Clinical study of 40 cases who have used steroid preparations was done during past 6 months from March 72 to September 72. 1. The youngest patient was twenty, the oldest seventy-four and the average fifty-two. Eighty percent was included between from 41 to 70 year of age. 2. And the sex ratio was 1:4.7. 3. Diagnostic incidence was 47.5% in degenerative arthritis and 40% in rheumatoid arthritis. 4. The causes of administration were multiple joint pain (35%), lumbago (27.5%) and pain on knee joint (25%) in order. 5. Prednisolone (60%), dexacortisil (25%) and dexamethasone (12.5%) were used in 97.5%. 6. The source of steroid was drung store (95%) or doctor (5%). 7. The time from first dose to last dose was less than 1month (20%), 1–3 month(10%), 4–6 month (7.5%) and more than 1 year (52.5%). And 3 cases have used for more than 5 years, 8. Eighteen cases (45%) used steroid continuously and 22 cases (55%) irregularly. 9. Transient effectiveness was experienced in 92.5% with steroid administration, that was one of the causes of steroid usage without doctor's prescription. 10. The side effects were as follows; moon face (62.5%), ulcer (20%), fat deposition (15%), osteoporosis (15%), peripheral edema (10%), elevation of blood pressure (7.5%), malar flush(7.5%), vertebral compression fracture (7.5%), obesity (5%), psychotic change (5%), pyogenic arthritis (5%), diabetes (2.5%), sepsis (2.5%), adrenal insufficiency (2.5%), avascular necrosis (2.5%) and stress fracture of femur neck (2.5%).
Adrenal Insufficiency ; Arthralgia ; Arthritis ; Arthritis, Rheumatoid ; Blood Pressure ; Clinical Study ; Dexamethasone ; Edema ; Femur Neck ; Fractures, Compression ; Fractures, Stress ; Humans ; Incidence ; Knee Joint ; Low Back Pain ; Moon ; Necrosis ; Obesity ; Orthopedics ; Osteoarthritis ; Osteoporosis ; Prednisolone ; Prescriptions ; Sepsis ; Sex Ratio ; Ulcer

Failure of total joint replacement is often due to infection. Many efforts have been made to reduce the rate of infection. The use of antibiotic-acrylic bone cement composites for the preventlon and treatment of infection after joint replacement surgery has been advocated. Early reports of clinical success using bone cement containing antibiotics are encouraging, but different results of antibacterial effect of antibiotic-acrylic bone cement were reported in vitro and in vivo studies. The purpose of this experiment is to determine the effectiveness of bone cement itself on bacterial growth, stability of antibiotics in cured bone cement, and whether antibiotic acrylic bone cement composites produce an effective antimicrobial concentration in tissue fluid of hip joint and if so, the duration of it. 30 rabbits were used as test animal: 3 each for hemiarthroplasty and for hemiarthroplasty with the insertion of bone cement as control; 6 each for dicloxacillin, cephacetrile, gentamycin and amlkacin impregnated bone cements. Antibiotic activities were measured by disk diffusion method and tube dilution method using tissue fluid collected through tube inserted in the hip joint of the animals. The results were as follows: 1. Bone cement itself does not have antibacterial effec: on the growth of Staphyiococcus aureus and Escherichia coli. Antibiotic impregnated acrylic bone cements showed antibacterial effects which were stable for 3 weeks in vitro test. 2. After the insertion of antibiotic-acrylic bone cement composites, maximal concentrations of antibiotics in tissue fluid were measured at 1 hour. The concentration of antibiotics remained in tissue fluid at relatively high level for 2 days, and decreased abruptly there after. Inhibition zones in disk diffusion method could be measured until 3rd day in dicloxacillin group and 4th day in cephacetrile, gentamycin and amikacin group. No antibacterial effect could be measured in control groups. 3. On first postoperative day the concentrations of antibiotics in tissue fluid were measured as 64 mcg/ml in dicloxacillin group and 128 mcg/ml in cephacetrille, gentamycin and amikacin group. The antiblotic activities in tissue fluid could be measured for 6 days in dicloxacillin group and 7 days in cephacetrile, gentamycin and amikacin group using tube dilution method. No antibiotic activities were measured in tissue fluid of control groups. As a result of this study, it is proved that the concentration of antibiotics in tissue fluid of hip joint can be maintained above the level of minimal inhibitory concentration for about a week when antibiotic-acrylic bone cement composite is used in joint replacement arthroplasty. The impregnation of antibiotics in crylic bone cement is proved to be effective in the prevention of exogenous infection, especially in the protection of damaged tissue prone to infection postoperatively.
Amikacin ; Animals ; Anti-Bacterial Agents ; Arthroplasty, Replacement ; Bone Cements ; Cephacetrile ; Dicloxacillin ; Diffusion ; Escherichia coli ; Gentamicins ; Hemiarthroplasty ; Hip Joint ; In Vitro Techniques ; Joints ; Methods ; Polymethyl Methacrylate ; Rabbits

No abstract available.
Congenital Abnormalities* ; Osteotomy* ; Recurrence*

No abstract available.
Arthroplasty* ; Knee*

OBJECTIVE: Endometriosis is a disease affecting a large population of women all over the world. A local sterile inflammation occurs in the peritonel cavity of patients with endometriosis. It suggests that immunological events play a major role in the pathogenesis of endometriosis. We have studied the levels of serveral T cell and monocyte derived cytokines, especially IL-6 (promoter of immune response) and IL-10 (inhibitor of immune response), in the peritoneal fluid of patients with endometriosis to characterize the change of immune response that occurs at the site of endometriosis. Method: This study was performed in Hallym university hospital from October, 1997 to October 1998 and enrolled 29 women with gross or microscopic findings of minimal to severe endometriosis in case group, and 28 women without visual evidence of pelvic endometriosis and with benign gynecologic disease in control group. IL-6 and IL-10 levels in the peritoneal fluid were determined using commercial ELISA and compared between endometriosis and controls and between fertile and infertile women with endometriosis and according to the revised American Fertility Society classification. RESULT: IL-6 was higher and IL-10 was lower in the peritoneal fluid of endometriosis group than of control group. Cyclic variations in the IL-6 concentrations were seen in endometriosis group : the concentrations in the secretory phase were significantly higher than those in the proliferative phase. In endometriosis group, IL-6 concentrations of infertile women were higher than fertile women. Both IL-6 and IL-10 in the peritoneal fluid of endomtriosis group did not show significant correlation according to r-AFS stages. CONCLUSION: Increased IL-6 and decreased IL-10 levels in the peritoneal fluid may be related to infertility and pathogenesis in the endometriosis, suggesting that partially contribute to the disturbed immune regulation observed in endometriosis.
Ascitic Fluid* ; Classification ; Cytokines ; Endometriosis* ; Enzyme-Linked Immunosorbent Assay ; Female ; Fertility ; Genital Diseases, Female ; Humans ; Infertility ; Inflammation ; Interleukin-10* ; Interleukin-6* ; Monocytes

No abstract available.
Humans ; Pregnancy* ; Twins*

No abstract available.
Stomach Neoplasms* ; Stomach*

As the number of primary total knee arthroplasties (TKA) have increased, there has been a corresponding increase in the number of revision TKAs. The purpose of the this study is to report on the follow-up results of 50 revision TKAs, and to assess their clinical outcome. From January 1990 to December 1995, 50 revision TKAs were perfomed in 43 patients, by one surgeon. Mean follow up time was 2.5 years (range, 1 to 6 years). The mean interval from the initial arthroplasty to revision was 4.6 years (range, 3 months-12.6 years). The causes of the revision were wear of polyethylene in 29 joints (58%), infection in seven (14%) and aseptic loosening in six. The revision components were fixed with cement in all cases. Additional fixations were obtained with modular stems (femoral 11 cases, tibial 13 cases), 9 tibial metal wedges, 7 femoral augmentations, and 12 allografts. The Knee Rating Scale of Hospital for Special Surgery was used for clinical assessment. The mean flexion contracture and further flexion of knee joint were 8.8degrees (range, 0-70degrees), 98.5degrees (range, 5-135degrees) preoperatively, and 3.7degrees (range, 0-15degrees), 112degrees (range, 75-135degrees) postoperatively. The Knee Rating Scale improved from 66.5 points (range, 15-83) to 87.5 points (range, 79-98). There were two cases of complications, dislocation of patella and superficial wound problem in each case. In conclusion, wear was the most common cause of failure of primary TKA. The results of revision in infected TKA were less favorable than that of wear and loosening. The prosthetic design and thickness of polyethylene were the most important factors related to wear. The tibial component of PCA and patellar component of Miller-Galante had significant wear problems.
Allografts ; Arthroplasty* ; Contracture ; Dislocations ; Follow-Up Studies ; Humans ; Joints ; Knee Joint ; Knee* ; Passive Cutaneous Anaphylaxis ; Patella ; Polyethylene ; Wounds and Injuries

A total of 15 revision total knee arthroplasties in infected cases had been followed for an average 31.4 moths(ranging between 1 year 4 months and 10 years) from 1983 to 1992 at Kyung Hee University Hospital. Average age of the patients was 60 years old (ranging between 27 and 80 years). Of the total 15 infected total knee arthroplasties, original diagnosis was osteoarthritis in 11 patients, rheumat,oid arthritis in three patients, and tuberculosis in one patient. In nine of 15 patients, causative orgamisms were not found. But such clinical evidences as increased erythrocyte sedimentation rate, draining sinus, local heating, intraoperative findings, and pathologic findings demonstrated the infection of total knee arthroplasty. In 15 cases, seven cases were early infection and eight were late infection. Two cases of tuberculosis were diagnosed with intraoperative pathology. The majority of prosthetic loosening was found on the tibial side. Several methods of treatment were applied to the infected cases. One-stage or two-stage reimplantation were used in seven cases, knee fusion in six cases, and conservative treatment was used in two cases. Average period from initial total knee arthroplasty to prosthesis removal of fusion is 20. 3 months(ranging between 11 months and 64 months). In cases of two stage reimplantation, antibiotic-mixed bone cement was implanted after removal of prosthesis to increase the local concentration of antibiotics. The average interval from prosthesis removal to revision in 4 cases of two stage reimplantation was 9.9 weeks(ranging between 43 days and 122 days). All patients were evaluated according to the knee rating Scale of Hospital for Special Surgery. Prior to revision operation in 7 reimplantation cases, the average knee score was 50.1 points, and the average range of motion was 70°. After revision, the average knee score was 81. 1 points. The average range of motion was 98°. Complete union was obtained in all cases of knee fusion. Even though at the time of follow up there has been no recurrence of infection after revision or fusion, long term follow up is needed. Interrmittent knee joint swelling and pus drainage were observed in conservatively treated cases.
Anti-Bacterial Agents ; Arthritis ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Blood Sedimentation ; Diagnosis ; Drainage ; Follow-Up Studies ; Heating ; Hot Temperature ; Humans ; Knee ; Knee Joint ; Osteoarthritis ; Pathology ; Prostheses and Implants ; Range of Motion, Articular ; Recurrence ; Replantation ; Suppuration ; Tuberculosis

In the classical ballet dancers, ankle joints are frequently overused. Especially the Pointe and the Releve are the two basic steps of ballet dance which cause the narrowing of the posterior aspect of the ankle joint. Posterior impingement syndrome of the ankle joint is defined as impingement occuring at the anatomical interval between the posterior tibial articular surface and os calcis. The purpose of this study is to describe the anatomy and etiology of this injury and to review the non-operative and operative treatments. Sixteen cases of posterior impingment syndrome had been treated between March 1994 and March 1995. Ten dancers were professional and six were students. The patients was divided 3groups by etiologic factor. Group 1 is anatomical problem factor, Group 2 is overuse factor and Group 3 is ankle sprain factor. Thirteen dancers (81.2%) improved with conservative treatment including local steroid injection. Among the other three dancers, operation was performed in one case. The other two cases stopped dancing. The result was good in one dancer after operation. In the classic ballet dancers, posrerior impingement syndrome was frequent disorder and major etiologic factors are anatomical problem and overuse. Operation was necessary in only group l. It is good result in conservative treatment and operation.
Ankle Injuries ; Ankle Joint* ; Ankle* ; Dancing ; Humans