No abstract available.
Humans ; Urinary Retention*

Pretwisting the patellar tendon graft has been advocated hy many authors. Lambert has described a 90 degrees pretwist to benifit the fat pad vascular supply as well as to "" simulate the helicoid course of the ACL "". This technique has also been recommended to fascilitate fixation. Jackson has recommended a 90 pretwist to decrease the possibility of abrasive wear on the tunnel edge, and also to fascilitate fixation as much as a 180 degrees pretwist has heen recommended. However, in spite of all these recommendations, little work has been done on the effect of such pretwisting on the biomechanical behavior of patellar tendon grafts. The purpose of this study is to discover, by experiment, the effects of a 360 degrees external rotation pretwist on the following tensile mechanical properties of canine central 1/3 patellapatellar tendon-tibia complex : (a) ultimate stress, (b) ultimate strain, (c) average elastic modulus, and (d) strain energy density. Five groups of each S specimens were divided as group 1 (0 degrees external rotation), group 2 (90 degrees external rotation). group 3 (180 degrees external rotation), group 4 (270 degreesexternal rotation), and group 5 (360 degrees external rotation). The direction of pretwist meant the twist of tibia around patella. The effects of pretwist were analyzed using parameter one-way analysis of variance (ANOVA)(P1) and nonparameter Kruskal-Wallis one-way analysis of variance (ANOVA)(P2) with repeated measures followed by Scheff multiple comparison test. A p values of < 0.05 was considered statistically significant. Among each groups ultimate stress (P1=0.059, P2=0.095), ultimate strain(P1=0.154, P2=0. l65), and average elastic modulus(P1=0.814, P2=0.818) were not statistically significant. Only strain energy density was the statistically significant difference between group 2 and group 5(P1=0.008, P2=0.022). As a result, there were observed that the ultimate stress and strain energy density were decreased and ultimate strain was decreased but there were not statistically significant differences hetween groups because of the small number of samples, and there will be advantages for graft to avoid ahrasive wear on the tunnel edge and lateral femoral condyle. But, more studies are needed for human being in the future.
Adipose Tissue ; Elastic Modulus ; Humans ; Patella ; Patellar Ligament* ; Tibia ; Transplants

Treatment of chronic localized osteomyelitis is the same as the other osteomyelitis, that is, curettage and debridement of all dead tissue which is called saucerization. After saucerization there leaves empty cavity and autogenous bone graft has been used for filling the cavity in lower extremity hecause of weight bearing and avoiding fracture. We treated seven cases of chronic localized osteomyelitis with one-staged saucerization and cancellous chip allograft and retrospective analysis was done. All healed without complication and no recurrence was ohserved. Most orthopaedic surgeons are not willing to use allograft on the site of osteomyelitis because of the fear of recurrence. But. we think that as far as complete removal of infected and dead tissue, allograft could he a good solution in terms of rapid remodelling and early weight hearing. Another advantages of allograft are to get a large amount of bone and no damage of iliac apophysis. In summary, one-staged saucerization and cancellous chip allograft would he very useful treatment for chronic localized osteomyelitis.
Allografts* ; Curettage ; Debridement ; Hearing ; Lower Extremity ; Osteomyelitis* ; Recurrence ; Retrospective Studies ; Transplants ; Weight-Bearing

PURPOSE: To evaluate the change of the sensitivity and resistance to ciprofloxacin of isolates in bacterial ocular disease, bacterial keratitis and conjunctivitis. METHODS: From January 1992 to December 1999 in KyungHee Medical Center, we carried out direct smear and culture from conjunctiva and cornea and studied retrospectively. RESULTS: A total of 420 bacteria and fungi were isolated and 39 strains were identified. Antibiotic sensitivity test was done in isolated bateria and fungi. Gram-positive bacteria accounted for 324 of all bacteria, gram-negative organisms for 81 in isolated causative organisms. Major causative organisms of bacterial ocular disease, bacterial keratitis and conjunctivitis are coagulase-negative staphylococcus, Staphylococcus aureus, Pseudomonas aeruginosa in that order. Among 420 isolates, 405 bacteria and 15 fungi was isolated. In vitro examination for susceptibility and resistance of causative organisms to ciprofloxacin was done in 67 of 420 isolates. Of the 67 isolates, 57 were sensitive to ciprofloxacin and 10 were resistant to ciprofloxacin. All resistant cases to ciprofloxacin was 2 cases in 1994, 7 cases in 1998, and 1 case in 1999. CONCLUSIONS: The resistance to ciprofloxacin has a increasing tendency. Therefore, ciprofloxacin should be used carefully, when used for prevention of infection and primary treatment in mild ocular diseases.
Bacteria ; Ciprofloxacin* ; Conjunctiva ; Conjunctivitis ; Cornea ; Fungi ; Gram-Positive Bacteria ; Keratitis ; Pseudomonas aeruginosa ; Retrospective Studies ; Staphylococcus ; Staphylococcus aureus

BACKGROUND: Neutropenia can be easily found in previously healthy children associated with various medical conditions, and the clinical course ranges from transient benign to life threatening. This study aimed to investigate the etiology, clinical characteristics, and clinical courses of neutropenia in previously healthy children. METHODS: We evaluated 215 previously healthy children under aged 18 years who diagnosed with neutropenia in two hospitals. Clinical and laboratory features were analyzed retrospectively based on the medical records. RESULTS: Transient infectious neutropenia (TIN) accounted for 97.7% of cases and chronic neutropenia (CN), for 2.3%. An infectious agent was identified in 128/210 (61%) patients with TIN, and the most frequent agents were viruses (46.5%). The most common viral agent was respiratory syncytial virus (RSV) (29%). TIN subgroups exhibited no differences in severity according to infectious agent (virus, bacteria, Mycoplasma); however, neutropenia severity differed among viral agents [mild-to-moderate neutropenia in the RSV group (857.3±293.3/µL) and moderate-to-severe neutropenia in the parainfluenza group (567.3±198.1/µL); P=0.017]. All patients with CN had anti-neutrophil antibody positivity (autoimmune neutropenia, AIN), and moderate-to-severe neutropenia predominated. The median duration of TIN was 8 days (range, 3–286 days), and it was significantly longer for AIN at 330 days (range, 217–730 days) (P=0.000). The median duration of neutropenia was also different according to each viral agent, with 4 days (range, 3–11 days) for the RSV group and longer durations for 3 other groups (influenza, parainfluenza, other respiratory viruses) (P=0.015). CONCLUSION: Neutropenia in previously healthy children is usually of transient infectious origin, with mild-to-moderate severity, and it resolves spontaneously without complications.
Autoimmune Diseases ; Bacteria ; Child* ; Humans ; Medical Records ; Neutropenia* ; Paramyxoviridae Infections ; Respiratory Syncytial Viruses ; Retrospective Studies ; Tin

Complication of transurethral prostatic resection is hemorrhage, water intoxication, urethral stricture, perforation of bladder neck and surgical capsule, urinary incontinence . and infection. Hemorrhage is the most usual complication of TURP. Measurement of blood loss during TURP is very difficult because of dilution of blood with irrigating fluid and is very important to management of patient during and after surgery because its objectives are elderly patient. We studied the blood loss during TURP in 41 patients from Jan., 1984 to June, 1985, but 6patients were excluded because blood transfusion was performed during TURP by recognition of massive blood loss. Blood loss was measured in 35 cases by spectrophotometer used benzidine-heme color reaction. Following results were obtained. 1. Blood loss during TURP per time was 329+/-241 ml (Mean+/-S.D.) 2. Resection time was 71+21 min (Mean+/-S.D.) and blood loss per minute was 4.61 ml. Correlation coefficient between resection time and blood loss was +0.12 and was not significant. 3. Resected prostatic chip weight was 17.6+/-7.3 gm(Mean+/-S.D.) and blood loss per gram was 18.7 ml. Correlation coefficient between resected weight and lood loss was +0.29 and was significant weakly. 4. Irrigation fluid was used 22.2+8.l L (Mean+/-S.D.) and blood loss per liter was 14.8ml. Correlation coefficient between irrigation fluid and blood loss was +0.32 and was significant weakly.
Aged ; Blood Transfusion ; Hemorrhage ; Humans ; Neck ; Transurethral Resection of Prostate* ; Urethral Stricture ; Urinary Bladder ; Urinary Incontinence ; Water Intoxication

BACKGROUND: Serious pulmonary complications after lung surgery increase morbidity and mortality in perioperative period. Ketamine hydrochloride produces strong analgesic effect in spite of the psychomimetic effects. Intravenous anesthesia with ketamine was performed in lung surgery of patients with decreased pulmonary function and compared with inhalation anesthesia with enflurane. METHODS: Sixty patients, scheduled for elective lung surgery, were randomly assigned to two groups. Patients received either enflurane (Group 1, n=30) or ketamine (Group 2, n=30) as main anesthetic drug. Blood pressure and heart rate were compared in preinduction, postinduction, postintubation, postincision, intraoperative period (30 minutes, 60 minutes) and recovery room between groups, and in each group. Arterial blood gas analysis was compared in preoperative period, intraoperative period and recovery room between groups. Postoperative psychological complications evaluated in group 2. RESULTS: Blood pressure and heart rate were significantly different in postinduction, postintubation and recovery room between groups. PaO2 in group 2 was higher than in group 1 during intraoperative period and recovery room. Postoperative psychological complications occured in 4 patients (13%) in group 2. CONCLUSIONS: Ketamine affords advantage over enflurane anesthesia in terms of PaO2 during intraoperative period and recovery room in lung surgery of patients with decreased pulmonary function.
Anesthesia ; Anesthesia, Inhalation* ; Anesthesia, Intravenous* ; Blood Gas Analysis ; Blood Pressure ; Enflurane* ; Heart Rate ; Humans ; Inhalation* ; Intraoperative Period ; Ketamine* ; Lung* ; Mortality ; Perioperative Period ; Preoperative Period ; Recovery Room

PURPOSE: This study was attempted to investigate the prevalence of the expression of c-fos protein, TGF-alpha and -beta, PCNA , DNA ploidy pattern and histopathological parameters of giant cell tumor (GCT) of bone and to correlate with prognosis and to extend our understanding on tumorigenesis of GCT. MATERIALS AND METHODS: Twenty eight cases of paraffin-embedded tissue were studied, classified as recurrent (5 cases) and non-recurrent group (12cases) within the limits of the cases which afforded surgical material on first operation. RESULTS: No significant difference was observed in cellularity of stromal cells, atypia of stromal and giant cells, presence of hemorrhage and necrosis between recurrent and non-recurrent group. However, presence of more than 10 mitotic figures in 10 high power fields in recurrent group was significantly higher than non-recurrent group (p<0.05). The immunoreactivity for PCNA was seen only in nuclei of stromal cells, whereas nuclei of giant cells showed negative staining. The positivity of PCNA revealed no significant difference between non-recurrent (mean; 40.9%) and recurrent group (34.4%). The expression of c-fos oncogene was seen in 5 cases (100%) in recurrent group, and 8 cases (66.7%) in non-recurrent group, and no significant difference was seen. No significant difference of expression of TGF-alpha was seen in 5 cases (100%) in recurrent group and in 11 cases (91.7%) in non-recurrent group. The expression of TGF-beta in stromal cells was significantly higher in non-recurrent group (80%) compared to recurrent group (100%) (p<0.05). In DNA analysis out of 18 cases, 4 cases (22.2%) were aneuploidy and 14 cases (77.8%) were diploidy. Among 4 aneuploidy cases, 3 cases (75%) had no recurrence, and 1 case (25%) had metastasis to lung and expired. No significant difference of DNA ploidy pattern was seen between the recurrent and non-recurrent group. CONCLUSION: Presence of more than 10 mitotic figures in 10 high power fields and less expression of TGF-beta are related to higher possibility of recurrence and it is suggested that the number of mitotic figure (more than 10/10HPF) and expression of TGF-beta could be helpful parameters in predicting recurrence of GCT.
Aneuploidy ; Carcinogenesis ; Diploidy ; DNA* ; Giant Cell Tumor of Bone* ; Giant Cell Tumors* ; Giant Cells* ; Hemorrhage ; Lung ; Necrosis ; Negative Staining ; Neoplasm Metastasis ; Oncogenes ; Ploidies ; Prevalence ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Recurrence ; Stromal Cells ; Transforming Growth Factor alpha ; Transforming Growth Factor beta ; Transforming Growth Factors*

The clinician is posed a serious clinical dilemma when confronted with absence of testis during surgical management of impalpable testis. Herein we performed a comparative clinical study of palpable and impalpable undescended testis in 135 patients, 150 undescended testes during the period from January, 1979 to June, 1984. The results were as follows: 1. Among the 150 undescended testes, 47 cases(31.3%), were impalpable undescended testes on physical examination. 2. In 135 patients of undescended testis, number of patients below 2 year-old(considered as optimal age of orchiopexy) were 15(11.1%) patients and below 10 year-old were 75(55.6%) patients. There was no marked difference of age distribution in patients of palpable and impalpable undescended testis. 3. Associated anomalies were found in 16 (11.9%) patients of total 135 patients, and twice more commonly found in the patients of impalpable undescended testis than palpable undescended testis. 4. As surgical location of undescended testis, abdominal type and absence of testis were more common in impalpable undescended testis (10.6% and 8.7% of cases) than palpable undescended testis (1% and 0% of cases).
Age Distribution ; Child ; Cryptorchidism* ; Humans ; Male ; Physical Examination ; Testis

Among many causes of calcium containing urinary stones, the hypercalciuria associated with normocalcemia is the most common one. Absorptive hypercalciuria and renal hypercalciuria constitute two major forms of idiopathic hypercalciuria. According to Coe et al., a renal leak of calcium and secondary hyperparathyroidism are present in renal hypercalciuria but not in absorptive hypercalciuria. It has been suggested that fasting urinary cAMP may provide a measure of parathyroid function. So determination of fasting urinary calcium and cAMP may be useful in the differentiation of the two major forms of idiopathic hypercalciuria. We performed the study to evaluate the significance of urinary calcium and cAMP in the determinating the types of hypercalciuria. Calcium metabolism studies and urinary cAMP determination were done in 28 in-patients with urinary stones under usual diet and fasting state. The results were as followings: 1. Among 28 patients, 15 patients had renal hypercalciuria, 6 had absorptive hypercalciuria and 7 had normocalciuria. 2. On usual diet, 24-hour urine cAMP level was 3.815+/-0.560 nmol/mg creatinine in renal hypercalciuria, 3.508+/-1.253 nmol/mg creatinine in absorptive hypercalciuria and 3.202+/-0.980 nmol/mg creatinine in normocalciuric patients. 3. On fasting state, 2-hour urine cAMP level was 4.611+/-2.591 nmol/mg creatinine in renal hypercalciuria, 4.304+/-3.173 nmol/mg creatinine in absorptive hypercalciuria and 2.400+/-1.080 nmol/mg creatinine in normocalciuric patients. 4. urinary cAMP on usual diet and fasting condition did not differ significantly among 15 renal and 6 absorptive hypercalciuric patients. (t-value; 0.82 and 0.22, respectively, p>0.1)
Calcium ; Creatinine ; Diet ; Fasting ; Humans ; Hypercalciuria ; Hyperparathyroidism, Secondary ; Metabolism ; Urinary Calculi*