1.Comparison of Monoblock and Modular Femoral Stem on Isolated Acetabular Revision with Use of Uncemented Cup.
Il Yong CHOI ; Kee Cheol PARK ; Kyoung Bo MIN ; Joon Hwan LEE ; Young Ho KIM
Journal of the Korean Hip Society 2006;18(4):160-166
Purpose: The purpose of our study was to assess the clinical and radiological results of isolated acetabular revision and the differences in the results between monoblock and modular femoral stems. Materials and Methods: Between October 1991 and June 2002, 39 patients (39 hips) underwent isolated acetabular revisions with use of uncemented cups and bone grafts. The mean period of follow-up was 5 years 3 months (range, 2 years 1 month to 9 years 8 months). The mean age of the patients at the time of the surgery was 51 years old (range, 26 to 75 years old). The monoblock femoral stems were used in 19 hips and the modular femoral stems were used in 20 hips. The monoblock stems were retained without exchange provided that there was no gross scratch on the femoral head and the femoral stem was confirmed to be stable and fixed intraoperatively. In the modular stems, the femoral heads were always exchanged with new ones. Results: The mean Harris hip score improved from 57 to 87 points. Radiologically, all the stems retained at surgery remained well osseointegrated without osteolysis. Re-revisions of the acetabular components were performed in 5 hips using monoblock stems due to periacetabular osteolysis caused by excessive wear of polyethylene and subsequent loosening of the cups in 3 hips and mechanically unstable acetabular cups without osteolysis in 2 hips. The mean wear rate of polyethylene coupled with the monoblock stem was 0.27 mm/year which was greater than the 0.11 mm/year in the cases with modular stems. Conclusion: To prevent failure of acetabular cups that may occur later by excessive wear of polyethylene, we recommend revision of the well-fixed monoblock femoral stems even though there is no gross scratch on the femoral heads of the monoblock stems.
Acetabulum*
;
Follow-Up Studies
;
Head
;
Hip
;
Humans
;
Osteolysis
;
Polyethylene
;
Transplants
2.A Case of Central Nervous System Langerhans Cell Histiocytosis: Brain MRI Findings and Clinical Course.
Kyu Sik KANG ; Han Joon KIM ; Kyoung Min LEE
Journal of the Korean Neurological Association 2002;20(3):279-282
A 28-year-old man with Langerhans cell histiocytosis of the gastric wall and hypophysial infundibulum had received local radiation therapy to the infundibulum. Eight months later he presented with left inferior temporal quadrantanopsia of the left eye. Brain MRI revealed multiple nodular enhancing lesions involving brainstem, left external capsule, both temporal lobes, prechiasmatic optic nerves and basal ganglia. After dexamethasone chemotherapy there had been partial remission. During tapering dexamethasone the symptom aggravated and then despite etoposide chemotherapy the size and number of lesions increased.
Adult
;
Basal Ganglia
;
Brain Stem
;
Brain*
;
Central Nervous System*
;
Dexamethasone
;
Drug Therapy
;
Etoposide
;
Hemianopsia
;
Histiocytosis, Langerhans-Cell*
;
Humans
;
Magnetic Resonance Imaging*
;
Optic Nerve
;
Temporal Lobe
3.Expression of Oncogene Product in the Colorectal Carcinoma.
Young Ran SHIM ; Woo Young JANG ; Kyoung Chan CHOI ; Joon Hyuk CHOI ; Won Hee CHOI ; Min Chul SHIM
Yeungnam University Journal of Medicine 1995;12(2):210-225
The expression of p62"' and p2l can be seen in many solid tumor, but the pattern and incidence of expression were different according to organ, countries, and examiners, thus it is not definitely defined. Total 67 colorectal carcinoma in paraffin sections are analysed by immunohistochemically for evaluation of the p62and p21- expression according to the age, sex, chief complaints, location, differentiation, modified Dukes stage, using the specific monoclonal antibodies. The results were summarized as follows : The age of patients ranged from 32 years to 82 years. The mean age was 57.6 years. The expression of p 62y' and p21 was not correlated with age. Male was 29 cases(43.3%) and female was 38 cases(56.7%). The male to female ratio was 1:1.31. The and 95.0% in moderately differentiated adenocarcinoma, 90.0% and 90.0% in poorly differentiated <,;, adenocarcmoma, 100.0% and 100.0% in mucinous carcinoma. The positive rate of p62!and and p2l' was 94.1% and 88.2% in Dukes stage B,, 96.0% and 96.0% in Dukes stage B,, 100.0% and 100.0% in Dukes stage C,, 100.0% and 88.9% in Dukes stage C, and 100.0% and 100. o% in Dukes stage D. The expression of p62 y' in metastatic colorectal carcinoma showed diffuse and strongly positive reaction than primary colorectal carcinoma. The expression of p21 in primary colorectal carcinoma showed diffuse and strongly positive reaction than metastatic colorectal carcinoma.
Adenocarcinoma
;
Adenocarcinoma, Mucinous
;
Antibodies, Monoclonal
;
Colorectal Neoplasms*
;
Female
;
Humans
;
Immunohistochemistry
;
Incidence
;
Male
;
Oncogene Proteins*
;
Oncogenes*
;
Paraffin
4.The Correlations between Temporomandibular Joint Symptoms and Magnetic Resonance Imaging Findings in German Patients.
Min Kyoung KYE ; Young Yuhn CHOI ; Kee Joon LEE
Journal of Korean Dental Science 2015;8(1):16-27
PURPOSE: The purpose of this study was to evaluate the correlation between the clinical symptoms of temporomandibular disorder and findings in the magnetic resonance imaging (MRI). MATERIALS AND METHODS: Clinical data and MRI images were collected from a total of 240 German patients. Clinical symptoms were briefed as joint clicking, crepitus and pain. MRI findings were further defined according to the condyle position, condyle degeneration, disc positon, disc degeneration and the presence of osteophyte/sclerosis/synovitis. Hypermobility was separately recorded. Correlation analysis between parameters was performed. RESULT: Joint clicking had a positive correlation with unilateral disc degeneration, osteophyte, sclerosis and synovitis. Crepitus had a significant correlation with bilateral osteophyte. Pain was not correlated with any MRI findings except hypermobility. CONCLUSION: Selective correlations between the MRI findings and clinical symptoms were elucidated. The results of this study imply that condyle-disc deformities could be advanced without pain, and that joint clicking and crepitus could be clinical symptoms of condyle-disc degeneration.
Congenital Abnormalities
;
Humans
;
Intervertebral Disc Degeneration
;
Joints
;
Magnetic Resonance Imaging*
;
Osteophyte
;
Sclerosis
;
Synovitis
;
Temporomandibular Joint Disorders
;
Temporomandibular Joint*
5.The Relationship Between Radial Artery Depth and Wrist Extension Angle Measured by Ultrasonography.
In Gu KANG ; Won Joon JEONG ; Kyoung Min MOON
Journal of the Korean Society of Emergency Medicine 2013;24(3):279-283
PURPOSE: Radial artery access has been promoted for anesthesia, critical care, and cardiac catheterization. Our aim was to establish the ideal wrist position for radial artery cannulation; thus we performed ultrasound examinations of the radial artery to analyze the effect of the angle of wrist extension on radial artery dimensions. METHODS: Measurements were performed in 30 healthy volunteers. The radial artery diameter and the depth from the skin to the radial artery were measured using an ultrasound technique. Radial artery dimensions were measured at wrist joint angles of 0, 15, 30, 45, and 60 degrees. RESULTS: The average age was 26.7+/-4.7 years. The mean height and weight were 171.0+/-6.9 cm and 68.3+/-15.1 kg, respectively. The mean width and height of the radial artery was 2.61+/-0.54 mm and 2.21+/-0.42 mm, respectively. The depth from the skin to the radial artery was 4.67+/-1.74 mm at a wrist joint angle of 0 degrees. A strong and direct association was found between body mass index with diameters (width and height length) and depth from the skin to the radial artery at wrist angles of 0 degrees. Repeated measure ANOVA revealed that the depth was affected by the wrist joint angle. Our volunteers were associated with shallower depth as increasing in the wrist joint angle statistical significantly (p=0.001). At wrist angles of 30 and 60 degrees, the depth was shallower than 0 degrees (p=0.027, p=0.004). CONCLUSION: Our results indicate that in healthy subjects the depth of the radial artery is shallow when the wrist joint is extended up. A wrist extension at 30 and 60 degrees for healthy subjects results in a decrease in the depth of the radial artery.
Anesthesia
;
Body Mass Index
;
Cardiac Catheterization
;
Cardiac Catheters
;
Catheterization
;
Critical Care
;
Healthy Volunteers
;
Radial Artery*
;
Skin
;
Ultrasonography*
;
Volunteers
;
Wrist Joint
;
Wrist*
6.M3 Subtype of Muscarinic Receptors Mediate Ca2+ Release from Intracellular Stores in Rat Prostate Neuroendocrine Cells.
Jin Kyoung KIM ; Soo Jung KIM ; Ji Eun LEE ; Kyeong Min MIN ; Sung Joon KIM
Journal of Korean Medical Science 2005;20(2):256-261
Our previous studies document the expression of adrenoceptors and purinoceptors in the rat prostate neuroendocrine cells (RPNECs). However, a direct investigation of the receptors for acetylcholine (ACh) is still lacking in the prostate neuroendocrine cells. RPNECs were freshly isolated from the ventral lobes of rat prostate by using collagenase. Effects of ACh and various muscarinic antagonists on the intracellular Ca2+ concentration ([Ca2+]c ) were investigated by using the fura-2 spectrofluorimetry. Single-cell RT-PCR analysis was applied to identify the transcripts for the muscarinic receptor subtypes. ACh (5 micrometer) induced a sharp transient increase in the [Ca2+]c of RPNECs, which was independent of the extracellular Ca2+. In the same RPNECs, high KCl (60 mM), phenylephrine (5micrometer), UTP (P2Y1/2 agonist, 50, micrometer), and alpha, beta-meATP (P2X1/3 agonist, 0.5micrometer) also increased the [Ca2+]c. The ACh-induced [Ca2+]c change (delta[Ca2+]c ) was blocked by atropine or by para-fluorohexahydrosiladifenidol (M3 antagonist, 0.3micrometer), but not by telenzepine (M1 antagonist, 1 micrometer) and himbacine (M2 and M4 antagonist, 1 mircoM). The single-cell RT-PCR demonstrated the selective expression of mRNAs for M3 in RPNECs. In summary, RPNECs express M3 muscarinic receptors that are linked to the release of Ca2+ from intracellular stores. The Ca2+ signals of RPNECs might mediate the parasympathetic regulation of prostate gland.
Acetylcholine/pharmacology
;
Animals
;
Calcium/*metabolism
;
Calcium Signaling
;
Male
;
Neurosecretory Systems/*metabolism
;
Prostate/*metabolism
;
Rats
;
Rats, Sprague-Dawley
;
Receptor, Muscarinic M3/*physiology
;
Research Support, Non-U.S. Gov't
7.Developing a Scoring Guide for the Appraisal of Guidelines for Research and Evaluation II Instrument in Korea: A Modified Delphi Consensus Process.
You Kyoung LEE ; Ein Soon SHIN ; Jae Yong SHIM ; Kyung Joon MIN ; Jun Mo KIM ; Sun Hee LEE
Journal of Korean Medical Science 2013;28(2):190-194
Korea has a relatively short history in the development and use of clinical practice guidelines (CPGs). Additionally, it has been difficult to employ the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument due to the lack of consensus and the presence of differences in Korean medical settings and in the Korean socio-cultural environment. An AGREE II scoring guide was therefore developed to reduce differences among evaluators using the same tool. In consideration of the importance of using a quantitative measure of satisfaction with the elements described in the AGREE II manual, a final draft was developed through a Delphi consensus process. Ninety-two draft scoring guides for anchor points 1, 3, 5, and 7 (full score) in 23 items were developed. Consensus was defined as agreement among at least 70% of the raters. Agreement on 88 draft scoring guidelines was reached in the first Delphi round, and agreement for the remaining four was achieved in the second round. The development of an AGREE II scoring guide in this study is expected to contribute to improving the CPG environment.
Consensus
;
Humans
;
Peer Review
;
*Practice Guidelines as Topic
;
Republic of Korea
8.Effect of Mannitol in Acute Cerebral Ischemia.
Kyoung Suck CHO ; Yong Kil HONG ; Min Woo BAIK ; Dal Soo KIM ; Joon Ki KANG ; Chang Rak CHOI
Journal of Korean Neurosurgical Society 1994;23(8):902-915
The development of postischemic irreversible brain damage depends upon the length of ischemia and its severity during arterial occlusion, although release of the occlusion always leads to restoration of normal or above noraml cerebral blood flow. The experiment was planned to determine the effects of mannitol on cerebral ischemia on subsequential regional cerebral blood flow(rCBF) and somatosensory evoked potential(SEP) following reperfusion after ischemia and also define the proper time of vascular occlusion without irreversible brain damage. Cerebral ischemia was induced in cat by transorbital occlusion of the left MCA with a Sugita clip for period of 30 minutes and the ischemic brain was reperfused for 180 minutes by removing the clip. Forty adult cats, weighing 2.5 to 4.0 Kg were divided into 5 group ; control(Group I, n=8), permanent MCA occlusion(Group II, n=8), permanent MCA occlusion with mannitol infusion(Group III, n=8), permanent MCA occlusion with mannitol infusion(Group III, n=8), 30 minutes MCA clipping followed by reperfusion(Group IV, n=8) and 30 minutes MCA clipping with mannitol infusion followed by reperfusion groups(Group V, n=8) respectively. The rCBF and SEP measurents were carried out in each animal immediately, after MCA occlusion, at 30 minutes, 60 minutes, 90 minutes, 120 minutes, 150 minutes and 180 minutes followed by perfusion. The rCBF was measured by the hydrogen clearance technique. Mannitol was given in bolus of lg/kg body weight as a 25% solution delivered via the femoral vein. The results were as follows : 1) Gradual elevation of intracranial pressure(ICP) and systolic blood pressure were observed after MCA occlusion. Treatment with mannitol in MCA occlusion animals(Group III & V) decreased ICP immediately after infusion of mannitol. 2) Normal control rCBF(ml/100 g/min) were 51.94+/-5.05 in the left temporal(LT) and 50.80+/-4.87 in the left perietal lobes(LP). 3) The MCA occlusion resulted in a reduction of the blood flows to 72% of the normal control ones(LT : 14.29+/-4.81 ml/100 g/min) at the left temporal area immediately after occlusion and also a reduction of flows to 80.4% of the normal control ones(LT : 10.24+/-3.69 ml/100 g/min) at 180 minutes after occlusion in Group II. 4) In the mannitol-treated group(group IV), reperfused animals, with removal of the clip on MCA had an improved postischemic recovery of blood flow and ipsilateral cerebral blood flows were restored to 42.5% of the normal control ones(LP : 21.2+/-4.13 ml/100 g/min) at 180 minutes after occlusion in Lt. parietal CBF. 5) In the reperfusion group(group IV), reperfused animals, with removal of the clip on MCA had an increase in rCBF to the level of 83.3% of the control value(LT : 45.78+/-6.80 ml/100 g/min) at 180 minutes after reperfusion and also reperfused animals, with treated mannitol had further increase the blood flow up to the level of 92.5% of the control value(LT : 49.04+/-43.6 ml/100 g/min) at 180 minutes after reperfusion. 6) After the MCA occlusion, the SEP was present but markedly altered in shape and particularly the early components of the SEP were suppressed in the ipsilateral occlusion hemisphere. 7) In the mannitol-treated reperfusion group(Group V) the amplitude of the SEP was restored to 80% of control value. The SEP was significantly suppressed if the rCBF fell below 10-14 ml/100 g/min. These result suggest that provided CBF can be restored to above the 40% threshold well within 30 minutes, prevention of ischemic brain damage can be expected and also the mannitol may of benefit in prolongation of the time threshold for the formation of the cerebral ischmia after vessel occlusion.
Adult
;
Animals
;
Blood Pressure
;
Body Weight
;
Brain
;
Brain Ischemia*
;
Cats
;
Evoked Potentials
;
Femoral Vein
;
Humans
;
Hydrogen
;
Ischemia
;
Mannitol*
;
Perfusion
;
Rabeprazole
;
Reperfusion
9.A Case Report of Reiter's Syndrome with Progressive Myelopathy.
Soo Kyoung KIM ; Jae Young AN ; Min Soo PARK ; Byoung Joon KIM
Journal of Clinical Neurology 2007;3(4):215-218
Reiter's syndrome belongs to the family of spondyloarthropathies that usually present with a triad of arthritis, urethritis, and uveitis. The diagnostic criteria include clinical, radiological, and genetic findings, and the response to treatment. Nervous system involvement in Reiter's syndrome is extremely rare. We report here on a 36-year-old man who initially presented with progressive cervical myelopathy and was diagnosed as Reiter's syndrome 2 years later. The myelopathy was stable after treatment with methotrexate and sulfasalazine. This case suggests that Reiter's syndrome can present as progressive myelopathy and should be considered in the differential diagnosis of treatable myelopathies.
Adult
;
Arthritis
;
Arthritis, Reactive
;
Diagnosis, Differential
;
HLA-B27 Antigen
;
Humans
;
Methotrexate
;
Nervous System
;
Spinal Cord Diseases*
;
Spondylarthropathies
;
Sulfasalazine
;
Urethritis
;
Uveitis
10.Midterm Results of Total Hip Arthroplasty Using the VerSys Fiber Metal Tapered Femoral Stem.
Joon Soon KANG ; Kyoung Ho MOON ; Bom Soo KIM ; Dae Kyu KWON ; Jong Min CHOI
Hip & Pelvis 2012;24(2):79-86
PURPOSE: We evaluated the clinical and radiological results of patients who received the cementless VerSys fiber metal tapered stem for total hip arthroplasty. MATERIALS AND METHODS: Thirty seven hip joint replacements(31 patients) were evaluated over a minimum four year period following the procedure with an average follow-up period of 56 months(48-96 months). The mean patient age was 47.9 years old. Clinical results were analyzed using Harris hip scores, incidence of thigh pain and radiographic analysis was used to assess fixation of the stem, stress shielding, cortical hypertrophy and radiolucent lines around the femoral stem. RESULTS: The average Harris hip score was 90.7 points(82-99 points). Thigh pain was noticed in 6 hips(16%). Proximal femoral bone resorption by stress shielding was observed in 32 hips(86.5%). Cortical hypertrophy was noticed in 16 hips(43.2%) and was statistically correlated with stress shielding of 2nd degree or more according to the Engh classification. Stable bone ingrowth at the last follow-up was seen in 36 hips(97.2%). CONCLUSION: Cementless total hip arthroplasty using the cementless VerSys fiber metal tapered stem demonstrated excellent midterm clinical results as well as excellent radiologic results for stable fixation and endosteal new bone formtion. However, long term follow-up evaluation will be required because of the high rates of proximal bone resorption by stress shielding.
Arthroplasty
;
Bone Resorption
;
Follow-Up Studies
;
Hip
;
Hip Joint
;
Humans
;
Hypertrophy
;
Incidence
;
Thigh