Generally, exposure and the operative technique are common difficulty encountered in the total knee arthroplasty of ankylosed knee due to old infection sequelae. Also the postoperative range of motion and relief of pain is poor due to deformity and excessive soft tissue contracture around knee. There have heen few reports, however, that address the reconstructive challenge of total knee arthroplasty in a previously infected ankylosed knee. We perfoined TKA in thirty six patients who had ankylosed knee between July l986 and Dec. 199S. After follow up of average five years and one month, we analysed the results. The definition of ankylosis was a knee ROM less than 90 degree. Average age of patients were 36.7 years old. Twelve patients were meii and twenty four patients were women. Sixteen patients of partial ankylosis and twenty patients of complete ankylosis were performed operation. There were nineteen cases of healed tubercuiosis knees and seventeen cases of healed pyogenic knees. For the release of soft tissue contracture in 9 cases, we lengthened quadrceps tendon with the method of modified V-Y advancement technique. Patella tendon was proximally reattached with staples and suture in 6 cases and tibial tubercle was proximally transferred in 3 cases. As results, the postoperative average range of motion was 79.3 (30 - l21') in complete ankylosis, 107 (60 - 135 ) in partial ankylosis. The average Hospital for Speciai Surgery knee rating score improved from 56.3 points preoperatively to 84.8 points postoperatively. Radiolucent line was observed in two Knees with less than 2mm width in three years and four months, and four years postoperatively, hut the patient had no pain. In five patients who had poor gain of range of motion after operation, we perfonned arthroscopic adhesiolysis. In conclusion, regarding patient selection, reasonable hony development, relative]y healthy extensor mechanism and adequate soft tissue condition are important for success of TKA in old intection sequelae. TKA of ankylosed knee in old infection sequelae is a successful procedui which can ohtain the restoration of function of the ankylosed knee.
Ankylosis ; Arthroplasty* ; Congenital Abnormalities ; Contracture ; Female ; Follow-Up Studies ; Humans ; Knee* ; Patellar Ligament ; Patient Selection ; Range of Motion, Articular ; Sutures ; Tendons

PURPOSE: The purpose of this study was to investigate the influencing factors of influenza vaccination in the elderly participating in lifetime transitional health examination. METHODS: This study was a secondary analysis of data collected from lifetime transitional health examination (for 66-year-old people) conducted by the National Health Insurance Corporation (NHIC) from January 1 to December 31, 2008. Questionnaires were received from NHIC to obtain information regarding gender, chronic diseases, health-related behaviors, and ADL. A total of 255,333 participants who responded all the questions in the questionnaire were included in the analysis. Collected data were analyzed by descriptive statistics, chi2 test, and multiple logistic regression. RESULTS: The influenza vaccine coverage rate in 66-year-old people was 66.1%. The influenza vaccine coverage rate was higher in female elders and those with hypertension, diabetes, heart disease or past smoking, and lower in those with stroke, current smoking, drinking, no-exercise or ADL-dependency. CONCLUSION: Strategies for improving the influenza vaccination coverage rate in the elderly are needed. The strategies should give priority to the elderly with current smoking, drinking, and no-exercise, and home visiting programs are needed for the elderly with stroke and ADL-dependency.
Activities of Daily Living ; Aged* ; Chronic Disease ; Drinking ; Female ; Heart Diseases ; House Calls ; Humans ; Hypertension ; Influenza Vaccines ; Influenza, Human* ; Logistic Models ; National Health Programs ; Smoke ; Smoking ; Stroke ; Vaccination* ; Surveys and Questionnaires

OBJECTIVES: This study was performed to compare health value cognition and health promotion behavior compliance between healthy group and not being healthy group, and to evaluate the difference of health promotion behaviors compliance between high group and low group in health value cognition. METHODS: The subjects of this study were 565 workers, 233 healthy workers, 172 observation cases and 160 disease cases, selected from 4,919 transit coporations workers. RESULTS: In health promoting behavior compliance, not being healthy group showed lower level than healthy group in exercise and showed higher level than healthy group in interpersonal support significantly. A worker who replied on health as the most value in life was consisted in 37.3% of healthy group and 36. 1% of not being healthy group, Health value cognition according to general characteristics showed no significant difference except only variable of age in healthy group. Health promoting behavior compliance according to cognition of health value showed in healthy group that a high level group of health value cognition was more significant difference than a low level group in self actualization and health responsibility of health promoting behavior and didn't show difference significantly in not being healthy group. CONCLUSIONS: In conclusion, the relationship between health value cognition, health promotion behavior compliance and periodic health examination results showed weakly. Therefore, in order to develop and apply spontaneous health promotion program, it was considered that should emphasize compliance than cognition.
Cognition* ; Compliance ; Health Promotion*

OBJECTIVE: The objective of this study is to compare the effectiveness and safety in the labor induction between the high dose oxytocin method and the new low dose oxytocin method. STUDY DESIGN: Firstly, we selected 125 pregnant women hospitalized, having the indication of labor induction from March, 1995 to August, 1996. Of them, we selected 61 pregnant women tothem the high dose oxytocin method was used, as the control group, and in- creased the quantity of 2.5 mU/min every 20 minutes with the start dose of 2.5 mU/min to them. On the other hand, with the start dose of 1.25 mU/min, we increased the quantity of 1.25 mU/min every 20 minutes to the study group of low dose oxytocin method, 64 pregnant women. RESULTS: No statistical significance was found in the time from the effective uterine contraction to the delivery in the study group, in contrast to that of the control group to them the labor induction was conducted by using the high dose oxytocin. Maximum amount used to the high dose oxytocin was significantly more than that of the low dose oxytacin, but in the total given dose, there was no significant difference between two groups. Maxi- mum uterine contraction of the control group did not show any significant. difference from that of the study group, and there was also no significant difference in the frequency of generating the complications such as fetal distress. CONCLUSION: There was no difference in the labor.induction -to delivery time, and the complications of fetus, between the existing high dose oxytocin method and the new low dose oxytocin method. Therefore it is thought the low dose oxytocin method may reduce the possibility of a complieation compared with the high dose oxytocin method. However, it is considered this matter must be investigated further in the futrre.
Female ; Fetal Distress ; Fetus ; Hand ; Humans ; Oxytocin* ; Pregnant Women ; Uterine Contraction

PURPOSE: Ascorbic acid has been reported to have an adipogenic effect on 3T3-L1 preadipocytes, while evidence also suggests that ascorbic acid reduces body weight in humans. In this study, we tested the effects of ascorbic acid on adipogenesis and the balance of lipid accumulation in ovariectomized rats, in addition to long-term culture of differentiated 3T3-L1 adipocytes. MATERIALS AND METHODS: Murine 3T3-L1 fibroblasts and ovariectomized rats were treated with ascorbic acid at various time points. In vitro adipogenesis was analyzed by Oil Red O staining, and in vivo body fat was measured by a body composition analyzer using nuclear magnetic resonance. RESULTS: When ascorbic acid was applied during an early time point in 3T3-L1 preadipocyte differentiation and after bilateral ovariectomy (OVX) in rats, adipogenesis and fat mass gain significantly increased, respectively. However, lipid accumulation in well-differentiated 3T3-L1 adipocytes showed a significant reduction when ascorbic acid was applied after differentiation (10 days after induction). Also, oral ascorbic acid administration 4 weeks after OVX in rats significantly reduced both body weight and subcutaneous fat layer. In comparison to the results of ascorbic acid, which is a well-known cofactor for an enzyme of collagen synthesis, and the antioxidant ramalin, a potent antioxidant but not a cofactor, showed only a lipolytic effect in well-differentiated 3T3-L1 adipocytes, not an adipogenic effect. CONCLUSION: Taking these results into account, we concluded that ascorbic acid has both an adipogenic effect as a cofactor of an enzymatic process and a lipolytic effect as an antioxidant.
3T3-L1 Cells ; Adipocytes/drug effects ; Adipocytes/metabolism ; Adipogenesis/drug effects ; Animals ; Antioxidants/pharmacology ; Ascorbic Acid/pharmacology ; Body Composition/drug effects ; Body Weight/drug effects ; Cell Differentiation/drug effects ; Female ; Fibroblasts/drug effects ; Fibroblasts/metabolism ; Lipolysis/drug effects ; Mice ; Ovariectomy ; Rats, Sprague-Dawley

This study was conducted to investigate the cause and magnitude of food poisoning among residents and visitors for a birthday party in a rural area of Kyongju city in september, 1996. The total subjects were 137 persons, 119 residents(53 males, 66 females), including 7 hospitalixed patients and 18 visitors(8 males, 10 females). The investigation consisted of an interview survey, a study on clinical characteristics for the patients hospitalized, bacteriological examinations of the underground water and microbiologic examinations on microbes isolated from the patients. The population at risk was 59 persons(24 males, 35 females). The attack rate was 50.0%(12 cases) for males, 48.6% for females(17 cases). The cases were distributed evenly for all age groups. The attack rates for each party-food and possible fooe groups were not significantly different. Most clinical symptoms were significantly more frequent among cases than non-ases: abdominal pain(73.1%), diarrhea(73.1%), chilliness(69.2%), fever(65.4%), anorexia(61.5%), nausea(53.8%), general weakness(50.0%) and dizziness(50.0%) were the major symptoms among the cases. The admission rate among the cases was 24.1%(1 male, 6 females). In the stool cultures, Salmonella species group D was isolated from 6 persons of 85 examinees. It was identified as Salmonella enteritidis by serological diagnosis. The samples of underground water were assessed Enon-compatible for drinking in 10 wells(83.3%) of this rural area and it was suggested that it could have been contaminated from cattle feces. There were two wells in the party house, one of them was contaminated by bacterias including E. coli. The contaminated water was stored in a water tank located on the rooftop. This water was used for dish washing and cooking. Wd concluded that the cause of this epidemic was the underground water contaminated by Salmonella enteritidis from guman carriers or domestic animal carriers.
Animals ; Animals, Domestic ; Bacteria ; Cattle ; Cooking ; Diagnosis ; Drinking ; Feces ; Foodborne Diseases ; Groundwater ; Gyeongsangbuk-do* ; Humans ; Korea* ; Male ; Population Characteristics ; Salmonella enteritidis* ; Salmonella*

BACKGROUND: Pleural effusion is a common disease in clinical practice but its effect on pulmonary function and altered pulmonary mechanics after removal of effusion are not still largely understood. Previous studies have shown that there is little or a relatively small improvement in pulmonary function and arterial blood oxygenation after therapeutic thoracentesis. The present study was designed to assess the effect on pulmonary function of pleural effusion and to test whether there was a significant improvement in pulmonary function and arterial oxygenation after thoracentesis and to observe long term effect after thoracentesis. METHOD: We examined flow-volume curve, body box and arterial blood gas analysis according to severity of effusion, present symptom, and symptom duration. Then, we measured changes of pulmonary function after thoracentesis and observed longterm effect after thoracentesis. RESULT: 1) Pleural effusion cause restrictive pulmonary insufficiency. Not only functional impairment of small airway but also large airway is provoked. 2) MMFR, FEV1, Raw, PO2 are earlier improved than FVC and TLC after thoracentesis and patients without complication have mild restrictive pulmonary insufficiency after longterm observation 3) FVC, FEV1, & TLC are similarly restricted as severity of pleural effusion and PO2 is relatively decreased. 4) Cases with symptom duration 1 week or less and cases with dyspnea have more severe pulmonary insufficiency than others. 5) The flow volume curves show a relatively greater improvement in flow rates at large lung volumes than small airway. 6) Significant relationship is shown between first thoracentesis amount and changes of FEV1, FVC, TLC. CONCUSION: Pleural effusion cause restrictive pulmonary insufficiency and not only functional impairment of small airway impairment but also large airway is provoked. Then, Pulmonary function is progressively improved after thoracentesis and remained mild restrictive pulmonary insufficiency after recovery
Blood Gas Analysis ; Dyspnea ; Humans ; Lung ; Maximal Midexpiratory Flow Rate ; Mechanics ; Oxygen ; Pleural Effusion* ; Tuberculosis, Pleural*

Gastrointestinal involvement has been reported to occur in about 5 to l0% of patients with lymphoma. The most common gastrointestinal site for a lymphoma is the stomach, followed by the small intestine and ileocecal region. When lymphoma is found in the esap us, generally it is with contiguous involvement of the gastric fundus, the cervical node, secondary to mediastinal lymph node compression, or a late manifestation of advanced desease. Such cases cannot be labeled as primary esophageal lymphoma. A search of the literature reveals that there have been about 20 or more published cases classified as esophageal lymphoma. However, more than ten cases are indistingishable from the case of distal esophageal involvement by gastric lymphoma. In 1935, Chiolero described a case of midesophageal stricture, which at autopsy was consistent with Hodgkin's disease for the first time. Berman reported an authentic case of primary histiocytic lymphoma confined to the lower esophagus. Only six or more cases were reported in literature until the present time. Here, a 30-year-old man with substernal discomfort was shown to have a mass lesion on the esophagus. The mass was proved to be malignant lymphoma on the histologic examination. This may be the first report dealing with spontaneous regression of maligant lymphoma of the esophagus possibly associated with the use of cimetidine.
Adult ; Autopsy ; Cimetidine ; Constriction, Pathologic ; Esophagus* ; Gastric Fundus ; Hodgkin Disease ; Humans ; Intestine, Small ; Lymph Nodes ; Lymphoma* ; Lymphoma, Large B-Cell, Diffuse ; Stomach

As well-being foods pursuing healthy life are becoming popular, interest in Rubus coreanus Miquel (RCM) fruit, a type of Korean blackberry, is increasing due to its medicinal actions including protecting the liver, brightening the eyes, and alleviating diabetes. This study was carried out to evaluate the hepatoprotective effects of RCM concentrates on liver injuries induced by carbon tetrachloride (CCl4) in rats. RCM, produced in June ~ July 2008 at Chunbook, Gochang (South Korea), was finely mashed. The seeds were removed and the juices were condensed. Thirty-two Sprague-Dawley rats were divided into four groups according to treatment: normal (eight rats), CCl4, 1% RCM, and 2% RCM. Experimental diets were provided to the experimental animals for 4 weeks. We measure total cholesterol, high density lipoprotein-cholesterol (HDL-C), aspartate amino transferase (AST), alanine amino transferase (ALT), and alkaline phosphatase (ALP) levels. Part of the livers was isolated for histopathological evaluation, and analyzed for lipid peroxide (TBARS), superoxide dismutase (SOD) and liver proteins. The activities of serum AST, ALT, and ALP were elevated following CCl4 administration. Levels of hepatic TBARS were also significantly increased in the CCl4 groups. However, hepatic TBARS levels and the activities of serum enzymes were markedly reduced by supplementation with the RCM concentrates (P < 0.05). Hepatic SOD activity increased in the RCM concentrates group versus CCl4 groups. Histopathological examination revealed massive necrosis in the centrilobular area and degenerative changes caused by CCl4 were ameliorated by dietary supplementation with RCM concentrates. These results suggest that RCM concentrates have hepatoprotective effects and may improve the symptoms of liver injuries.
Alanine ; Alkaline Phosphatase ; Animals ; Aspartic Acid ; Carbon Tetrachloride* ; Carbon* ; Cholesterol ; Diet ; Dietary Supplements ; Fruit ; Liver* ; Necrosis ; Rats* ; Rats, Sprague-Dawley ; Superoxide Dismutase ; Thiobarbituric Acid Reactive Substances ; Transferases

PURPOSE: We evaluated the MRI findings that suggested the presence of a residual cancer after a mammotome biopsy in pathologically proven breast cancer patients and the usefulness of MRI to diagnose a residual cancer and additional lesions. MATERIALS AND METHODS: We reviewed 41 breast cancer patients that underwent an ultrasonography-guided mammotome biopsy for complete resection of a breast lesion. MRI was performed for preoperative assessment and MRI findings suggestive of a residual cancer at the procedure site were analyzed and correlated to the pathological findings. Additional enhancements on breast MRI were analyzed, and the diagnostic accuracy of MRI for occult additional lesions was calculated. RESULTS: A total of 32 (78.0%) patients had a residual tumor. A mass was the most common MRI finding that suggested a residual cancer. Thick rim enhancement or a mass with a non-mass like enhancement were the most suspicious findings that suggested the presence of a residual cancer. The sensitivity, specificity and accuracy of MRI for the detection of a residual cancer were 81.3%, 66.7% and 78.0%, respectively. Additional malignant lesions were found in 7 cases. The sensitivity, specificity and accuracy of MRI for the detection of additional lesions were 100%, 60.0% and 76.5%, respectively. CONCLUSION: Further complete surgery should be performed, as residual tumors are found in 50% of the negative MRI examinations, whereas preoperative MRI is helpful to evaluate occult additional lesions.
Biopsy ; Breast Neoplasms* ; Breast* ; Humans ; Magnetic Resonance Imaging* ; Neoplasm, Residual ; Sensitivity and Specificity ; Ultrasonography, Mammary