At Orthopaedic Department of Kyung Hee University Hospital, we performed 50 total knee replacement in 32 patients who had suffered from rheumatoid arthritis during the period from Aug. 1982 to Dec. 1987. We studied these cases and compared the results of total knee replacement surgery in preoperative ambulatory patients(group I ) with those in preoperative non-ambulatory patients(group II ). 1. Preoperatively, 19 patients were able to walk, and 13 patients were unable to walk. 2. 7 patients of bilateral TKR(36.8%) were included in group I, and 11 patients (86.9%) in group II. 3. The improvement of range of motion after TKR was greater in group II (34 degrees) and in group I, average postoperative range of motion was similar to the average preoperative ROM. 4. Flexion contracture was more markedly improved in group II. 5. In group I, the average preoperative knee rating score by Hospital for Special Surgery rating system was 38.8 and improved to 93.4 postoperatively. In group II, the average preoperative knee rating score was 27.4 and improved to 85.7 postoperatively. 6. Postoperatively most of the patients were able to walk without support except one cases of infection(group I ) and the other who had severe rheumatoid involvements in other joints (group II ). 7. Preoperative evaluation for involvements of cervical spine and surrounding soft tissue structure was necessary endotracheal anesthesia. 8. There was 2 cases of complications in group I, and 4 cases in group II.
Anesthesia, Endotracheal ; Arthritis ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Knee ; Contracture ; Humans ; Joints ; Knee ; Range of Motion, Articular ; Spine

The resection of levator aponeurosis and its muscle through the anterior approach had been performed on 50 ptotic lids of 40 patients from April, 1985 to January, 1988. Their age ranged from 28 months to 44 years old(mean, 7.5 years old). All but one of them were congenital origin. Thirty-four per cent of eyes were associated with ocular abnormalities such as strabismus, entropion, and blepharophimosis. Three patients had inguinal hernia, tongue tie, and ventricular septal defect respectively as systemic abonrmalities. The cycloplegic refraction revealed mild hyperopia in 74%, mild myopia in 18%, and moderate or severe hyperopia in 8%. Seventy per cent of eyes had with-the-rule astigmatism, while 8% had againgt-therule astigmatism. Twenty-two per cent had no astigmatism. Amblyopia was noted in 11 patients of 31 patients in whom we could check the visual acuity. The amount of levator muscle resected, which depended on the function of levator muscle and the degree of ptosis, ranged from 15mm to 24mm (mean, 20.2mm). We also applied this procedure to the patient whose levator function was less than 2mm. Good surgical results were obtained in 45 eyes(90%). Undercorrected one eye underwent reoperation using the frontalis sling.
Amblyopia ; Astigmatism ; Blepharophimosis ; Blepharoptosis* ; Entropion ; Heart Septal Defects, Ventricular ; Hernia, Inguinal ; Humans ; Hyperopia ; Myopia ; Reoperation ; Strabismus ; Tongue ; Visual Acuity

BACKGROUND: Diabetes mellitus is a common condition, and the majority of patients have one or more cutaneous complications. Among them, xerosis is well known to be closely related to diabetics. The xerosis is inversely reflected upon skin surface hydration, the state of which can be exactly assessed with various investigating instruments, such as a hydrometer and corneometer. OBJECTIVE: Our purpose was to compare the hydration state of diabetics with normal persons by the use of a corneometer and hydrometer. METHODS: A total of 267 diabetics were asked whether they felt xerosis or pruritus. In a subgroup of 31 patients, the water content was evaluated and compared by the parameters of diabetic severity. Forty-one non-diabetics were selected for the normal control.
Diabetes Mellitus ; Humans ; Pruritus ; Skin* ; Water

PURPOSE: We present our experience of a retroperitoneoscopic nephrectomy for a benign renal disease, and evaluate the clinical efficacy and safety of a retroperitoneoscopic nephrectomy. MATERIALS AND METHODS: The clinical results of 20 retroperitoneoscopic nephrectomies (RN) were compared with 20 open nephrectomies (ON). The surgery time, hospital stay, analgesic requirements, and complications were analysed. RESULTS: The mean operative time was 255.2 +/- 72.5 minutes for the RN patients and 161.1 +/- 22.7 minutes for the ON patients (p< 0.05). The mean hospital stay was 4.2 +/- 1.1 days for the RN patients and 9.0 +/- 1.1 days for the ON patients (p< 0.05). The analgesic dose was 80.0 +/- 23.4mg of piroxicam for RN and 240.0 +/- 26.8mg of piroxicam for the ON patients (p< 0.05). Minor and major complications occurred in 4 (20%) patients who underwent a RN and 12 (60%) patients who underwent an ON (p< 0.05). Of the 23 retoroperitoneoscopic nephrectomies, an open conversion was necessary in 3 (13%) patients. CONCLUSIONS: While operative time is longer in RN patients than ON patients, the postoperative hospital stay, analgesic requirement and complication rate are significantly lower than in ON patients. Retroperitoneoscopic nephrectomy appears to be a safe and effective alternative to a traditional open nephrectomy.
Humans ; Length of Stay ; Nephrectomy* ; Operative Time ; Piroxicam

PURPOSE: We present our experience of a retroperitoneoscopic nephrectomy for a benign renal disease, and evaluate the clinical efficacy and safety of a retroperitoneoscopic nephrectomy. MATERIALS AND METHODS: The clinical results of 20 retroperitoneoscopic nephrectomies (RN) were compared with 20 open nephrectomies (ON). The surgery time, hospital stay, analgesic requirements, and complications were analysed. RESULTS: The mean operative time was 255.2 +/- 72.5 minutes for the RN patients and 161.1 +/- 22.7 minutes for the ON patients (p< 0.05). The mean hospital stay was 4.2 +/- 1.1 days for the RN patients and 9.0 +/- 1.1 days for the ON patients (p< 0.05). The analgesic dose was 80.0 +/- 23.4mg of piroxicam for RN and 240.0 +/- 26.8mg of piroxicam for the ON patients (p< 0.05). Minor and major complications occurred in 4 (20%) patients who underwent a RN and 12 (60%) patients who underwent an ON (p< 0.05). Of the 23 retoroperitoneoscopic nephrectomies, an open conversion was necessary in 3 (13%) patients. CONCLUSIONS: While operative time is longer in RN patients than ON patients, the postoperative hospital stay, analgesic requirement and complication rate are significantly lower than in ON patients. Retroperitoneoscopic nephrectomy appears to be a safe and effective alternative to a traditional open nephrectomy.
Humans ; Length of Stay ; Nephrectomy* ; Operative Time ; Piroxicam

Obesity is one of the well-known risk factors of breast cancer. We evaluated the relationship between serum adiponectin and resistin levels and breast cancer risk in 41 biopsy-proven breast cancer patients and 43 age- and body mass index-matched controls. The mean serum adiponectin level was lower in the breast cancer group than the control group (6.93+/-3.2 microgram/mL, vs. 7.60+/-3.5 microgram/mL), but this difference did not reach statistical significance (p=0.37). There was a statistically significant difference in serum resistin levels between the groups (breast cancer group 5.23+/-6.9 ng/mL vs. control 1.46+/-2.0 ng/mL; p<0.001). The risk of breast cancer was significantly increased in the highest tertile group for serum resistin level compared to the lowest tertile group (adjusted odds ratio 2.77 [95% CI 1.40-5.50]). The lymph node metastasis was significantly increased in the patients with less than the median adiponectin level (p=0.017). In the patients whose resistin level was higher than the median, the frequency of tumor with the highest histological grade was significantly increased (p=0.025). In conclusions, both the low serum adiponectin levels and high resistin levels are likely to be associated with increased breast cancer risk in Korean women.
Resistin/*blood ; Odds Ratio ; Middle Aged ; Insulin Resistance ; Humans ; Female ; Case-Control Studies ; Breast Neoplasms/*blood/etiology/pathology ; Adult ; Adiponectin/*blood

Spinal cord injury often leads to central neuropathic pain syndromes, such as allodynic and hyperalgesic behaviors. Electrophysiologically, spinal dorsal horn neurons show enhanced activity to non-noxious and noxious stimuli as well as increased spontaneous activity following spinal cord injury, which often called hyperexcitability or central sensitization. Under hyperexcitable states, spinal neurons lose their ability of discrimination and encoding somatosensory information followed by abnormal somatosensory recognition to non-noxious and noxious stimuli. In the present review, we summarize a variety of pathophysiological mechanisms of neuronal hyperexcitability for treating or preventing central neuropathic pain syndrome following spinal cord injury.
Animals ; Central Nervous System Sensitization ; Discrimination (Psychology) ; Neuralgia ; Neurons ; Posterior Horn Cells ; Rats ; Spinal Cord ; Spinal Cord Injuries

Hyperglycemia-induced hemichorea (HGHC) is a rare but characteristic hyperkinetic movement disorder involving limbs on one side of the body. In a 75-year-old woman with a left-sided HGHC, conventional brain MR imaging showed very subtle T1-hyperintensity and unique gadolinium enhancement in the basal ganglia contralateral to movements. Multi-parametric MRI was acquired using pulse sequence with quantification of relaxation times and proton density by multi-echo acquisition. Myelin map was reconstructed based on new tissue classification modeling. In this case report of multi-parametric MRI, quantitative measurement of myelin change related to HGHC in brain structures and its possible explanations are presented. This is the first study to demonstrate myelin loss related to hyperglycemic insult in multi-parametric quantitative MR imaging.
Aged ; Basal Ganglia ; Brain ; Classification ; Extremities ; Female ; Gadolinium ; Humans ; Hyperglycemia ; Hyperkinesis ; Magnetic Resonance Imaging ; Movement Disorders ; Myelin Sheath ; Protons ; Relaxation

Acute eosinophilic pneumonia is reported as a specific disease entity. But, it is different from chronic eosinophilic pneumonia in its onset, clinical course and recurrence. Badesh et al reported the following diagnostic criteria os acute eosinophilic pneumonia a less than one-month history of symptoms prior to diagnosis, no evidence of asthma, the absence of other organic disease, no obvious etiology and an evidence of recurrent disease. We experienced a case of acute eosinophilic pneumonia in 37 old male. Pathologically eosinophilic pneumonia is confirmed and other features meet Badesh's criteria.
Asthma ; Diagnosis ; Eosinophils* ; Humans ; Male ; Pulmonary Eosinophilia* ; Recurrence

To identify regulatory molecules which play key roles in the development of obesity, we investigated the transcriptional profiles in 3T3-L1 cells at early stage of differentiation and analyzed the promoter sequences of differentially regulated genes. One hundred and sixty-one (161) genes were found to have significant changes in expression at the 2nd day following treatment with differentiation cocktail. Among them, 86 transcripts were up-regulated and 75 transcripts were down-regulated. The 161 transcripts were classified into 10 categories according to their functional roles; cytoskeleton, cell adhesion, immune, defense response, metabolism, protein modification, protein metabolism, regulation of transcription, signal transduction and transporter. To identify transcription factors likely involved in regulating these differentially expressed genes, we analyzed the promoter sequences of up- or -down regulated genes for the presence of transcription factor binding sites (TFBSs). Based on coincidence of regulatory sites, we have identified candidate transcription factors (TFs), which include those previously known to be involved in adipogenesis (CREB, OCT-1 and c-Myc). Among them, c-Myc was also identified by our microarray data. Our approach to take advantage of the resource of the human genome sequences and the results from our microarray experiments should be validated by further studies of promoter occupancy and TF perturbation.
3T3-L1 Cells* ; Adipogenesis* ; Binding Sites ; Cell Adhesion ; Cytoskeleton ; Gene Expression Profiling* ; Genome, Human ; Humans ; Metabolism ; Microarray Analysis ; Obesity ; Signal Transduction ; Transcription Factors ; Transcriptome*