No abstract available.
Motor Cortex*

PURPOSE: Introduction of shock wave lithotripsy has provided an avenue for dealing with many urinary stones noninvasively. Although shock wave is known to cause pathologic changes in various organ, little is k nown about its effect on the ureter and recovery after shock wave, the target organ in SWL of injury induced by shock wave and the potential protective effect of allopurinol and nifedipine against shock wave. MATERIALS AND METHODS: A total 24 rabbits were assigned to 2 groups. 12 rabbits received allopurinol(10mg.each) and nifedipine (1mg.each) that were given orally 3 times a day for 5 days starting the night before SWL. The other 12 rabbits reseived no medication. The left lower Ureter segments of 24 rabbits were removed ureter. Groups of 8 rabbits(4were medication group and 4, no medication group) were sacrificed 1, 3 and 5 days after shock wave exposure. The histomorphological alterations were examined under light and transmission electron microscopy. RESULTS: The epithelial cells disclosed no change after shock wave application. Histologically the muscular layer was the most affected part of ureter. There was interstitial and intracellular edema on light microscopy and made chromatin and mitochondrial changes at the subcellular level. The adventitial layer wes also edematous. This chanfes were prominent on day 1and 3 and returned to normal on day 5. The medication group showed less severe features of injury, compared with the no medication group. CONCLUSIONS: Electromagnetic shock waves produce reversible morphological changes in rabbit ureteric muscle and allopurinol and nifedipine may have its role in protecting the tissue injury produced by high energy shock waves.
Allopurinol* ; Chromatin ; Edema ; Epithelial Cells ; High-Energy Shock Waves ; Lithotripsy ; Magnets ; Microscopy ; Microscopy, Electron, Transmission ; Nifedipine* ; Rabbits ; Shock* ; Ureter* ; Urinary Calculi

BACKGROUND: To identify the prevalence and related factors for vitamin D deficiency in the patients who admitted to the medical intensive care unit (ICU) of a Korean tertiary care hospital. METHODS: We retrospectively analyzed the data from ICU patients requiring mechanical ventilation (MV) for a period of > 48 h to identify the prevalence and associated factors for vitamin D deficiency. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D [25(OH)D] level < 20 ng/mL. RESULTS: Among 570 patients admitted to the ICU, 221 were enrolled in the study, 194 in the vitamin D deficient group and 27 in the non-deficient group. Prevalence of vitamin D deficiency in critically ill patients was 87.8%. The patient age was lower in the vitamin D deficient group compared with the non-deficient group (64.4 ± 15.4 vs. 71.0 ± 9.6 years, p = 0.049). A higher acute physiology and chronic health evaluation II (APACHE II) score (odds ratio [OR] 1.23, 95% confidence interval [CI] 1.10-1.37) and chronic illness (OR 3.12, 95% CI 1.08-9.01) were associated with vitamin D deficiency after adjusting for age and body mass index. Clinical outcomes of duration of MV, ICU stay, and 28- and 90-day mortality rates were not significantly different between the vitamin D deficient and nondeficient groups. CONCLUSIONS: Vitamin D deficiency was common in critically ill patients, particularly among younger patients. Higher APACHE II score and chronic illness were associated with vitamin D deficiency.
APACHE ; Body Mass Index ; Calcitriol ; Chronic Disease ; Critical Care ; Critical Illness* ; Humans ; Intensive Care Units ; Mortality ; Prevalence* ; Respiration, Artificial ; Retrospective Studies ; Tertiary Healthcare ; Vitamin D Deficiency* ; Vitamin D* ; Vitamins*

No abstract available.
Barium* ; Colon* ; Humans ; Neoplasm Metastasis*

Arthroscopic anterior cruciate ligament reconstruction with bone-patella tendon-bone has been commonly using for ACL insufficient patients. Bone-patellar tendon-bone graft is a strong intra-articular substitute, which allows, by means of its bony end, a rigid fixation with early bone to hone healing. As a counterpart, potentially serious cornplications & donor site morbidity has been reported, such as patella fracture & patella tendon avulsion, anterior knee pain, patella tendinitis, dcmor site pain and bone defect. We suppose tightly packing the donor site bony defect with hetrograft (Lubboc) may be also useful. So, we analyzed the morphological change in bony defect and donor site morbidity between the group of non-replaced bony defect and the group of replaced bony defect using by heterograft (Lubboc). We replaceJ hetrograft into the patellar side bony defect in 15 knees and left alone in l5 knees. The average follow up period was 17 months. The results werc as follows: 1. Nearly norma1 appearance on the bony defect showed at the long tenn follow up roentgenogram in the group of replaced hetrograft, but scalloping on the pateltar bomp defect was seen in non-replaced group. 2. Donor site morbidity (pain or patellai tendinitis) was developed 8 knees in the replaced group, and 7 knees in the non-rep)aced group. 3. We conclude that the filled in the bony defect hy hone graft (heterografl:) can not decrease the donor site morbidi ty.
Anterior Cruciate Ligament Reconstruction ; Bone-Patellar Tendon-Bone Grafts ; Follow-Up Studies ; Heterografts* ; Humans ; Knee ; Patella ; Patellar Ligament* ; Pectinidae ; Tendinopathy ; Tissue Donors* ; Transplants

No abstract available.
Knee*

A retrospective review was performed in 33 knees of 30 patients who had undergone arthroscopic debridement for degenerative osteoarthritis of the knee. The mean age of the patients at operation was 55 years and the mean follow-up after operation was 15 months. We divided the knec:s into 2 groups; meniscectomy group (23 knees) and non-meniscectomy group (10 knees). The preoperative radiographic findings were divided into 3 groups according to the classification systern by Lotke et al. The postoperative results were evaluated using the nine-point scale by Baumgaertner et al. Our study was conducted to: 1) assess the overall efficacy of arthroscopic debridement, 2) compare the results between the. Meniscectomy group and nonmeniscectomy group, and 3) identify the relationship between the preoperative radiographic findings and out- come at the final follow-up time. Overall excellent or good results were ac.hieved in 22 knees (67%) and the preoperative radiographic findings correlated with the outcome at the final follow-up time. But the results in the meniscectomy and non-meniscectomy poups showed no significant differences statistically. We believe that arthroscopic debridement is an effective option of treatments for mild I:o moderate degenerative arthritis of the knee after failure of conservative measures.
Classification ; Debridement* ; Follow-Up Studies ; Humans ; Knee* ; Osteoarthritis* ; Retrospective Studies

It would be naive to assume that any operative procedure is the solution to the problem of sacral pressure sore in the field of the orthopaedic surgery. The procedures outlined here involve the creation of compound myocutaneous flaps of the gluteus maximus muscle, skin, and the subcutaneous tissue. The myocutaneous flap us- ing the gluteus maximus muscle is a vascular flap instead of a random flap, with better blood supply for healing and advantage of an increased amount of cushion effect. We present an alternative method which will provide satisfactory and substantial soft tissue coverage in sscral pressure sores.
Methods ; Myocutaneous Flap ; Pressure Ulcer ; Skin ; Subcutaneous Tissue ; Surgical Procedures, Operative

Wear of articular cartilage usually occurs at flexion zones (30°–60°) of the femorotibial articulation, which is demonstrable on the 45°posteroanterior (PA) weight-bearing view. The authors measured and evaluated the cartilage space on the non weight-bearing AP view, AP extension weight-bearing view and 45°PA flexion weight-bearing view, comparing operative findings in cases of 18 osteoarthritis, 7 rheumatoid arthritis and 2 spontaneous osteonecrosis of the lateral femoral condyle, who underwent total or hemiarthro plasty (1 case) of the knee. The results were as follows. l. Operative findings of 11 out of 18 osteoarthritis (61.1%) showed cartilage defect of middle 3/4–4/5 of the medial tibial condyle (sparing finger tip sized anterior & posterior edge) and corresponding femoral condyle. The cartilage space on the AP non weight-bearing, AP extension weight-bearing and 45°PA flexion weight-bearing view were normal to 20% decrease (4.1–5.0mm remained), 60–80% decrease (1.1–2.0mm remained) and 80–100% decrease (0–1.0mm remained), respectively, showing one grade increased cartilage space narrowing on the 45°PA flexion weight-bearing view comparing to AP extension weight-bearing view. 2. Uniform cartilage defect of medial compartment was found in 7(38.9%) osteoarthritic knees. The cartilage space on the non weight-bearing AP view were normal. Both AP & PA weightbearing views showed 60–80% decrease (1.1–2.0mm remained) in 3 knees & 80–100% decrease (0–1.0 mm remained) in 4 knees without any difference between the two views. 3. Uniform cartilage space narrowing of both medal & lateral compartment was noted in 7 rheumatoid knees. The cartilage space on the AP non weight-bearing view were 20–40% decrease (3.1–4.0mm remained) in all knees. The AP extension & 45°PA flexion view showed 40–60% decrease (2.1–3.0mm remained) in 2 knees, 60–80% (1.1–2.0mm remained) in 5 knees respectively without any difference between two groups. 4. The anterior horn of menisci was always intact. The presence of menisci didn't affect the radiological cartilage space. 5. The 45°PA flexion weight-bearing view functioned as a tunnel view showing bone defect and less than 20% decrease of cartilage space in cases of the spontaneous osteonecrosis of the lateral femoral condyle. From our results it was concluded that the radiologic cartilage space could be more accurately demonstrated with 45°PA flexion weight-bearing view in addition to the conventional AP extension weight-bearing view.
Animals ; Arthritis, Rheumatoid ; Cartilage ; Cartilage, Articular ; Clothing ; Fingers ; Horns ; Knee ; Numismatics ; Osteoarthritis ; Osteonecrosis ; Weight-Bearing

BACKGROUND: Intracoronary stent implantation is a promising modality for establishing the blood flow of complex coronary arterial stenosis. However, previous studies have demonstrated that the angiographically visible thrombus is a high risk factor for possibility of stent thrombosis. So many investigators avoided stent implantation traditionally for thrombus containing lesion because of the potency of thrombogenecity of stent. But recently, advanced rapidly growing technique for stenting and powerful antithrombotic regimens make stent thrombosis rare. Stent implantantion has already been showed a acceptable method for bailout procedure of thrombotic occlusion in patients with angioplasty for acute myocardial infarction and also effective in intimal dissection, suboptimal results and arterial recoil. Accordingly, we investigated the effectiveness of stent implantation in the presence of intracoronary thrombus. METHODS: Eighteen patients(AMI 14, Unstable angina 4) underwent PTCA & stent implantation on culprit arterial lesion in all successfully. The stent group was comprised of Palmatz-Schatz stent 10, Cordis 2, Cook 5 and Jo-Med stent 1. Stent implanted to the lesion of remained thrombus visualization on coronary angiography after PTCA. RESULTS: No major complications were developed during hospitalization in all 18 patients. In all patients no stent thrombosis have occurred within 2 weeks after stent implantation. But one patients have showed intracoronary stent thrombus persistently, so we used intracoronary urokinase infusion for 36 hours but there was no visible thrombus after modified anticoagulation and antithrombotic regimen CONCLUSIONS: We harvested good preliminary results of intracoronary stent implantation in the setting of thrombus containing lesion.
Angina, Unstable ; Angioplasty ; Constriction, Pathologic ; Coronary Angiography ; Hospitalization ; Humans ; Myocardial Infarction ; Research Personnel ; Risk Factors ; Stents* ; Thrombosis* ; Urokinase-Type Plasminogen Activator