Total knee arthroplasty(TKA) has been used for the treatment of knee joint pain, deformity, and instability caused by osteoarthritis, rheumatoid arthritis, or tuberculous arthritis, and by virtue of good results and rapid development, the procedure has been increasingly employed. With the development of total knee prosthesis, complications have also increased, however, and due to complications occurring up to six years after surgery, fusion occurs in about 2% of all replaced knees. The most common complication of TKA is loosening, followed by infection. Others are thrombosis, subluxation, dislocation and fracture, and complications may be divided into four groups: biologic, technical, specific to type of components, and associated with certain diagnosis. Where these complications occur, a patient must undergo a second procedure, but the success rate is lower than for the initial procedure. Exact etiological evaluation important clinically and radiologically. We illustrate the etiologies and radiologic characteristics of TKA complications according to classification.
Arthritis ; Arthritis, Rheumatoid ; Arthroplasty* ; Classification ; Congenital Abnormalities ; Diagnosis ; Dislocations ; Humans ; Knee Joint ; Knee Prosthesis ; Knee* ; Osteoarthritis ; Thrombosis ; Virtues

No abstract available.
Catheterization* ; Fingers* ; Radial Artery*

This is to report the technique of reversed iliac leg stent-graft in endovascular treatment for isolated internal iliac artery (IIA) aneurysm, which had significant size discrepancy between the common iliac artery (CIA) and external iliac artery (EIA) in 3 patients from different hospitals. Three patients were a 85- and two 82-year-old men. Treated were right IIA aneurysms, sized 6.5x6.2 cm, 5.0x4.0 cm, and 4.1 cm in longest diameter, respectively. The diameters of the right CIA and right EIA measured 21 mm/11 mm, 15 mm/11 mm, and 20 mm/10 mm, respectively. In all cases, reversed iliac leg stent-grafts were prepared on-site; unsheathed and mounted upside-down manually, and deployed in each right CIA. Post-stent-graft angiograms showed complete exclusion of the aneurysms, except for minimal type 1 endoleak in one case. This technique is a useful treatment option in patients with isolated IIA aneurysm.
Aged, 80 and over ; Aneurysm* ; Endoleak ; Endovascular Procedures ; Humans ; Iliac Aneurysm ; Iliac Artery* ; Leg* ; Male

Adult-onset type II citrullinemia (CTLN2) is a disorder caused by an inborn error of metabolism affecting the liver. CTLN2 is an autosomal recessive disorder characterized by recurrent encephalopathy with hyperammonemia due to highly elevated plasma levels of citrulline and ammonia, caused by a deficiency of argininosuccinate synthetase in the liver. A small number of patients have undergone liver transplantation with favorable results. In Korea, the limitations of the deceased donor pool have made living donor liver transplantation a common alternative treatment option. We report the case of a patient with type II citrullinemia who was treated successfully with auxiliary partial orthotopic liver transplantation (APOLT) from a living donor. This is the first description of an APOLT for a patient with adult onset type II citrullinemia in Korea.
Adult ; Ammonia ; Argininosuccinate Synthase ; Citrulline ; Citrullinemia ; Humans ; Hyperammonemia ; Korea ; Liver ; Liver Transplantation ; Living Donors ; Plasma ; Tissue Donors

OBJECTIVE: To investigate the technical feasibility, clinical usefulness, and safety of a guiding sheath in fluoroscopic stent placement for patients with malignant colorectal obstructions. MATERIALS AND METHODS: Between June 2007 and January 2011, fluoroscopic placement of a dual colorectal stent was attempted in a total of 97 patients with malignant colorectal obstructions. A polytetrafluoroethylene guiding sheath was used in patients in whom a stent delivery system failed to reach the obstruction. Usefulness of the sheath was evaluated depending on whether the sheath could successfully assist the stent delivery system reach its area of interest. RESULTS: The guiding sheath was needed in 22 patients (15 men, 7 women; age range, 33-77 years; mean age, 59 years). The overall success rate for passing the sheath to the area of interest was 100%. There were no procedure-related deaths or major complications. The majority of the patients reported mild discomfort. In 2 of 22 patients with successful passing of the sheath to the area of interest, stent placement failed because of failure in the negotiation of a guide wire through the obstruction. CONCLUSION: Using a guiding sheath seems to be easy, safe and useful in fluoroscopic stent placement for patients with malignant colorectal obstructions.
Adult ; Aged ; Colorectal Neoplasms/*surgery ; Equipment Safety ; Feasibility Studies ; Female ; Fluoroscopy ; Humans ; Intestinal Obstruction/*surgery ; Male ; Middle Aged ; Polytetrafluoroethylene ; *Stents ; Treatment Outcome

The repair of abdominal aortic aneurysm (AAA) in patients with functioning renal transplant is critical because it is important to avoid ischemic and reperfusion injury to the transplanted kidney. Endovascular aneurysm repair (EVAR) avoids aortic cross clamping and can prevent renal graft ischemia. Here we report the endovascular management and outcome of AAA in two renal transplant patients using a bifurcated aortic stent graft. One patient underwent EVAR using a small amount of contrast (30 mL) due to decreased renal function resulting from chronic rejection. Another patient had EVAR performed with iliac conduit because of the heavily calcified, stenotic lesion of external iliac artery. EVAR in patients with a renal transplant is a feasible option without impairing renal arterial flow.
Aneurysm ; Aortic Aneurysm, Abdominal ; Constriction ; Endovascular Procedures ; Humans ; Iliac Artery ; Ischemia ; Kidney ; Kidney Transplantation ; Rejection (Psychology) ; Reperfusion Injury ; Stents ; Transplants

PURPOSE: Various duplex criteria have been used to predict hemodynamically significant carotid artery stenosis. Clinicians have relied on published institutional experience for carotid duplex ultrasound interpretation. Duplex parameters for interpreting carotid artery stenosis severity consist of peak systolic velocity (PSV) and end-diastolic velocity of the internal carotid artery (ICA), the ratio of ICA PSV and end-diastolic velocity (EDV) to common carotid artery (CCA) PSV (PSVICA/CCA) and EDV (EDVICA/CCA). This study was performed to elucidate which duplex parameter can predict the severity of the carotid artery stenosis more accurately. METHODS: The carotid duplex ultrasound and angiographic results of 121 carotid arteries were analyzed. Receiver operater characteristic (ROC) curves were used to compare PSV, EDV, and both ratios in detecting > or =50%, > or =60%, and > or =70% stenosis of the internal carotid artery. RESULTS: The PSVICA/CCA ratio can accurately detect > or =50%, > or =60%, and > or =70% stenosis of the internal carotid artery. To detect > or =50% angiographic stenosis, a PSVICA/CCA ratio of 1.2 has a sensitivity of 83% and specificity of 77%. A PSVICA/CCA ratio of 1.8 can detect > or =60% angiographic stenosis with a sensitivity of 80% and specificity of 79%. Finally, a PSVICA/CCA ratio of 2.2 can detect > or =70% angiographic stenosis with a sensitivity and specificity of 70 and 89%, respectively. CONCLUSION: The PSVICA/CCA ratio can be used for detecting internal carotid artery angiographic stenosis. PSVICA/CCA ratios of 1.2, 1.8, and 2.2 are proper criteria for interpreting 50%< or =, 60%< or = and 70%< or = stenosis, respectively.
Carotid Arteries ; Carotid Artery, Common ; Carotid Artery, Internal ; Carotid Stenosis ; Constriction, Pathologic ; Sensitivity and Specificity

BACKGROUND: So many electronic devices have been introduced in the operating room. However, little was known about the hazards of electromagnetic fields (EMF) to the human body. We have studied about how much the anesthesiologists are exposed to EMF. METHODS: In 19 operating rooms of our hospital, the intensity of magnetic fields was measured by an ELF (Extremely low frequency) field strength measurement system. The distances were 30 cm, 50 cm and the anesthesiologist's proximity to the monitoring devices. RESULTS: The average strength of 19 operating rooms were 2.22 +/- 1.13 mG at 30 cm from the monitors, 1.29 +/- 0.84 mG at 50 cm and 1.00 +/- 0.78 mG at the anesthesiologist's stand. CONCLUSIONS: We found that in some of our operating rooms the exposure to EMF was measured above Sweden's TCO limit which has been accepted as the EMF radiation rule for computer monitors. Although the hazards of EMF have not been definitely confirmed yet, the effort not to be exposed to EMF should be considered by anesthesiologists.
Electromagnetic Fields* ; Human Body ; Magnetic Fields ; Magnets* ; Operating Rooms*

BACKGROUND: Obtaining and utilizing the feed-backs from residents who have finished four year of anesthesia residency could well contribute to improvement in training program. Therefore authors have designed a self questionnaire to analyze the degrees or measures of satisfaction from such training program and data were evaluated to provide,in future,the guideline which would improve the quality of the training program. METHODS: The self-questionnaires were sent to residents(n=148),who have been through the entire four year of residency training courses under anesthesia department. The assessment was conducted to measure the degree of satisfaction based on several variables such as motivation, selection of anesthesiology as a first choice, type of training hospital, and sex. To evaluate the current problems of anesthesia residency program, we made 30 open-ended and close-ended questions. Data analysis was made using Fishers exaet test. RESULTS: There were no statistically significant difference between the degree of satisfaction and their motivation for choosing anesthesia, anesthesia as a major, selection of anesthesiology as a first choice, and types of hospitals. As for the difference in satisfaction of training, male residents showed significantly higher satisfaction rate( n=92, 36.2%) than female residents(n=47, 17%). CONCLUSIONS: These results suggest that degrees of satisfaction was more likely related to the program of each training hospital and sex compared to other variables studied.
Anesthesia Department, Hospital ; Anesthesia* ; Anesthesiology ; Education ; Female ; Humans ; Internship and Residency* ; Male ; Motivation ; Surveys and Questionnaires ; Statistics as Topic

Primary biliary cirrhosis is a chronic progressive cholestatic liver disease of unknown cause that usually affects middle-aged women and eventually leads to cirrhosis and liver failure. It is characterized by the progressive destruction of small intrahepatic bile ducts, portal inflammation, and progressive scarring. The diagnosis is made by these characteristic pathologic findings and the presence of antimitochondrial antibody. Immunofluorescence, the most widely used method for determining antimitochondrial antibody, is less sensitive and specific than ELISA or immunoblotting and influenced by observer interpretation. Therefore, it is important to detect anti-M2 antibody, the most specific antibody of primary biliary cirrhosis, by ELISA or immunoblotting when antimitochondrial antibody is not detected by immunofluorescence method which can lead to the incorrect diagnosis as autoimmune cholangitis. We describe a case of primary biliary cirrhosis with antimitochondrial antibody negative by immunofluorescence, anti-M2 antibody positive by ELISA. We confirmed primary biliary cirrhosis by liver biopsy.
Bile Ducts, Intrahepatic ; Biopsy ; Cholangitis ; Cicatrix ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Female ; Fibrosis ; Fluorescent Antibody Technique ; Humans ; Immunoblotting ; Inflammation ; Liver ; Liver Cirrhosis, Biliary* ; Liver Diseases ; Liver Failure