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

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.
Liver Diseases* ; Liver*

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*

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*

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

BACKGROUND: We hypothesized that intermittent pneumatic compression device (IPCD) compression system might induce more decreases on the core temperature by increasing the lower extremity blood flow. This study investigated the effects of IPCD compression system on the body temperature in patients undergoing minor surgery under propofol-remifentanil anesthesia. METHODS: Forty female patients were randomly assigned to treat with either elastic stockings (ES group, n = 20) or IPCD (IPCD group, n = 20). Anesthesia was induced and maintained with propofol and remifentanil. The core temperature and arteriovenous shunt in the lower leg were measured using esophageal temperature and the calf to toe skin-surface temperature gradient, respectively. The measurements were taken at 15-minute intervals immediately after anesthesia induction (baseline values, T0) until the end of the surgery. RESULTS: During the study period, the core temperature and skin temperature gradient were comparable between the two groups. The core temperature decreased from 60 min in both groups. And, skin-surface temperature gradient decreased from 15 min in the IPCD group and 30 min in the ES group after anesthesia induction, without intergroup differences across time. CONCLUSIONS: This study demonstrated that the IPCD system did not affect the change in the core temperature when compared to the ES, in patients undergoing minor surgery during propofolremifentanil anesthesia. Thus, the IPCD system could be safely used during propofol-remifentanil anesthesia, without increasing the risk of the intraoperative hypothermia.
Anesthesia ; Body Temperature ; Female ; Humans ; Hypothermia ; Leg ; Lower Extremity ; Piperidines ; Propofol ; Skin Temperature ; Stockings, Compression ; Surgical Procedures, Minor ; Toes

Glutamate Is the predominant excitatory neurotransmitter in the mammalian CNS. To elucidate the influence of glutamate on the noradrenergic neurotransmission in rat cortex, we examined the effects of agents that act in several steps of neurotransmission on [3H]norepinephrine ([3H])NE) release evoked by glutamate. Glutamate (1 mM) evoked significant release of [3H]NE from rat cortex slices in the absence of Mg2+in the incubation media. This effect was attenuated by cromakalime (10 nM) and lemakalime (10 nM), and the inhibitory effect of cromakalime was abolished by glipizide. Inhibitory effect of muscimol (30 uM) and baclofen (3 uM, 30 uM) was antagonized by biccuculine (3 uM), respectively. Nipecotic acid(10 uM), DABA(300 uM), and beta-alanine(100 uM) attenuated the glutamate-induced release of [3H]NE. Dihydrokinate (300 uM) PDC (100 nM) increased the glutamate-induced release of [3H]NE. Ifenprodile (10 nM) and arcaine (1 uN), blockers of polyamine site, attenuated the release of ("H)NE. The stimulatory effect of spermine was abolished by arcaine. CPA(100 nM) and CPCA(100 nM), EHNA(30 uN) and NBTI(1 uN) attenuated the release of ("H)NE. Verapamil(S uN), nitredipine(10 uN), u- conotoxin (100 nM) and flunarizine (5 uM) attenuated the release of (3H)NE. Dantrolene(30 uM), KT-362(3 uM), and ryanodine(10 nM), attenuated the glutamate-induced release of [3H]NE. Glycine (10 uM) increased the release of [3H]NE. DCQX (30 uN) attenuated the release of [3H]NE. These results suggest that glutamate-evoked release of norepinephrine can be modulated by GABAergic, adenosinergic neurotransmitters, and by various drugs which modulate ion channel activities in rat cortex.
Animals ; Baclofen ; Cerebral Cortex ; Conotoxins ; Cromakalim ; Flunarizine ; Glipizide ; Glutamic Acid ; Glycine ; Ion Channels ; Muscimol ; Neurotransmitter Agents ; Norepinephrine* ; Rats* ; Spermine ; Synaptic Transmission