The authors performed a retrospective matched-pair study for 54 uncemented total hip arthroplasties which were performed in management of avascular necrosis of femoral head from July, 1989 to May, 1991 to investigate what kind of stem is better between Anatomic stem as a proximal filling stem and Harris-Galante stem as a distal filling stem. The results were as followings: 1. Clinical results of Anatomic group were slightly better than those of Harris-Galante group in terms of incidence of thigh pain, groin or buttock pain and final functional score of hip. 2. Incidence of radiolucency around femoral stem in Harris-Galante group was higher than that in Anatomic group, especially in zone I, V of anteroposterior view and in zone IV of lateral view, which were statistically significant(p < 0.05). 3. The incidence of vertical subsidence of femoral stem in Harris-Galante group was significantly higher than that in Anatomic group(p < 0.05) and the average distance of subsidence was 3.2mm. 4. The incidence of endosteal osteolysis and bone resorption in Harris-Galante group was higher than that in Anatomic group. 5. In overall view, clinical and radiographic results of Anatomic group were better than those of Harris-Galante group.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Bone Resorption ; Buttocks ; Groin ; Head ; Hip ; Incidence ; Necrosis ; Osteolysis ; Retrospective Studies ; Thigh

Hemolytic disease of newborn due to Rhesus incompatibility occurs mostly by anti-Rh(D) antibodies. But recently, because of Rh(D) immune globuin prophylaxis, Rh(D) incompatibility is decreased and importance of minor group incompatibility is increasing. The majority of minor blood group incompatibilities are anti-c, anti-E or anti-Kell, but hemolytic diseases caused by combination of these antibodies are relatively rare. The 21 day-old male neonate was admitted because of pallor and poor feeding for 2 days. Laboratory data showed severe normochromic and normocytic anemia with increased reticulocyte and bilirubin. Patient's and his mothers blood type was B, Rh(D) positive. Minor blood groups of mother's and sons were different and anti-c and anti-E antibody were detected in mother's serum. After transfusions of two times with anti-c and anti-E free B, Rh(D) positive blood, the baby was discharged at 11th hospital day with good general condition.
Anemia ; Antibodies ; Bilirubin ; Blood Group Antigens ; Blood Group Incompatibility ; Erythroblastosis, Fetal ; Humans ; Infant, Newborn* ; Male ; Mothers ; Pallor ; Reticulocytes

BACKGROUND: For gastric cancer, primary prevention by risk factor modification might have some important roles. However, previous studies having investigated the factors associated with stomach cancer reported various results. In addition, there were only a few studies based on Korean population. METHODS: A case control study was carried out on 106 cases matched for age and sex with 106 controls in a tertiary care hospital. In patients who were aged 75 years or less and had been newly diagnosed as adenocarcinoma of stomach between July 1996 and January 1997 were included into the case group. Information on baseline characteristics, health habits, dietary habits of study subjects was obtained through an interview using structured questionnaire. Conditional logistic regression analysis was used to evaluate the factors associated with stomach cancer. RESULTS: Salt preference was associated with significantly increased risk of stomach cancer (odds ratio[OR]=9.81, 95% confidence interval[CI]=2.28 42.2). Eating broiled food more than three times a week significantly increased the risk of stomach cancer (OR=3.33, 95% CI=1.16 9.55) compared to eating it less than once a week. Blood type, family history of stomach cancer, smoking, and alcohol consumption were not associated with stomach cancer. CONCLUSION: Salt preference and frequent eating of broiled food are the risk factors significantly associated with stomach cancer in this study subjects.
Adenocarcinoma ; Alcohol Drinking ; Case-Control Studies* ; Diet ; Eating ; Food Habits ; Humans ; Logistic Models ; Primary Prevention ; Risk Factors* ; Smoke ; Smoking ; Stomach Neoplasms* ; Stomach* ; Tertiary Healthcare ; Surveys and Questionnaires

BACKGROUND: Long-chain triglyceride/medium-chain triglyceride (LCT/MCT) propofol is less painful than standard long chain triglyceride (LCT) propofol; however, there is still a need to reduce severe pain. 5-Hydroxytryptamine type 3 (5-HT3) receptor antagonists have an analgesic effect during the injection of standard LCT propofol. This study compared the incidence of moderate-to-severe injection pain with LCT/MCT propofol using pretreatment with palonosetron versus pretreatment with saline or lidocaine. METHODS: This prospective, randomized double-blind study divided 98 patients scheduled for general anesthesia into three groups: control (n = 33), palonosetron (n = 32), and lidocaine (n = 33) groups. An 18-gauge intravenous catheter was inserted into the peripheral vein at the dorsum of the hand. The patient's vein was occluded by a rubber tourniquet at mid-forearm, and we then administered 2 ml of the pretreatment drug. One minute after venous occlusion, we released the tourniquet and administered LCT/MCT propofol 2 mg/kg for 10-15 seconds. The degree of pain on propofol injection was evaluated using a 4-point scale. RESULTS: The incidence of moderate-to-severe pain in the control, palonosetron, and lidocaine groups was 9.1, 15.6, and 12.1%, respectively. The incidence of overall pain was lower in the lidocaine group than in the control or palonosetron group. CONCLUSIONS: Palonosetron and lidocaine pretreatment does not reduce moderate-to-severe pain on injection of 1% LCT/MCT propofol. Lidocaine pretreatment reduced the overall incidence of injection pain.
Anesthesia, General ; Catheters ; Double-Blind Method ; Hand ; Humans ; Incidence ; Lidocaine* ; Propofol* ; Prospective Studies ; Rubber ; Serotonin ; Tourniquets ; Triglycerides ; Veins

PURPOSE: Although considered uncommon, periprosthetic fracture of the femur after hip arthroplasty is a serious complication that can be difficult to treat. Authors analyzed the types of fracture and modality of treatment. MATERIALS AND METHODS: Between Jan. 1983 and Dec. 1997, 17 cases of postoperative periprosthetic fractures had been treated at our hospital. These cases were followed up for an average of 58 (13-123) months. The fractures were classified according to Duncan and Masri classification. Three cases of type A, and 6 cases of type B1, 3 cases of type B2, 3 cases of type B3 and 2 cases of type C. The 3 cases of type A and 2 cases oftype B1 were conservative treatments. The 4 cases of type B1 were treated with open reduction and internal fixation with bone graft. The 3 cases of type B2 and 3 cases in type B3 were treated with long stem revision. The 2 cases of type C were treated with open reduction and internal fixation with bone graft. RESULTS: Bony union happened in all cases. The results according to Beals and Tower criteria were excellent in 12 cases, good in 3 cases and poor in 2 cases. CONCLUSIONS: The most frequent cause of periprostic fracture was trauma and other causes were loosening and osteolysis. Proper treatment method of periprosthetic fracture were important for stability of femoral stem
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Classification ; Femur* ; Hip ; Osteolysis ; Periprosthetic Fractures ; Transplants

No abstract available.
Classification* ; Female ; Hydatidiform Mole* ; Pregnancy

The change of venous capacitance has an influence on venous return to the heart and cardiac output, and causes the alteration of preload, cardiac filling pressure and myocardial wall tension. Venous capacitance is assesed by measuring the mean circulatory filling pressure (MCFP), and MCFP is measured during brief periods of circulatory arrest produced by inflating an indwelling balloon in the right atrium It is important to know the effects of vasodilator and anesthetic drugs on venous capacitance. Therefore, this study was performed to know the effects of nitroglycerin and diltiazem on venous capacitance in rats. Rats were anesthetized with ketamine 125 mg/kg given intraperitoneally and added 10 mg/kg every 30 minutes. Their mean arterial pressure (MAP) was lowered to 60 mmHg by intravenous injection of 0.82+/-0.36 mg/kg nitroglycerin and/or 6.7+/-1.5 mg/kg diltiazem. Hemodynamic parameters such as MAP, heart rate, central venous pressure and MCFP were measured before and after drug-injection. Hemodynamic values measured before drug-injection in two groups were little differences statistically. However, the MCFP of nitroglycerin was significantly decreased (p<0.01) from 7.3+/-0.61 mmHg to 5.4+/-0.58 mmHg after drug-injection, and that of diltiazem was not significantly changed from 7.1+/-0.54 mmHg to 6.9+/-0.63 mmHg. The results suggested that nitroglycerin was predominantly a venous dilator in terms of MCFP but diltiazem had little effect of venodilation.
Anesthetics ; Animals ; Arterial Pressure ; Cardiac Output ; Central Venous Pressure ; Diltiazem* ; Equidae ; Heart ; Heart Atria ; Heart Rate ; Hemodynamics ; Injections, Intravenous ; Ketamine ; Nitroglycerin* ; Rats*

BACKGROUND: Females generally have a lower pain and temporal summation threshold than men. However, the results of studies designed to evaluate gender differences in the thresholds of heat pain and the temporal summation have been inconsistent. Newly developed device, CHEPS (Contact Heat Evoked Potential Stimulation) model of PATHWAY, have superiority on its fast rise and return time in temperature. Therefore we investigated gender differences in heat pain and temporal summation threshold. METHODS: Forty healthy volunteers (20 males and 20 females) were enrolled in this study. A thermode was applied to the volar side of each volunteer's left forearm and heat pain and the temporal summation threshold was then measured. The heat pain threshold was estimated using the staircase method by starting from 36degrees C and then increasing the temperature in 0.5degrees C increments. The temporal summation threshold was estimated by applying five successive stimulation of the same temperature starting at 2degrees C lower than the heat pain threshold and then increasing the temperature in 0.5degrees C increments. RESULTS: The mean heat pain thresholds was found to be 41.63 +/- 1.63degrees C for males and 41.60 +/- 1.84degrees C for females and the temporal summation thresholds were found to be 40.83 +/- 1.64degrees C for males and 40.77 +/- 1.93degrees C for females. The differences between males and females were not statistically significant. CONCLUSIONS: The result of this study suggested that there are no gender differences in heat pain and temporal summation threshold.
Evoked Potentials ; Female ; Forearm ; Hot Temperature ; Humans ; Male ; Pain Threshold

BACKGROUND: Nerve root sleeve injection has become popular in the treatment of lumbar radicular complaints. However reported data on nerve root sleeve injection is more of a technical nature. The present study was designed to evaluate the therapeutic success of a fluoroscope guided nerve root sleeve injection of local anesthetics and corticosteroids. METHODS: Fifty seven patients who had persistent radicular pain and/or low back pain that is resistant to conservative treatment were treated with fluoroscope guided injection therapy. 0.125% bupivacaine 2.5 ml and triamcinolone 40 mg were injected at intervals of 2 - 4 weeks. Before and after treatment and at follow up, a visual analogue scale (VAS) was measured. Treatment success was evaluated on a ratio based on the visual analogue scale (post-treatment VAS/pre-treatment VAS) and categorized as following (good improvement = > 70%, moderate improvement = 70 50%, no improvement = < 50%). RESULTS: Short-term good and moderate improvement was observed in 46% of the patients with radiating pain and/or lower back pain, and in 43% of patients with lower back pain only. CONCLUSIONS: Results indicated that nerve root sleeve injections of corticosteroids done under fluoroscopic guidance as an outpatient procedure was effective and safe in our study and may deserve to be used as part of the conservative management of lumbar radiculopathy before resorting to more invasive methods.
Adrenal Cortex Hormones ; Anesthetics, Local ; Bupivacaine ; Follow-Up Studies ; Health Resorts ; Humans ; Low Back Pain ; Outpatients ; Radiculopathy ; Spine* ; Triamcinolone

BACKGROUND AND OBJECTIVES: With the increasing use of high resolution sonography and fine needle aspiration biopsy, the proportion of newly diagnosed thyroid papillary carcinomas have increased. However, it is not entirely clear whether microcarcinomas detectable by the above technology the should be considered a threshold for risk evaluation. The purpose of this study is to evaluate the clinical behavior of papillary carcinomas smaller than 1.5 cm. SUBJECTS AND METHOD: A retrospective chart review was conducted for 181 patients who underwent surgery for thyroid cancer and was proven to have papillary carcinoma smaller than 1.5 cm in size from 1997 to 2006. The patients were divided into 3 groups according to cancer size. The patient's gender, age, surgical method, pathology, initial neck node and neck recurrence was analyzed by chi-square test, analysis of variance (ANOVA) test and multinomial logistic regression analysis. RESULTS: Progressively increasing frequency of signs of tumor aggressiveness (multifocal, bilateral, extracapsular spread) was observed with increasing size. The rate of lymph node metastasis increased also, but it did not reach a significant value. Despite the increasing rate of aggressiveness and lymph node metastasis, there was no significant difference in recurrence between these groups. CONCLUSION: Although the long term outcome does not seem to directly depend on tumor size in these small thyroid cancers, a progressing frequency of aggressiveness with increasing cancer size at presentation is evident.
Biopsy ; Biopsy, Fine-Needle ; Carcinoma ; Carcinoma, Papillary ; Humans ; Logistic Models ; Lymph Nodes ; Neck ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms