PURPOSE: To analyze the clinical and radiologic results after total knee arthroplasties using down-sizing femoral prosthesis for tight fitting in patients over 75 years old. SUBJECTS AND METHODS: The study tracked the histories of 99 elderly patients aged 75 and over who underwent total knee arthroplasties with at least five years of follow-up from January 1st, 2005 to December 31st, 2007. The average age of the 99 patients was 78.58 years, and 17 women an 82 men patients underwent 78 cases of total knee arthroplasties on the right and 77 cases of total knee arthroplasties on the left. The HSS score and VAS scoring systems were introduced for clinical analysis. We compared the results of the width of the radiolucent line in 7 sections around the femoral component, 7 sections around the tibia component and 5 sections in the patella component using the American Knee Society Radiographic Evaluation and Scoring system respectively. RESULT: The average period of postoperative follow-up study was 6.2 years. The average femoral prosthesis size in preoperative measurement was 2.41 while the size selected in surgery was 1.89. The average VAS score decreased from 8.15 in preoperative measurement to 2.85 in postoperative measurement. Clinical significant loosening or dislocation of femoral prosthesis was not observed. Although the radiolucent line was observed in 5 cases, the score was less than 4. CONCLUSION: Total knee arthroplasties using down-sizing femoral prosthesis does not increase osteolysis and dislocation of femoral prosthesis but does reduce pain and help patients return to normal activities. Therefore this study showed that total knee arthroplasties using down-sizing femoral prosthesis helped elderly patients aged 75 and over.
Aged* ; Arthroplasty ; Dislocations ; Female ; Follow-Up Studies ; Humans ; Knee ; Male ; Osteolysis ; Patella ; Prostheses and Implants ; Tibia

BACKGROUND: Policy-makers are required to know the current patterns of resource use and the costs of stroke. However, the scientific evidence, on which health policy-making can be based, is not sufficient. Our study aimed to investigate resource utilization and costs during the one year after stroke. METHODS: Among patients with acute ischemic stroke (7 days from onset) who were admitted from July of 2001 to July of 2002, 223 were interviewed one year after the onset of stroke through a home visit by an experienced research nurse. Resource utilization and related costs were investigated. RESULTS: The average length of stay was 25 days. The average first inpatients costs was won 2, 230, 000. After discharge, the average outpatient visit was 22 days. The average expenditure per patient during the one year from onset of stroke was won 5, 235, 000. The hospital charge was 59% of the total cost, the cost for hiring a care-giver was 14%, and the fee for the outpatient clinic was 13%. Thirty-nine percent (won 2, 051, 000) of the total expenditure was consumed in the first month, 12% was in the second, 8% was in the third, and around 5% monthly was after 3 months. CONCLUSIONS: Our study is the first one to investigate the resource utilization and the related costs in stroke patients in Korea. The results of this study should not be generalized to all Korean stroke patients, but this study may serve as a reference for inferring the real status in Korea and may be a starting point for further nationwide resource utilization and costs studies.
Ambulatory Care Facilities ; Delivery of Health Care* ; Fees and Charges ; Health Expenditures ; Hospital Charges ; House Calls ; Humans ; Inpatients ; Korea ; Length of Stay ; Outpatients ; Stroke*

Cerebral aneurysms associated with arteriovenous malformation (AVM) have been reported with a variable incidence, averaged 10% of total AVM cases. It has been AVM. We report four cases of the intracranial aneurysm associated with AVM. Three cases of aneurysm were located in distal portion of feeding artery, and one case was proximal on major feeding artery. And bleeding resulted from rupture of aneurysm. Three of them located in the posterior circulation. Removal of aneurysm and AVM was successfully accomplished in 3 cases.
Aneurysm ; Arteries ; Arteriovenous Malformations* ; Hemorrhage ; Incidence ; Intracranial Aneurysm ; Rupture

This study was started to find out if plasma malondialdehyde(MDA), alpha-tocopherol and erythrocyte superoxide dismutase(SOD) activity could be markers of biological activity resulting from exposed to lead in workers. Blood samples were randomly obtained from lead -exposed workers(n=29), CO2 welders(n=60) and office workers(n=60). We used whole blood to analyse blood lead with atomic absorption spectrophotometer. Superoxide dismutase activity in erythrocyte was measured with spetrophotometer. MDA and alpha-tocopherol in plasma were measured with high performance liquid chromatography. Lead-exposed workers was significantly high in blood lead concentration(29.37 ng/dl) compared with welders(6.42 ng/dl) and office workers(5.01 ng/dl). The level of plasma MDA was significantly higher in the lead-exposed workers(1.87 nmol/g cholesterol) than the welders(1.41 nmol/g cholesterol) and office workers(1.41 nmol/g cholesterol). Erythrocyte SOD activity in lead-exposed workers(56.80 U/g Hb) was significantly increased than those of welders(37.63 U/g Hb) and office workers(20.47 U/g Hb). The plasma alpha-tocopherol level of lead-exposed workers(4.93 ng/g cholesterol) was statistically different from welders(4.25 ng/g cholesterol) and office workers(4.28 ng/g cholesterol). Neither age nor smoking was related to SOD or MDA level. Blood lead was significantly correlated with erythrocyte SOD activity(r=0.405), plasma MDA(r=0.296) and alpha-tocopherol(r=0.207). Plasma MDA was also significantly correlated with SOD (r=0.217). In multiple regression analysis, the change of MDA and SOD activity level related to the blood lead concentration. These results suggested that the increase of plasma MDA and erythrocyte SOD activity in lead-exposed workers had a close relationship with the oxidative stress induced by lead.
Absorption ; alpha-Tocopherol ; Antioxidants* ; Chromatography, Liquid ; Erythrocytes ; Lipid Peroxidation* ; Oxidative Stress ; Plasma ; Smoke ; Smoking ; Superoxide Dismutase ; Superoxides

BACKGROUND: Liver failure due to ischemia-reperfusion injury is a serious problem in liver transplantation and radical wide resection of the liver. This injury is believed to be closely related to the generation of oxygen free radicals. Gabexate mesilate, a synthetic protease inhibitor, has an effect on the suppression of extracellular release of oxygen free radicals in the microvascular endothelium, as well as on protease inhibition. In order to understand the effects of gabexate mesilate on ischemia-reperfusion injury to the liver, we performed animal experiment with rats. METHODS: We divided the rats into two ischemia-reperfusion groups:the experimental group which received a 30 minutes ischemic injury along with the infusion of gabexate mesilate and a control group which received only the injury. Each group was subdivided into 4 sub-groups:ischemic injury only and ischemic injury plus 60, 120 or 180 minutes reperfusion injury. The test parameters were TNF-a and IL-6 in the serum, and superoxide dismutase(SOD), catalase, and malondialdehyde(MDA) in liver and lung tissues. RESULTS: The group receiving gabexate mesilate had a significantly higher level of liver SOD and liver catalase and a significantly lower level of liver MDA and lung MDA than the control groups. The TNF-a levels in the gabexate mesilate groups were significantly lower in the early phase, and a comparison of the IL-6 levels between two main groups yielded no significant results. The levels of lung catalase and SOD showed no significant difference between the two main groups. CONCLUSIONS: Protease inhibitor has the beneficial effect of liver ischemia-reperfusion injury suppression due to an increase in antioxidants or oxygen-free-radical suppression. The roles of TNF-a and IL-6 in liver reperfusion injury was not clear in our investigation. However, TNF-a might have an effect in the early phase. The mechanism of reperfusion injury to the lung in liver ischemia-reperfusion injury might be different from that to the liver.
Animal Experimentation ; Animals ; Antioxidants ; Catalase ; Endothelium ; Free Radicals ; Gabexate ; Interleukin-6 ; Liver Failure ; Liver Transplantation ; Liver* ; Lung ; Oxygen ; Protease Inhibitors* ; Rats* ; Reperfusion Injury* ; Superoxide Dismutase ; Superoxides

The purpose of this study is to review the validity of quantitative indices on the Evaluation of Korean Medical Schools in 1996. The data required for the indices were obtained from the 1996's edition of the Directory of Korea Medical Education and compared to the results of the evaluation. Among the quantitative indices of the evaluation the number of professors and assistants of basic medical science was the most valuable index to differentiate the better group from lesser groups of medical schools in Korea.
Education, Medical ; Korea ; Schools, Medical*

BACKRGROUND: Cervix cancer is the most common form of cancer among Korea women. In spite of proof that cervical cancer screening could reduce death rates substantially, the screening rates reported by previous Korean studies remain stubbornly very low. Behavioral studies to increase the cervix cancer screening rate are essential in order to develop the cancer screening program. OBJECTIVE: To evaluate the factors which are related to the intention and behavior for cervix cancer screening using the Theory of Planned Behavior (TPB) and the Theory of Reasoned Action (TRA). METHODS: The survey was conducted from July 21st to 26th in 1998. Of 3,218 women, 393(12.2%) between 30 and 65 years old, voluntarily participated in the survey in the 3 Myeons in Choongju city. Charge-free cervix cancer screening was provided for the subjects 3 months later. RESULTS: The R-square of both TPB and TRA to the intention (30% and 42%, respectively) was greater than the actual behavior (21% and 13%, respectively. TPB and TRA were found to provide an appropriate framework for the study of cervix cancer screening behavior. However, TRA was more powerful in explaining the intention, not only because the perceived behavioral control component exhibited lower reliability and validity than other components(attitude and subjective norm), but also because there may have been a few limitations in this study design. Consequently, the use of TRA is preferred in attempting to explain intention and actual behavior in this study. CONCLUSIONS: This study suggests that a successful intervention program should focus on changing attitudes and reducing psychologic barriers, rather than on just providing information. Physician recommendations, and the support of family members and friends are also very important factors in cervix cancer program participation. Physicians, friends, family members, and opinion leaders in rural areas, all of whom could affect the individual subjective norm, may all have the potential to play great roles as facilitators.
Aged ; Cervix Uteri* ; Chungcheongbuk-do ; Early Detection of Cancer ; Female ; Friends ; Health Behavior ; Humans ; Intention ; Korea ; Mass Screening* ; Mortality ; Reproducibility of Results ; Uterine Cervical Neoplasms*

PURPOSE: To evaluate the usefulness of echo-planar FLAIR imaging in various cerebral lesions as compared with fast FLAIR imaging. MATERIALS AND METHODS: We obtained consecutive fast FLAIR and echo-planar FLAIR images in 33patients in whom MR imaging had revealed ischemic infarction (n=11), acute infarction (n=5), brain tumor (n=3), other conditions (n=3) or no abnormality (n=11). On both sets of images, percentage contrast and contrast to noise ratio (CNR) were calculated for white matter-gray matter and white matter-lesion. RESILTS: White matter-gray matter percentage contrast and CNR were lower on echo-planar FLAIR imaging than on fast FLAIR imaging (percentage contrast, 19 +/- 2 % vs 28 +/- 3 %, CNR, 2.77 +/- 0. 5 vs 4.86 +/- 0.7). White matter-lesion percentage contrast on echo-planar FLAIR imaging was similar to or greater than that on fast FLAIR imaging; 75 +/- 12 % vs 45 +/- 11 % in ischemic infarction, 80 +/- 12 % vs 78 +/- 11% in acute infarction, and 121 +/- 25 % vs 102 +/- 15 % for tumors. White matter-lesion CNR was similar on both sets of images: 8.3 +/- 0.9 vs 7.9 +/- 0.8 in ischemic infarction, 11 +/- 1.5 vs 9.5 +/- 1.2 in acute infarction, and 24 +/- 4 vs 27 +/- 3 for tumors. Due to high susceptibility to magnetization, echo-planar FLAIR imaging showed image degradation at the interface of the paranasal sinus and adjacent to the temporal bone. CONCLUSION: Echo-planar FLAIR imaging may be a useful pulse sequence in the diagnosis of various cerebral lesions.
Brain Neoplasms ; Diagnosis ; Infarction ; Magnetic Resonance Imaging ; Noise ; Temporal Bone

A 62-year-old female patient was scheduled for emergent explo-laparotomy under general anesthesia because of traffic accident. Preoperative checked chest x-ray showed multiple fractures of the ribs but didn't show the sign of pneumothorax or hemothorax. she had no dyspnea. Compared with previous value(PaO2; 210.5 mmHg), Arterial PO2 value(PaO2; 143.0 mmHg) was reduced significantly two hours after starting general anesthesia. Chest x-ray was taken in the operating room, which showed pneumothorax in the right side lung. The patient was treated with immediate closed thoracostomy. She recovered uneventfully three days later with complete resorption of the pneumothorax.
Accidents, Traffic ; Anesthesia, General* ; Dyspnea ; Female ; Hemothorax ; Humans ; Lung ; Middle Aged ; Operating Rooms ; Pneumothorax* ; Ribs ; Thoracic Injuries* ; Thoracostomy ; Thorax*

The incidence of thymolipoma or thynuc cyst is very rare among the tumors of thymic origin, which are usually benign or invasive thymoma. Thymic tumor has been found among 10 to 15% of the patients with myasthenia gravis(MG). However the patients with thymolipoma or thynuc cyst rarely manifestated as MG. Moreover the case of MG with thymolipoma and thymic cyst is extremely rare ; Only one case has been reported hitherto. We hereby report a 41-year-old woman presenting as ocular MG with thymolipoma and thymic cyst. She complained diplopia, ptosis and headache, which had begun 3 months prior to admission and have been fluctuating thereafter. Ocular MG was confirmed by positive Tensilon and Jolly test. Her chest CT showed an enlarged thymus which turned out to be thymolipoma with thymic cyst on the pathologic examination. Although rare, thymolipoma and/or thymic cyst should be considered in the differential diagnosis of thymic tumor in MG.
Adult ; Diagnosis, Differential ; Diplopia ; Edrophonium ; Female ; Headache ; Humans ; Incidence ; Mediastinal Cyst* ; Myasthenia Gravis* ; Thymoma ; Thymus Gland ; Thymus Neoplasms ; Tomography, X-Ray Computed