To determine size and shape discrepancy between the bone of Korean women and the prostheses in total knee arthroplasty, the height(antero-posterior length) and width(medio-lateral length) of the distal femur and the proximal tibia were measured at the bone resection level for 104 knees of 62 female patients who underwent primary total knee arthroplasty and compared with the same parameters of the total knee prostheses designed by five different companies. On the condition that the height of the prostheses matched with each cases of the bone were optimal, the difference in the width was evaluated, and the criteria of the discrepancy were overhang if the width of the prosthesis was larger than bone, optimal if width of the prosthesis was same or smaller and difference was within 5 mm, and down-size if smaller and difference was over Smm. In femoral prostheses, 34.6% of all were optimal, 13.1%, overhang and 52.3%, down-size. In tibial prosthesis, 54.1% of all were optimal, 13.9%, overhang and 32%, down-size. In conclusion, although further investigation for clinical application is needed, there were discrepancies in size and shape between the femur and tibia of Korean women and total knee prostheses and improvement in design should be considered.
Arthroplasty* ; Female ; Femur ; Humans ; Knee Prosthesis ; Knee* ; Prostheses and Implants* ; Tibia

Sacro-iliac joint is, as other joints, the prediIection site of tuberculous or pyogenic arthritis as well as primary or metastatic tumor. The writers reviewed twenty cases of sacro-iliac lesion performed at the Department of Orthopedic Surgery, Seoul National University Hospital, for the period of five years from June 1972 till May 1977. 1. They are tuberculous arthritis eleven, pyogenic arthritis five, ankylosing spondylitis two(one associated with spinal stenosis, the other with hip invoIvement), osteosarcomatosis one, metastatic tumor from adenocnrcinoma of prostate one 2. Infection is the predominant Iesion in sacro-iliac joint, and tuberculous arthritis is twice than pyogenic arthritis. 2. Early diagnosis of sacro-iliac lesion is difficult, but S-I stress test is a valuable finding. 4. Two of eleven cases of tuberculous arthritis, two of five cases of pyogenic arthritis with mild involvement were treated conservatively without sequele, but in more advanced cases, surgical intervention was preformed.
Arthritis ; Early Diagnosis ; Exercise Test ; Hip ; Joints ; Orthopedics ; Prostate ; Seoul ; Spinal Stenosis ; Spondylitis, Ankylosing

Cybex evaluation of muscle strength was performed on 15 patients with chronic anterior cruciate ligament tears following arthroscopic reconstruction using central one-third patella tendon autograft. Cybex testing was done preoperatively and at 3, 6, 9, and 12 months postoperatively. Peak torque and total work of the quadriceps and hamstrings at the angular velocity of 60 degree/sec and 180 degree/sec were measured and analyzed. The results were as follows: l. At the angular velocity of 60 degree/sec, the muscle strength of the quadriceps showed 45.4% deficit in peak torque and 50.9% deficit in total work compared to the contralateral normal knee preoperatively, 48.2% and 49.0% deficit respectively at 3 months after operation, 40.3% and 37.7% deficit at 6 months, 30.6% and 32.5% deficit at 9 months and 23.4% and 24.7% deficit at 1 year after operation. 2. At the angular velocity of 60 degree/sec, the muscle strenggth of the hamstrings showed 32.3% deficit in peak torque and 42.9% deficit in total work compared to the contralateral normal knee preoperatively, 39.3% and 42.4% deficit respectively at 3 months after operation, 27.3% and 32.3% deficit at 6 months, 21.2% and 22.3% deficit at 9 months and 17.9% and 18.4% deficit at 1 year after operation. 3. At the angular velocity of 180 degree/sec, the muscle strength of the quadriceps showed 38.4% deficit in peak torque and 42.0% deficit in total work compared to the contralateral normal knee preoperatively, 41.1% and 47.54% deficit respectively at 3 months after operation, 34.4% and 33.7% deficit at 6 months, 28.5% and 28.6% deficit at 9 months and 21.0% and 22.1% at 1 year after operation. 4. At the angular velocity of 180 degree/sec, the muscle strength of the hamstrings showed 26.9% deficit in peak torque and 31.8% deficit in total work compared to the contralateral normal knee preoperatively, 41.2% and 45.2% deficit respectively at 3 months after operation, 32.3% and 36.0% deficit at 6 months, 21.4% and 25.1% deficit at 9 months and 16.1% and 15.7% at 1 year after operation.
Anterior Cruciate Ligament Reconstruction ; Anterior Cruciate Ligament ; Autografts ; Humans ; Knee ; Muscle Strength ; Patellar Ligament ; Tears ; Torque

We reviewed the post-reconstructive results and complications of arthroscopic anterior cruciate ligament reconsbuction using the patellar bone-tendon-bone autograft in 91 patients who underwent the index surgery at least one year ago. The changes of Lysholm knee score, limitation of motion, instability of the reconstructed ACL, musc)e strength, presence of anterior knee pain and other complications were evaluated at final fol- low-up(mean, 2.6 year). The results were as follows. 1. The mean Lysholm knee score was 65.5+-15.5 preoperatively and improved to 88.5+-7.4 postoperatively(p<0.05), 2. Of all, nine(9.9%) complained anterior knee pain. 3. Three patients(3.3%) showed limited range of motion. 4. Five(3.5%) showed instability of reconstructed ACL during the followup. Two were caused by trauma. Ln other three, no definite causes were found. 5. In 23 patients, cybex isokinetic thigh muscle strength test was perfornied preoperatively and at post-up. One year. The strength of quadriceps of the operated side at the angular velocity of 60 degrees per second showed mean 41.7% deficit of the normal side at postoperative one year. 6. Other complications were one case of chronic click sound in motion, and one case of the fracture which occurred at the autograft donor site of the proximal tibia.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Autografts* ; Follow-Up Studies ; Humans ; Knee ; Muscle Strength ; Postoperative Complications ; Range of Motion, Articular ; Thigh ; Tibia ; Tissue Donors

BACKGROUND AND OBJECTIVES: The incidence of obstructive sleep apnea syndrome (OSAS) among obese patients is about three times higher than that of non-obese patients. Obesity is the most significant risk factor of OSAS. But in the treatment of OSAS, we tended to neglect treating obesity till now. The aim of this study was to assess the effect of weight loss after surgery on the quality of the life in OSAS patients with obesity. SUBJECTS AND METHOD: Twenty OSAS patients with obesity (body mass index >25) completed the preoperative SF-36v2TM questionnaire. All patients were treated by LAUP or UPPP. Ten of them (experimental group) were induced to lose weight by 10 mg of sibutramine for 3 months whereas nothing was done in the others (control group). And then all patients completed the same questionnaire again. The changes of the SF-36v2TM scores have been assessed. RESULTS: In the experimental group, the mean BMI decreased from 30.2 to 28.4 (p<0.05), the mean physical component sum-mary of SF-36v2TM scores was increased from 50.2 to 54.6 (p<0.05) and mean mental component summary was also increased from 45.8 to 49.6 (p0.05). But in the control group, only mean mental component summary was statistically increased from 49.1 to 50.8. CONCLUSION: This study demonstrates that the trial of postoperative weight loss may improve the quality of life in OSAS patients with obesity. So we must consider the positive trial of weight loss as well as the surgeries in the treatment of OSAS patients with obesity.
Humans ; Incidence ; Obesity ; Quality of Life ; Surveys and Questionnaires ; Risk Factors ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Weight Loss*

Molded tympanic graft is beneficial in the difficult cases of middle ear surgery, for instance, total perforation of ear drum or revision surgery. For producing molded graft, it is essential to treat the graft material with physico-chemical methods. However, morphological change by influence to the epithelial migration by treatment of graft have not been clarified. To evaluate the morphological effects of molding process on the graft, human temporalis muscle fascias were taken and molded through drying, heating or treatment with chemical preservatives. Their ultrastructures were also evaluated using scanning electron microscope. In molding process, drying of fascia produced widening of interfiber space as well as flattening and fusion of fibers. Heating of fascia produced crater-like defects with amorphous matrix. Formaldehyde preservation induced more remarkable changes of fascia than alcohol.
Ear* ; Ear, Middle ; Fascia* ; Formaldehyde ; Fungi* ; Heating ; Hot Temperature ; Humans ; Transplants*

PURPOSE: To assess the efficacy of glucosamine sulfate in the treatment of patients with knee osteoarthritis. MATERIALS AND METHODS: Using a double blind, randomized controlled trial design, patients with clinical and radiographic evidence of knee osteoarthritis were recruited into 3 groups, The glucosamine group of 43 patients was treated with glucosamine 550mg capsule and the placebo group of 27 patients with rice powder 250mg and lactose 250mg capsule, three times daily for 12 weeks. The NSAID group of 26 patients was treated with etodolac(lodine(R) 200mg capsule three times daily for 6 weeks. Clinical and radiographic change was evaluated by assessing the Lysholm knee score, pain score, passive range of knee motion, deformity of the knees, Kellgren-Lawrence radiographic scale and width of the tibio- femoral joint space in weight bearing radiography. RESULTS: In the glucosamine group, significant improvement was found in Lysholm knee score since 6 weeks of treatment and in pain score since 9 weeks compared with the placebo group, but not in radiographic indices. In the NSAID group, both Lysholm knee score and pain score were significantly improved than other groups since 3 weeks of treatment. In both glucosamine and NSAID groups, significant improvement was not found in passive range of motion and deformity of the knees. CONCLUSION: The effect of glucosamine was lower and slower than NSAlD in the treatment of the patients with knee osteoarthritis and improvement of Lysholm knee score was expected with long-term use of glucosamine over 6 weeks and pain-relief over 9 weeks.
Congenital Abnormalities ; Glucosamine* ; Humans ; Joints ; Knee* ; Lactose ; Osteoarthritis ; Osteoarthritis, Knee* ; Radiography ; Range of Motion, Articular ; Weight-Bearing

BACKGROUND: Although the genetic determinants of most sporadic breast cancers remain unknown, the understanding of the molecular and genetic events that contribute to breast carcinogenesis has been significantly advanced. We investigated the clinicopathologic significance of allelic imbalance or mutation of both p53 and PTEN tumor suppressor genes in sporadic breast carcinomas. METHODS: Genomic DNA from 62 breast carcinoma cases was extracted from paraffin blocks, and PCR was performed to determine loss of heterozygosity (LOH) for DNA markers around the p53 and PTEN genes and to amplify exons 5, 6, 7, and 8 of p53 and all 9 coding axons of PTEN. RESULTS: Somatic p53 mutations were detected in 6 (9.7%) of the 62 cases. LOH for DNA markers surrounding p53 was observed in 18 (29.0%) of the 62 cases. LOH for DNA markers surrounding PTEN was detected in 29 (46.8%) of the 62 cases. Only one case (1.6%) showed somatic PTEN mutations. Tumors with LOH on 17p or p53 mutation were large in size and negative for ER, had a high Ki-67 index, and exhibited p53 immunoreactivity (p<0.05). Tumors with LOH on 10q23 were associated with c-erbB-2 positivity (p=0.018). CONCLUSIONS: Our results indicate that LOH at 17p and/or p53 mutation is significantly associated with the aggressive pathologic parameters of breast cancer.
Allelic Imbalance ; Axons ; Breast Neoplasms* ; Breast* ; Carcinogenesis ; Clinical Coding ; DNA ; Exons ; Genes, Tumor Suppressor* ; Genetic Markers ; Loss of Heterozygosity* ; Paraffin ; Polymerase Chain Reaction ; PTEN Phosphohydrolase

BACKGROUND AND OBJECTIVES: Long-term immunotherapy lasting for 3 to 5 years is known to be one of the effective treatment modalities for the perennial allergic rhinitis. However, it is questionable whether open-ended immunotherapy is beneficial to control the symptoms of perennial allergic rhinitis. This study was designed to confirm the effectiveness of open-ended immunotherapy with every 3-month injection after 3-year immunotherapy by comparing the results of immunotherapy between patients who received less than 3 years and those who received more than 3 years. MATERIALS AND METHOD: One hundred-one perennial allergic rhinitis patients who received immunotherapy more than 1 year and had no history of sinonasal operation were chosen. They were divided into two groups; the duration of immunotherapy was from 1 year to 3 years in one group and more than 3 years in the other group. They were surveyed with global study and the questionnaires regarding practical problems about nasal, eye, and generalized systemic symptoms as well as their medical treatment history. This questionnaire was administered twice in one sitting, with the first on recalling symptoms before immunotherapy treatment, and the second on an evaluation of current symptoms. RESULTS: Improvement in the allergic symptoms was preserved in group B as well as in Group A. With the treatment, the patients in both groups experienced decrease in the frequency of absence from work or school, hospital visits and the use of antibiotics. There were no significant differences in the results between two groups. CONCLUSION: The long-term maintenance of immunotherapy with 3-month injection after 3-year immunotherapy is effective for the prevention of recurrence of perennial allergic rhinitis.
Anti-Bacterial Agents ; Humans ; Immunotherapy* ; Quality of Life* ; Surveys and Questionnaires* ; Recurrence ; Rhinitis*

BACKGROUND AND OBJECTIVES: Spectral gradient acoustic reflectometry (SGAR) determines the probability of middle ear fluid by measuring the response of the tympanic membrane to a sound. To assess the sensitivity and specificity of SGAR for the diagnosis of otitis media with effusion (OME) in the Korean population, we compared accurate diagnostic rates of OME obtained from SGAR and tympanometry. Pneumatic otoscope was used for diagnostic standard of OME. SUBJECTS AND METHOD: SGAR and tympanometry were performed on 488 ears from May 27th, 2008 to July 30th, 2008. Exclusion criteria were the presence of tympanic membrane perforation, and/or pressure equalization tubes, noncompliance, otorrhea, external auditory canal stenosis and signs of acute inflammation such as fever or otalgia. In all cases, pneumatic otoscopic examination was conducted and diagnostic accurate rates of OME were calculated in SGAR and tympanogram. RESULTS: Using spectral gradients of 3 or higher as breakpoints for indicating OME, in the case of pediatrics under 2 years old, with the sensitivity of 58.3%, specificity of 94.7%, positive predictive value (PPV) of 77.8% and negative predictive value (NPV) of 87.8%. In the case of the pediatrics between 2 and 12 years old, it showed the sensitivity of 67.2%, specificity of 90.3%, PPV of 74.5% and NPV of 86.8%. In the case of the pediatrics over 12 years old, they showed sensitivity of 87.3%, specificity of 88.8%, PPV of 67.6% and NPV of 96.3%. CONCLUSION: SGAR has the higher tendency of specificity and NPV, and will be a useful screeningtest with good portability and economical efficiency.
Acoustic Impedance Tests ; Acoustics ; Constriction, Pathologic ; Ear ; Ear Canal ; Ear, Middle ; Earache ; Fever ; Inflammation ; Otitis Media with Effusion ; Otoscopes ; Pediatrics ; Sensitivity and Specificity ; Tympanic Membrane ; Tympanic Membrane Perforation