Insall-Burstein Posterior stabilized knee prosthesis is a variant of total condylar prosthesis. It is designed to get more wide range of flexion and stability with the transverse cam. We analyze with modified HSS knee rating score clinically and scoring system of AKS(American Knee Society) radiologically. We report the operative results in 34 cases of 25 patients whom we operated with Insall-Burstein PSP from August, 1982 to May, 1985 and the long term follow-up result of 24 cases of 16 patients, excluding three death and 7 cases of 6 patients who were lost to follow up. Follow-up period is average 11 years and 5 months. The average preoperative flexion contracture improved markedly. The average preoperative flexion arc was 95° and preoperative flexion contracture was 14°. The postoperative ROM and flexion contracture improved markedly. The average preoperative modified HSS knee rating scoring was 52 points and improved to 91 points at last follow-up. Patients with rheumatoid arthritis had progression of other joints involvement which limited the activity of daily living. At the last follow up, loosening signs were not observed radiologically but three cases of radiolucent zone were observed in the zone I, II, III, IV, VII of tibial components and zone III, VI of femoral components. There were two deep infections.
Arthritis, Rheumatoid ; Arthroplasty ; Contracture ; Follow-Up Studies ; Humans ; Joints ; Knee Prosthesis ; Knee ; Lost to Follow-Up ; Prostheses and Implants

Sebaceous carcinoma is uncommon and usually presents in the ocular adnexa as a cancer of the meibomian glands. They are frequently mistaken for chalazion. Considerable time often elapses before a diagnosis is made. We present a case of sebaceous carcinoma of the left eye lid in 59 year old female who had a history of 3 repeated surgical resections clinically diagnosed as chalazion during last 3 years.
Female ; Humans

The purpose of the study is to research the side effects of chemotherapy which are experienced by cancer patients, theirself-care behaviors to manage the side effect symptoms, and to for provide the fundamental knowledge basis for nursing intervention and self-care education. The subjects were 15 cancer patients receiving chemotherapy in 2 university hospitals. The side effects and self-care behaviors were categorized into 7 themes. 1) First theme Patients experienced nausea, vomiting, alteration in appetite, constipation, diarrhea, and indigestion. Patients used emetics, ate sweets, fruits, drank alcohol and cold veberages to deal with nausea and vomiting. They took their favorites, and yogurt and medicine, and an easily digestible diet to decrease the side effects on digestive function. 2) Second theme Patients experienced oral-dryness & stomatitis. Patients consumed water, candy a warm food and various beverages. 3) Third theme, To cope with changed sense of taste, patient ate their favorite foods, and to help offset alteration in tactile sense they used massage. Concerning changed sensitivity to decreased temperature, ultraviolet treatment and various means of keeping warm were used. To deal with the changed sense of smell and hearing, they avoided noise and bad odors as much as possible. 4) Fourth theme Patients experienced discoloured skin and alopecia. Patients wore appropriate clothes to hide it. To deal with alopecia, they used hats, head kerchief, and positive thinking. 5) Fifth theme Patients experienced weight loss, URI symptoms, fatigue, pain, insomnia and they took various food health products, medicines, and naps. 6) Sixth theme Patients experienced musculoskeletal changes and decreased amounts and range of activities. They did self-care behaviors such as taking baths, exercising etc. 7) Seventh theme Patients felt varing level of anxiety and for this they had fellowship with support companies and used religion, self-control, and positive thinking. From the above research, it can be concluded that : Patients used self-care behaviors which were not proved in effectiveness and education for the prevention and management of the related side effects of chemotherapy was not effective, either.
Alopecia ; Anxiety ; Appetite ; Baths ; Beverages ; Candy ; Constipation ; Diarrhea ; Diet ; Drug Therapy ; Dyspepsia ; Education ; Emetics ; Fatigue ; Fellowships and Scholarships ; Fruit ; Head ; Hearing ; Hospitals, University ; Humans ; Massage ; Nausea ; Noise ; Nursing ; Odors ; Self Care* ; Skin ; Sleep Initiation and Maintenance Disorders ; Smell ; Stomatitis ; Thinking ; Vomiting ; Water ; Weight Loss ; Yogurt

Fractures of the carpal navicular is a serious injury, particulary in a manual worker, because non union and the resultant disability may limit the usefulness of the extremity. There is almost unanimous agreement that fresh fractures of the carpal navicular should be treated by immobilization in a plaster cast and how immobilization should be maintained. As a result of this study we have arrived at several conclusion regarding to the conservative treatment of fresh navicular fracture.
Casts, Surgical ; Clinical Study ; Extremities ; Immobilization

The proper distribution of stress & a low rate of wear has become major concern in recent design consideration of total knee prosthesis. The TC IV knee system has kept the original anatomical design of the total condylar knee and improved and refined it. And it has some characteristics: deep patellar groove of the femoral component, 5 degree posterior tilted tibial UHMWPE articulating surface with increased potential range of motion, and beaded porous coating applied to the bone-component interface. This study reports the consecutive 61 arthroplasties in 42 patients. Follow up period was average three years and six months. There were 29 osteoarthritis, 29 rheumatoid arthritis, and three infection sequelae. In all cases, we used TC IV prosthesis, bone-cement for prosthesis fixation and sacrificed PCL. All patients were assessed using HSS knee score and American knee society clinical rating system, and roentgenographic evaluation and scoring system. 1. The range of motion was significantly increased from average 87.8 degrees preoperatively to average 122.9 degrees postoperatively. 2. The HSS knee score increased from average 47.7 points preoperatively to average 90.9 points postoperatively, and the functional score of AKS was average 85.6 and knee score was 93.4 postoperatively. 3. The flexion contracture was decreased from average 29.3 degrees preoperatively to average 3.9 degrees postoperatively. 4. In radiological review, the tibiofemoral angle changed from average varus 1.5 degrees preoperatively to average valgus 6.3 degrees postoperatively, and the joint line changed average 9.3mm preoperatively to average 13.7mm postoperatively, and nine knees(14%) had a radiolucency with a width of 2mm or more beneath one or two tibial zone. 5. Complications included two superficial infections and each case of transient peroneal palsy and patellar component wear in the metal backing type. 6. In summary, although the follow-up period was short, functional score of TC IV is no less than that of the other prosthesis with PCL retention.
Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Contracture ; Follow-Up Studies ; Humans ; Joints ; Knee ; Knee Prosthesis ; Osteoarthritis ; Paralysis ; Prostheses and Implants ; Prosthesis Retention ; Range of Motion, Articular

PURPOSE: To describe the lived experience of nursing students when faced with clinical judgment in a nursing practicum at the hospital. METHODS: A descriptive research design was utilized. Participants were 79 students in the clinical practicum. Participant consent was obtained for ethical protection. Data were collected from August to December 2007 using a semi-structured questionnaire. Content analysis was utilized for data analysis. RESULTS: Two categories and 5 themes were extracted from the data for 'difficult' and 'easy' clinical judgments. For the student category, the two themes were 'knowledge' and 'skill', while the three themes for the clinical education environment category were, 'judgment of clinical symptoms and signs', 'differences between theory and practice' and 'human relationships'. For coping, 2 categories and 5 themes were extracted for the difficult clinical judgment situation, while one category and one theme were found for the easy clinical judgment situation. CONCLUSION: To develop students' clinical judgment, there is need to develop the method of clinical skills using simulation in clinical teaching. For future research, a study on factors affecting clinical judgment of nursing students in hospitals is needed.
Clinical Competence ; Humans ; Judgment ; Research Design ; Statistics as Topic ; Students, Nursing ; Surveys and Questionnaires

No abstract available.
Carcinoma, Renal Cell* ; Caveolin 1*

CT scans of 21 patients(intrathoracic goiter=7. Castleman disease=6, pulmonary carcinoid tumor=3, parathyroid adenoma=1, thyroid carcinoma=1, paraganglioma=1, benign pleural mesothelioma=1, sclerosing hemangioma=1) with mediastinal tumors that are known to be enhanced with intravenous injection of contrast media, were studied retrospectively to investigate the enhancing capabilities f those tumors and to describe their CT findings. The degree of enhancement was estimated by visual inspection with a grading system. All but one case of cystic parathyroid adenoma showed enhancement on post-contrast scan. The degree of enhancement was not helpful in differentiating these tumors. Characteristic location and pattern of tumor extension were found in cases of intrathoracic goiter, parathyroid adenoma, thyroid carcinoma and paraganglioma. Calcifications were found in intrathoracic goiter(5/7). Castleman disease(2/6). Pulmonary carcinoid(1/3), thyroid carcinoma. Necrotic low-attenuation areas were in intrathoracic goiter(7/7), parathyroid adenoma, thyroid carcinoma and paraganglioma. In conclusion, mediastinal tumors that are known to be enhanced in the literature were enhanced with rare exception, and if we consider the predilection site of those tumors, the scope of differential diagnosis can reasonably be narrowed.
Carcinoid Tumor ; Contrast Media ; Diagnosis, Differential ; Goiter, Substernal ; Injections, Intravenous ; Paraganglioma ; Parathyroid Neoplasms ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms ; Tomography, X-Ray Computed

No abstract available.
Child* ; Humans ; Kidney Failure, Chronic*

The PFC (Press Fit Condylar) knee was first implanted clinically in 1984 with retention of posterior cruciate ligament. Thereafter PFC modular version had been developed at 1988 with option of posterior cruciate ligament substitution and minor design changes. We classified the 170 patients, 252 knees which underwent the PFC total knee arthroplasty in the period from January 1988 to May 1995 into three groups. In group I, 62 patient. Had 93 total knee arthroplasties with insertion of the original PFC total knee prosthesis with retention of posterior cruciate ligament from January 1988 to October 1991. In group Iia, 51 patients had 74 total knee arthroplasties with insertion of the modular PFC total knee prosthesis with retention of posterior cruciate ligawient from November 1991 to May 1995. In group III, 57 patients had 85 total knee arthroplasties with insert.ion of the modular PFC total knee prosthesis with substitution of posterior cruciate ligament from November 1991 to May l995. Average follow-up periods were 7 years 5 months in group I and 3 years 2 months in group Iia and Ilb. Clinical and radiographic results were similar among the group I, Iia and llb except slight better scores in group Iia and Iib than group I, even though group IlI and IlI had short follow-up periods, Postoperative implant wear was developed at 5 knees in group I, 1 knee in group Iia and not developed in group Ilb. Implant loosening was developed at 1 knee only in group 1. Revisional arthroplasty was performed to 7 knees in group I, 1 knee in group Iia and not in group 1Ib. In conclusion, posterior cruciate ligament substitution group had no difference in functional results with the retention group. In the problem of implant wear, posterior cruciate ligament substitution group was superior to the retention group but similar in loosening.
Arthroplasty* ; Follow-Up Studies ; Humans ; Knee Prosthesis ; Knee* ; Posterior Cruciate Ligament ; Postoperative Period