Serum C-reactive protein (CRP) levels and erythrocyte sedimentation rates (ESR) were measured in 46 patients treated with uncomplicated primary hip replacements, 39 total tip replacements and 7 bipolar hip replacements. In uncomplicated primary hip replacements, ESR levels were slightly elevated preoperatively and were variable postoperatively. But CRP was normal before surgery and elevated in postoperative course, but back to normal within three weeks in most cases. Early success of hip arthroplasty is in indicated by normalization of CRP within three weeks, regardless of ESR. Since ESR seems to react somewhat differently from the CRP, both methods are useful in the monitoring of complications after hip arthroplasty.
Arthroplasty* ; Blood Sedimentation* ; C-Reactive Protein* ; Erythrocytes* ; Hip* ; Humans

No abstract available.
Animals ; Rats* ; Urinary Bladder Neck Obstruction* ; Urinary Bladder*

One of the patellar function is to protect the femoral condyle from direct blowing to knee, so it is known that ligament injuries of the knee are rare in the presence of patellar fracture. We experienced four cases of posterior cruciate ligament injury associated with patellar fracture. Unfortunately, three cases were initially neglected, and one case was identified by visualization on avulsed posterior tibial spine in plain X-ray film. We reviewed these cases and obtained several results as follows; 1. Among four cases, three cases(75%) are fractured at the lower pole of patella without displacement and one case is a longitudinal fracture. 2. We consider possible two mechanisms of this injury; first, in flexed knee, posteriorly directed force on the proximal tibia produces posterior cruciate ligament injury followed by avulsed fracture at the lower pole of patella. Second, by fall on a flexed knee, the load is sustained on the inferior pole of the patella first and continuously drives the tibia backwards producing posterior cruciate ligament injury. We recommend that all surgeon should be aware of possibility of the ligament injury in the presence of patellar fracture, especially in lower pole fracture.
Knee ; Ligaments ; Patella ; Posterior Cruciate Ligament ; Spine ; Tibia ; X-Ray Film

No abstract available.

Bovine collagen (Contigen(R), Bard Inc.) injection has been used for treating urinary incontinence caused by intrinsic sphincter deficiency (ISD) with relatively high success rate and fewer complication. Retrospective analysis was made for 11 urinary incontinent patients who have undergone collagen injection. Of the total, stress urinary incontinence (SUI) associated with ISD were noted in six, myelodysplasia in one, short bladder neck in one, cauda equina syndrome in one and, two with pelvic bone fracture. Average duration of symptoms was 10.8 years. Four patients had history of failed surgery to correct incontinence (two with Raz operations and two with plication of bladder neck). Transurethral injections of 4~12 ml of collagen were made at 4 and 8 o'clock position of the bladder neck with the bevelled portion of needle facing the urethral lumen. After the first injection, cure and improvement of incontinence were noted in 3 (SUI) and 6 (3 with SUI, 1 with short bladder neck, 1 with myelodysplasia and 1 with pelvic bone fracture) respectively. After the repeated injection for 3 patients who had improved after first injection, all became dry. At 13 months of follow-up, total success rate was 82% (5 with cure and S with improvement of the incontinence). Two patients who showed failure were all males with periurethral scar formation. Collagen injection seemed an effective therapeutic method in female SUI with ISD or myelodysplasia provided repeated injection is to be made However, it was suggested that the male patients or one with extensive scar formation were not good candidate for injection therapy.
Cicatrix ; Collagen* ; Female ; Follow-Up Studies ; Humans ; Male ; Neck ; Needles ; Pelvic Bones ; Polyradiculopathy ; Retrospective Studies ; Urinary Bladder ; Urinary Incontinence*

No abstract available.
Neurofibroma* ; Scalp*

No abstract available.
Temporomandibular Joint*

No abstract available.
Temporomandibular Joint*

AIMS OF STUDY: Present study designed to observe inhibitory effects of propiverine HC1 and tiropramide against the smooth muscle contraction of female rat bladder. Propiverine has both direct smooth muscle relaxation and anticholinergic effect and has relatively fewer side effect than conventionally used drugs such as oxybutinin. Tiropramide has been known as modulatory agents of gastrointestinal motility but also has inhibitory effects against the bladder contraction. METHODS: 30 adult female Sprague-Dawley rats were used. Bladder body above ureteral orifice was resected under pentobarbital anesthesia. 1 x 0.5 cm sized smooth muscle strip was made, and incubated in Tyrode`s solution aerated with 95% oxygen. After reaching equilibrium state, each strip was stimulated by field stimulation (FS, 1-32 Hz) and bethanechol administration (0.0000001-0.0001M). From each strip, degree of muscle contraction was recorded by physiograph (Gilson IC-MP). After the control stimulations, each strip was treated by atropine, tiropramide, oxybutinin and propiverine HC1. After 30 minutes, same stimulation were repeated and degree of muscle contraction was compared to pre incubation data. RESULTS: Frequency and dose dependent muscle contractions were noted for both FS and bethanechol stimulation. Greater degree of contractions were noted for FS than for bethanechol stimulation. Inhibitory effects of tiropramide, propiverine HC1 and oxybutinin were greater than those of atropine at FS (1-32 Hz). At high concentration (0.0001M), all of the drugs but atropine inhibited field stimulated smooth muscle contraction more than 90%. At lower concentration (0. 0000001-0.000001M), inhibitory actions of oxybutinin and propiverine HC1 were greater than that of tiropramide (p>0.05). Propiverine HC1 and oxybutinin had similar inhibitory effect for all con-centration. At higher concentration (0.0001M), inhibitory effects of tiro-pramide were more than 98% whereas those of oxybutinin and propiverine HC1 were 88%. At low concentration (0.0000001-0.000001M), oxybutinin exhibited greater inhibition against the bethanechol induced contraction than did tiropramide and propiverine HC1. With these results, it was suggested that in low concentration, oxybutinin and propiverine HCI had greater inhibitory effect than did tiropramide against smooth muscle contraction of the bladder. In high concentration though, tiropramide had superior inhibitory effect than did oxybutinin and propiverine HC1. Since, no difference was noted between oxybutinin and propiverine HC1 for the inhibitory action of bladder contraction, propiverine HC1 seems reasonable substitute for the treatment of detrusor hyperreflexia with less side effects. Also these results indicate that tiropramide can be used for the management of unstable bladder.
Adult ; Anesthesia ; Animals ; Atropine ; Bethanechol ; Female ; Gastrointestinal Motility ; Humans ; Muscle Contraction ; Muscle, Smooth* ; Oxygen ; Pentobarbital ; Rats* ; Rats, Sprague-Dawley ; Reflex, Abnormal ; Relaxation ; Ureter ; Urinary Bladder*

PURPOSE: The valsalva leak Point pressure(VLPP) has been suggested as an objective tool for diagosing female stress urinary incontinence(SUI) accompained by intrinsic sphictor deficiency(ISD) Our aims were to determine the predictive value of VLPP in patients with ISD and correlation between VLPP and other parameters as a diagnostic tool for ISD. MATERIAL AND METHODS: Sixty-seven patients with stress urinary incontinence were evaluated propectively with symptom grade(Stamey grade). Q-tip test, 1hr pad test, and VLPP. Correlations of VLPP and these clinical parameters were computed. VLPP of 60cm H2O was determined as a cut-off value of ISD and compared with other parameters(symptom grade, hypermobility). RESULTS: Of the total 67 patients, SUI was grade lin 20(29.8%) ll in 32(47.8%) and lllin 15(22.4%). Of the 67 patients, 48 had VLPP of more than 60cmH2O. Among these, SUI was grade l in 20(100%), ll in 26(81.3%) and lllin 2(13.3%). There were significant differences in the incidence between grade llland grade l or ll (P<0.01). Of the 19 patients with VLPP of 60cmH2O or less, SUI grade lllin 77 in 13(86.7%); where SUI was grade lin 0(0%) and ll in 6(18.7%) with statistical significance between grade llland grade l or ll. Urethral hypermobility was noted in 56(83.6%); this was l in 20(100%), ll in 26(81.8%) and lllin 10(67%). Among the SUI patients without hypermobility, none had symptoms of grade l: whereas 33.3% of grade lllpatients didn't show hypermobility. There appeared significant correlation(p<0.001) between the VLPP and symptom grade(correlation coefficient=0.68). Moderate correlations were present between either symptom grade or VLPP and amount of urine leakage(correlation coefficient=0.5). No statistically significant relationship existed between either VLPP or symptom grade and urethral hypermobility. CONCLUSION: subjective degree(such as symptom severity or amount of urine loss) of stress incontinence seems useful in predicting the likelihood of low valsalva leak point pressure which suggests intrinsic sphinctor deficiency. By the result that some women of grade ll incontinence with urethral hypermobility exhibited low VLPP, measurement of VLPP could be a valuable tool in choosing the treatment modality of stress urinary incontinence.
Female ; Humans ; Incidence ; Urinary Incontinence*