type I ; Immunohistochemistry ; Mice ; Mice, Hairless ; Rejuvenation ; Skin ; Transforming Growth Factor beta1 ; Up-Regulation

The purpose of this study was to evaluate the spatial changes of mesial-in rotated maxillary molar and opposite anchor tooth during derotation by the precision transpalatal arch (TPA) with the use of a new typodont simulation system, the Calorific machine system, which was designed to observe the whole process of tooth movement. The maxillary right first molar was used for the anchor tooth and the maxillary left first molar was used for the mesial-in rotated tooth, and the angle of rotation was increased to 20, 40, and 60. A passive precision TPA was fabricated and then activated by bending the left arm to 20, 40, and 60. Each experiment was repeated five times under the same conditions and analyzed by ANOVA and Tucky's Studentized Range (HSD) test. In the occlusal plane, when the bending angle of precision TPA was increased, the mesiobuccal cusp of the rotated molar moved more buccally (p<0.001) and less distally (p<0.001) while the distolingual cusp moved in the mesiopalatal direction. In the sagittal plane, the palatal roots of the derotated molar moved mesially (p<0.001). In the traverse plane, the derotated molar showed slight extrusion (p<0.001). The upper right first molar, which was used as an anchor tooth, showed clinically insignificant movement across all three planes.
Arm ; Dental Occlusion ; Humans ; Molar* ; Tooth ; Tooth Movement

BACKGROUND AND OBJECTIVES: Globus pharyngeus is the feeling of a lump or foreign body in the throat. Otolaryngologists are often confronted with this condition, and some authors report that it represents 3 percent of all new clinic referrals. Unfortunately, we still do not completely understand the etiologies of globus pharyngeus, but there are recently increasing evidences to link the globus symptoms with various diseases. MATERIAL AND METHODS: We selected 32 globus patients, who exhibited no pathologic condition in physical examinations, and were analysed by general work up, barium esophagogram, 24 hour-ambulatory double-probe pH monitoring, esophageal manometry test, Fuchs' series, and MMPI. RESULTS: The results were as follows, gastroesophago-laryngopharyngeal reflux disease (n=15: 46.9%), various psychotic problems (n=11: 34.4%), esophageal motility disorders (n=7: 21.9%), duodenal ulcer (n=2: 6.3%), Eagle's syndrome (n=2: 6.3%), and hiatal hernia (n=1: 3.1%). In 5 cases, we couldn't find the etiology of globus pharyngeus. CONCLUSION: Globus pharyngeus patients, who had no pathologic findings in layrnx and pharynx, might have laryngopharyngeal-gastroesophageal reflux diseases and psychologic problems.
Barium ; Duodenal Ulcer ; Esophageal Motility Disorders ; Esophageal pH Monitoring ; Foreign Bodies ; Hernia, Hiatal ; Humans ; Hypopharynx* ; Manometry ; MMPI ; Pharynx ; Physical Examination ; Referral and Consultation

STUDY DESIGN: Prospective analysis was based on radiographic appearance in 80 cases of spondylolisthesis taken in positional change. PURPOSE: The aim of the study was to investigate the flexion-extension lateral radiographs about the difference between decubitus and upright position and the measurement method of displacement in spondylolisthesis. SUMMARY OF LITERATURE REVIEW: Although the flexion-extension lateral radiographs of spine were known the most preferable diagnostic method for spine instability, there are some debates about the difference of displacement according to the patient position and measurement methods. MATERIALS AND METHODS: The radiographs of 80 patients with spondylolisthesis were taken in the decubitus and upright position. Extent of the displacement were measured by Taillard, DuPuis, modified Qunnell & Stockdale method and Ferguson angle, slip angle, lordosis angle and vertebral centroid measurement of lumbar lordosis(CLL) were measured, according to position. RESULTS: Significant difference between the positions was shown on the CLL and lordosis angle. Differences between positions analyzed from Taillard, DuPuis, modified Qunnell & Stockdale method, Ferguson angle and slip angle had no statistical significance. Differences between positions analyzed from the pathologic movement of translation(>4 mm) had a clinically significance in the upright position rather than the decubitus. CONCLUSION: The lateral flexion-extension radiographs on upright position rather than decubitus position are considered as the more useful diagnostic method.
Animals ; Humans ; Lordosis ; Prospective Studies ; Spine ; Spondylolisthesis*

A case of gastric anisakiasis due to the larva of Pseudoterranova decipiences was con- firmed by a gastroendoscopic examination. A long whitish nematode larva invading the stomach wall (fundus) was discovered and was extracted using biopsy forceps after 3 days to the onset of symptoms. The worm was 42.6 X 1.1 mm size, and was identified as being a the 4th stage larva of P. decipiens, based upon its morphological characteristics, The patient, residing in Seoul, was a 51-year-old housewife, who complained of severe epi- gastric pain and recalled that she had previously eaten the raw flesh of an Astroconger myriaster in a Japanese restaurant (sushi Bar). This study probably emerges as the 7th human case of gastric anisakiasis of pseudoterranoviasis in Korea.
Anisakiasis ; Asian Continental Ancestry Group ; Biopsy ; Humans* ; Korea ; Larva* ; Middle Aged ; Restaurants ; Seoul ; Stomach ; Surgical Instruments

OBJECTIVE: Microscopic indocyanine green (ICG) angiography is useful for identifying the completeness of aneurysm clipping and the preservation of parent arteries and small perforators. Neuroendoscopy is helpful for visualizing structures beyond the straight line of the microscopic view. We evaluated our prototype of endoscopic ICG fluorescence angiography in swine, which we developed in order to combine the merits of microscopic ICG angiography and endoscopy. METHODS: Our endoscopic ICG system consists of a camera, a light source, a display and software. This system can simultaneously display real-time visible and near infrared fluorescence imaging on the same monitor. A commercially available endoscope was used, which was 4 mm in diameter and had an angle of 30degrees. A male crossbred swine was used. RESULTS: Under general anesthesia, a small craniotomy was performed and the brain surface of the swine was exposed. ICG was injected via the ear vein with a bolus dose of 0.3 mg/kg. Visible and ICG fluorescence images of cortical vessels were simultaneously observed on the display monitor at high resolution. The real-time merging of the visible and fluorescent images corresponded well. CONCLUSION: Simultaneous visible color and ICG fluorescent imaging of the cortical vessels in the swine brain was satisfactory. Technical improvement and clinical implication are expected.
Anesthesia, General ; Aneurysm ; Angiography ; Arteries ; Brain ; Craniotomy ; Ear ; Endoscopes ; Endoscopy ; Fluorescein Angiography* ; Fluorescence* ; Humans ; Indocyanine Green* ; Male ; Neuroendoscopy ; Optical Imaging ; Parents ; Swine* ; Veins

OBJECTIVE: To describe the angiographic embolization as a safe and an effective alternative treatment in the management of obstetrical hemorrhage and in preserving fertility. METHODS: Between March 1999 and May 2003, 43 patients at Asan Medical Center underwent angiographic embolization for the management of obstetrical hemorrhage. All cases received arterial embolization because of obstetrical hemorrhage unresponsive to conservative management or prophylaxis for massive obstetrical hemorrhage. Medical records were reviewed and detailed to collect adequate clinical data such as clinical status, underlying conditions, amount of transfusion, embolization sites, materials of embolization, duration of the procedure, complications associated with embolization, hospital stay, and the success rate. Patients were contacted by telephone to obtain long-term outcome for menstruation, desire for conception, and subsequent pregnancies. RESULTS: We have experienced the clinical successful embolization in 37 (86.0%) of 43 patients of obstetrical hemorrhage resulting from various causes. The main cause of hemorrhage was atony of uterus (n=17), followed by abnormal placentation (n=6), genital tract laceration (n=5). The average amount of blood transfusion was 7.0 units (range; 0-36 units). The average length of the time for the procedure was 68.2 minutes (range; 30-150 minutes). The average duration of hospitalization was 6.4 days (range; 3-20 days). The main complication after embolization was numbness and pain on right lower extremities in 5 cases and vessel dissection occurred in 1 case. But there was no major complication related to the procedure. We were able to follow up 28 patients. In all cases menses resumed spontaneously soon after the procedure. Seven cases of long-term follow-up became pregnant, and 3 cases of them completed gestations giving birth to healthy babies. CONCLUSION: The results suggest that angiographic embolization is a relatively noninvasive and highly effective method for the management of obstetrical hemorrhage and a useful technique for preserving fertility.
Blood Transfusion ; Chungcheongnam-do ; Female ; Fertility ; Fertilization ; Follow-Up Studies ; Hemorrhage* ; Hospitalization ; Humans ; Hypesthesia ; Lacerations ; Length of Stay ; Lower Extremity ; Medical Records ; Menstruation ; Parturition ; Placentation ; Pregnancy ; Telephone ; Uterus