BACKGROUND: This study investigated the effects of total knee arthroplasty (TKA) on bone mineral density (BMD) of the proximal femur in patients who underwent the procedure. METHODS: Forty-eight patients scheduled to undergo unilateral TKA because of primary knee osteoarthritis were included in this study, which was conducted at a medical center between October 2006 and October 2009. In these 48 patients, 96 hips were evaluated. Measurement of BMD was performed preoperatively and one month, three months, six months, and one year after unilateral TKA. Repeated measured analysis of variance and paired t-tests for comparison of two repeated samples were used to compare differences between time points (preoperation, one, three, six, and 12 months) and between the operative and nonoperative sides. RESULTS: Preoperatively, BMD of the femoral neck, trochanter, and total hip on the operative side were lower than on the nonoperative side; however, there was no statistical difference. BMD of both femoral neck areas was significantly lower than preoperative BMD at one month and three months after TKA. BMD of both trochanter areas was significantly lower than preoperative BMD at one month and three months after TKA. BMD of both total hips was significantly lower than preoperative BMD at three months after TKA. However, no statistical differences of changes in BMD were observed between the operative and nonoperative sides at each measurement time. CONCLUSIONS: According to our results, TKA was found to affect both proximal femurs during the acute period. However, TKA did not affect a change in BMD of the proximal femur during one year postoperative.
Aged ; Arthroplasty, Replacement, Knee/*adverse effects ; Bone Density/*physiology ; Female ; Femur Neck/*physiopathology ; Follow-Up Studies ; Humans ; Male ; Middle Aged

One of the latest concepts in bonding are "total etch", in which both enamel and dentin are etched with an acid to remove the smear layers, and "wet dentin" in which the dentin is not dry but left moist before application of the bonding primer. Ideally, the application of a bonding agent to tooth structure should be insensitive to minor contamination from oral fluids. Clinically, contaminations such as saliva, gingival fluid, blood and handpiece lubricant are often encountered by dentists during cavity preparation. The aim of this study was to evaluate the effect of contamination by hemostatic agents on shear bond strength of compomer restorations. One hundred and ten extracted human maxillary and mandibular molar teeth were collected. The teeth were removed soft tissue remnant and debris and stored in physiologic solution until they were used. Small flat area on dentin of the buccal surface were wet ground serially with 400, 800 and 1200 abrasive papers on automatic polishing machine. The teeth were randomly divided into 11 groups. Each group was conditioned as follows: Group 1: Dentin surface was not etched and not contaminated by hemostatic agents. Group 2: Dentin surface was not etched but was contaminated by Astringedent(R)(Ultradent product Inc., Utah, U.S.A.). Group 3: Dentin surface was not etched but was contaminated by Bosmin(R)(Jeil Pharm, Korea.). Group 4: Dentin surface was not etched but was contaminated by Epri-dent(R)(Epr Industries, NJ, U.S.A.). Group 5: Dentin surface was etched and not contaminated by hemostatic agents. Group 6: Dentin surface was etched and contaminated by Astringedent(R). Group 7: Dentin surface was etched and contaminated by Bosmin(R). Group 8: Dentin surface was etched and contaminated by Epri-dent(R). Group 9: Dentin surface was contaminated by Astringedent(R). The contaminated surface was rinsed by water and dried by compressed air. Group 10: Dentin surface was contaminated by Bosmin(R). The contaminated surface was rinsed by water and dried by compressed air. Group 11: Dentin surface was contaminated by Epri-dent(R). The contaminated surface was rinsed by water and dried by compressed air. After surface conditioning, F2000(R) was applicated on the conditoned dentin surface. The teeth were thermocycled in distilled water at 5degrees C and 55degrees C for 1,000 cycles. The samples were placed on the binder with the bonded compomer-dentin interface parallel to the knife-edge shearing rod of the Universal Testing Machine(Zwick Z020, Zwick Co., Germany) running at a cross head speed of 1.0 mm/min. Group 2 showed significant decrease in shear bond strength compared with group 1 and group 6 showed significant decrease in shear bond strength compared with group 5. There were no significant differences in shear bond strength between group 5 and group 9, 10 and 11.
Collodion ; Dental Enamel ; Dentin ; Dentists ; Head ; Humans ; Molar ; Running ; Saliva ; Tooth ; Utah ; Water

Anisakiasis of the gastrointestinal tract is usually caused by the ingestion of raw marine fish infested with Anisakis larvae. A majority of cases present as gastric and intestinal anisakiasis. Anisakiasis of colon is rare and asymptomatic colon anisakiasis has a particularly low incidence. A 45-year-old man received colonoscopy that revealed a 1.0 cm sized whitish linear larva penetrating the mucosa of the cecum and it was removed by colonscopy. He had no complaint before the colonoscopy. A 52-year-old man complained of right upper quadrant abdominal pain with weight loss for one month. Colonoscopy revealed a 1.5 cm sized whitish linear larva penetrating the mucosa of the distal part of ascending colon. Abdominal pain and weight loss were improved by colonoscopic removal of larva.
Male ; Humans ; Incidence

BACKGROUND: Some studies have reported that bacterial infection is more common in alcoholic compared to non-alcoholic liver cirrhosis such as viral liver cirrhosis. However, other studies reported no significant differences in the bacterial infection rate between alcoholic and non-alcoholic liver cirrhosis. This study was performed to compare the frequency of bacterial infection between alcoholic and viral liver cirrhosis. METHODS: We analyzed 190 cirrhotic patients (alcoholic 83, viral 107) with 539 hospitalized cases (alcoholic 242, viral 297) who were followed for more than 12 months. RESULTS: During the follow up period, 82 patients (43.2%) presented with bacterial infectionsthat developed in 34 (41.0%) patients with alcoholic liver cirrhosis and 48 (44.9%) patients with viral liver cirrhosis. There was no significant difference in the frequency of bacterial infection including community acquired and nosocomial infection between alcoholic and viral cirrhotic patients regarding the Child-Pugh class, various laboratory parameters and site of infection. Gram-negative and enteric bacterial strains were the most frequently isolated pathogens in both groups. CONCLUSIONS: There was no significant difference in the frequency of infection between patients with alcoholic and viral liver cirrhosis. Further efforts are needed to reduce bacterial infection by gram negative and enteric bacteria in patients with both alcoholic and viral cirrhosis.
Alcoholics* ; Bacterial Infections* ; Cross Infection ; Enterobacteriaceae ; Fibrosis ; Follow-Up Studies ; Humans ; Liver Cirrhosis* ; Liver Cirrhosis, Alcoholic* ; Liver*

BACKGROUND: We performed a prospective, double blind study to compare the clinical effect of vertical infraclavicular brachial plexus block produced by 0.75% vs 0.5% ropivacaine for upper limb surgery. METHODS: We included 80 patients receiving upper limb surgery under infraclavicular brachial plexus block. The infraclavicular brachial plexus block was performed via the vertical technique with 30 ml of 0.75% or 0.5% ropivacaine. By observation, we determined nerve type was stimulated and scored the level of sensory block and motor block. The quality of blocks was assessed intra-operatively. The duration of sensory block and motor block and their complications were assessed. RESULTS: There were no significant differences in the frequency of stimulated nerve type, evolution of sensory and motor block quality, or success of block. There were no significant differences in the duration of sensory block and motor block. Vascular puncture was noted in 1 patient in the 0.75% ropivacaine. CONCLUSIONS: Both the 0.75% and 0.5% ropivacaine had similar effects in the vertical infraclavicular brachial plexus block.
Amides ; Brachial Plexus ; Double-Blind Method ; Humans ; Prospective Studies ; Punctures ; Upper Extremity

In tetraplegia patients, activities of daily living are highly dependent on the remaining upper limb functions. In other countries, upper limb reconstruction surgery to improve function has been applied to diverse cases, but few cases have been reported in Korea. The current authors experienced a case of posterior deltoid-to-triceps tendon transfer and rehabilitation in a complete spinal cord injury with a C6 neurologic level, and we introduce the case-a 36-year-old man-with a literature review. The patient's muscle strength in C5 C6 muscles were normal, but C7 muscles were trace, and the Spinal Cord Independence Measure III (SCIM III) score was 24. The tendon of the posterior deltoid was transferred to the triceps brachii muscle, and then the patient received comprehensive rehabilitative treatment. His C7 muscle strength in the right upper extremity was enhanced from trace to fair, and his SCIM III score improved to 29.
Activities of Daily Living ; Adult ; Elbow* ; Humans ; Korea ; Muscle Strength ; Muscles ; Quadriplegia* ; Rehabilitation ; Spinal Cord ; Spinal Cord Injuries ; Tendon Transfer* ; Tendons* ; Upper Extremity

BACKGROUND: The purpose of this study was to investigate the frequency and distribution of associated carpal bone fractures (CBFs) in distal radial fractures (DRFs). METHODS: Three hundred and thirteen patients who underwent surgical treatment for DRFs between March 2007 and January 2010 were reviewed retrospectively. In this study, 223 patients who had preoperative computed tomography (CT) were included. We investigated the frequency and distribution of associated CBFs on CT scans. The relationship between the frequency of associated CBFs and patient factors such as age, gender, body mass index, and the mechanism of injury was assessed. RESULTS: CBFs were complicated in 46 of 223 DRFs (20.9%). The distribution of CBFs was 23 cases in the triquetrum, 16 in the lunate, 12 in the scaphoid, five in the hamate, and four in the pisiform. Among the 46 cases, a fracture of one carpal bone occurred in 36 cases, two in seven cases, three in two cases, and four in one case. In 10 of the 46 cases, associated CBFs occurred in more than two carpal bones. No significant differences were observed for age, sex, body mass index, or the mechanism of injury between patients with DRFs and CBFs and those without CBFs. CONCLUSIONS: Because CBFs that mainly occur in the proximal carpal row are complicated in DRFs at a relatively high frequency, assessment of carpal bones using CT scans is beneficial.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carpal Bones/*injuries/radiography ; Female ; Fractures, Bone/*complications/radiography ; Hand Injuries/*complications/radiography ; Humans ; Male ; Middle Aged ; Radius Fractures/*complications/radiography ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: This study reviewed the development of and analyzed the early results from syndromic surveillance based on emergency departments, which was developed to detect bioterrorism attacks, especially during the 2002 FIFA Korea-Japan World Cup games. METHOD: Data from homepages and server computers were analyzed from May 13 2002, to August 5 2002. The data were gathered everyday from 121 emergency departments in Korea via the internet by using PC or PDA. Some data gathered via telephone or FAX were also digitalized. RESULTS: The daily report rate was 82.5% on average. Most of the cases were acute respiratory syndrome (63.4%) and acute sporadic diarrheal syndrome (34.8%). No bioterrorism was confirmed during this period. The peak times and distributions of sporadic and cluster cases of acute diarrheal syndrome are not equivalent. In the case of level 2 reports, there was an average of 12 cases per one institute and 32.8 cases per institute of level 1 and 2 reports totally. CONCLUSIONS: The emergency department syndromic surveillance system for bioterrorism is the first everyday reporting system based on the clinical basis in emergency depart-ments. It has been and is functioning without large problems, but exact knowledge of and more participation by reporting institutes are required. It is necessary to survey the results for a longer period and to correct the early problems if we want to know the ultimate usefulness of this system.
Academies and Institutes ; Bioterrorism* ; Emergencies* ; Emergency Service, Hospital* ; Internet ; Korea ; Telephone

Anatomical variations of the extensor tendon of the hand are common. However, the majority of anomalous variations are asymptomatic throughout a lifetime and are found incidentally during surgery or after trauma of the hand. The index finger has two independent extensor tendons and lower incidence of anomalous variations than other extensor tendons. We experienced a rare muscular variant of extensor indicis proprius (EIP) during a tendon reconstruction for spontaneous rupture of the 3rd and 4th extensor digitorum communis. Tendon reconstruction using EIP was planned preoperatively. However, EIP was absent and anomalous muscle known as extensor indicis brevis, which originated from the capsular ligament of the wrist and inserted into the ulnar side on the 2nd extensor digitorum communis of the extensor hood, was found. We performed tendon reconstruction using an alternative surgical procedure because extensor indicis brevis was not useful. Attention is required during tendon reconstruction because anatomical variation of EIP may affect a surgical procedure.
Fingers ; Hand ; Incidence ; Ligaments ; Rupture, Spontaneous ; Tendons ; Wrist

STUDY DESIGN: Literature review. OBJECTIVE: The aim of this article is to introduce the EOS imaging device, with a focus on spinal and pelvic alignment. SUMMARY OF LITERATURE REVIEW: The EOS imaging device can obtain images of spinal and pelvic alignment with almost no distortion, using a low radiation dose. MATERIALS AND METHODS: We searched for studies related to the use of EOS imaging device for spinal and pelvic alignment. RESULTS: The EOS is not only capable of simultaneously obtaining paired anteroposterior and lateral X-ray images with a low radiation dose, but also can reconstruct the image as if it was acquired in the patient's reference plane, limiting the distortion to the patient's thickness instead of the whole distance between the source and detector. The EOS device also has the advantage of accurately measuring the sagittal alignment of the spine and pelvis and the torsional deformity of the lower limbs, as the subject can be imaged while standing upright in a weight-bearing posture. CONCLUSIONS: EOS is a new diagnostic technique that can detect spinal and pelvic alignment and deformities of the lower limbs under weight-bearing conditions with a low radiation dose.
Congenital Abnormalities ; Lower Extremity ; Pelvis ; Posture ; Spine ; Weight-Bearing