This study was performed to estimate the effect of alphacalcidol supplementation or nutrition education on the nutrient intakes, bone mineral density and bone markers in continuous ambulatory peritoneal dialysis (CAPD) patients. The 90 CAPD subjects were randomly assigned to 3 groups (alphacalcidol group: AG, nutrition education group: NG, and control group: CG). Alphacalcidol supplementation(0.5 microgram/day) was carried out for 8 months. Nutrition counseling was performed according to the patient's individual question for the first 6 months and scheduled nutrition education with individual counseling was carried out for the last 2 months. In baseline data, there were no significant differences in age, sex, family number, education years and monthly income except the NG showed significantly less duration of CAPD (p <0.05) compared to other two groups. After intervention all three groups showed tendency of lower intakes. NG revealed less decrease in protein, especially in animal protein, calcium from Ca-P binder, dietary calcium, dietary iron and niacin. NG showed significantly more increase in dry weight (p <0.05) and AG in waist circumference (p <0.001) after intervention. The groups did not show significant differences in the changes of biochemical indices related to bone metabolism. NG revealed more increase in trochanter BMD (p <0.05) compared to other two groups. It seems that nutrition education is more effective in preventing deterioration or improving the bone and general nutrition status.
Animals ; Bone Density* ; Calcium ; Calcium, Dietary ; Counseling ; Education* ; Femur ; Humans ; Iron, Dietary ; Metabolism ; Niacin ; Nutritional Status ; Peritoneal Dialysis, Continuous Ambulatory* ; Waist Circumference

No abstract available.
Child* ; Humans ; Roxithromycin* ; Scrub Typhus*

No abstract available.
Animals ; Rats* ; Transplants* ; Veins*

We designed this study to analyze the causes of repeat surgery in the low back disorder after primary procedure, to evaluate the risk factors and to suggest the rational approachs can prevent and solve the problems related with repeat surgery. We retrospectively reviewed the medical record and radiographs of 24 patients who had sustained persistent or recurrent pain, failed to extended conservative therapy, showing abnormal myelogram and/or CT scan with nerve root compression, and with segmental instability consistent with patients symptom and sign after the primary procedures. We evaluated the functional outcome according to Kims(1986) criteria. The causes of remained or recurrent pain with neurologic symptom were persistent or aggravated lumbar spinal stenosis in 10 cases(42%), recurrent disc herniation in 4 cases(17%), infection in 3 cases(12%), instability in 2 cases(8%) and others in 5 cases(20%). Satisfactory outcome was recorded in 79%(19/24) of patients. The characteristics of the patients associated with satisfactory outcome were those who operated by recurrent disc herniation, instability, retained disc, metal malposition, and nerve root compression by bone chip. But the characteristics of the patients associated with unsatisfactory outcome were those who operated by infection, lumbar spinal stenosis aggravated by degenerative spondylosis and multiple herniated disc, inadequate decompression of lateral and/or foraminal stenosis in aged patients. The most common lesion site was on L4-5 disc, and unsatisfactory result was expected at the upper lumbar spine involvement. Favorable outcome could be expected in the presence of a pain-free interval more than 1 year from the date of the previous operation or persistent symptoms immediately after the initial operaion. We were expected the risk factors leading to repeat surgery were old aged(more than 60) patients, upper lumbar spine involvement and multiple lumbar disc herniation. Postoperative diskitis or osteomyelitis, pain free interval more than 1 month or less than 1 year, and those who had a revision on the lumbar spine previously could be considered as a poor prognostic indicators. When surgery is indicated for degenerative lumbar spinal disorders, adequate diagnostic tests and the execution of appropriate procedures based upon this information should be carried out to prevent the repeat surgery in the low back disorders. Adequate postoperative management can reduce the occurrence of failed back surgery syndrome and in cases necessitating repeat surgery, thorough analysis of causes following proper surgical stabilization can reduce the operative morbidity with early return to daily life.
Constriction, Pathologic ; Decompression ; Diagnostic Tests, Routine ; Discitis ; Failed Back Surgery Syndrome ; Humans ; Intervertebral Disc Displacement ; Medical Records ; Neurologic Manifestations ; Osteomyelitis ; Radiculopathy ; Reoperation* ; Retrospective Studies ; Risk Factors ; Spinal Stenosis ; Spine ; Spondylosis ; Tomography, X-Ray Computed

The ankle is a complex structure supporting the entire musculoskeletal system during standing and walking. The injuries to the ankle joint result in a severe functional disturbance because of complex anatomical characteristics around the ankle joint. 69 patients(72 cases) of the ankle fracture that were treated in Orthopedic Dept. Chonbuk National University Hospital from Jan. 1979 to Dec. 1983 were analized in clinical and radiological aspects. The following results were obtained: 1. Among the 69 patients, male was 54 and female 15 with ratio of 3.5: 1.The average age was 32. 2. Main cause of fracture was traffic accident(58%). 3. The musculoskeletal system was injured most frequently associated with the ankle fracture(66%). 4. According to the ankle fracture classification, the most common type was Pronation-external rotation type in Lauge-Hansen classification, and the type C in Weber classification. 5.The average duration of cast immobilization was 8.8 weeks in closed reduction and 7.4 weeks in open reduction. 6. The lateral malleolar fracture involving the distal tibiofibular syndesmosis was very important in ankle stability so accurate anatomical reduction by internal fixation was necessary for satisfactory functional results. 7. In clinical and radiological analysis, the better results were obtained from open reduction.
Ankle Fractures ; Ankle Joint ; Ankle ; Classification ; Clinical Study ; Female ; Humans ; Immobilization ; Jeollabuk-do ; Male ; Musculoskeletal System ; Orthopedics ; Walking

No abstract available.
Hyperbaric Oxygenation* ; Skin* ; Transplants*

BACKGROUND: Osteoporosis is an important health concern among the postmenopausal women. Therefore, it is necessary to find out acceptable screening tools for osteoporotic patients. The purpose of this study was to evaluate the Risk Index by OSTA as a screening test for osteoporosis. METHODS: The study population was 322 naturally caused menopausal women in Korea. Their was of femoral neck and lumbar spine BMD measured by DEXA. Risk Index by OSTA, based on weight and age, was calculated and the sensitivity and specificity for osteoporosis and osteopenia were evaluated. To find out the proper cut-off point for osteoporosis and osteopenia among the postmenopausal women in Korea, we also compared the sensitivity and specificity of each Risk Index value. RESULTS: The mean age and ages at menopause were 59.1(+/-6.2) and 50.7 (+/-2.7) years, respectively. The prevalence of osteoporosis was 9.6% with femoral neck BMD. For oeteoporosis, using a cut-off point of -1 yielded a sensitivity of 74.3% and a specificity of 52.2% with femoral neck BMD. Using a cut-off of -2 yielded a sensitivity of 87.3% and a specificity of 70.9%. The ROC curve showed an AUROC 0.88 for Risk Index in identifying osteoporosis. CONCLUSION: The Risk Index is an acceptable, simple and useful method in the diagnosis of osteoporosis with a Risk Index of -2 in Korean postmenopausal women.
Bone Diseases, Metabolic* ; Diagnosis ; Female ; Femur Neck ; Humans ; Korea ; Mass Screening* ; Menopause ; Osteoporosis* ; Prevalence ; ROC Curve ; Sensitivity and Specificity ; Spine

No abstract available.
Mesotherapy* ; Mycobacterium*

The use of a cultured autologous keratinocyte sheet has become a recognized method for the coverage of extensive bums during recent years. The disadvantages of these sheet grafts are a long time-lag until keratinocyte sheets are available, the fragility and difficulty in handling of grafts, an unpredictable take rate and extremely high costs. In this study we investigated the transplantation of cultured keratinocytes as single cells suspended in autologous fibrin glue. In a rat model with standardized full thickness wounds, this new transplantation technique was evaluated and compared directly to the conventional keratinocyte sheet grafting technique. After transplantation, wounds were evaluated for the degree of epithelial coverage, and then microscopic structures were evaluated under light and electron microscopy. The results were as follows: 1) The fibrinogen solution prepared from autologous blood had 12 times more fibrinogen compared to the original blood. 2) After transplantation of cultured keratinocyt-es in fibrin glue, the degree of epithelial coverage was 79% at 2 weeks, which was comparable to 17% for cultured keratinocyte sheet graft 3) Typical basement membrane structures were consistently found at 2 weeks after transplantation of keratinocytes in fibrin glue. 4) Rete ridges were found at 4 weeks after transplantation of keratinocytes in fibrin glue. In conclusion, the transplantation technique of keratinocytes in fibrin glue is available earlier than sheet grafts, it transfers actively proliferating cells and it simplifies the grafting procedure. As well, this technique leads to an earlier epithelial covering and an earlier restoration of the dermo-epidermal junction than sheet grafting.
Basement Membrane ; Fibrin Tissue Adhesive* ; Fibrin* ; Fibrinogen ; Keratinocytes* ; Microscopy, Electron ; Models, Animal ; Transplants ; Wounds and Injuries

No Abstract Available.
Adenoviridae* ; Coinfection* ; Herpesvirus 3, Human* ; Humans ; Synovial Fluid* ; Synovitis*