This is a follow up study on 124 cases of primary total hip arthroplasty with Harris-Galante porous-coated acetabular component with the line-to-line technique, performed at the Department of Orthopaedic Surgery, Pusan National University Hospital from January 1986 to February 1992. The follow-up ranged from 24 months to 92 months, the average being 53 months. The results were as follows; 1. At the last follow-up, a radiolucent line was found in 20 cases(16.1%), but the width was less than one millimeter. Among the 20 cases, the continuous radiolucent line was found in two cases(1.6%), the progressive radiolucent line in five cases(4.0%). 2. Areas of non-contact(initial gap) between the porous mesh of the acetabular component and the bone were seen on the immediate postoperative radiographs of 35 cases(28.2%) among 124 cases. A radiolucent line developed around 13 cases(34.2%) of the 35 cases that were associated with an initial gap, but a radiolucent line developed around only seven cases(7.8%) of the 89 cases(71.8%) not associated with such a gap. 3. At the last follow-up, a vertical migration was found in five cases(4.0%), an angulation change of the acetabular cup in two cases(1.6%), but a horizontal migration of the acetabular cup was not found. 4. There was no evidence of the disruption of the titanium porous mesh of the acetabular component, and loosening, bending or breakage of the screw for fixation of the acetabular cup. And there was no revision for acetabular loosening. In conclusion, because overall loosening rate was less than 5%, the results were very satisfactory. Considering an initial gap is a important factor of acetabular loosening, we think that it is important to make less initial gap during operation.
Acetabulum ; Arthroplasty, Replacement, Hip ; Busan ; Follow-Up Studies ; Titanium

The tibial plateau fracture involving the articular surface clinically is a very important injury which often can cause disabilities of the knee joint. Open reduction and internal fixation have been proposed as the optimal treatment of patient with Schatzker's type VI tibial plateau fracture because of the decrease in the functional impairment of the knee joint by allowing early motion. But the injury to the soft tissue is usually severe, which may lead to wound complications after internal fixation. Also delayed union, nonunion, and infection after such operation is not a few. Recently some authors have studied about the external fixation or minimal internal fixation as the treatment for tibial plateau fracture. The purpose of the current study was to compare the results of two different operative methods. The authors analyzed 9 cases of Schatzker's type VI tibial plateau fracture surgically treated at the Pusan National University Hospital from March 1991 to August 1994. The follow-up period ranged from 1 year to 4 year 7 months. The results were obtained as follows. 1. Of the 9 cases, 7 were male and 2 were female, the major population were the 6th and 7th decades. 2. The most common cause of this injury was traffic accident in 7 cases(78%). 3. About the fracture pattern, the most commom type was intercondylar fracture type in 5 cases(56%), the next one lateral condyle fracture type in 4 cases (44%). 4. Common associated injuries were ipsilateral fibula fracture in 8 cases(89%) and ipsilateral femur fracture in 4 cases(44%). 5. Six cases were treated by open reduction and internal fixation, and 3 cases were treated by external fixator. 6. According to Poster's criteria, the results were “Acceptable” in 7 cases(89%), “Unacceptable” in 2 cases(11%).
Accidents, Traffic ; Busan ; Diaphyses ; External Fixators ; Female ; Femur ; Fibula ; Follow-Up Studies ; Humans ; Knee Joint ; Male ; Methods ; Tibia ; Wounds and Injuries

Endovascular treatment of the aortic aneurysm with a stent graft is rapidly evolving. We describe here a case of hybrid TEVAR (thoracic endovascular aortic repair) in which the stent grafts were placed in the aortic arch after debranching of the arch vessels. The patient had undergone ascending aorta replacement for acute type I aortic dissection 2.5 years earlier. The aneurysmal change of the distal dissection progressed with time. A provisional bypass surgery from the ascending aorta to the innominate artery and left carotid artery was performed and then stent grafts were inserted via an antegrade route that covered the whole aortic arch and proximal descending thoracic aorta.
Aneurysm ; Aneurysm, Dissecting ; Aorta ; Aorta, Thoracic ; Aortic Aneurysm ; Brachiocephalic Trunk ; Carotid Arteries ; Chimera ; Humans ; Stents ; Transplants

OBJECTIVE: The purpose of this study was to review the incidence, types, chemotherapy regimens, operation methods, pregnancy rate and propiosis of the ov#arian malignancy under the age of twenty years old. METHODS: Retrospective reviews of the medical recordings for 22 patients with ovarian malignancy under the age of twenty years old in the Department of Obstetrics and Gynecology, Hanyang University from 1986 to 1997 were done. RESULTS: Gerin cell tumor accounts for the majority of cases (77%), whereas 5 patients(23%) belong to the common epithelial poup which were all mucinous type. Our experiences with 22 cases are as followings: 5 mucinous cystadenocarcinoma, 8 immature teratoma, 4 endodermal sinus tumor, 3 dysgernma and 2 mixed germ cell tumor. The incidence of this group was 8.2% (22/266) in all ovarian malignancy. Fourteen of them are stage I, each one is, stage II and IV, and six patients are stage III. The average age was 14.9 years old in germ cell tumor and 18.4 yems old in mucinous cystadenoearcinoma. Malignant ovarian cancer under the age of twenty can be treated with conservative surgery, followed by adjuvant chemotherapy. Commonly used chemotherapeutic regimens were VAC(Vincristine, Actinomycin-D; Cyclophosphamide), VBP(Vinblastine, Bleomycin, Cisplatin) and BEP(Bleomycin, Etoposide, Cisplatin). Second look operations were done in 11 patienth and histologic positive findings were detected in 4 of them. The length of follow-up ranged ftom 3 months to 137 months and median value was 44 rnonths. CONCLUSIONS: It is concluded that for young women who wish to preserve child-bearing capacity, regardless of the stage of the tumor, fertility preserving surgery with complete surgical staging, if necessary followed by combination chemotherapy is an appropriate treatment.
Bleomycin ; Chemotherapy, Adjuvant ; Cystadenocarcinoma, Mucinous ; Drug Therapy ; Drug Therapy, Combination ; Endodermal Sinus Tumor ; Etoposide ; Female ; Fertility ; Follow-Up Studies ; Gynecology ; Humans ; Incidence ; Medical Records ; Mucins ; Neoplasms, Germ Cell and Embryonal ; Obstetrics ; Ovarian Neoplasms ; Pregnancy Rate ; Retrospective Studies ; Teratoma

Although compressed gas (CO2) blowers have been used safely to aid accurate grafting during off-pump coronary bypass surgery, hemodynamic collapse due to gas embolism into the right coronary artery may occur. Supportive measures to facilitate gas clearance by increasing the coronary perfusion pressure have been reported to be successful in restoring hemodynamic stability. However, right ventricular dysfunction and atrioventricular nodal ischemia may hinder effective systemic delivery of the vasoactive medications, even when performing resuscitative measures such as direct cardiac massage. We herein report a case of cardiac arrest that was caused by a right coronary gas embolism and that could not be restored by cardiac resuscitation. When supportive measures fail, direct aortic injection of epinephrine to increase the coronary perfusion pressure can be attempted before initiating cardiopulmonary bypass, and this approach may be life-saving in situations that limit systemic drug delivery from the venous side despite the performance of direct cardiac massage.
Aorta ; Cardiopulmonary Bypass ; Coronary Artery Bypass, Off-Pump ; Coronary Vessels ; Embolism* ; Embolism, Air ; Epinephrine* ; Heart Arrest* ; Heart Massage ; Hemodynamics ; Ischemia ; Perfusion ; Resuscitation* ; Transplants ; Ventricular Dysfunction, Right

BACKGROUND: Psoriasis is a chronic inflammatory skin disease that affects approximately 1~3% of the general population. OBJECTIVE: We performed cDNA microarray analysis with using the dendrimer labelling method to investigate the gene expression profile in the peripheral blood mononuclear cells (PBMCs) of psoriatic patients. METHODS: The peripheral blood mononuclear cells of 5 patients with psoriasis and 8 control subjects were used in the gene expression analyses of psoriasis. RESULTS: We identified 212 differentially expressed genes that showed at least a two-fold induction and/or reduction in psoriatic patients. Among those, 63 genes, including CD44, CD56 and IL7R, were induced, while 139 genes, including the sphingosine kinase 1 and p16-INK genes, were reduced in the psoriatic patients. CONCLUSION: We can speculate that these genes may have a role for the pathogenesis of psoriasis via their affecting different cellular functions. Our results suggest a possible mechanism by which activated immune cells migrate from the blood to the skin in psoriatic patients, and we provide novel putative targets for developing drugs to treat psoriasis
Cell Adhesion ; Dendrimers ; Gene Expression ; Humans ; Oligonucleotide Array Sequence Analysis ; Phosphotransferases ; Phosphotransferases (Alcohol Group Acceptor) ; Psoriasis ; Skin ; Skin Diseases ; Sphingosine ; Transcriptome

Most ingested foreign bodies pass readily throughout intestinal tract if they reach the stomach. In some cases, foreign bodies may be impacted behind a luminal constriction but are rare in colon. Here, we report the case of a 59-year-old man who did laparoscopic anterior resection due to sigmoid colon cancer 2 years ago and ischemic colitis was repeated on the anastomosis site. He initially presented with symptoms of abdominal pain 3 months before and melena 1 day before admission. Abdomen computerized tomography showed a 3.2 cm segment of luminal narrowing of the proximal colon involving upstream foreign material stasis. Sigmoidoscopic approaches revealed near complete obstruction on the anal verge of 20 cm and scope passing failed. Balloon dilatations were done on the obstruction site four times all and a foreign body impacted above the obstruction site was removed by an alligator without any complications. The foreign body removed looks like plastic or a shell, about 20 mm in size.
Abdomen ; Abdominal Pain ; Alligators and Crocodiles ; Colitis, Ischemic ; Colon* ; Constriction ; Constriction, Pathologic* ; Dilatation* ; Foreign Bodies* ; Humans ; Melena ; Middle Aged ; Phenobarbital ; Plastics ; Sigmoid Neoplasms ; Stomach

BACKGROUND: Dilution of blood cardioplegia is not needed in IAWBC as it is in cold blood cardioplegia because it does not aggregate red blood cells on normal body temperature and does not compromise micro coronary circulation. This study was designed to evaluate the safety and efficacy of undiluted potassium solution in IAWBC. MATERIAL AND METHOD: Thirty patients who underwent CABG with IAWBC were grouped into dilutedplegia (n=14) and microplegia (n=16). Potassium was delivered conventionally with 4:1 delivery kit in the dilutedplegia group. The undiluted potassium was directly connected on the blood of oxygenator in the microplegia group. RESULT: There were no differences in sex, age, left ventricular ejection fraction, number of grafts, aortic cross clamping time, and the value of perioperative myocardial enzyme between the two groups. There were no perioperative myocardial infarction and hospital mortality. The amount of crystalloid cardioplegia was 1346+/-597 mL in dilutedplegia (mean+/-standard deviation, and 28+/-9 mL in microplegia (p<0.0001). The hematocrit during cardiopulmonary bypass was 21+/-4% in dilutedplegia and 24+/-3% in microplegia (p>0.05). 11 patients in dilultedplegia received blood transfusion, but 4 patients in microplegia received blood transfusion (p<0.05). The amount of urine and hemofiltration during the operation were more in dilutedplegia (1250+/-810 mL, 1689+/-548 mL) than in microplegia (959+/-410 mL, 1481+/-784 mL; p<0.05). CONCLUSION: The undiluted potassium of IAWBC in CABG operation is a safe, effective technique for myocardial protection to prevent fluid overload, and blood transfusion. There is no need to use the delivery kit.
Blood Transfusion ; Body Temperature ; Cardiopulmonary Bypass ; Constriction ; Coronary Circulation ; Erythrocytes ; Heart Arrest, Induced* ; Hematocrit ; Hemofiltration ; Hospital Mortality ; Humans ; Myocardial Infarction ; Oxygen ; Oxygenators ; Potassium* ; Stroke Volume ; Transplants

BACKGROUND & OBJECTIVE: The purpose of this study is to prove the effectiveness of professional maintenance care to the periodontal disease by non-surgical approach with the toothpick method to improve the periodontal health. METHODS: The patients of this study were composed of 46 patients( 18 men and 28 women), suffering from chronic adult periodontitis, who had visited the department of dental clinic center. All of the subjects were over 50years old and be treated just by non-surgical method. Professional maintenance care using the toothpick method was performed every 3 months, and evaluations were also done after 1, 2, and 3 year-professional maintenance care based on the indices such as plaque index(O' Leary index), periodontal probing pocket depth, bleeding on probing, tooth mobility, the number of tooth loss, and the rate of tooth loss representing the state of periodontal health. RESULTS: 1. The longer the maintenance care, the more the effectiveness of controlling plaque. The rate of decrease in the dental plaque index was 1.5%, 4.2%, and 6.5% in 1, 2, and 3 year maintenance groups respectively(P>0.05). 2. The periodontal pocket depth decreased depends on the severity of periodontal pocket depth in all groups the maintenance years(P<0.05). 3. On the evaluation of the bleeding tendency on probing, there was a significant difference in 1 year- maintenance group(P<0.05), but the other groups did not show any difference statistically(P>0.05). 4. Tooth mobility has decreased in the maintenance years, but did not show any difference statistically(P>0.05). 5. The number and the rate of tooth loss among the patients of 1year-maintenance group was 0.38, 1.44% respectively and that of 3 year-maintenance group was 0.44, 1.73% each. CONCLUSION: The results of this study mentioned above suggest that professional maintenance care should be operated effectively to prevent and to maintain the periodontal disease systematically on the purpose of proving the quality of life, and that it could be applied to the medical insurance system in other to try to make the most of the adult oral health care positively.
Adult ; Chronic Periodontitis ; Dental Clinics ; Dental Plaque Index ; Hemorrhage ; Humans ; Insurance ; Male ; Methods ; Oral Health ; Periodontal Diseases* ; Periodontal Pocket ; Periodontitis ; Quality of Life ; Tooth Loss ; Tooth Mobility

OBJECTIVES: This study investigated on the severity of dry mouth in the hansen people and the association between dry mouth(low, moderate and high) with pre and post wearing denture satisfaction. METHODS: Data were obtained from a cross-sectional survey of 104 hansen people(mean age=69.3). Data were collected by means of a personal interview from April 30 through to Jane 20, 2014. Pre and post wearing denture satisfaction was measured by the 24-items and dry mouth was measured by the 4-items. The data was analysed with t-test, One-way ANOVA, and Logistic regression using the SPSS program. RESULTS: Regarding perception of dry mouth, the subjects achieved a mean of 6.13 out of a maximum 12 points. Scores were categorised as high(8~12), medium(5~7) or low(1~4) and the proportion were 24.5%(9.56), 42.2%(5.81) and 33.3%(4.00) respectively. Those who were older and had fewer natural teeth felt that their perception of dry mouth was more severe. A logistic regression analysis showed that the subjects perception of dry mouth had a significant impact on their gender (OR=2.73), comfort (OR=0.21), aesthetic appreciation (OR=7.56) satisfaction. CONCLUSIONS: Based on the findings, the perception of dry mouth has a significant and negative impact on denture satisfaction. These results suggest that oral health promotion should be considered various factors related dry mouth in the elderly with removable denture.
Aged ; Cross-Sectional Studies ; Dentures* ; Humans ; Logistic Models ; Mouth* ; Oral Health ; Tooth