Insall-Burstein Posterior stabilized knee prosthesis is a variant of total condylar prosthesis. It is designed to get more wide range of flexion and stability with the transverse cam. We analyze with modified HSS knee rating score clinically and scoring system of AKS(American Knee Society) radiologically. We report the operative results in 34 cases of 25 patients whom we operated with Insall-Burstein PSP from August, 1982 to May, 1985 and the long term follow-up result of 24 cases of 16 patients, excluding three death and 7 cases of 6 patients who were lost to follow up. Follow-up period is average 11 years and 5 months. The average preoperative flexion contracture improved markedly. The average preoperative flexion arc was 95° and preoperative flexion contracture was 14°. The postoperative ROM and flexion contracture improved markedly. The average preoperative modified HSS knee rating scoring was 52 points and improved to 91 points at last follow-up. Patients with rheumatoid arthritis had progression of other joints involvement which limited the activity of daily living. At the last follow up, loosening signs were not observed radiologically but three cases of radiolucent zone were observed in the zone I, II, III, IV, VII of tibial components and zone III, VI of femoral components. There were two deep infections.
Arthritis, Rheumatoid ; Arthroplasty ; Contracture ; Follow-Up Studies ; Humans ; Joints ; Knee Prosthesis ; Knee ; Lost to Follow-Up ; Prostheses and Implants

No abstract available.
Intervertebral Disc*

BACKGROUND: Balloon PTCA for the distal, long, eccentric coronary artery stenosis will be at high risk for severe dissection or acute occlusion during or after procedure. METHODS AND RESULTS: High Speed Rotational Atherectomy followd by low pressure balloon angioplasty due to distal, long, eccentric coronary artery stenosis. Rotational coronary atherectomy debulked the lesion quickly without difficulty. Rotational Coronary Atherectomy with adjuctive low pressure balloon inflation was successful without event. CONCLUSIONS: This case illustrates the point that complementary deployment of devices may not only improve success of percutaneous coronary intervention, but also may extend its scope.
Angioplasty, Balloon ; Atherectomy, Coronary* ; Coronary Stenosis ; Inflation, Economic ; Percutaneous Coronary Intervention

The symptoms of the rheumatoid arthritis are variable enough to be ranged from mild to severe case. Synovectomy, fusion, and total knee replacement are to be applied according to the site and degree of involvement as surgical treatments. In the analysis, we compare the result of PCL retention TKR patients with those of PCL sacrificing TKR patients and of cemented TKR patients with those of cementless TKR patients. Function of the knee was evaluated using the knee score system of the Hospital for Special Surgery. From Nov, 1982 to Nov. 1990, total knee replacment was performed on 128 knees in 77 patients with rheumatoid arthritis at the Kyung Hee University Hospital and were followed for from two to ten years(average, four years eleven months). 1. The age at operation was ranged from 21 years to 72 years(average 53.2 years). There were seventy one female and six male patients. 2. The cruciate sacrificing prosthesis(group I ) were 42 cases and cruciate retention prosthesis(group II) were 86 cases. 3. The average preoperative range of motion was 85. 5 degree and the average post-operative range of motion was 107. 7 degree. Group I changed from 74. 7 degree to 105. 8 degree and Group II changed from 90. 5 degree to 108. 5 degree. 4. The average preoperative flexion contracture was 28. 7 degree and average post-operative flexion contracture was 7.8 degree. Group I changed from 37 degree to 8.4 degree and Group II changed from 24. 7 degree to 7. 5 degree. 5. The average preoperative tibiofemoral angle was varus 7. 4 degree in 69 cases and valgus 7. 6 degree in 59 cases. The average postoperative tibiofemoral angle was valgus 7. 2 degree. 6. The average preoperative knee Rating Score was 35. 2 point and the average postoperative score improved to 82. 7 point. Group I changed from 31. 3 point to 79. 4 point and Group II changed from 37 point to 84. 2 point. 7. 107 cases were cemented TKR and the 21 cases were cementless. There was no significant difference in those groups. 8. Additional operations were THR in eight cases, TER in five cases, TAR in four cases, TSR in one case, TWR in one case, Swanson prosthesis in one case, knee synovectomy in two cases, elbow synovectomy in three cases, and wrist synovectomy in two cases. 9. Complication included loosening in one case, partial ankylosis in three cases, and deep infection in one case.
Ankylosis ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Knee ; Contracture ; Elbow ; Female ; Humans ; Knee ; Male ; Prostheses and Implants ; Range of Motion, Articular ; Wrist

After Kilian first described apondylolisthesis in 1854, there has been diverse opinions over the surgical treatment of the spondylolisthesis: in situ fusion vs. reduction and fusion, PLIF vs. PLF, and instrumentation vs. non-instrumentation. The advantages of the instrumentation are rigid fixation, better union rate of grafted bone and early rehabilitation after surgery. The disadvantages are long operation time and increased chance of the wound infection. The purpose of this retrospective study is to review the clinical results and fusion rate of 41 patients who were treated with decompression and posterolateral fusion in situ with autograft with or without instrumentation from January 1986 to June 1992. 1. Among 41 patients, 20 patients were degenerative type and 21 were isthmic type, and most commonly involved level was L4-5(46.4%). 2. Fusion was obtained in all patients. 3. Clinically 11 of 15 patients(73.4%) showed excellent or good results in instrumentation group, and 19 of 26 patients(73.0%) showed excellent or good results in non-instrumentation group. 4. Postoperative complications developed in two cases(13.3%) with instrumentation and five cases(19.2%) without instrumentation. Comparing with the non-instrumentation, we could not find great advantage of the instrumentation on the clinical results or union rate, although instrumentation showed a little better result.
Autografts ; Decompression ; Humans ; Postoperative Complications ; Rehabilitation ; Retrospective Studies ; Spondylolisthesis ; Transplants ; Wound Infection

BACKGROUND: Despite improvement of mortality in acute myocardial infarcrtion, high mortality rate associated with cardiogenic shock remains essentially unchanged. We have reviewed our result of coronary intervention in 15 patients and found relative survival advantage. METHODS: Between Sep. 1992 and Aug. 1995, 15 consecutive patients(M. 10, F. 5) with cardiogenic shock in acute myocardial infarction were treated with coronary intervention using ballon PTCA. IABP was inserted in all patients prior to PTCA. RESULTS: 1) Most commonly found infarct related artery was left anterior descending artery(11) followed by right coronary artery(3) and left main coronary artery(1). 2) Successful reperfusion rate was 86.7%(13/15), and in-hospital mortality rate was 26.7%(4/15). 3) In-hospital mortality was higher in elderly patients compared with less than 70yaer old patients(0%(0/11)vs. 75.0%(3/4)(P < 0.05). 4) Mortality rate was lower in single vessel disease than multivessel disease(11.1%(1/9) vs. 50%(3/6) p<0.05). CONCLUSION: Although this study is uncontrolled, the date suggest that urgent coronary intervention for improving coronary perfusion may reduce mortality of acute myocardial infarction complicated by cardiogenic shock, particularly with single vessel disease and young age group.
Aged ; Arteries ; Hospital Mortality ; Humans ; Mortality ; Myocardial Infarction* ; Perfusion ; Reperfusion ; Shock, Cardiogenic*

No abstract available.
Mass Screening* ; Uterine Cervical Neoplasms*

We report a case of recurrent choroidal neovascularization (CNV) in an eye with chorioretinal coloboma. A 36-year-old woman presented complaining of decreased visual acuity (VA) in her left eye. Best corrected visual acuity (BCVA) was 20/200 and iris coloboma was observed. Funduscopy and fluorescein angiography (FA) showed CNV in the superior extrafoveal region with chorioretinal coloboma reaching just inferior to the optic disc. No other cause for CNV was observed except for the chorioretinal coloboma. BCVA improved to 20/30 after laser photocoagulation. She revisited our clinic for deteriorating VA (20/400) in the same eye 3 years after treatment. Funduscopy and FA demonstrated recurrent CNV with subfoveal hemorrhage. Photodynamic therapy (PDT) was followed by three consecutive intravitreal bevacizumab injections (IVB) for the subfoveally-located CNV. However, the CNV persisted with the appearance of a fresh subretinal hemorrhage. Additional PDT was combined with IVB on the same day 6 months after the initial PDT. The CNV regressed 3 months after treatment and has not recurred as of 8 months after the last treatment. The patient's BCVA improved to 20/60. This case suggests that PDT combined with IVB can be an alternative treatment for the management of recurrent CNV after laser photocoagulation in eyes with chorioretinal coloboma.
Adult ; Angiogenesis Inhibitors/administration & dosage ; Antibodies, Monoclonal/administration & dosage ; Choroid Diseases/*complications/drug therapy/surgery ; Choroidal Neovascularization/diagnosis/*etiology/physiopathology ; Coloboma/*complications/drug therapy/surgery ; Female ; Fluorescein Angiography ; Fundus Oculi ; Humans ; Intravitreal Injections ; Laser Coagulation ; Photochemotherapy ; Recurrence ; Visual Acuity

PURPOSE: Recently, the list of Epsterin-Barr Virus (EBV)-associated diseases has been growing. It is now known that there are two types (type 1 & 2) of EBV, but it has yet to be fully investigated as to whether type B EBV differs in any way from type A virus in terms of geographical distribution or disease association. We performed this study to find out the prevalence of the two types of EBV in EBV seropositive healthy children and adults by using one step Polymerase chain reaction(PCR). METHODS: Fifty-four viral capsid antigen (VCA) IgG positive healthy children (5 to 15 yrs of age) and 60 healthy adults (20 to 50 yrs of age) were involved in this study. DNA extracted from saliva samples of healthy study children and adults were subjected to amplification using the modified one step general PCR, which was developed by M. Kunimoto et al for detection of EBV types. And B95-82 cells (type 1) and Jijoye cells (type 2) were used as positive controls, and K-562 cells was used as a negative control. RESULTS: EBV was detected in mouth washing saliva of 8 (14.8%) of 54 healthy children. Five EBV detected cases contained type 1 and the remaining three cases contained type 2. EBV was detected in mouth washing saliva of 21 (35%) of 60 healthy adults. Twenty EBV detected cases contained type 1 and the remaining one was type 2. In total, EBV was detected in the saliva samples of 29 cases (25.4%), and 25 (86.2%) contained type 1. CONCLUSION: The results of our study indicate that type 1 is highly dominant in Korea, and EBV excretion is more frequent in EBV positive healthy adults compared to EBV positive healthy children in Korea.
Adult* ; Capsid ; Child* ; DNA ; Herpesvirus 4, Human* ; Humans ; Immunoglobulin G ; Korea ; Mouth ; Polymerase Chain Reaction ; Prevalence ; Saliva

Primary tumors of the heart are rare. Half of all cardiac tumors are myxoma of which 20% are located in the right atrium. Especially multiple myxomas in the cardiac chamber were rarely reported. Clinically, myxomas present with various manifestations due to obstruction to blood flow, embolization,and constitutional changes. The association of pulmonary emboli and right atrial myxoma has been well documented but pulmonary emboli are more likely to be asymptomatic, misdiagnosed, or diagnosed late than peripherally-sited emboli. We report a case of multiple right atrial myxomas complicating pulmonary emboli in a 73-year-old man who had features of pulmonary embolism and was found to have multiple right atrial myxomas.
Aged ; Heart ; Heart Atria ; Heart Neoplasms ; Humans ; Myxoma* ; Pulmonary Embolism*