No abstract available.

The superior volume maintenance of membranous over endochondral bone grafts, which was shown in several studies has provided the basis for its preferred clinical use as an onlay grafting material on the craniofacial skeleton. The scientific rationale for this seeming embryological advantage, however, has never been proven, Since the cortical component of membranous bone is proportionally greater than that of endochondral bone, it follows that membranous grafts would show greater volume maintenance over time. Our hypothesis is that the pattern of onlay bone graft resorption is primarily determined by a graft's micro-architecture (relative cortical and cancellous composition) rather than its embryololgical origin(membranous versus endochondral). Fourty adult New Zealand white rabbits were used for this study. There were 8 animals in each of 4 groups. The rabbits of each group were sacrificed at 3, 8, and 16 weeks. Four types of grafts were placed subperosteally, onto each rabbit's cranium: a hydroxyapatite, a cortical bone graft of membranous origin, a cortical bone graft of endochondral origin and a cancellous bone graft of endochondral origin. Membranous bone grafts were obtained from the lateral mandible and endochondral bone grafts were obtained from the ileum. In order to determine post-sacrifice volume and density of the bone grafts, a caliper technique and bone densitometry(bone densitometer: LUNAR, DPX-L, U.S.A.) were performed on all of the bone grafts. Bone graft specimens were histologically examined at 3, 8, and 16 weeks.The measurement of volume and density show that there is a statistically greater resumption in the cancellous endochondral bone grafts for all parameter, compared to either the endochondral or membranous cortical bone grafts or hydroxyapatite at all time points(p< 0.05). In addition, there is no significant difference in the resorption rates between the endochondral and membranous cortical bone grafts for all parameters at all time points. By placing cortical bone grafts and cancellous bone grafts on the recipient sites separately, we have shown that the former grafts maintain their volumes, widths and projections significantly better than the latter grafts. Futhermore, we found no statistical difference in resorption rates between the two cortical bone grafts of different embryologic origins, a finding which has never been previously shown. Bone volume fraction, measured with bone densitometry, was shown to be higher in cortical bone than in cancellous bone at all time points, further illustrating the differences between cortical and cancellous bone.From our results, we believe cortical bone to be a superior onlay-graftiong material, independent of its embryololgic origin.
Adult ; Animals ; Biological Factors* ; Densitometry ; Durapatite ; Humans ; Ileum ; Inlays* ; Mandible ; Rabbits ; Skeleton* ; Skull ; Transplants*

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy*

No abstract available.
Transplants*

No abstract available.
Graft Survival* ; Transplants*

The ancillary practice for the management of upper ureteral stones is to push the stone up the renal pelvis before extracorporeal shock wave lithotripsy(ESWL). We evaluated 103 patients with mid and upper ureteral stones for identifying the significant factors of success in push up procedure. The clinical factors of success of push up procedure may be regarded to location (upper, mid), size( 12mm>=,12mm<), duration of impaction( 1Mo>=, 1Mo<), duration of symptoms (1Mo>=, 1Mo<), smoothness of the surface of the stone (Smooth, Rough), degree of obstruction (partial, complete), pyuria or not (WBC> 5, WBC<=5 in microscopic urinalysis) Our results showed that the success rate of push up were 92.7%, 96.3%, 92.9%, 93.3%, 96.6 %, 94.4%, and 93.5% in the case of upper ureter stone, less than 12mm in diameter in stone size, less than 1 month in duration of initial symptoms and impaction, smooth stone surface, partial obstruction, presence of pyuria, respectively compared to 28.6%, 60.7%, 68.4%, 53.3%, 77.8 %, 75%. and 84.2% in the case of mid ureter stone. more than 12mm in diameter, more than 1 month in duration of initial symptoms and impaction, rough stone surface, complete obstruction, absence of pyuria respectively. These are clinically significant factors of affecting success in push up procedure (P<0.05 ) except appearance of pyuria or not (P>0.05). Complications of push up were infrequent, with hematuria (30.7%), flank pain (29.7% ), and ureteral perforation (2.2% ), all of which were managed conservatively. From these data we conclude that upper ureter stones with successful clinical factors should be tried push-up into the renal pelvis before ESWL to improve the therapeutic results.
Flank Pain ; Hematuria ; Humans ; Kidney Pelvis ; Pyuria ; Shock ; Ureter*

OBJECTIVE: We have attempted to identify prognostic factors regarding CC/hMG ovarian stimulation and IUI in infertility and to seek factors valuable in planning infertility treatment and predicting the success rate of IUI therapy in individual couples. METHODS: The variables selected for initial analysis were female age, duration of infertility, type and diagnosis of infertility, number of pre-ovulatory follicles (>or=16 mm, >or=18 mm follicles), thickness of the endometrium, number of the treatment cycles, result of semen analysis, ovarian stimulation protocol, number of IUI. A logistic regression method was used to identify significant variables that contribute to the success of CC/hMG/IUI treatment. RESULTS: Logistic regression analysis revealed four predictive variables as regards pregnancy: duration of infertility (p=0.011), infertility etiology (p=0.049), number of IUI (p=0.004), method of ovarian stimulation (p=0.042). A cause of infertility, especially ovarian dysfunction other than tubal factor, a shorter duration of infertility (<6 years) and CC/hMG minimal ovarian stimulation protocol with double IUI resulted in better treatment success in CC/hMG with IUI cycles. CONCLUSION: We concluded that careful patient selection criteria coupled with successful ovarian stimulation and increased sperm count in female reproductive tract is the model for CC/hMG/IUI sucess.
Diagnosis ; Endometrium ; Family Characteristics ; Female ; Humans ; Infertility ; Insemination* ; Logistic Models ; Ovulation Induction* ; Patient Selection ; Pregnancy ; Semen Analysis ; Sperm Count

No abstract available.
Risk Factors*

BACKGROUNDS: Obstructive sleep apnea syndrome(OSA) can divided into two groups, positional (PP) and non-positional(NPP) obstructive sleep apnea syndrome, according to the body position while sleeping. In this study, we evaluated the differences of anthropometirc data and polysomnographic recordings between the two types of sleep apnea syndrome. MATERIALS: Fifty patients with OSA were divided two groups by Cartwright's criteria. The supine respiratory disturbance index (RDI) was at least two times higher than the lateral RDI in the PP group, and the supine RDI was less than twice the lateral RDI in the NPP group. This patients underwent standardized polysomnographic recordings. The anthropometirc data and polysomnographic data were analyzed, statistically. RESULTS: Of all 50 patients, 30% were found to be positional OSA. BMI was significantly higher in the PP group(p<0.05). Total sleep time was significantly longer in the PP group (350.6±46.0min, p<0.05). Sleep efficiency was high in the PP group(89.6± 6.4%, 85.6±9.9%, p<0.05). Deep sleep was significantly higher and light sleep was lower in the PP group than in the NPP group but no difference was observed in REM sleep between the two groups. Apnea index(AI) and RDI were significantly lower(17.0±10.6, 28.5±13.3, p<0.05) and mean arterial oxygen saturation was higher in the PP group(92.7 ±1.8%, p<0.05) than in the NPP group. CONCLUSION: Body position during sleep has a profound effect on the frequency and severity of breathing abnormalities in OSA patients. A polysomnographic evaluation for suspected OSA patients must include monitoring of the body position. Breathing function in OSA patients can be improved by controlling their obesity and through postural therapy.
Apnea ; Humans ; Obesity ; Oxygen ; Polysomnography ; Respiration ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Sleep, REM

PURPOSE:To describe the features of displaced bucket-handle tears of the menisci on magnetic resonance (MR) images and to assess associated knee injuries. MATERIALS AND METHODS: We retrospectively reviewed coronal and sagittal MR images in 21 bucket-handle tears. The subjects were patients who had underwent preoperative MR evaluations of the knee and were identified from the arthroscopic surgical records as bucket-handle tear. We also described patterns of associated injuries. RESULTS:On coronal MR images, (a) in all cases, peripheral portion of the meniscus(bucket) had the appearance of a truncated or altered wedge;(b) central fragments(handle) were observed to be sitting in the intercondylar notch(16 cases) or located between the fernoral condyle and tibial plateau (5 cases). On sequential sagittal MR images, (c) the bow-tie appearance of the body of the meniscus was not seen (13 cases);(d) the bow-tie appearance of the displaced inner fragment was seen at the intercondylar notch level (9 cases);(e) "double posterior cruciate ligament" sign was presented (7 cases). Associated joint abnormalities included anterior cruciate ligament tears(l 1), contralateral meniscal tears(l 1), posterior cruciate ligament tears(3), medial collateral ligament tears(3), osteoarthritis(1), and Baker's cyst(l). CONCLUSION:Awareness of these characteristic MR findings(a-e) may increase the sensitivity of MR imaging in the diagnosis of displaced bucket-handle tears, and the MRI may be helpful to correctly characterize the displaced fragment and patterns of associated injury, providing arthroscopists a guide to appropriate surgical plans.
Anterior Cruciate Ligament ; Collateral Ligaments ; Diagnosis ; Humans ; Joints ; Knee ; Knee Injuries ; Magnetic Resonance Imaging* ; Posterior Cruciate Ligament ; Retrospective Studies