Articular cartilage have dual functions of shock absorber and bearing surface in a moving joint. Articular cartilage is avascular, so the chondrocytes in mature adult must receive their nourishment solely from synovial-fluid perfusion, and it is known that alteration of synovial-fluid perfusion causes degeneration of articular cartilage. Now, in orthopedic fields, the corrective cast immobilization and traction is in popular use. In order to study the cartilage changes induced by this long-term cast immobilization and traction, compression-immobilization and condylar resection of knee joint in rabbits were performed, and weekly histoiogic examinations of articular cartilage up to 5 weeks were followed. The observations were as follows: 1. Degenerative changes of articular cartilage were observed respectively with compression-immobilization and condylar resection, and the severity of the histologic changes appeared to be proportional to the duration of compression-immobilization and condylar resection. 2. Earlier degenerative changes of articular cartilage in condylar resection group than in compression-immobilization group were noted, and this earlier degenerative changes in condylar resection group suggests that hemarthrosis may play a role in cartilage degeneration. 3. Histologically unchanged calcific cartilage zone and mildly hypertrophied subchondral bone were noted in compression-immobilization group, but vascular invasion to calcific cartilage zone and subchondral osteoporosis were noted in condylar resection group.
Adult ; Cartilage ; Cartilage, Articular ; Chondrocytes ; Hemarthrosis ; Humans ; Immobilization ; Joints ; Knee Joint ; Knee ; Orthopedics ; Osteoporosis ; Perfusion ; Rabbits ; Shock ; Traction

We have reviewed our experiences of computerized tomography(CT) in the fracture of the spine. Between December 1983 and June 1985, we treated 33 fractures of the spine in 32 patients. We have used CT for the diagnosis of fractures of the spine in 29 cases (28 patients). Also we have used Louis scoring system to evaluate the stability of the fractured spine. The results are as follows. 1. CT has many advantages that were not given from simple radiograp hies or laminagrams. It reveals the vertebral body, vertebral column, posterior compartments and surrounding soft tissues excellently, and it is easy to interpretate. Also it can be done comfortably and rapidly without the need of manipulations. 2. We could acquire many informations from post-operative or long term following up of CT examinations. 3. If the Louis score is higher than 3, we should think it is unstable, and should take internal fixation of the vertebral column. 4. There is a correlation between Louis score and neurologic signs (p < 0.01). If there was a neurologic sign with low Louis score, less than 1, the recovery was soon, less than 24 hours. 5. According to CT findings for fragmentation or location of fragment, we can alternate an anterior decompression or a posterior decompression. 6. It is necessary to use CT as a initial diagnostic procedure with the simple radiographic examination in spine fracture.
Clinical Study ; Decompression ; Diagnosis ; Humans ; Neurologic Manifestations ; Spine

OBJECTIVE: Our purpose was to compare the pregnancy outcomes of nulliparous women aged 40 years and older with those of nulliparous women under 35 years of age. METHODS: From January 1989 to December 1998 total 57,563 deliveries were seen in Gachon Gil Medical Center. Among them we experienced 59 cases of nulliparas at 40 years and older. These women were compared with 188 young nulliparas under 35 years of age as the control group. The statistical analysis was performed using Chi-square tests, and statistical significance was defined as p<0.05. RESULTS: The incidence rate of elderly nulliparas aged 40 years and older was increased from 0.04% in 1989 to 0.30% in 1998. The age distribution was from 40 years to 45 years. The gravidity of eldery nulliparas was 2.2 in comparison with 1.6 in control group. The incidence of uterine myoma, gestational DM, IUGR and oligohydramnios was significantly high rate in elderly nulliparas. There was significantly high rate of cesarean section in elderly nulliparas(88.1%) in comparison with control group(40.4%). The reasons of cesarean section were her demand(39.0%), CPD(15.3%) and breech presentation(13.6%) in decreasing order. The preterm delivery rate was 10.2% in elderly nulliparas in comparison with 4.3% in the control group. Placenta accreta and uterine atony were significantly high in elderly nulliparas and mean estimated blood loss was also high. There was no difference in 5-minute Apgar score between both group, but there were more cases of neonatal intensive care unit admission in neonates of elderly nulliparas(6.8% vs 0%). CONCLUSION: The incidence of elderly nulliparas is continuously increasing. The elderly nulliparas and their babies are at greater risk than young women. Therefore all elderly nulliparas aged 40 years and older can be regarded as high risk patients and they must be managed with careful attention.
Age Distribution ; Aged ; Apgar Score ; Cesarean Section ; Female ; Fetal Growth Retardation ; Gravidity ; Humans ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal ; Leiomyoma ; Oligohydramnios ; Placenta Accreta ; Pregnancy ; Pregnancy Outcome ; Uterine Inertia

No abstract available.
Humans

BACKGROUND: In this Study, we investigated the effects of lifestyle and metabolic syndrome on free oxygen radical levels in men and women in Korea. METHODS: A total of 254 adults were included in this study from February 2011 to June 2012 at a health promotion center. Information of the lifestyles and presence of metabolic syndrome factors was obtained. Biochemical markers were measured and free oxygen radicals test (FORT) was performed on the blood. RESULTS: Of the 254 subjects, 86 (33.9%) had metabolic syndrome, and 187 (73.6%) were men. Between the subjects with and without metabolic syndrome, there was a significant increase in alanine aminotransferase and serum FORT values in the subjects with metabolic syndrome. Multiple linear regression analysis showed that high-sensitivity C-reactive protein (hs-CRP) (P = 0.004), metabolic syndrome (P = 0.037), and female gender (P = 0.030) were independent predictors of serum FORT values. The subjects with high fasting blood sugar level or low high density lipoprotein cholesterol levels showed high serum FORT values. CONCLUSION: High hs-CRP, the presence of metabolic syndrome, and female gender were associated with the high oxidative stress. High oxidative stress was associated with the presence of metabolic syndrome.
Adult* ; Alanine Transaminase ; Biomarkers ; Blood Glucose ; C-Reactive Protein ; Cholesterol ; Cholesterol, HDL ; Fasting ; Female ; Health Promotion ; Humans ; Life Style ; Linear Models ; Lipoproteins ; Male ; Oxidative Stress* ; Oxygen ; Reactive Oxygen Species

> BACKGROUND: The accuracy of flow-related changes in aortic valve area (AVA) determined by the Gorlin formula or the continuity equation remains disputable. However, anatomic AVA can be determined by using by direct planimetry of transesophageal echocardiography (TEE). The purpose of this study was to assess the impact of changes in flow on AVA determined by TEE using direct planimetry. METHOD: Determination of AVA by TEE using direct planimetey was performed intraoperatively under three different hemodynamic conditions - pre-dobutamine (baseline) period, post-dobutamine period, post-CABG period - in 17 CABG patients and cardiac output (CO) with left ventricular ejection fraction (EF) were also determined by TEE simutaneously. The changes in aortic flow were induced by dobutamine infusion. RESULTS: AVA at pre-dobumaine period, post-dobutamine period, and post-CABG period were 2.99+/-0.80 cm2, 3.01+/-0.79 cm2, and 3.01+/-0.80 cm2, respectively. Before dobutamin infusion, CO and EF were 2.01+/-0.64 L/min and 47+/-10%. After dobutamine infusion, CO and EF were 3.03+/-1.05 L/min, 54+/-9% respectively and significantly increased by 54%, 18% than those measured before dobutamine infusion (p<0.01, p<0.01), respectively. After CABG, CO and EF were 3.86+/-1.86 L/min and 58+/-11% and also significantly increased by 98%, 26% than those measured before dobutamine infusion (p<0.01, p<0.01), respectively. However, despite of these significant hemodynamic changes, there were no significant changes in AVA and no significant correlations between these hemodynamic and AVA changes, neither at post-dobutamine period nor post-CABG period. CONCLUSION: The acute changes in CO and EF do not result in significant alterations in the anatomic AVA determined by TEE using direct planimetry. Thus, TEE using direct planimetry could be accurate and useful in the determination of AVA in hemodynamically unstable patient.
Aortic Valve* ; Cardiac Output* ; Dobutamine ; Echocardiography, Transesophageal* ; Hemodynamics ; Humans ; Stroke Volume*

PURPOSE: Visceral fat (VF) is closely associated with many metabolic risk factors and is also known to be a strong predictive factor for severe metabolic complications in adults. But there are only a few studies concerning the association of VF and risk factors for metabolic syndrome (MS) in children and adolescents. In our study, we emphasized the association of VF [measured by VF computed tomography (VFCT)] and risk factors for metabolic syndrome in children and adolescents. MATERIALS AND METHODS: The subjects were outpatients aged 6 to 18 years who underwent VFCT in the family medicine of The Catholic University of Korea from January 2005 to August 2009. There were 82 patients in total (42 children, 40 adolescents). Height, weight, blood pressure (BP), blood tests, body composition analysis and VF were measured. The three groups were also classified by metabolic score. RESULTS: In children, only high density lipoprotein cholesterol (HDL-C) showed a statistically significant difference, while in adolescents, triglyceride, HDL-C, BP, body mass index (BMI), waist circumference (WC) and VFA showed statistically significant differences. In terms of VFA, fasting glucose, BP, BMI, basal metabolic rate (BMR) and WC showed statistically significant differences. BMI showed a statistically significant difference in terms of BP, BMR, WC, VFA and HDL-C. CONCLUSION: There is a need to acknowledge the statistically significant associations of VF and risk factors for MS in children and adolescents. Screening tests for BP, cholesterol, fasting glucose and WC should be given in clinics for children and adolescents so that MS can be detected and its risk factors treated early.
Adolescent ; Body Mass Index ; Child ; Female ; Humans ; Intra-Abdominal Fat/*physiology ; Male ; Metabolic Syndrome X/*epidemiology/metabolism/physiopathology ; Risk Factors ; Waist Circumference/physiology

> BACKGROUND: The accuracy of flow-related changes in aortic valve area (AVA) determined by the Gorlin formula or the continuity equation remains disputable. However, anatomic AVA can be determined by using by direct planimetry of transesophageal echocardiography (TEE). The purpose of this study was to assess the impact of changes in flow on AVA determined by TEE using direct planimetry. METHOD: Determination of AVA by TEE using direct planimetey was performed intraoperatively under three different hemodynamic conditions - pre-dobutamine (baseline) period, post-dobutamine period, post-CABG period - in 17 CABG patients and cardiac output (CO) with left ventricular ejection fraction (EF) were also determined by TEE simutaneously. The changes in aortic flow were induced by dobutamine infusion. RESULTS: AVA at pre-dobumaine period, post-dobutamine period, and post-CABG period were 2.99+/-0.80 cm2, 3.01+/-0.79 cm2, and 3.01+/-0.80 cm2, respectively. Before dobutamin infusion, CO and EF were 2.01+/-0.64 L/min and 47+/-10%. After dobutamine infusion, CO and EF were 3.03+/-1.05 L/min, 54+/-9% respectively and significantly increased by 54%, 18% than those measured before dobutamine infusion (p<0.01, p<0.01), respectively. After CABG, CO and EF were 3.86+/-1.86 L/min and 58+/-11% and also significantly increased by 98%, 26% than those measured before dobutamine infusion (p<0.01, p<0.01), respectively. However, despite of these significant hemodynamic changes, there were no significant changes in AVA and no significant correlations between these hemodynamic and AVA changes, neither at post-dobutamine period nor post-CABG period. CONCLUSION: The acute changes in CO and EF do not result in significant alterations in the anatomic AVA determined by TEE using direct planimetry. Thus, TEE using direct planimetry could be accurate and useful in the determination of AVA in hemodynamically unstable patient.
Aortic Valve* ; Cardiac Output* ; Dobutamine ; Echocardiography, Transesophageal* ; Hemodynamics ; Humans ; Stroke Volume*

BACKGROUND: Chronic discogenic pain is commonly intractable to various conservative treatments and anatomic correction through operation. Nowadays, a radiofrequency thermocoagualation technique applying the pathophysiologic mechanism that cause discogenic pain and the pathways of transmission of discogenic pain have been successfully tried. This study was performed to evaluate the efficacy of radiofrequecy thermocoagulation of the ramus communicans nerve in patients who suffered from intractable discogenic pain even after intradiscal electrothermal therapy. METHODS: The authors evaluated 13 cases in which radiofrequency thermocoagulation of the ramus communicans nerve was used for patients suffering from chronic discogenic pain even after intradiscal electrothermotherapy. Ten weeks after the procedure, we compared VAS scores of the pre- procedure and post-procedure state. RESULTS: Fifty-four percent of patients had an excellent decrease in the VAS score (VAS < 3). One patient complained of a mild motor weakness of the lower extremity but recovered completely by postoperative day 26. CONCLUSIONS: In the cases of intractable chronic discogenic pain, it is valuable to perform a rhizotomy of the ramus communicans nerve with radiofrequency.
Electrocoagulation ; Humans ; Lower Extremity ; Rhizotomy

BACKGROUND: Gore-Tex implants started out as a product with the distinct advantage of producing a natural nose shape, but using Gore-Tex, it is difficult to predict the height of the nose after rhinoplasty because Gore-Tex contracts over time, making the nose shrink. However, Surgiform, a new form of expanded polytetrafluoroethylene (ePTFE) implant, enables prediction of the height of the nose after rhinoplasty because the implant does not change in thickness even after many years. Thus, we investigated whether changes in implant thickness occurred after rhinoplasty using Surgiform implants. METHODS: This study enrolled 12 patients who had Surgiform nasal implants removed for any reason after receiving rhinoplasty in 2007 or later. After the Surgiform implants were removed, we measured the thickness of the central part of the implants using calipers. RESULTS: At the time of the initial operation, the mean implant thickness was 4.48±0.30 mm at the supra-tip. At the time of implant removal, the mean thickness was 4.32±0.29 mm. The implants maintained 96.5% of their initial thickness. There was a negligible reduction in the Surgiform implants' thickness over time. CONCLUSIONS: Surgiform implants maintained their shape after rhinoplasty, making it possible to predict the height of the nose. Thus, Surgiform is more useful for nasal implants than other ePTFE implants.
Humans ; Nose ; Polytetrafluoroethylene ; Rhinoplasty