[Objective] To determine the long term survivorship and establish the idea I correction angle in proximal tibial osteotomy for primary osteoarthritis. [Method] Seventy-nine patients suffering from primary osteoarthritis (111 knees) were performed with proximal tibial valgus osteotomy from 1985 to 1997, among which 74 women (106 knees) and 5 men (5 knees). The age ranged from 37 to 70 years (mean, 55 years). Postoperatively, hospital for Special Surgery knee score (HSS) was used for clinical assessment. The femorotibial angle (FTA) was measured to classifiy patients to group Ⅰ of 61 knees with less than 7 of valgus; group Ⅱ of 23 knees with 7～9 of valgus; group Ⅲ of 27 knees with over 10 of valgus. Closed wedge osteotomy was performed in all cases. HSS was assessed pre-and post-operatively. [Result] The average follow-up period was 9 years and 6 months (2 years and 4 months to 14 years and 1 month). The HSS knee score averaged 60 points preoperatively, 94 after 1 year and 87 at the last follow-up. Falure I was the need for conversion of a proximal tibial osteotomy to a total knee arthrop lasty, and Failure Ⅱ was the need for conversion of HSS knee score of less than 60 points. The 4 and 14 years survival rates were 99% and 85% using the first definition of failure, and 96. 4% and 75.1% using the second. [Conclusion] Proximal tibial osteotomy is reliable for treating unicompartmental osteoarthritis, providing that the postoperative femorotibial angle is corrected to more than 7° of valgus and falls in the range of 10°～15°.

PURPOSE: To evaluate the change in blink rate in adolescents according to the type and duration of computer tasks and to analyze the risk of ocular dryness using an ocular protection index. METHODS: Fifteen male high school students played computer games and viewed Internet lectures for 20 minutes each. Blink rate was measured by USB camera, and ocular protection index (OPI, the ratio of BUT to inter-blink interval) was calculated for each subject during the two tasks. In addition, 7 of the 15 subjects played computer games again for 40 minutes on another day, and the change in blink rate according to the duration of computer games was observed. RESULTS: The average blink rate was 5.44+/-3.29 per minute (median 5, range 2-12.75) while playing computer games and 20.63+/-11.21 per minute (median 18.25, range 4.93-42.2) while viewing Internet lectures, and this difference was statistically significant (p=0.001). The percentage of subjects with OPI values less than 1 was 53% for computer games and 13% for Internet lectures (p=0.025). While playing computer games for 40 minutes, the mean of total blinks during ten-minute intervals decreased over time: 59.43 times (median 57) during the first 10 minutes, 33.86 times (median 41) during the last 10 minutes. CONCLUSIONS: The blink rate in adolescents was significantly lower and the risk of ocular dryness was higher while playing computer games compared with that of viewing internet lectures. As playing time increased, the blink rate decreased and risk of ocular dryness increased.
Adolescent* ; Humans ; Internet ; Lectures ; Male ; Video Games

Computer assisted surgery (CAS) was used to improve the positioning of implants during total knee arthroplasty (TKA). Most studies have reported that computer assisted navigation reduced the outliers of alignment and component malpositioning. However, additional sophisticated studies are necessary to determine if the improvement of alignment will improve long-term clinical results and increase the survival rate of the implant. Knowledge of CAS-TKA technology and understanding the advantages and limitations of navigation are crucial to the successful application of the CAS technique in TKA. In this article, we review the components of navigation, classification of the system, surgical method, potential error, clinical results, advantages, and disadvantages.
Arthroplasty, Replacement, Knee/*methods ; Humans ; *Surgery, Computer-Assisted

No abstract available.
Arthritis*

Computer-assisted navigation is used to improve the accuracy and precision of correction angles during high tibial osteotomy. Most studies have reported that this technique reduces the outliers of coronal alignment and unintended changes in the tibial posterior slope angle. However, more sophisticated studies are necessary to determine whether the technique will improve the clinical results and long-term survival rates. Knowledge of the navigation technology, surgical techniques and potential pitfalls, the clinical results of previous studies, and understanding of the advantages and limitations of the computer-assisted navigation are crucial to successful application of this new technique in high tibial osteotomy. Herein, we review the evidence concerning this technique from previous studies.
Knee ; Osteotomy* ; Surgery, Computer-Assisted ; Survival Rate ; Tibia

A female patient who underwent total knee arthroplasty presented with a snapping sensation over the left knee at 10 years postoperatively. Initially, the bony mass was visible on the medial femoral condyle radiographically at 5 years postoperatively. The mass had enlarged over time and her symptoms were progressive. The mass was excised at postoperative 18 years and confirmed as an osteochondroma histopathologically. The patient’s symptoms have been completely resolved for 3-year follow-up after excision. LEVEL OF EVIDENCE: V
Arthroplasty ; Arthroplasty, Replacement, Knee ; Female ; Follow-Up Studies ; Humans ; Knee ; Osteochondroma ; Sensation

Despite a recent trend toward increased screening and public awareness for colorectal cancer, 30% of patients present with incurable disease. This study was designed to identify objective criteria that might help surgeons decide which patients with incurable colorectal cancer will benefit from palliative resection. Among 33 patients considered incurable colorectal cancer, twenty one patients underwent palliative resection and twelve patients had bypass surgery. Incidence of postoperative complication after palliative resection was 61.9%(13 cases), and after bypass surgery was 58.3%(7 cases). Among patients treated by palliative resection, one patient required reoperation for postoperative bleeding. The operative mortality after palliative resection was 19%(4 cases), and after bypass surgery was 25%(3 cases). The median survival was 11.4 months for patients treated by palliative resection, and was 9.7 months for patients treated by bypass surgery. These results show that palliative resection can be done safely and effectively in patients with incurable colorectal cancer. We believe this approach improved the quality of the remaining life in these patients.
Colorectal Neoplasms* ; Hemorrhage ; Humans ; Incidence ; Mass Screening ; Mortality ; Postoperative Complications ; Reoperation

Problem-based learning(PBL) is defined as a process of acquiring understanding, knowledge, skills and attitudes in the context of an unfamiliar situation, and applying such learning to that situation. PBL is a way of enabling students thinking more efficiently than they can do in the traditional methods of largely rote learning. Because mordern medical knowledge is growing at an enormous rate, PBL is though as a mean to cope with the rapidly increasing, rapidly changing information base of medicine. The definition, goals, practice, strength, and problems of PBL in medical education are discussed. The curriculum and educational philosophy of McMaster Medical School, where PBL in small group tutorials predominates the programme, are also introduced. Hinderences from implementing PBL in our medical education are discussed.
Curriculum ; Education, Medical ; Humans ; Learning ; Philosophy ; Problem-Based Learning* ; Schools, Medical ; Thinking

No abstract available.
Humans ; Mucin-1*

A 63-year-old man had a huge verrucous protruding mass over the suprasternal area. The lesion enlarged rapidly over 3 mooths, and measured about 10×8 cm. The histologic finding of the biopsy specimen showed nests of squamous epithelium with central keratinization, infiltrating the dermis. The neoplasm was treated successfully with surgical excision.
Biopsy ; Dermis ; Epithelium ; Humans ; Keratoacanthoma* ; Middle Aged