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

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

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

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

OBJECTIVES: The purpose of this study is to analyze the previously unreported effect of fetal sex on the fetal heart rate and to measure its magnitude in relation to the effects of other independent clinical variables. METHODS: Three hundred and seventeen pregnant women who were able to provide electronic fetal heart rate monitoring were evaluated. On the basis of fetal sex after birth, 167 pregnant women who delivered male neonate were for males group and 146 examples who delivered female neonate were for female group. We analyzed fetal heart rate data using the Catholic Computer Assisted Obstetric Diagnosis System(CCAOD). RESULTS: Female fetuses had significantly faster basal heart rate(140.51+/-12.43bpm) than male fetuses(137.64+/-13.68 bpm).(P=0.007) Percent acceleration time(PAT) increased significantly for males(6.10+/-4.00bpm), comparing to females(4.90+/-3.34bpm).(P=0.001) Also percent deceleration time(PDT) was significantly higher in male fetuses(7.50+/-8.70bpm) than female fetuses(6.18+/-7.70bpm).(P=0.039) But there was no differences in standard deviation(SD)(8.84+/-10.11bpm, 8.11+/-3.56bpm), long term variation(LTV)(80.38+/-62.79msec, 73.65+/-54.60msec), and short term variation(STV)(14.06+/-9.79msec, 13.33+/-12.32msec) between male and female fetuses. CONCLUSION: The fetal heart rate of female fetuses differ from that of male fetuses. Computerized linear analysis and nonlinear analysis of antepartum fetal heart rate will need to take into account the multiple factors that influence the fetal heart rate to identify precisely which pattern predict clinical outcome.
Acceleration ; Deceleration ; Diagnosis ; Female ; Fetal Heart* ; Fetus ; Heart ; Heart Rate, Fetal* ; Humans ; Infant, Newborn ; Male ; Parturition ; Pregnancy ; Pregnant Women

Three-dimensional computed tomographic angiography (CTA), a representative noninvasive radiologic technique, is being widely used for detecting vascular lesions in specific intracranial bleeding under a certain circumstance (acute nontraumatic subarachnoid hemorrhage). We encountered a case of extravasation of the contrast medium on CTA images that appeared as ribbon-like high-attenuation lesion from an aneurysm at the distal anterior choroidal artery in a young adult moyamoya patient. As CTA is used more frequently, it is imperative to understand such unusual but, potentially lethal image findings to conduct a prompt intervention.
Aneurysm* ; Angiography* ; Arteries* ; Choroid* ; Hemorrhage ; Humans ; Moyamoya Disease ; Young Adult

Patients with achondroplasia manifest various neurologic symptoms including megaencephaly, hydrocephalus, and progressive myelopathy or radiculopathy secondary to spinal stenosis. However, only anecdotal postmortem reports proved ruptured aneurysm or vascular malformation as a source of intracranial hemorrhage. We herein report a case of a 26-year-old woman with achondroplasia who underwent uneventful surgical treatment for the aneurysmal subarachnoid hemorrhage. In this literature, we review the pathophysiologic mechanism and emphasize the necessity of considering the possibility of sudden mental deterioration in achondroplastic patient.
Achondroplasia* ; Adult ; Aneurysm* ; Aneurysm, Ruptured ; Female ; Humans ; Hydrocephalus ; Intracranial Aneurysm ; Intracranial Hemorrhages ; Neurologic Manifestations ; Radiculopathy ; Spinal Cord Diseases ; Spinal Stenosis ; Subarachnoid Hemorrhage* ; Vascular Malformations