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

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

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*

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

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*

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

BACKGROUND: The relationship between infection of microorganism and atherosclerosis has been studied because the pathophysiology after infection is similar to those of cell injury and/or lipid theory. Although there are many reports which described the relationships between the infection of chalamydia pneumoniae and the atherosclerosis. In Korea, even the prevalence of chlamydia infection has not been studied yet. This study was purposed on the prevalence of chlamydia infection and it's correlation to atherosclerosis. METHODS: 235 subjects were enrolled and age and sex adjusted subjects were divided into two groups, normal controls (n=43), atherosclerosis (AS, n=90) group:coronary artery disease (CAD, n=61) and cerebrovascular disease (CVD, n=29). Serum total cholesterol (TC), triglyceride (TG), HDL-cholesterol (HDL-C) were measured, LDL-cholesterol (LDL-C) was calculated. Serum IgG chlamydia antibody were measured by ELISA method. RESULTS: TG was significantly higher in AS (162.51+/-100.04 mg/dL vs 122.91+/-63.31 mg/dL, mean+/-SD, p=0.019), and HDL-C was significantly higher in controls (47.30+/-9.88 mg/dL vs 39.38+/-8.29 mg/dL, p<0A65A>0.01). Levels of LDL-C and TC were not statistical significant. Serum IgG chlamydia antibody was positive in 29.8% (70/235), 30% (27/90) in AS group and 28% in controls and there was no statistical significance between groups (p=0.804). CONCLUSION: In conclusion, there was no significant differences in positivity of IgG chlamydia antibody in AS compared with that of controls. Overall positivity of chlamydia antibody was lower in Korea than in other country. It is still controversial whether Chlamydia pneumoniae is a primary etiologic agent of atherosclerosis or not. This study could not demonstrate the relationship between chlamydia infection and atherosclerosis in Korea. The effectiveness and indications of antichlamydial antibiotics for prevention of cardiovascular complications in atherosclerosis and overall chlamydia infection in general population will be needed in large scale trials.
Anti-Bacterial Agents ; Arteries ; Atherosclerosis* ; Chlamydia Infections ; Chlamydia* ; Chlamydophila pneumoniae* ; Cholesterol ; Coronary Artery Disease ; Enzyme-Linked Immunosorbent Assay ; Immunoglobulin G ; Korea ; Pneumonia ; Prevalence ; Triglycerides

OBJECTIVE: Although clinical guidelines for major depressive disorder (MDD) recommended sufficient duration of treatment, many patients discontinue antidepressant medication early in the course of treatment in clinical practice. In this study, we investigated the rate of early treatment-discontinuation and risk factors related to the discontinuation. METHODS: Medical records of 400 outpatients were reviewed. Patients who were diagnosed as MDD according to the DSM-IV criteria and were prescribed a single antidepressant were included in this study. Information on age, sex, education, marital status, job, disease recurrence, clinical severity and type of antidepressant medications were obtained. The rate of early treatment-discontinuation and factors leading to early discontinuation were also investigated. RESULTS: Data of 354 patients were analyzed. Mean age was 50.6+/-15.9 years and female patients were 225 (63.6%). Treatment-discontinuation rate was 29.1% at 2 weeks and 43.5% at 6 weeks. Logistic regression analysis demonstrated that severity of depression decreased the risk of treatment-discontinuation at 2 weeks. Other clinical factors and type of antidepressant medications did not affect the risk of early treatment-discontinuation. CONCLUSION: This study shows that the rate of early treatment-discontinuation is high in patients with MDD in usual clinical practice. Considering chronicity and high relapse rate of MDD, education programs to enhance drug compliance in patients and their family are needed to reduce early treatment-discontinuation in MDD patients.
Female ; Humans ; Risk Factors

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

Cystic dilatation of bile duct, so called choledochal cysts are a well documented abnormalities. Although choledochal cyst is a relatively rare disease, the number of reports have been increasing especially in tht Orient. It may be easily overlooked by the conventional diagnostic methods, such as upper gastrointestinal series, intravenous cholangiography and abdominal ultrasonogrsphy. Recent advances on diagnostic methods, such as endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography had been helpful in demonstrating choledochal cysts. 29 patients with choledochal cysts who had been admitted in Hanyang Universty Hospital between September l981 and August 1991 were reviewed and the clinical endoseopic and rediographic findings were discussed comparing with that from foreign literatures. (continue...)
Bile Ducts ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Choledochal Cyst* ; Dilatation ; Humans ; Rare Diseases