Ankle arthrodesis has been regarded as a good operative treatment for post traumatic and rheumatoid arthritis of ankle, and ankle arthroplasty has been also developed with several types, from 1970, by Lord & Marotte. Ankle arthroplasty is more functional & less cosmetic troublesome than arthrodesis, and with more developed prosthesis design, more good result will come. The authors operated 6 cases of total ankle arthroplasty for posttraumatic and rheumatoid arthritis of ankle, which were also indications of arthrodesis, and introduce the results and operative problems of ankle arthroplasty.
Ankle ; Arthritis, Rheumatoid ; Arthrodesis ; Arthroplasty ; Prosthesis Design

Regular hemodialysis has been established as a way of treatment for end stage renal failure. In adults, hemodialysis 5 hours each time, three times weekly with one square meter hemodialyzer is now widely accepted as a standard, and there are many reports on long term follow up studies. Quite a large difference are present, however, in our community mainly originated from patient's poor compliance in frequent dialysis with short interdialysis interval. The author analyzed 200 cases of chronic renal failure who have received hemodialysis treatments during the 5 year period from July 1976 to June 1981 at the hemodialysis unit of the hanyang University Hospital and the following results are obtained; 1. Actual one year survival rate was much higher in thrice(87.1%) than one(35.1%) or twice(54.1%) weekly dialysis. 2. Long term(more than 6 months) complications were also more frequent in once(85.7%) or twice(70.2%) weekly treatments than in thrice(22.2%). The predominant complications were congestive heart failure, pericarditis, and infections. 3. Those who recieved three times weekly dialysis had better rehabilitation grades than the patients groups of twice or once weekly treatment. 4. Of peridialysis distressful symptoms, nausea, vomiting dizziness were less frequent in the group three times a week dialysis. In contrast, headache, hypotension, muscle cramps, and weakness were not significantly related with frequency of hemodialysis. 5. Those who voided a large amount of urine output had better survival and less frequent requirement of blood transfusions. 6. Main causes of death were due to patient poor compliance, hyperkalemia and cerebrovascular acidents. 7. Economic problems were the major cause of dialysis interruption.
Adult ; Blood Transfusion ; Cause of Death ; Compliance ; Dialysis ; Dizziness ; Follow-Up Studies ; Headache ; Heart Failure ; Humans ; Hyperkalemia ; Hypotension ; Kidney Failure, Chronic* ; Kidneys, Artificial ; Muscle Cramp ; Nausea ; Pericarditis ; Rehabilitation ; Renal Dialysis* ; Renal Insufficiency ; Survival Rate ; Vomiting

No abstract available.
Knee*

No abstract available.
Angioplasty*

BACKGROUND: Ketamine has an indirect sympathetic stimulation effect. We investigated heart rate variability (HRV) as a marker of cardiac autonomic function after a target controlled infusion (TCI) of ketamine with a plasma concentration of 30 or 60 ng/ml. METHODS: In 20 adult volunteers, the mean of the R wave to the adjacent R wave interval (RRI), the range of RRI, the root mean square successive difference of intervals (RMSSD), the total power, the low frequency (LF, 0.04-0.15 Hz) power, the high frequency (HF, 0.15-0.4 Hz) power, the normal unit HF (nuHF), the normal unit LF (nuLF), the LF/HF ratio and the SD1 and the SD2 in the Poincare plot were measured before and after a TCI of ketamine. We observed for any psychedelic symptoms or sedation. RESULTS: There were no differences in the mean and range of the RRI, RMSSD, total power, LF power, HF power, nuHF, nuLF, LF/HF ratio, SD1 and SD2 between before and after ketamine administration. The OAA/S score was higher and there were more psychedelic symptoms with a 60 ng/ml plasma concentration than with a 30 ng/ml plasma concentration. CONCLUSIONS: This study did not show any effect of a low plasma concentration of ketamine on the autonomic nervous system.
Adult ; Autonomic Nervous System ; Heart ; Heart Rate ; Humans ; Ketamine ; Plasma ; Syndactyly

STATEMENT OF PROBLEM: Implant screw loosening remains a problem in implant prosthodontics. Some abutment screws with treated surfaces were introduced to prevent screw loosening and to increase preload. DLC(Diamond Like Carbon) film has similar properties on hardness, wear resistance, chemical stability, biocompatibility as real diamond materials. PURPOSE: The purpose of this study was to investigate the effect of lubricant layer on abutment screw and to discriminate more effective method between soft lubricant and hard lubricant to prevent screw loosening. MATERIAL AND METHOD: In this study, 1mum thickness DLC was used as protective, lubricating layer of titanium screws and 3 times removal torque was measured on the abutment screws to investigate the difference in 10 coated and 10 non-coated abutment screws. RESULTS: The results indicated that the implants with DLC coating group were not more resistant to the applied force in screw loosening. At 32Ncm, the 3 times removal torque in DLC group were 27.7+/-2.89, 25.85+/-2.35 and 26.2+/-2.57. The removal torque in no-coated abutment screws were 27.85+/-4.23, 27.35+/-2.81 and 27.9+/-2.31, respectively. CONCLUSION: The lubricant layer used in this study was Diamond Like Carbon(DLC) and it have a properties of hard and stable layer. The DLC coating layer was hard enough to prevent distortion of screws in the repeated unscrewing procedure in clinical situation. The reduced friction coefficient in hard DLC layer was not effective to prevent screw loosening.
Carbon* ; Diamond* ; Friction ; Hardness ; Prosthodontics ; Titanium* ; Torque*

No abstract available.
Lung Neoplasms* ; Lung* ; Lymph Nodes* ; Needles*

Spontaneous intestinal perforation is characterized by isolated mucosal ulceration with acute inflammation, submucosal edema and serosal inflammation, and considered as a separate clinical entity from necrotizing enterocolitis. The causes of spontaneous intestinal perforation are administration of indomethacin, dexamethasone, umbilical artery catheterization, defect of intestinal musculature, and systemic candidasis. Intestinal perforation caused by defects of intestinal musculature is rare, and its pathogenesis remains uncertain. The authors report one case of a premature infant with defect in intestinal musculature confirmed through postoperation biopsy who was misdiagnosed as intestinal perforation due to necrotizing enterocolitis.
Biopsy ; Catheterization ; Catheters ; Dexamethasone ; Edema ; Enterocolitis, Necrotizing ; Humans ; Indomethacin ; Infant, Newborn ; Infant, Premature ; Inflammation ; Intestinal Perforation* ; Ulcer ; Umbilical Arteries

Twenty six cases of borderline ovarian tumor(BOT) were treated between Jan. 1985 and Dec. 1997 at the Department of Obstetrics and Gynecology, Hanyang University. The clinical records were reviewed for all patients including histopathology, clinical features, and follow-up. The frequency of BOT was 12%(26/214) of epithelial ovarian malignancies, and patients with these tumors tend to present at a younger age(36 yrs) than those with invasive carcinomas. In terms of histologic type, mucinous type(21/26: 81%) were more prevalent than serous tumor(5/21: 19%) in this study. The positive rate of CA 125 was 20% in serous, and the positive rate of CA 19-9 was 24% in mucinous tumor. The size of mucinous was larger than that of serous tumors(17.1 cm vs 9,3 cm). Almost all of these tumor categorized as early stage(stage I: 96%), however, only one patient with serous tumor had advanced stage of disease(stage III: 4%), Therefore BOT tend to be diagnosed as earlier than invasive carcinoma. About 2/3 of patients were treated as conservative surgery(unilateral salpingooophorectomy or enuclation). Postoperative adjuvant chemotherapy was not given about half of cases(13/26). Median follow-up was 43 months and recurrent case was found only one in serous tumor, All patients in this study are still alive and free of disease except one, 5-year survival rate was 100%. But large number of study and long-term follow-up are needed to make a decision to treat and manage of BOT.
Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; Gynecology ; Humans ; Mucins ; Obstetrics ; Ovary* ; Survival Rate

Portal vein invasion is a grave prognostic indicator in the setting of hepatocellular carcinoma (HCC). There is currently no effective method for preventing the invasion of HCC into the main portal vein. We report here a case of advanced HCC with portal vein tumor thrombosis that was effectively treated with percutaneous ethanol injection (PEI), having previously enabled subsequent successive transarterial chemoembolization (TACE). A 60-year-old male patient was diagnosed with a huge HCC, based on computed tomography and angiographic findings. Despite two sessions of TACE, the tumor invaded the right portal vein. PEI was performed on the malignant portal vein thrombosis, and three sessions thereof reduced the extent of tumor thrombi in the portal vein. Successive TACEs were performed to treat the HCC in the hepatic parenchyma. The patient was still living 19 months after the first PEI with no evidence of tumor recurrence, and his liver function remained well preserved.
Carcinoma, Hepatocellular/complications/*diagnosis/pathology ; Chemoembolization, Therapeutic ; Ethanol/*administration & dosage ; Humans ; Injections, Intralesional ; Liver Neoplasms/complications/*diagnosis/pathology ; Male ; Middle Aged ; Neoplasm Invasiveness ; *Portal Vein/pathology ; Tomography, X-Ray Computed ; Venous Thrombosis/complications/diagnosis/*therapy