No abstract available.
Osteoarthritis*

Infection in primary total hip arthroplasty may cause catastrophic results and is the major reason for implant failure. The purpose of this study was to evaluate the utility of the hip joint fluid culture as a method of predicting the possibility of a hip joint infection by calculating the sensitivity, specificity and accuracy. We performed 628 primary total hip arthroplasty and aerobic and anaerobic bacterial cultures for hip joint fluid between January 1989 and June 1996. The hip joint fluid culture was routinely performed to evaluate the utility of the femoral head for bone banking. Thirty-two cases out of the 628 hips showed positive intraoperative culture and 596 cases showed negative intraoperative culture. The isolated organisms from 32 positive cultures were 11 for Staphylococcus aureus, eight for Staphylococcus coagulase negative, seven for Enterococcus, three for E.coli and one each for Enterobacter, Acinetobacter and Pseudomonas. Anaerobic culture was negative in all cases. In the positive intraoperative culture cases, none had delayed infection during the follow-up period. But in the negative intraoperative culture cases, one case had acute infection and two cases had delayed infection. In the case with acute infection, Staphylococcus aureus was isolated and on two cases with delayed infection, Enterococcus and Staphylococcus coagulase negative were isolated, respectively. All 32 positive culture cases were fa~lse positive and 595 negative culture cases were true negative and one negative culture case was fa~lse negative. The sensitivity of the hip joint culture was 0%, the specificity was 94.9% and the accuracy was 0%. The specificity of hip joint fluid culture in primary total hip arthroplasty was high, hut the sensitivity score was zero. Therefore, the hip joint fluid culture should not be used for a routine check of infection status in primary total hip arthroplasty. We recommend the hip joint fluid culture in revision arthroplasty or hips in which infection is clinically suspected.
Acinetobacter ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Bone Banks ; Coagulase ; Enterobacter ; Enterococcus ; Follow-Up Studies ; Head ; Hip Joint* ; Hip* ; Pseudomonas ; Sensitivity and Specificity ; Staphylococcus ; Staphylococcus aureus

Bile canaliculi is closely related to the cytoskeleton; actin filament web, microtubules and cytokeratin intermediate filaments. To understand how cytoskeletal alteration affects bile canalicular structure, the investigators injected cytochalasin B and colchicine into mice intraperitoneally to inhibit the polymerization of actin filaments and microtubules respectively, and observed the structural changes of bile canaliculi and hepatocytes with transmission and scanning electron microscopes. Bile canaliculi were dilatated and microvilli were decreased in number and length after injection of cytochalasin B and colchicine. Some bile canaliculi branched irregularly after colchicine treatment. Actin filament web in the canalicular ectoplasm was disrupted leaving granular zone after cytochalasin B treatment, but was intact after colchicine treatment. Intermediate filament bundles located at angles to the canalicular membrane appeared after colchicine treatment. Intercellular junctions delimiting bile canaliculi were intact after colchicine treatment, however were disrupted after cytochalsin B treatment. Focal junctions resembling desmosome were formed between microvilli after colchicine treatment. In both cytochalasin B and colchicine treated groups, lumen of rough endoplasmic reticulum were dilated, Golgi apparatus became prominent, and lipid droplets were appeared in the cytoplasm. These results suggest that both intact actin filaments and microtubules are necessary to keep the structural integrity of bile canaliculi.
Actin Cytoskeleton ; Animals ; Bile Canaliculi* ; Bile* ; Colchicine* ; Cytochalasin B* ; Cytoplasm ; Cytoskeleton ; Desmosomes ; Endoplasmic Reticulum, Rough ; Golgi Apparatus ; Hepatocytes* ; Humans ; Intercellular Junctions ; Intermediate Filaments ; Keratins ; Liver* ; Membranes ; Mice* ; Microtubules ; Microvilli ; Polymerization ; Polymers ; Research Personnel

PURPOSE: To analyze angiearchitecture of arteriovenous malformations(AV malformation) in order to clarify the angiegraphic risk factors for intracerebral hemorrhage and other nonhemorrhagic symptoms. MATERIALS AND METHODS: Eighty-five patients with angiegraphically-proved brain arteriovenous malformation were included in this study. Retrospective review of clinical history and angiography was done. Topographic analysis and evaluation of 17 angiearchitectural characteristics were conducted. RESULTS: Deep-seated and cortico-callosal type, small nidus size, intranidal pouch, one draining vein, deep venous drainage only venous stenosis and venous aneurysm were the most discriminating or predictive characteristics of hemorrhage in brain arteriovenous malformation. And those with large nidus size, dural supply and venous hypertension were correlated with nonhemorrhagic symptoms such as seizure, headache and neurologic deficit. CONCLUSION: Detailed analysis of the angiearchitecture of brain arteriovenous malformations is needed to identify the features that are correlated with prognostic implications for the treatment of patients with ^V malformations.
Aneurysm ; Angiography ; Arteriovenous Malformations* ; Brain* ; Cerebral Hemorrhage ; Constriction, Pathologic ; Drainage ; Headache ; Hemorrhage ; Humans ; Hypertension ; Neurologic Manifestations ; Retrospective Studies ; Risk Factors ; Seizures ; Veins

PURPOSE: To determine postoperative astigmatic changes after surgery for congenital ptosis and the astigmatic changes depending on surgical method and to discern cases of postoperatively developed anisometropia or amblyopia. METHODS: Fifty-one patients who underwent surgery due to congenital ptosis were reviewed. Refraction or cycloplegic refraction was conducted preoperatively and 3 to 6 months after surgery to measure astigmatic changes. Astigmatic changes in operated eyes were compared to control eyes. Astigmatic changes were compared depending on surgical method. RESULTS: The mean astigmatism was 1.33+/-1.29D preoperatively and 1.48+/-1.13D postoperatively (P=0.10) and the mean astigmatic change in the ptotic and control eye was an increase in cylinder +0.56+/-0.55D and +0.68+/-0.72D (P=0.37). The mean astigmatic change of patients receiving frontalis sling was +0.57+/-0.67D which was similar to those who received levator resection (+0.56+/-0.50D). Newly developed anisometropia was found in three patients postoperatively due to an increase in astigmatism, but newly developed amblyopia was not found. CONCLUSIONS: The increase of astigmatism by ptosis surgery was not statistically significant and there was no statistically significant difference when accounting for surgical method. However, it is necessary to monitor refractive error carefully in younger patients to prevent amblyopia because postoperative increase of astigmatism can cause anisometropia.
Amblyopia ; Anisometropia ; Astigmatism* ; Humans ; Refractive Errors

OBJECTIVE: Although a high incidence of chronic subdural hematoma (CSDH) following traumatic subdural hygroma (SDG) has been reported, no study has evaluated risk factors for the development of CSDH. Therefore, we analyzed the risk factors contributing to formation of CSDH in patients with traumatic SDG. METHODS: We retrospectively reviewed patients admitted to Hallym University Hospital with traumatic head injury from January 2004 through December 2013. A total of 45 patients with these injuries in which traumatic SDG developed during the follow-up period were analyzed. All patients were divided into two groups based on the development of CSDH, and the associations between the development of CSDH and independent variables were investigated. RESULTS: Thirty-one patients suffered from bilateral SDG, whereas 14 had unilateral SDG. Follow-up computed tomography scans revealed regression of SDG in 25 of 45 patients (55.6%), but the remaining 20 patients (44.4%) suffered from transition to CSDH. Eight patients developed bilateral CSDH, and 12 patients developed unilateral CSDH. Hemorrhage-free survival rates were significantly lower in the male and bilateral SDG group (log-rank test; p=0.043 and p=0.013, respectively). Binary logistic regression analysis revealed male (OR, 7.68; 95% CI 1.18–49.78; p=0.033) and bilateral SDG (OR, 8.04; 95% CI 1.41–45.7; p=0.019) were significant risk factors for development of CSDH. CONCLUSION: The potential to evolve into CSDH should be considered in patients with traumatic SDG, particularly male patients with bilateral SDG.
Craniocerebral Trauma ; Follow-Up Studies ; Hematoma, Subdural, Chronic* ; Humans ; Incidence ; Logistic Models ; Male ; Retrospective Studies ; Risk Factors* ; Subdural Effusion* ; Survival Rate

The authors analysed radiologic findings of the posterior fossa lesions as well as incisural and supratentorial lesions in 40 patients who were diagnosed by transfemoral serial vertebral angiography at Catholic Medical Center since October 1972 to April 1976. We also attempted to evaluate the diagnostic value in the diagnosis of the lesions according to the site of involvement. The tumors of the fourth ventricle or vermis demonstrated abnormal findings corresponding to the area of involvement, however the lesion could not be defined accurately with the study. Cerebellar hemispheric or tentorial tumors were diagnosed with considerable accuracy by vertebral angiography. Infratentorial vascular lesions were clearly demonstrated with serial vertebral angiography but the accuracy of diagnosis was argumented with subtraction technique. The evidence of compression of the brain stem was demonstrated with considerable accuracy by serial vertebral angiography. Furthermore exact site and direction of the compression could be outlined with the study. For the posterior temporal or occipital tumors which were not able to diagnose definitely with carotid angiography, considerable diagnostic accuracy was carried by the vertebral angiography. Definite diagnosis of the posterior third ventricle tumors or thalamic lesions was able to obtain with serial vertebral angiography.
Angiography* ; Brain Stem ; Brain* ; Diagnosis* ; Fourth Ventricle ; Humans ; Subtraction Technique ; Third Ventricle

Cases of spontaneous regression of cerebral aneurysm remnant after incomplete surgical clipping have been rarely reported. This paper reports the regression of an aneurysm remnant after incomplete surgical clipping during postsurgical follow-up. A 50-year-old male presented with subarachnoid hemorrhage because of rupture of an anterior communicating artery aneurysm. An emergency clipping of the aneurysm was performed. A cerebral angiography, which was performed two weeks postoperatively, revealed an aneurysm remnant. The patient refused additional treatment and was discharged without apparent neurological deficit. One-year follow up cerebral angiography demonstrated a partially regressed aneurysm remnant.
Aneurysm* ; Cerebral Angiography ; Emergencies ; Follow-Up Studies ; Humans ; Intracranial Aneurysm* ; Male ; Middle Aged ; Rupture ; Subarachnoid Hemorrhage ; Surgical Instruments*

OBJECTIVE: This study is aimed to describe our experience with performing hemicraniectomy for treating patients with malignant cerebral infarction. This study also aimed at describing the difference between our experience and that of the published articles. METHODS: Ten patients who had anterior circulation territory cerebral infarction underwent decompressive hemicraniectomy for treating their life threatening brain swelling between August 2004 and October 2007. We retrospectively analyzed the patients' medical records and radiological films and we described the patients' clinical and radiological details. The outcomes were measured according to the case fatality rate at 2 weeks and the modified Rankin scale (mRS) at 9 months. We compared our institution's outcomes with the pooled analysis result of three randomized controlled trials (DESTINY, DECIMAL, HAMLET trial). RESULTS: Nine men and one woman were included in this study. Their mean age was 61.5 +/- 11.9 years, and the mean National Institute of Health Stroke Scale (NIHSS) score on admission was 17.3 +/- 6.0. Five patients died within 2 weeks after operation. Four patients had a mRS of 5 and one had a mRS of 4 at 9 months. Our series included elder patients (mean difference : 9.9~18.3 years) who had a low NIHSS score on admission (mean difference : -4.8~-6.8) as compared to that of the pooled analysis group. Our series revealed a higher proportion of an unfavorable outcome (mRS > or = 4) compared to that of the pooled analysis results (p=0.01). No patient in our series would have been eligible, according to the inclusion criteria, for inclusion in the pooled analysis studies. CONCLUSION: We think that the higher proportion of an unfavorable outcome in our series was a consequence of the elder age of our patients.
Brain Edema ; Cerebral Infarction ; Female ; Humans ; Male ; Medical Records ; Retrospective Studies ; Stroke

OBJECTIVE: To measure the orientation of the facet joints of cervical spine (C-spine) segments in the sagittal plane, known as the pedicle-facet (P-F) angle, and to use these measurements to evaluate the relationship between the P-F angle and the amount of vertebral anterolisthesis in patients with degenerative cervical spondylolisthesis (DCS). METHODS: A retrospective case-control study was performed including 30 age- and sex-matched patients with DCS and 30 control participants. Anterior-posterior and lateral view radiographs of the C-spine were obtained in a standing position. The P-F angle at all cervical levels and the amount of anterolisthesis at C4-5 were measured from lateral view plain radiographs. RESULTS: The P-F angles at C4-5 were 141.14+/-7.14degrees for the DCS group and 130.53+/-13.50degrees (p=0.012) for the control group, and at C5-6 were 137.46+/-8.53degrees for the DCS group and 128.53+/-16.01degrees for the control group (p=0.001). The mean P-F angle at C4-5 did not correlate with the amount of anterolisthesis (p=0.483). The amount of anterior slippage did correlate with age (p<0.001). CONCLUSION: The P-F angle was intrinsically higher at C4-5, compared to C5-6, in both the DCS and control groups, which might explain the increased likelihood for anterolisthesis of C4. Higher P-F angles in the DCS group may be a predisposing factor to slippage. The P-F angle may interact with age to increase incidence of anterolisthesis with increasing age.
Case-Control Studies ; Causality ; Humans ; Incidence ; Retrospective Studies ; Spine ; Spondylolisthesis* ; Zygapophyseal Joint