We performed a retrospective analysis of twenty-four consecutive hip arthroplasties (Total Hip Arthroplasty 18, Bipolar Arthroplasty 1, Cup revision 5) during which intraoperative frozen sections were analyzed to identify the occult active infection. We also reviewed the data such as laboratory findings (ESR, CRP), intraoperative culture, hip joint sonographic evaluation and permanent histologic section. Among the twenty-four patients those who received hip arthroplasties, 10 cases received revisional hip arthroplasties due to painful hip prosthesis loosening, 9 cases with infected hip prosthesis, 3 cases with infection after open reduction and internal fixation due to hip fracture and 2 cases with septic hip sequelae. Intraoperative frozen section had been obtained during staged revisional hip arthroplasties to determine the presence of active infection. We considered positive for infection if it shows more than 10 PML/HPF (Polymorphonuclear leukocyte /high power field) in at least 5 distinct microscopic fields from intraoperative tissue frozen section and postponed implantation of prosthesis. If it shows less than 5 PML/HPF, we performed revisional hip prosthesis implantation. We decided the implantation based on patient's condition, laboratory findings and intraoperative tissue conditions if it shows between 5 and 10 PML/HPF from intraoperative frozen section. At last follow up, 20 of 21 patients who had a revisional hip arthroplasties as below 10 PML/HPF from intraoperative frozen section remained free of infection (Specificity; 95%). We concluded that analysis of the intraoperative frozen sections is a reliable predictor as a guide to sepsis for the successful hip joint arthroplasties.
Arthroplasty* ; Arthroplasty, Replacement, Hip ; Follow-Up Studies ; Frozen Sections* ; Hip Joint ; Hip Prosthesis ; Hip* ; Humans ; Leukocytes ; Prostheses and Implants ; Retrospective Studies ; Sepsis* ; Ultrasonography

Authors report the preliminary result of 86 consecutive femoral head replacements with ceramic head performed at Chonnam University Hospital(73 hips) and Kwangju Christian Hospital(13 hips) during the period of 2 years and 6 months between January 1985 and June 1987. The results were as follows ; l. Eighty-three patients were comprised of 41 men(44 hips) and 42 women(42 hips). 2. Their average age at operation was 62.8 years, the oldest being 86 and the youngest being 24 years and 57 patients(68.7%) of them were over 60 years of age. 3. The causative diseases of the femoral head were hip fracture and its related conditions in 74 hips, and idiopathic avascular necrosis in 12 hips. 4. Associated general diseases, a total of 69 in number, could be diagnosed in 54 patients of them. These included hypertension(18 patients), cardiovascular disease(10 patients), and diabetes mellitus(8 patients). 5. The average diameters of the ceramic head were 49.8 mm in men and 45.1 mm in women. 6. The types of femoral stem were cemented stem(Xenophor 900 stem) in 45 hips and noncemented stem(Autophor 900S stem) in 41 hips. 7. The early postoperative complications, a total of 9 in number, were encountered and these included death in hospital(3 patients), trochanteric fracture(2 patients), pneumonia (1 patient), and others(3 patients). 8. The late postoperative complications, a total of 9 in number, were encountered and these included acetabular erosion(4 hips) and heterotopic ossification(5 hips). 9. Forty-nine hips could be followed more than 1 year with average follow-up of 19.9 months. The hip function of these 49 hips were excellent in 13 hips, good in 24 hips, fair in 8 hips, poor in 3 hips and bad in 1 hip. 10. In conclusion, it can be stated that the femoral head replacement with ceramic head prosthesis is very promising in reducing the incidence of acetabular erosion and maintaining the regained hip function.
Acetabulum ; Ceramics ; Female ; Femur ; Follow-Up Studies ; Gwangju ; Head ; Hemiarthroplasty ; Hip ; Humans ; Incidence ; Jeollanam-do ; Male ; Necrosis ; Pneumonia ; Postoperative Complications ; Prostheses and Implants

No abstract available.
Liver Diseases* ; Liver*

Confocal scanning laser flowmetry(HRF: Heidelberg Retina Flowmetry) is a new kind of instrument which enables non-invasive two-dimentional mapping of perfusion of the retina and optic disc and to evaluate the clinically available reproducibility of the peripapillary and retinal perfusion measurement with the confocal scanning laser flowmetry, the authors calculate the coefficient of variation (CV) from the parameters(volume, flow, velocity). The authors indicate two region of interest in the peripapillary region and retina, not overlapping the large vessels and measure the parameters three times consecutively(one session) while visiting three times intervalled(three session), thereafter calculate the mean CV of parameters in ten healthy eyes of ten subject. The CV of parameters obtained with the confocal scanning laser flowmetry was low relatively and therefore reproducibility was high as the CV lower, the reproducibility higher. Comparing the CV between one session and three session measurement to know the clinically available measurement frequency, the CV of three session (volume 13%, flow 16.7%, velocity 16%) was lower than the CV of one session (volume 16.7%, flow 20.7%, velocity 20.1%) in the peripapillary region(Students t test; volume p=0.009, flow p=0.03, velocity p=0.016) and the CV of three session (volume 16.7%, flow 20.7%, velocity 17%) was lower than the CV of one session (volume 18.2%, flow 21.8%, velocity 21.7%) in the retina(Students t test; volume p=0.017, flow p=0.0009, velocity p=0.0004). Above the results, the CV of parameters(13~21.8%) in one and three session had relatively high reproducibility. Also the CV between two measurements had a difference statistically but the difference was not so high, the authors concluded the confocal scanning laser flowmetry which have high resolution measure the peripapillary region and retina reproduciblly with only one time visit, three consecutive measurements.
Perfusion* ; Retina ; Retinaldehyde* ; Rheology*

Twenty eight rabbit eyes which underwent astigmatic photorefractive keratectomy with excimer laser were analyzed to evaluate the effect of excimer laser photorefractive keratectomy on high astigmatic refractive error. Non-astigmatic eyes were divided into 4 groups according to their operative technique for inducing astigmatism(Group I: 50micrometer ablation with no astigmatism, Group II: 3.00 diopter with the rule astigmatism, Group III: 6.00 diopter with the rule astigmatism, Group IV: 9.00 diopter with the rule astigmatism). During the follow-up period, changes of astigmatism were examed with corneal topography, The results were as follows; 1. Two months after surgery, the mean achieved astigmatisms were 0.23(Group I), 1.78(Group II), 2.63(Group III) 2.65 diopters(Group IV), respectively. 2. Mean astigmatic induction rates of the group II,III and IV were 59.4%, 48.3% and 29.48%, respectively, Astigmatic induction rate of group II, in which the attempted astigmatism was -3.00 diopters, was highest(P<0.05) 3. Highly achieved astigmatism at postoperative 7 days regressed in all groups except group I(P<0.05). The regression was most significantly progressed in group IV, but the regression pattern did not reveal any statistically significant difference between the groups(P<0.05) 4. In SEM study, the rabbit cornea samples showed the different irregularities. Deeper ablation group tissues exhibited a much rougher surface appearance than shallow ablation group tissues. In this study, it was concluded that the achieved astigmatism and induction rate of astigmatism were statistically significant correlation(P<0.05), but the induction rate was smaller compared to the attempted astigmatism, and increased tendency for regression.
Astigmatism* ; Cornea ; Corneal Topography ; Follow-Up Studies ; Lasers, Excimer* ; Photorefractive Keratectomy* ; Rabbits* ; Refractive Errors

Since the first report on the blood triglyceride level of normal korean in 1962, more than 12 authors published their normal value ranging from 78.0~151.0mg% as mean value. In an attempt to establish normal triglyceride level in Korean, the timing of sampling and method of sample preservation were reevaluated in terms of quality control. Although the number of samples and tests were too small to make an unequivocal conclusion, the following results were observed. 1. Plasma triglyceride levels were stable on continuing fasting 12~16 hours, slightly decreased thereafter. 2. Samples kept in room temperature were stable up to 3 days and the triglyceride level dropped moderately on the 5th day. 3. No significant change in plasma triglyceride level was found with freezing up to one month. 4. Significant change in plasma triglyceride level was noted with repeated melting and refreezing of specimen. 5. The probable reasons for marked differences in normal value of plasma triglyceride level were discussed.
Fasting ; Freezing ; Plasma* ; Quality Control ; Reference Values ; Triglycerides*

Persistent epithelial defect (PED) is an important ocular surface disorder. These defects can be frustrating chronic diseases as in the cases of inflammation, chemical burn, denervated cornea, tear deficiency and radiation keratitis. Therapeutic modalities that have been utilized in the treatment of PED included topical steroid, patching, bandage soft contact lenses, superficial keratectomy and anterior stromal puncture. We reported here the use of 193 nm excimer laser phototherapeutic keratectomy (PTK) for the treatment of indolent and persistent epithelial defect as the new Therapeutic device for PED. Twelve eyes diagnosed as PED were treated with Summit excimer laser phototherapeutic keratectomy. All cases were failed to cover the epithelium with therapeutic contact lenses. The laser treatments(diameter 1mm, depth 5micrometer) were delivered to sites surrounding the epithelial defect area for promoting of the epithelial ingrowth. All cases received PTK were covered with new epithelium in two or three days as shown by photorefractive keratectomy and remained completely healed through at least three months follow-up period. We found PTK with the 193 nm excimer laser to be a safe, effective treatment modeling for PED that is unresponsive to conventional therapy.
Bandages ; Burns, Chemical ; Chronic Disease ; Contact Lenses ; Contact Lenses, Hydrophilic ; Cornea ; Epithelium ; Follow-Up Studies ; Inflammation ; Keratitis ; Lasers, Excimer ; Photorefractive Keratectomy ; Punctures

No abstract available.
Child* ; Fracture Fixation, Intramedullary* ; Humans

PURPOSE: To assess the utility of magnetic resonance(MR) cerebral blood volume (CBV) map in the evaluation of brain tumors. MATERIALS AND METHODS: We performed perfusion MR imaging preoperatively in the consecutive 15 patients with intracranial masses (3 meningiomas, 2 glioblastoma multiformes, 3 low grade gliomas, 1 lymphoma, 1 germinoma, 1 neurcyotma, 1 metastasis, 2 abscesses, 1 radionecrosis ). The averages age of the patients was 42 years (22yr-68yr), composed of 10 males and 5 females. All MR images were obtained at 1.5T imager(Signa, GE Medical systems, Milwaukee, Wisconsin). The regional CBV map was obtained on the theoretical basis of susceptibility difference induced by first pass circulation of contrast media.(contrast media: 15cc of gadopentate dimeglumine, about 2ml/sec by hand, staring at 10 second after first baseline scan). For each patient, a total of 480 images (6 slices, 80 images/slice in 160 sec) were obtained by using gradient echo(GE) single shot echo-planar image(EPI) sequence (TR 2000ms, TE 50ms, flip angle 90degree, FOV 240x240, matrix 128x128, slice-thick/gap 5/2.5). After data collection, the raw data were transferred to GE workstation and rCBV maps were generated from the numerical integration of deltaR2* on a voxel by voxel basis, with home made software(deltaR2*=-ln(S/S0/TE). For easy visual interpretation, relative RGB color coding with reference to the normal white matter was applied and color rCBV maps were obtained. The findings of perfusion MR image were retrospectively correlated with Gd-enhanced images with focus on the degree and extent of perfusin and contrast enhancement. RESULTS: Two cases of glioblastoma multiforme with rim enhancement on Gd-enhanced T1 weighed image showed increased perfusion in the peripheral rim and decreased perfusion in the central necrosis portion. The low grade gliomas appeared as a low perfusion area with poorly defined margin, In 2 cases of brain abscess, the degree of perfusion was similar to that of the normal white matter in the peripheral enhancing rim and was low in the central portion. All meningiomas showed diffuse homogeneous increased perfusion moderate or high degree. One each of lymphoma and germinoma showed homogenously decreased perfusion with well defined margin. The central neurocytoma showed multifocal increased perfusion areas of moderate or high degree. A few nodules of the multiple metastasis showed increased perfusion of moderate degree. One radionecrosis revealed multiple foci of increased perfusion within the area of decreased perfusion. CONCLUSION: The rCBV map appears to correlate well with the perfusion state of brain tumor, and may be helpful in discrimination between low grade and high grade glioma. The further study is needed to clarify the role of perfusion MR image in the evaluation of brain tumor.
Abscess ; Blood Volume ; Brain Abscess ; Brain Neoplasms* ; Brain* ; Clinical Coding ; Data Collection ; Discrimination (Psychology) ; Female ; Germinoma ; Glioblastoma ; Glioma ; Hand ; Humans ; Lymphoma ; Magnetic Resonance Imaging* ; Male ; Meningioma ; Necrosis ; Neoplasm Metastasis ; Neurocytoma ; Perfusion* ; Retrospective Studies

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