The types of patellar component of total knee replacement prostheses are dome-shape, metalbacked, anatomically shaped, and press fit condylar type, etc. The fixation of inset patella type is achieved with bone cement supplemented by a central peg and a small extended flange around the circumference, providing resistance to torsional and shear loads. From October 1990 to June 1992, 53 cases in 40 patients had total knee arthroplasties. Ortholoc II implant was used in all patients. Cementless femoral and tibial component were used. But, cement was used in patellar component. The average follow up was 29 months(range 21-40 months). There were 37 women and 3 men and the average age was 51 years(range 22-71 years). The diagnosis of 40 patients was osteoarthritis in 25, rheumatoid arthritis in 9, infection sequelae in 6. For alignment of the patellar and congruency of the patellofemoral joint, additional retinacular release was done in 7 cases. The average preoperative Hospital for Special Surgery(H.S.S) knee rating score was 50.7 point, which improved to 89.4 point at last follow up. Postoperative patellar pain was 4 cases. In the roentgenorgraphic follow up, ratellar subluxation was 2 cases and lateral tilting of the patella was 5.9 degrees in 10 cases. The average patellar depth was 20.8mm preoperatively and 21.6mm postoperatively. In the Merchant's view, the preoperative lateral patellofemoral angle of Laurine was average 14.3 degree, which changed to average 16.4 degree at last follow up, and the preoperative Merchant's congruence angle was average 14 degrees, which decreased to average
Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Knee ; Male ; Osteoarthritis ; Patella ; Patellofemoral Joint ; Prostheses and Implants

Patellofemoral complications are the most frequent problems in total knee arthroplasty. In the literature, the subject of patella resurfacing and nonresurfacing is controversial. Twenty-seven osteoarthritic patients who received bilateral total knee prostheses were studied to evaluate the advantages and disadvantages of patella resurfacing prospectively. Only patients with mild patellofemoral disease were included in the study. The Ortholoc modular implant was used in all cases. Cementless femoral and tibial component were used. But, if we resurfaced the patella, cement was used. In all patients, patella resurfacing had been done in the left knee but not in the right knee. For the clinical analysis, We used Knee Rating Score of the Hospital for Special Surgery(HSS), For the roentgenographic analysis, We used Laurin's lateral patellofemoral angle & Merchant's congruence angle. In the follow up, blind test for patellar pain was performed to compare between right and left knee joint clinically. The average age was 61 years(range 28-72 years) and the average follow up was 21 months(range 12-27 months). Preoperative ROM was 104.4 degrees in right side and 106.7 degrees in left side. Postoperative ROM was 112.7 degrees in right side and 109.6 degrees in left side. Preoperative HSS Knee Rating Score was 53.1 point in right side and 54.8 point in left side. Postoperative HSS Knee Rating Score was 81.5 point in right side and 81.2 point in left side. In the plain knee AP view, preoperative tibiofemoral angle was varus 7.0 degrees in right side and varus 5.6 degrees in left side. Postoperative tibiofemoral angle was valgus 5.1 degrees in right side and valgus 4.9 degrees in left side. Preoperative Merchant's congruence angle was 14.9 degrees in right side and 15.3 degrees in left side. Postoperative Merchant's congruence angle was
Arthroplasty, Replacement, Knee ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Knee Prosthesis ; Patella ; Prospective Studies ; Range of Motion, Articular

The AO internal fixation system(the Fixateur Interne) is effective in reducing and stablizing a variety of unstable thoracolumbar fracture patterns. It is relatively effective in decompressing the canal of retropulsed bony fragments associated with burst fracture. Sixty-Two patients with unstable thoracolumbar spine fractures were treated with the AO internal fixator. They were followed for an average of 21 months(range 15-29 months). A compartive radiographic analysis of kyphosis and vertebral height was made using pre-operative, post-operative and follow-up radiogram. Changes in neural canal compromise were measured in 18 cases of burst fractures. Failure of instrumentation occured in 9 cases which were carefully analyzed. Recently, we've constructed the system of which the Schanz screws would be directed divergently in sagittal plane in the hope that the load to the screws might be reduced, thus the failure rate.
Follow-Up Studies ; Hope ; Humans ; Internal Fixators ; Kyphosis ; Neural Tube ; Spine

BACKGROUND: The incidence of cervical esophageal cancer is low compared with that of thoracic esophageal cancer, and the role of surgery for cervical esophageal cancer is limited compared with that of radiotherapy or chemotherapy. This study was carried out to determine the outcome of surgery for cervical esophageal cancer. MATERIAL AND METHOD: We analyzed retrospectively medical records of 43 patients who had undergone curative surgical resection for cervical esophageal cancer from January 1989 to December 2002. Follow-up loss was absent and the last follow-up was carried out in February 28, 2004. RESULT: The mean age was 60 years old and the male to female ratio was 40:3. Histologic types were squamous cell carcinoma 42 patients and malignant melanoma 1 patient. The methods used for esophageal reconstruction were gastric pull-up 32 patients, free jejunal graft 7 patients and colon interposition 4 patients. Postoperative complications occurred in 31 patients (72%), and operative mortality occurred in 7 patients (16%). Pathologic stages were I 3, IIa 14, IIb 1, III 19, and IVa 6 patients. Tumor recurrence occurred in 16 patients (44%), and the 3 and 5-year survival rates were 29.3% and 20.9%. CONCLUSION: The reported surgical results for cervical esophageal cancer showed somewhat high operative mortality, postoperative complication rates and recurrence rates and a low long-term survival rate. It is suggested that multimodality treatment including surgery is needed for the treatment of cervical esophageal cancer because radiotherapy or chemotherapy without surgery could not relieve dysphagia or resolve the tumor completely.
Carcinoma, Squamous Cell ; Colon ; Deglutition Disorders ; Esophageal Neoplasms ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Medical Records ; Melanoma ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Survival Rate ; Transplants

Kabuki (Niikawa-Kuroki) syndrome was first reported by Niikawa et al(1981). The faces of the patients are similar to the make-up of traditional Japanese Kabuki actors: long palpebral fissures, an ectropium of the lateral third of the eyelids,and arching eyebrows with sparse lateral halves. Craniofacial findings include a depressed nasal tip, short nasal septum, large and prominent ears, and micrognathia. Other main features area mild to moderate mental deficiency, short stature, skeletal and dermatoglyphic abnormalities, including prominent finger tip pads. Oral anomalies are common in KS(over 60percent) and include abnormal dentition, widely spaced teeth, cleft palate or lip, high vault of palate, hypodontia, conical incisors, screw driver-shaped incisors and ectopic upper 6-year molars. The increased occurrence of cleft lip and palate or the development of a high vault of palate has been described by a number of authors. This condition is believed to be common in Japan, but has been reported from other parts of the world. The objective of this presentation is to report a case of this syndrome in six-year-old girl, with characteristic findings.
Anodontia ; Asian Continental Ancestry Group ; Cleft Lip ; Cleft Palate ; Dentition ; Dermatoglyphics ; Ear ; Eyebrows ; Female ; Fingers ; Humans ; Incisor ; Intellectual Disability ; Japan ; Lip ; Molar ; Nasal Septum ; Palate ; Tooth

Multiple primary cancer is defined as the case of primary malignant tumors of different histologic origins each other in one person, The incidence of multiple primary cancer has been increasing recently due to more developed diagnostie procedure and long survival of cancer patients. In esophageal cancer patients, comibined prevalence of other malignancy is rela tively high. We have experienced three cases of gastric adenocarcinoma with esophageal squamous cell carcinoma and report these cases with a review of literatures.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Esophageal Neoplasms ; Esophagus* ; Humans ; Incidence ; Prevalence ; Stomach*

PURPOSE: The spectrum of melanoma antigen gene (MAGE)-expressing tumor is very wide and the gene of MAGE express antigens that are targets for specific recognition by cytotoxic T lymphocytes derived from tumor-bearing patients. All of these characteristics represent MAGE as tumor vaccine can be useful for cancer prevention or treatment. Here, we detected MAGE-3 gene expression in cancer cell lines and evaluated recombinant MAGE-3 protein producibility of MAGE plasmid to develope MAGE DNA vaccine. MATERIALS AND METHODS: MAGE-3 gene expression of cancer cell lines was evaluated by reverse transcription-polymerase chanin reaction (RT-PCR). Two kinds of MAGE-3 expressing plasmids were constructed and their MAGE-3 protein producibility was evaluated by immunohistochemistry and immunoblotting using monoclonal anti-MAGE-3 antibody. RESULTS: Among 13 cell lines, SNU484, AMC-HN-3, AMC-HN-4, AMC-HN-7, HeLa, NCI H1703 and HT29 expressed MAGE-3 mRNA. In order to make MAGE plasmid, cDNA that showed 100% DNA homology with MAGE-3 gene was cloned into pcDNA 3 plasmid and pSecTag plasmid. Intracytoplasmic and secretory recombinant MAGE-3 was produced by MAGE-3 containing pcDNA 3 plasmid and pSecTag plasmid, respectively. CONCLUSION: In this study, we showed high expression frequency of MAGE-3 in cancer cell line, and established two kinds of plasmid that produce recombinant MAGE-3 in cell lines. We expect these plasmids will be used in cancer treatment or MAGE-3 function study in future.
Cell Line ; Clone Cells ; DNA* ; DNA, Complementary ; Gene Expression ; Humans ; Immunoblotting ; Immunohistochemistry ; Melanoma ; Plasmids* ; RNA, Messenger ; T-Lymphocytes, Cytotoxic

PURPOSE: This randomized, controlled, double-blind study was designed to determine the optimal dose of remifentanil for preventing complications associated with the removal of a laryngeal mask airway (LMA) without delaying emergence. MATERIALS AND METHODS: This study randomly assigned 128 patients to remifentanil effect-site concentrations (Ce) of 0 ng/mL (group R0), 0.5 ng/mL (group R0.5), 1.0 ng/mL (group R1.0), and 1.5 ng/mL (group R1.5) during emergence. The emergence and recovery profiles were recorded. Adverse events such as coughing, airway obstruction, breath-holding, agitation, desaturation, nausea, and vomiting were also evaluated. RESULTS: The number of patients with respiratory complications such as coughing and breath-holding was significantly lower in the R1.0 and R1.5 groups than in the R0 group (p<0.05). Emergence agitation also decreased in the R1.0 and R1.5 groups (p<0.0083). The time to LMA removal was significantly longer in the R1.5 group than in the other groups (p<0.05). CONCLUSION: Maintaining a remifentanil Ce of 1.0 ng/mL during emergence may suppress adverse events such as coughing, breath-holding, and agitation following the removal of LMA without delayed awakening.
Adult ; Airway Management/*methods ; Anesthesia Recovery Period ; Anesthetics, Intravenous/*administration & dosage ; Cough/prevention & control ; Device Removal ; Dose-Response Relationship, Drug ; Double-Blind Method ; Female ; Humans ; Infusions, Intravenous ; Laryngeal Masks/*adverse effects ; Male ; Middle Aged ; Piperidines/*administration & dosage ; Postoperative Complications/prevention & control ; Psychomotor Agitation ; Vomiting/prevention & control

PURPOSE: This randomized, controlled, double-blind study was designed to determine the optimal dose of remifentanil for preventing complications associated with the removal of a laryngeal mask airway (LMA) without delaying emergence. MATERIALS AND METHODS: This study randomly assigned 128 patients to remifentanil effect-site concentrations (Ce) of 0 ng/mL (group R0), 0.5 ng/mL (group R0.5), 1.0 ng/mL (group R1.0), and 1.5 ng/mL (group R1.5) during emergence. The emergence and recovery profiles were recorded. Adverse events such as coughing, airway obstruction, breath-holding, agitation, desaturation, nausea, and vomiting were also evaluated. RESULTS: The number of patients with respiratory complications such as coughing and breath-holding was significantly lower in the R1.0 and R1.5 groups than in the R0 group (p<0.05). Emergence agitation also decreased in the R1.0 and R1.5 groups (p<0.0083). The time to LMA removal was significantly longer in the R1.5 group than in the other groups (p<0.05). CONCLUSION: Maintaining a remifentanil Ce of 1.0 ng/mL during emergence may suppress adverse events such as coughing, breath-holding, and agitation following the removal of LMA without delayed awakening.
Adult ; Airway Management/*methods ; Anesthesia Recovery Period ; Anesthetics, Intravenous/*administration & dosage ; Cough/prevention & control ; Device Removal ; Dose-Response Relationship, Drug ; Double-Blind Method ; Female ; Humans ; Infusions, Intravenous ; Laryngeal Masks/*adverse effects ; Male ; Middle Aged ; Piperidines/*administration & dosage ; Postoperative Complications/prevention & control ; Psychomotor Agitation ; Vomiting/prevention & control

No abstract available.
Glycopeptides*