Despite continually improving results of total hip arthroplasty, infection remains the major debilitating complication. The treatments of infected total hip arthroplasty were variable. but initially we removed infected implants and inserted antibiotic containing cemented spacer so called PRSTALAC to prevent scar contracture and disuse osteoporosis. After 6 weeks later, control of infection was clinically and radiologically determined, we inserted new prosthesis with cement. Three weeks postoperatively, patient began touch down standing exercise. We observed infected total hip patient in whom hip had been salvaged successfuily with twostage implantation using so called "" PROSTALAC "" which was made with Moore stem.
Arthroplasty, Replacement, Hip* ; Cicatrix ; Contracture ; Hip ; Humans ; Osteoporosis ; Prostheses and Implants ; Replantation*

BACKGROUND/AIMS: Hepatitis C virus(HCV) was known to most common etiologic agent of chronic liver disease in United states and Japan. Although hepatitis B virus(HBV) was well known to be a its major etiologic agent in Korea, it has been showed that HCV and HBV are associated with liver cirrhosis and hepatocellular carcinoma as major causative agent of chronic liver disease. Interferon alpha therapy is generally accepted as effective single agent for chronic hepatitis or to decrease the chronicity of acute hepatitis C. So, we evaluated the efficacy of interferon alpha in hepatitis C. METHODS: 46 patients who were positive for anti-HCV antibody and HCV RNA were included in this study. Liver biopsy was per formed on all patients and all of them were tested as negative for serum HBsAg, anti Hbe. Patients were divided into 2 groups . 30 patients received interferon therapy(treated group) and 16 patients received no therapy(untreated group). We compared the change of liver function test and HCV RNA before and after therapy between two groups. Treated group was subdivided into 5 groups according to response to interferon therapy '. Non-response, partial response, breakthrough, relapse and sustained response. RESULTS: 1) The mean age and sex distribution were 49.9 year old, male 19, female 11 in treated group and 48.7 years, male 12, female 4 in untreated group. 2) The number of patients with acute hepatitis, chronic persistent hepatitis, chronic active hepatitis and liver cirrhosis were 1, 2, 23, 4 in treated group and 0, 1, 12, 3 in untreated group, respectively. 3) The mean follow up period was 1.7 year and 2.3 years in treated and untreated group, respectively. 4) The activity of serum ALT before and after therapy were 195+ 134.6 IU/L, 87.4+ 40.5 IU/L and 186.7+ 106.4 IU/L, 157+ 87.1 IU/L in treated and untreated group, respectively. Serum ALT after therapy in treated group was significantly lower than untreated group(P<0.01). 5) The number of patients for patterns of reponse in treated group was non-response 5, partial response 8, breakthrough 1, relapse 4, sustained response 12 and there was no difference in age among them(P>0.05). 6) The case of negative conversion for HCV RNA in treated group was 12, but there was no case in untreated group. 7) Sex distribution of sustained response was 6(31% ) of 19 male, 6(54.5%) of 11 female and 12 patients(40.0%)(1 of 1 patients with acute hepatitis, 1 of 2 chronic persistent hepatitis, 10 of 23 chronic active heaptitis) included in sustained reponse, but any patients with liver cirrhosis had response. 8) Mean total dose and duration of interferon therapy was non-response 10353.6 million unit(MU)/5.8month(M), partial response 20025.06MU/6.4 M, breakthrough 36000.0MU/5.0M, relapse 11700.0MU/3.3M, sustained response 28100.0MU/6.6M, respectively. 9) 3 of 7 patients who were followed up over 1 year in sustained response and mean time to the relapse was 2.2 years. CONCLUSION: Our results showed that interferon alpha therapy is effective in patients with hepatitis C and further study and attempts should be performed to augument the efficacy of interferon alpha for the treatment of hepatitis C.
Biopsy ; Carcinoma, Hepatocellular ; Female ; Follow-Up Studies ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis C* ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Interferon-alpha* ; Interferons* ; Japan ; Korea ; Liver ; Liver Cirrhosis ; Liver Diseases ; Liver Function Tests ; Male ; Recurrence ; RNA ; Sex Distribution ; United States

BACKGROUND: The purpose of this study was to assess the results of arthroscopic bridging repair using a human dermis allograft in the treatment of massive irreparable rotator cuff tears. METHODS: From November 2009 to April 2011, 12 patients underwent arthroscopic bridging repair using a human dermis allograft in the treatment of massive irreparable rotator cuff tears. Patients were followed for an average of 33.9 months. Clinical outcome was evaluated preoperatively and postoperatively using the mean University of California, Los Angeles (UCLA) score and the Korean Shoulder Scoring System (KSS). Magnetic resonance imaging (MRI) was performed postoperatively at an average of 6.5 months. RESULTS: At a mean follow-up of 33.9 months (range, 25 to 42 months), 11 out of 12 patients were satisfied with their procedure. Patients showed significant improvement in their mean modified UCLA score from 15.9 preoperatively to 29.4 postoperatively (p=0.001). The mean KSS score improved from 45.6 preoperatively to 80.5 postoperatively (p=0.002). In MRI studies, 9 out of 12 patients had full incorporation of the graft into the native rotator cuff remnant. To date, there has been no intraoperative or postoperative complication from the graft procedure, such as infection or allograft rejection, in any patient. CONCLUSIONS: Arthroscopic bridging repair using a human dermis allograft can be considered as an option in treatment of select cases of massive irreparable rotator cuff tears, resulting in high patient satisfaction.
Allografts* ; California ; Dermis* ; Follow-Up Studies ; Humans* ; Magnetic Resonance Imaging ; Patient Satisfaction ; Postoperative Complications ; Rotator Cuff* ; Shoulder ; Tears* ; Transplants

In anesthetized cats the effects of lactate-activated muscle spindle upon the group Ia muscular afferent fibers were studied. Laminectomy was done from L5 to Sl spinal cord level. Extracellular recording was done at dorsal root to record the impulse discharge from group Ia muscular afferent fibers. 1) Muscle spindle of Gastrocnemius-Soleus muscle were activated by lactate injection and exhibited increased impulse discharge through group Ia muscular afferent fibers. 2) There was latency of 7-12 seconds before muscle spindle is activated by lactate injection. But the whole response was not dose related. 3) The response pattern after lactate injection was divided into three groups which were excitation, inhibition and inhibition with preceding excitation. 4) Some responses were similar to those of bradykinin, sympathetic stimulation (adrenaline injection) and succinylcholine injection. 5) It was suggested that muscle spindle has characteristics of polymodal receptor which has responses to not only mechanical stimulation but also chemical stimulation.
Animals ; Bradykinin ; Cats ; Lactic Acid ; Laminectomy ; Muscle Spindles ; Spinal Cord ; Spinal Nerve Roots ; Stimulation, Chemical ; Succinylcholine

Osteoclasts are a major component of bone metabolism in physiologic condition and in rheumatoid arthritis (RA). RA is a chronic, autoimmune, inflammatory disease primarily affecting the joints. Joint inflammation leads to cartilage and bone destruction by osteoclast activation. This osteoclast activation leads to typical RA symptoms and is the therapeutic target. Several kinds of drugs are used for preventing bone loss by osteoclasts in RA patients. However, the bone destructive action of osteoclasts is not the only mechanism in RA pathogenesis. Recent research suggests that the osteoclasts regulate hematopoietic stem cell niches and invoke immune responses in bone. Osteoclasts are derived from bone marrow hematopoietic stem cells, and maintain the hematopoietic stem cell niches contract with osteoblasts. Osteoclasts secret several cytokines to regulate inflammation and T cell differentiation, and present antigen to T cells via major histocompatibility complex class I and class II molecules. Osteoclast concepts in both origins and functions are under major reconsideration and research. In this review, we will discuss these new insights.
Arthritis, Rheumatoid* ; Bone Marrow ; Cartilage ; Cell Differentiation ; Cytokines ; Hematopoietic Stem Cells ; Humans ; Inflammation ; Joints ; Major Histocompatibility Complex ; Metabolism ; Osteoblasts ; Osteoclasts* ; RANK Ligand ; T-Lymphocytes

BACKGROUND: Because systolic and diastolic dysfunction frequently coexist in acute myocardial infarction(AMI), we hypothesize that a combined measure of ventricular performance using Doppler echocardiography may be more sensitive and time-saving diagnostic tool for the evaluation of patients presenting with cardiogenic chest pain. METHOD AND RESULTS: Seventy-one patients with AMI (47 male, 59+/-11 years) and 45 patients with normal coronary artery (29 male, 52+/-11 years) were included in the study for measurement of cardiac performance index and established parameters of ventricular function using conventional echo-Doppler methods. a new derived index of cardiac performance: (ICT+IRT)/ET, was obtained by subtracting ejection time(ET) from the interval between cessation and onset of the mitral inflow velocity to give the sum of isovolumic contraction time(ICT) and isovolumic relaxation time(IRT). The mean value of the index was significantly different between normal and AMI(p<0.01). The degree of inter-group overlap was smaller for the index compared to other parameters. within functional groups, the value of the index did not appear to be related to heart rate, mean arterial pressure and the degree of mitral regurgitation. CONCLUSION: cardiac performance index is a conceptually new, simple and reproducible Doppler index of combined systolic and diastolic myocardial performance, and it is useful as screening test for patients with cardiac dysfunction due to AMI.
Arterial Pressure ; Chest Pain ; Coronary Vessels ; Echocardiography, Doppler ; Heart Rate ; Humans ; Male ; Mass Screening* ; Mitral Valve Insufficiency ; Myocardial Infarction* ; Relaxation ; Ventricular Function

No abstract available.
Humans

PURPOSE: This study compared the effectiveness and ease of operation of two different training methods, response sequence based training (RBST) and chest compression first training (CCFT), for cardiopulmonary resuscitation (CPR). METHODS: Eighty-five railroad workers were divided into two groups: those who applied the usual CPR training method (response sequence based training, 44 people) and those who applied our CPR training method (chest compression first training, 41 people). The objective skill performances were evaluated by using a mannequin (JAMY-IV RECO, Kyotokagaku, Japan). RESULTS: There was no statistical difference in CPR performance and artificial ventilation success rate between the RSBT group and the CCFT group. However, the artificial compression success rate and compression depth of the CCFT group compared to the RSBT group was statistically higher (p=0.006, 0.001). In addition, the wrong-hand-position rate of the RSBT group compared to the CCFT group was statistically higher (p=0.000). Furthermore, instructor satisfaction with practical training operations in the CCFT group compared to the RSBT group was statistically higher (p=0.001) and instructors reported that students were focused and easily capable of performing the CCFT training method. CONCLUSION: The chest compression first training method is easy to perform and not too complex to operate, making it effective in student performance and instruction. More effective CPR training is expected based on this method.
Cardiopulmonary Resuscitation* ; Education ; Humans ; Manikins ; Methods* ; Railroads ; Teaching ; Thorax ; Ventilation

PURPOSE: This study was to examined the moderated mediation effect of self-esteem on the relationship between parenting stress and depression among married women with children using longitudinal data from the 3rd to 6th Panel Studies on Korean. METHODS: The data from the Panel Study of Korean Children (Korea Institute of Child Care and Education) was collected as part of a longitudinal inquiry of babies born in 2008, their parents and their community environments. Only the data collected from the married women over the age of 20 who participated in the maternal survey was used for this study. RESULTS: The initial level of married women's parenting stress affects the initial level and the rate of change in self-esteem; the initial level of self-esteem, the initial level and rate of change in depression; and the initial level of parenting stress, the initial level of depression. However, the impact of the rate of change in parenting stress on that of self-esteem was significant only in employed women while the impact of the rate of change in self-esteem on that of depression was significant only in unemployed women. CONCLUSION: It is necessary to manage parenting stress among married women through various programs and education that increase self-esteem in order to reduce their level of depression.
Child Care ; Child* ; Depression* ; Education ; Employment* ; Female ; Humans ; Longitudinal Studies* ; Negotiating* ; Parenting* ; Parents*

In the case of a soft tissue defect which requires thin & pliable tissues, the choice of donor site is limited due to flap bulkiness and donor site morbidity. To overcome these problems, a variety of perforator-based flaps such as paraspinous and parasacral perforator flap, deep inferior epigastric perforator flap, gluteal perforator flap, and thoracodorsal artery perforator flap have recently been introduced. We experienced 8 cases of soft tissue defects from December 1996 to March 1999 using the thoracodorsal artery perforator flap for reconstruction. We could elevate the cutaneous flap with preservation of the latissimus dorsi muscle flap only when it was based on one cutaneous perforator. Defatting procedure was possible for further thinning of skin flap. In one case, axillary defect after release of postburn scar contracture was repaired with island perforator flap and the other seven cases were repaired with free flap. The results were satisfactory. We believe the thoracodorsal artery perforator flap is useful for reconstruction of soft tissue defects which are large or under conditions requiring thin flap.
Arteries* ; Cicatrix ; Contracture ; Free Tissue Flaps ; Humans ; Perforator Flap ; Skin* ; Superficial Back Muscles ; Tissue Donors