The goal of total knee replacement is to relieve pain, to stabilize joint movement and to correct deformity. It is indicated for patients with rheumatoid arthritis, osteoarthritis and severe post-traumatic arthritis. The author analyzed 71 patients(106 cases), who received the PFC type of total knee replacement from August 1992 and the results were as follows; 1. Among the 71 patients, male was 8 patients and female was 63 patients whose average age was 56 years and average follow up period was 24 months, ranged from 8 months to 3 years 8 months. 2. Rheumatoid arthritis was the most common cause with 31 patients(56 cases) followed by osteoarthritis with 39 patients(49 cases). There was also one patient(1 case) that showed bony union of the knee due to old tuberculosis. The average duration of the illness was 12 years and the average weight of the patients was 57.7kg. 3. Flexion contracture decreased from an average of 21 degrees to 5 degrees after the operation. The range of motion increased from an average of 92 degrees before the operation to 117 degrees afterwards in cases of rheumatoid arthritis and decreased slightly from 108 degrees to 106 degrees in cases of osteoarthritis. 4. The tibiofemoral angle was corrected from an average 1.5 degrees varus before the operation to an average 6.7 degrees valgus after operation. Eighty seven percent of patients with rheumatoid arthritis showed valgus deformity and seventy eight percent of degenerative osteoarthritis patients showed varus deformity preoperatively. 5. Radiographically, the joint line position shifted an average 2.3mm in rheumatoid arthritis and an average 0.3mm in osteoarthritis. The component position, the femoral flexion was an average 89.6 degrees in the anteroposterior view, an average 87 degrees in the lateral view. 6. The thickness of the patella measured in the operating room of 61 cases was an average 21mm and after resection of patella, the remaining bone measured an average of 13.6mm. 7. To achieve soft tissue balance, 29 patients(33 cases) underwent medial stripping and 23 patients(30 cases) had patella lateral release. 8. The Insall Knee Rating Score was used to evaluate the results. The results were 69 cases excellent, 33 cases good, 3 fair and 1 poor. Ninety two percent of the patients had good or excellent results in average 24 months follow-up. 9. The complications consisted of one case of delayed deep infection, one case of patellar subluxation and one case of supracondylar fracture of the femur.
Arthritis ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Knee ; Congenital Abnormalities ; Contracture ; Female ; Femur ; Follow-Up Studies ; Humans ; Joints ; Knee ; Male ; Operating Rooms ; Osteoarthritis ; Patella ; Range of Motion, Articular ; Tuberculosis

The rupture of anterior cruciate ligament has been diagnosed by stress test, radiogram and diagnostic arthroscopy, but these methods have several disadvantages of lack of objectivity, exposure to radiation and risk of anesthesia. To eliminate these difficulties, the K-T 1,000 knee ligament arthrometer was used for the objective diagnosis in the injury of anterior cruciate ligament. We performed instrumented measurement of anterior-posterior laxity of the knee in 100 normal subjects by using the K-T 1,000 knee ligament arthrometer under the 15 lb., 20 lb. and maximum anterior pulls, and 20 lb. posterior push. The following results were obtained: 1. The mean anterior displacement at 20 lb.: 4.43mm The mean posterior displacement at 20 lb.: 2.30mm 2. The mean right knee-left knee difference in anterior displacement: 0.89mm 3. The mean anterior compliance index: 1.16mm So, we believed that a right knee-left knee difference and a anterior compliance index are sensitive measures of the integrity of the anterior cruclate ligament. And this test method was helpful for the diagnosis and objective recording in the injury of anterior cruciate ligament. This test method has following advantages: 1. There is no anesthesia risk. 2. The patient and examiner undergo no radiation exposure. 3. Diagnostic arthroscopy may be avoided. 4. Due to patient comfort, there is minimal muscle guarding.
Anesthesia ; Anterior Cruciate Ligament ; Arthroscopy ; Compliance ; Diagnosis ; Exercise Test ; Humans ; Knee ; Ligaments ; Methods ; Radiation Exposure ; Rupture

No abstract available.
Magnetic Resonance Imaging* ; Relaxation*

BACKGROUND: Candida species are one ol the major pathogens causing opportunistic infection. The need for a standardized. and clinically relevant method for antifungal susceptibility testing has become more increased because resistance to antifungal agents is now being reported with increasing frequency. The purposes of this study were to measure the minimal inhibitory concentrations actions amphotericin B, flucytosine and fluconazole of clinical isolates of Candida species, and to evaluate broth microdilution method as a more efficient test method, compared with NCCLS standard broth macrodilution. METHODS: The minlmal Inhibitory concentrations of C. parapsilosis ATCC 90018, C, albicans ATCC 90028 and 32 Candida isolates from Korea University Hospital were evaluated against amphotericin B, flucytosine and fluconazole by broth macrodilution and microdilution methods. RESULTS: The minimal inhibitory concentrations of Candida species ranged 0.25 to 1.0 microgram/mL for amphotericin B, 0.125 to 2.0 microgram/mL for flucytosine and 0.125 to 64 microgram/mL for fluconazole. The percent of agreement between NCCLS standard broth macrodilution and microdilution was highest when inoculum size was 0.5-2.5x103 CFU/mL and incubation time was 48 hours, and one fold dilution agreement was 100% for amphotericin B, 100% for flucytosine and 88-96% for fluconazole. CONCLUSIONS: This study showed good agreement of results of broth microdilution test with those of macrodilution, and suggested that broth microdilution method is an accessible and useful method and can be substituted for broth macrodilutlon method with the expectation of good results.
Amphotericin B ; Antifungal Agents ; Candida* ; Fluconazole ; Flucytosine ; Korea ; Opportunistic Infections

We have many unsolved problems about the femoral neck fracture, especially non-union of the fracture and avascular necrosis of the femoral head. It seems clear that underlying these are two basic problems; first, the mechanical difficulties in maintaining secure fixation; and second, biological factors interfering with union, paramount of which is damage to the blood supply of the femoral head. Intra-capsular fracture of the femoral neck heals in the same way as other intra-articular fractures-only by endosteal and not by periosteal repair. If the femoral head has an intact blood supply, repair appears early on both sides of the fracture. But if the femoral head is not viable, this repair appears only on the neck side of the fracture. It can migrate into the head and heal the fracture only if there is close apposition and rigid fixation of well reduced fracture fragments. Clearly the femoral neck fracture heals not by periosteal callus but by callus arising from the marrow supporting structure. Yet there is still no reliable clinical method of determining early the union of the femoral neck fracture and the viability of the femoral head. The femoral head intra-osseous venography, first described by Hulth (1953), to predict viability of the femoral head after fracture of the femoral neck has been carried by various previous authors (Hulth1953 1956 1958, Dahlgren 1959, Harrison 1962, Hulth and Johansson 1962, Nagai 1962). However, they did not mention healing process of fractures of the femoral neck in these studies. To observe the fracture healing and to predict the viability of the femoral head, authors adopted a femoral trochanteric intra-osseous venographic technique. The precedure was carried out under the control of a T-V image intensifier. Venous drainage of the femoral head parallels the arterial supply. There are several venous drainage routes in the hip region; the medial and lateral circumflex vein, gluteal vein, nutrient vein, femoral vein, vein of the ligamentum teres and obturator vein. With the aid of a T-V image intensifier, a bone marrow needle is driven 1 inch below the femoral greater trochanter. When the tip of the needle is in the marrow cavity, about 30cc, of 75% Urograffin is injected. Next X-rays are taken at intervals of 2 seconds, the last film at 5 minutes. A positive venography is one in which venous drainage is seen, and opaque fluid is seen in mottled distribution throughout neck region and part of the head. A negative venography is one in which no venous drainage is seen, on the contrary, opaque fluid pools within the trochanteric region are evident and remain for at least 5 minutes. A positive venography indicates that the head has an intact circulation, thus it may be predicted that the fracture can unite and the head is alive. Negative venography suggests that fracture union is not and will not take place and that the head may be dead. This study provided information about fracture heaIing processes and vascularities of the femoral head and its surrounding tissues during and after fractures healing. We have found that trochanteric intra-osseous venography is a useful diagnostic tool in hip injuries.
Biological Factors ; Bone Marrow ; Bony Callus ; Drainage ; Femoral Neck Fractures ; Femoral Vein ; Femur ; Femur Neck ; Fracture Healing ; Head ; Hip Injuries ; Hip ; Methods ; Neck ; Necrosis ; Needles ; Phlebography ; Round Ligaments ; Veins

No abstract available.
Aged* ; Calcinosis* ; Humans

No abstract available.

No abstract available.
Toes*

No abstract available.
Toes*

The present study was carried out to find a simple and safe in. vitro test for phtotoxic drugs. Authors selected two strains of Salmonella typhimurium(TA98 and TA102) which have been used in Ames test for the detsction of mutagenecity af various chemical substances. Both strains are genuine products of genetic enzineering. The etrain TA98 should be highly vulnerable to ultraviolet radition because it lacks normal I)NA excision repair gene. The strain TA102 was chosen as control since it maintained the DNA repair gene. These strains were subjected to increasing dosea of UVA with or without pretreatment of 8 methoxypsoralsn(8-MOP) which is a prototype of photatoxic druge. The authors made use of a perforated stain-less steel template which provided a simple and eosy monitoring of ultraviolet irradiation effects i.e. clear zones due to inhibition of the atrains could be determined. By using this methad, the authors acquired the following results .' I. 8-MOP alone exerted no inhibition on both strains at concentration upto 100mg /ml. 2. UVA irradiation alone showed no growth inhibition at dose upto 5J/cm. 3. UVA irradiation after pretreatment with 8 MOP resulted varying growth inhibition in proportion to irradiation doses. 4. Authors found a suitable concentration of 8-MOP for this test is 10pg/ml. With this ccncentrstion, minimal phatatoxic dose of UVA were O.l J/cm for the strain TA98 and 1.0J/cm for the strain TA102 respectively.
Dermatitis, Phototoxic ; DNA Repair ; Methoxsalen ; Salmonella ; Steel