Core decompression is still widely used in avascular necrosis of the femoral head but the results are unpredictable and the indications are not settled yet. The reparative process of the decompressed femoral head is poorly understood. Seven cases in 5 patients were undertaken THRA following failed decompression and these were studied for the radiological and pathological changes of the core tracts. The lesions of failed cases were involved more than 1/3 of femoral head on MRI and all cases were stage II A or B. The extent of the necrotic area in MRI was enlarged with crack, sclerosis and sometimes gas collection. Depression of the subchondral plates were also observed. Capillary ingrowth or neovascularization was not found at all and there were only fibrosis, inflammatory response and foreign body reactions.
Capillaries ; Decompression* ; Depression ; Fibrosis ; Foreign Bodies ; Head* ; Humans ; Magnetic Resonance Imaging ; Necrosis* ; Sclerosis

STATEMENT OF PROBLEM: The current trend in prosthodontics is the adoption of a conservative approach to preparing dental prostheses by minimizing the amount of sound tooth structure removal during preparation. PURPOSE: The major disadvantage of the adhesion bridge is the inherently poor resistance to dislodgement that its use in areas subjected to high occlusal load is limited. The purpose of this study was to compare the dislodgement resistance of Bio-pin(R), conventional 3-unit and adhesion bridges. MATERIAL AND METHODS: The experimental groups were classified as follows: .Group I : 3-unit bridge cemented using Super-Bond. C&B .Group II : Adhesion bridge cemented using Super-Bond. C&B .Group III : Bio-pin(R) design adhesion bridge without incorporation of Bio-pin(R) (cemented using Super-Bond. C&B) .Group IV-1: Bio-pin(R) retained adhesion bridge incorporating a single Bio-pin(R) (cemented using Super-Bond. C&B) .Group IV-2: Bio-pin(R) retained adhesion bridge incorporating a single Bio-pin(R) (cemented using Panavia. F) .Group V : Bio-pin(R) retained adhesion bridge incorporating two Bio-pins. (cemented using Super-Bond. C&B) RESULTS: The results of this study were as follows: 1. Significant differences in dislodgement resistance of the restorations were found between Group I, Group II and Group III (p<0.05). No significant differences in dislodgement resistance of the restorations were observed between Group I, GroupIV-1 and GroupV. However, there were significant differences in dislodgement resistance between GroupII and the other groups (p<0.05). 2. No significant differences in dislodgement resistance of the restorations were observed between GroupIV-1 and GroupIV-2, both of which utilized a single Bio-pin(R). However, significant differences were observed when GroupIII was compared to either GroupIV-1 or GroupV (p<0.05). 3. No significant differences in dislodgement resistance relative to the type of dental cements used were found. CONCLUSION: From the above results, it is concluded that the dislodgement resistance of Biopin. bridge restorations utilizing a single Bio-pin(R) is similar to that of a conventional 3-unit bridge. The results also suggest that Bio-pin(R) bridge restorations using a single Bio-pin(R) are a viable alternative to the conventional 3-unit bridge when minimal removal of sound tooth structure and fulfillment of both function and esthetic aspects are considered.
Dental Cements ; Dental Prosthesis ; Prostheses and Implants* ; Prosthodontics ; Tooth

OBJECTIVE: Since the management of pregnancy is gestational age dependent, accurate knowledge of the dating of gestational age is essential. The gestational age calculation system(GACS) was made to get a precise informations of exact gestational age of pregnant mothers. METHODS: Using the personal computer and Microsoft Visual Basic soft ware, the GACS program was made to meet obstetrician's desire. This program is designed and embodied to calculate gestational age controlling many variables such as last menstrual period(LMP), expectant date of confinement(EDC), gestational age on the calculating date, ultrasonographical gestational age, and conceptional date. RESULTS: The accurate gestational age was displayed by GACS according to various input data. The work sheet of whole gestational age can be printed by GACS. CONCLUSION: The GACS is a tool to calculate gestational age of pregnant mothers precisely. This can be used very conveniently and informatively by obstetric clinicians. We recommend this program for the members of perinatologists and obstetricians.
Gestational Age* ; Humans ; Microcomputers* ; Mothers ; Pregnancy

A 17-year-old male was presented withfpruritic grouped erythematous papules on the face, chest, upper back, both axillae, and genital area. The histologic picture of a benign papilloma and spongiosis around the acrosyringium were prominent findings. The term acrosyringeal epidermal nevus is proposed for this histological picture, and some explanations for its pathogenesis are suggested.
Adolescent ; Axilla ; Humans ; Male ; Nevus* ; Papilloma ; Thorax

OBJECTIVES: In healthcare, mobile computing made possible by smartphones is becoming an important tool among healthcare professionals. However, currently there is very little research into the effectiveness of such applications of technology. This study aims to present a framework for a smartphone application to give doctors mobile access to patient information, then review the consequences of its use and discuss its future direction. METHODS: Since 2003 when Samsung Medical Center introduced its first mobile application, a need to develop a new application targeting the latest smartphone technology was identified. To that end, an application named Dr. SMART S was officially launched on December 22nd, 2010. RESULTS: We analyzed the usage data of the application for a month until April 25th, 2011. On average, 170 doctors (13% of the entire body of doctors) logged on 2.4 times per day and that number keeps growing. The number was uniformly distributed across all working hours, with exceptions of heavy accesses around 6-8 AM and 4-6 PM when doctors do their regular rounds to see the patients. The most commonly accessed content was inpatient information, this constituted 78.6% of all accesses, within this 50% was to accesses lab results. CONCLUSIONS: Looking at the usage data, we can see the use of Dr. SMART S by doctors is growing in sync with the popularity of smartphones. Since u-Health seem an inevitable future trend, a more rigorous study needs to be conducted on how such mobile applications as Dr. SMART S affect the quality of care and patient safety to derive directions for further improvements.
Computers, Handheld ; Delivery of Health Care ; Hospital Information Systems ; Humans ; Inpatients ; Medical Informatics Applications ; Patient Safety ; Pyridines ; Thiazoles

PURPOSE: The purpose of the study was to describe psychosocial difficulties experienced by cancer patients. METHODS: Three focus group interviews were conducted to collect the data from 19 outpatients with cancer undergoing treatments during 2009. All interviews were audio-recorded and transcribed verbatim. The data were analyzed using constant comparative analysis of grounded theory. RESULTS: As a result of constant comparative analysis, 'psychosocial distress' was identified as a core category, and seven subcategories were identified. 'Plunged into negative emotions' and 'damaged self-identity' were identified as major categories in the individual dimension. 'Difficulty in dealing with diagnosis' and 'hasty expectations and concerns' were identified in the dimension of family. 'Inefficient communication' and 'lack of necessary information' were identified in the dimension of health care setting. 'Lonely journey into a strange territory' was identified in the dimension of society. CONCLUSION: The results of the study indicate that cancer patients experience a wide range of psychosocial problems. Thus, in assessing and relieving psychosocial distress of cancer patients, it is necessary to focus not only on the level of the individual but also on the levels of family, health care setting, and society in general is necessary.
Adaptation, Psychological ; Delivery of Health Care ; Focus Groups ; Humans ; Outpatients ; Qualitative Research

BACKGROUND: The incidence of candidemia has increased, and an early differentiation of transient or central venous catheter (CVC)-related candidemia from deep-seated invasive candidiasis is often difficult. The Pastorex Candida antigen assay (Sanofi Diagnostics Pasteur, Marnes-la-Coquette, France) is known to be an useful and specific tool for the diagnosis of invasive candidiasis. We assessed the clinical significance of Pastorex Candida antigen assay in patients with candidemia. METHODS: Eighty-five sera from 27 patients with candidemia and 42 control sera (32 patients with superficial Candida colonization and 10 healthy subjects) were tested. The Pastorex Candida latex agglutination test was performed to evaluate the presence of Candida mannan antigen. Candidemia was divided into 3 categories; (i) transient, (ii) CVC-related, and (iii) non-CVC-related persistent types. RESULTS: Thirty-two patients with superficial Candida colonization and 10 healthy subjects were negative for the Pastorex Candida antigen. Of the 85 sera from 27 patients with candidemia, 14 (16.4%) were positive for the Pastorex Candida antigen. The Pastorex Candida antigen was detected neither in 6 patients with transient candidemia nor 15 patients with CVC-related candidemia. Conversely, it was detected in at least one serum sample of 5 of the 6 (83.3%) patients with non-CVC-related persistent candidemia. Of the 24 sera from 6 patients with non-CVC-related persistent candidemia, 14 (58.3%) were positive for the Pastorex Candida antigen. Overall, the sensitivity and specificity of the Pastorex Candida antigen assay for the diagnosis of non-CVC-related persistent candidemia were 83.3% and 100%, respectively. CONCLUSIONS: Our data suggest that the Pastorex Candida antigen assay has a potential for the differential diagnosis of non-CVC-related persistent candidemia from transient or CVC-related candidemia.
Candida* ; Candidemia* ; Candidiasis, Invasive ; Central Venous Catheters ; Colon ; Diagnosis ; Diagnosis, Differential ; Humans ; Incidence ; Latex Fixation Tests ; Mannans ; Sensitivity and Specificity

OBJECTIVE: The ovine fetus responds to hemorrhage with a 10-20 fold increase in plasma erythropoietin (EPO) concentration at 24 hr and a return toward normal at 48 hr after the hemorrhage. The objective of the present study was more accurately to compare the magnitude and time course of the plasma EPO response after fetal hemorrhage. METHODS: Chronically catheterized, 12 of late gestation ovine fetus were gradually hemorrhaged 40% of their blood volume over 2 hr (1ml/min). Plasma was sampled for EPO concentration at 1, 2, 3, 4, 6, 8, 10, 12, 16, 20, 24, 30, 36 hr after initiating the hemorrhage were collected at these times. Radioimmunoassay was used to measure plasma EPO concentrations. Analysis of variance was used for statistical analysis. RESULT: After a slow hemorrhage in the ovine fetus (1ml/min over 2hr), plasma EPO concentration increased significantly at 4hr (2.3 times basal values), reached a maximum at 16 hr (33.3 times basal values), and declined thereafter. CONCLUSION: We studied change in time course of the fetal plasma EPO after slow hemorrhage and recent studies have shown that the fetal kidney, liver and placenta express EPO mRNA. These observation suggest that plasma EPO increase may be mediated by a tissue specific up-regulation of EPO transcription in the fetal kidney, liver and placenta. We have studied change in Epo mRNA expression in various fetal tissue after slow haemorrhage.
Blood Volume ; Catheters ; Erythropoietin* ; Fetus ; Hemorrhage* ; Kidney ; Liver ; Placenta ; Plasma* ; Pregnancy ; Radioimmunoassay ; RNA, Messenger ; Sheep ; Up-Regulation

BACKGROUND: To collect high concentration of granulocytes for transfusion to neutropenic cancer patients with infections, we investigated the effect of G-CSF or dexamethasone as granulocyte mobilizers and 10% pentastarch (PS) as the sedimentation agent in granulocyte collection by leukapheresis. Subsequently, the therapeutic effect of the granulocyte transfusions was assessed. METHODS: Forty five leukapheresis were performed with CS-3000Plus (Baxter, Deerfield, IL, USA) using 10% pentastarch. The donors were classified into three groups according to their premedication drugs and the interface detector offset; group 1 used dexamethasone with offset 15 (n=16), group 2 used dexamethasone with offset 33 (n=16), and group 3 used G-CSF with offset 33 (n=10). We compared total collected granulocyte counts and granulocyte collection efficiency (GCE). RESULTS: The mean counts of total granulocytes collected and GCE were as follows; 0.9 0.5 x 1010 and 31.6 14.3% in group 1, 1.3 0.6 x 1010 and 39.0 14.2% in group 2, and 1.6 0.9 x 1010 and 63.9 32.2% in group 3, respectively. The counts of granulocytes collected in group 3 was significantly higher than that in group 1 (P<0.05). The GCE of group 3 was significantly higher than that of group 1 and group 2 (P<0.05). Sixteen granulocyte transfusions were performed to 11 patients. We observed successful therapeutic effects in 10 out of 16 transfusions (63%). CONCLUSIONS: G-CSF indicates greater potency than dexamethasone although its high cost is limitation of routine use as mobilizing agents and PS was an excellent red cell sedimenting agent in granulocyte collection. Large volume granulocyte transfusions allow high therapeutic effects in neutropenic patients with marrows of sufficient regenerating capacity.
Bone Marrow ; Dexamethasone ; Granulocyte Colony-Stimulating Factor ; Granulocytes* ; Humans ; Hydroxyethyl Starch Derivatives* ; Leukapheresis* ; Neutropenia ; Premedication ; Tissue Donors

BACKGROUND: Vestibular neuritis (VN) is a common peripheral vestibulopathy. VN is most likely a partial rather than a complete vestibular paralysis, It has a natural history of gradual recovery within 1-6weeks. The investigation of vestibulo-ocular reflex (VOR) change in acute and compensated VN are relatively few in Korea. We performed the vestibular function test including electronystagmography (ENG) and rotary chair test (RCT) in the patients with acute and compensated VN, and evaluated the efficacy of ENG and RCT to know the degree of compensation. METHODS: Tweenty-four patients with acute VN, 14 patients who had cllinically compensated VN during follow-up period and 30 normal controls were studied. Mean intervals from symptom onset to test were 3.6 days (acute) and 102.5 days (com-pensated). RESULTS: Eight patients had asymmetrically impaired pursuit, and ten patients had asymmetrcally impaired OKN during acute stage. The degree of side differences in pursuit and OKN gain was correlated with intensity of spon-taneous nystagmus. In the acute stage, the gain of the VOR was reduced at low frequency (0.01-0.16Hz), but it was normal at high frequency (0.32Hz). Prolonged phase lead and gain asymmetries were present at all range of frequency. In the compensated stage, the gain, phase and symmetry of the VOR at all range of frequency were not different from those of controls, except for prolonged phase lead and asymmetry at 0.01 Hz. The rate of the patients with unilateral canal paresis was 100% at acute stage and 50% at compensated stage in mono-thermal cold caloric stimulation. CONCLUSIONS: These results suggested that pursuit and OKN abnormalities may be found in acute peripheral vestibu-lopathy, in which coarse spontaneous nystagmus may contribute to the development of these abnormality. Absence of caloric response does not indicate an complete absence of vestibular function and RCT is a useful method in evaluation of VOR status in patients with acute and compensated VN.
Compensation and Redress ; Electronystagmography ; Follow-Up Studies ; Humans ; Korea ; Natural History ; Paralysis ; Paresis ; Reflex, Vestibulo-Ocular ; Vestibular Function Tests* ; Vestibular Neuronitis*