The congenital ball-and-socket ankle joint is a rare condition and is associated with congenital shortening of the lower extrimity and various skeletal abnormalities of the foot. This disease entity was reported in the German literature by Politzer in 1931 and in the English literature by Lamb in 1958. Several series have been reported since, suggesting that the condition may not be as rare as generally thought. This case is, to our knowledge, the first reported in this country.
Ankle Joint ; Ankle ; Foot

Bartonellosis is spotlighted recently as an emerging zoonosis and Bartonella henselae is reported to be the main infectious agent. In Korea, however, few studies have been made on the epidemiology and microbiology on bartonellosis. Thus, this study was conducted to produce a new monoclonal antibody that can be used for identifying B. henselae. In order to prepare monoclonal antibodies against B. henselae, we inoculated mice with the isolated strain from Korean patient and performed cell fusion experiment. The selected hybridoma clones produced monoclonal antibodies which showed positive immunofluorescence staining of bacteria and specific protein bands in western blot analysis. In order to examine whether these antibodies could be used for the identifying and quantifying Bartonella, we performed confocal microscopy and flow cytometry using the new antibodies. These monoclonal antibodies can be used as a useful tool in further researches on the biology of Bartonella.
Animals ; Antibodies ; Antibodies, Monoclonal ; Bacteria ; Bartonella ; Bartonella henselae ; Bartonella Infections ; Biology ; Blotting, Western ; Cell Fusion ; Clone Cells ; Flow Cytometry ; Fluorescent Antibody Technique ; Humans ; Hybridomas ; Korea ; Mice ; Microscopy, Confocal ; Sprains and Strains

No abstract available.
Blood Flow Velocity* ; Humans ; Infant, Newborn*

These studies were performed to identify the localization, and neuronal function of calcitonin gene-related peptide[CGRP] in the neural axis of rat stomach by retrograde tracing and immunohistochemical techniques. After injection of pseudorabies virus Bartha strain[PRV] as tracer between serosa and muscle layer of stomach, the rats were perfused and the brains were removed. PRV-immunoreactive cells were observed in central nucleus of amygdaloid, insular cortex, subfornical organ, bed nucleus of stria terminalis, paraventricular nucleus, organum vasculosum of terminalis, suprachiasmatic nucleus, lateral hypothalamic area, K lliker-Fuse nucleus, parabrachial nucleus, locus ceruleus, A1 noradrenaline area, A5 noradrenaline area, area postrema, dorsal motor nucleus of vagus nerve, nucleus tractus solitarius and raphe nuclei. CGRP-immunoreactive cells are observed in insular cortex, bed nucleus of stria terminalis, paraventricular nucleus, lateral hypothalamic area, parabrachial nucleus, area postrema, nucleus tractus solitarisu, neucleus ambiguus, facial nucleus, hypoglossal nucleus and raphe nuclei. The dobule immunofluorescent study was carried out to examine the coexistence of CGRP and PRV in several nuclei : insular cortex, bed nucleus of stria terminalis, paraventricular nucleus, later hypithalamic area, parabrachial nucleus, area postrema, nucleus tractus solitarius and raphe nuclei. At the results of double immunofluorescent study, we could not observe the double immunoreactive neurons CGRP and PRV in those nuclei but raphe nuclei. These results suggest that CGRP should not have a neural functions in the neurons in nuclei projecting to rat stomach except raphe nuclei.
Animals ; Area Postrema ; Axis, Cervical Vertebra ; Brain* ; Calcitonin Gene-Related Peptide* ; Calcitonin* ; Herpesvirus 1, Suid ; Hypothalamic Area, Lateral ; Locus Coeruleus ; Neurons ; Norepinephrine ; Paraventricular Hypothalamic Nucleus ; Raphe Nuclei ; Rats* ; Septal Nuclei ; Serous Membrane ; Solitary Nucleus ; Stomach ; Subfornical Organ ; Suprachiasmatic Nucleus ; Vagus Nerve

The present study has been performed to investigate the neural axis of rat digastric muscle using viral tracer, pseudorabies virus. The upper nuclei to innervate digastric muscle were in accumbens nucleus, agran-ular insular cortex, central nucleus of amygaloid, lateral septal nucleus, frontal cortex, and subfornical organ etc, in telencephalon ; arcuate hypothalamic nucleus, lateral hypot-halamic area, medial preoptic nucleus, bed nucleus of stria terminalis, dorsomedial hypot-halamic nucleus, suprachiasmatic nucleus, paraventricular nucleus, and retrochiasmatic area etc, in diencephalon ; nucleus Darkschewitsch, interstitial nucleus of the medial logitudinal fasciculus, parabrachial nucleus, locus ceruleus, Kolliker-Fuse nucleus, trigeminal mesencephalic nucleus, red nucleus, substantia nigra, nucleus of posterior commissure, Edinger-Westphal nucleus, and dorsal raphe nucleus etc, in mesencephalon ; giganto-cellular reticular nucleus, raphe magnus nucleus, raphe pallidus nucleus, raphe obscuous nucleus, nucleus of solitary tracts, lateral reticular nucleus, parvocellular reticular nucleus, area postrema, facial nucleus, pontine reticular nucleus, pontine nucleus of trigeminal nerve and spinal nucleus of trigeminal nerve etc, in rhombencephalon. There are significant difference of numbers of PRV-Ba immunoreactive cells between right and left sides of brain in almost nuclei[P< 0.05]. But PRV-Ba immunoreactive cells were observed only ipsilaterally in accessory trigeminal motor nucleus, accessory facial nucleus and agranular insular cortex. Frontal cortex was the only area which were shown contralateral immunoreactivity. The results of this study provide anatomical support that both the cranial and caudal bellies are innervated by the same upper nuclei. The results also support the suggestion that the lower nuclei of digastric muscle, accessory trigeminal motor nucleus and accessory facial nucleus consist of somatotopic motor complex.
Animals ; Area Postrema ; Axis, Cervical Vertebra* ; Brain ; Diencephalon ; Herpesvirus 1, Suid ; Hypothalamic Area, Lateral ; Immunohistochemistry ; Locus Coeruleus ; Mesencephalon ; Paraventricular Hypothalamic Nucleus ; Raphe Nuclei ; Rats* ; Red Nucleus ; Rhombencephalon ; Septal Nuclei ; Subfornical Organ ; Substantia Nigra ; Suprachiasmatic Nucleus ; Telencephalon ; Trigeminal Nerve ; Trigeminal Nuclei

No abstract available.

Although stems improve initial mechanical stability in revision total knee arthroplasty (TKA), ideal indications, proper lengths and diameters, and appropriate fixation methods remain controversial. The topics of the present article include the indications, selection of lengths and diameters, and fixation methods of stems in revision TKA. The use of a stem in revision TKA can protect the juxta-articular bone. A stem cannot be a substitute for optimal component fixation; it plays an adjunctive role in transferring the loads from the compromised metaphysis to the stronger diaphysis. Proper bone surface preparation and appropriate use of the stem based on a great store of knowledge are required to support the stemmed components effectively in revision TKA. The balance between overshielding and overloading the juxta-articular bone would provide excellent structural protection. The stem length and diameter should be tailored according to patients’ anatomical characteristics and determined fixation strategy. There are two traditional methods of stem fixation including the total cementation technique and the hybrid technique with a cementless press-fit stem. Selection of a cementation technique should be based on thorough consideration of advantages and disadvantages of each technique.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Cementation ; Diaphyses ; Knee ; Methods

OBJECTIVE: This study was conducted to investigate the effect of vitrification on the implantation the pregnancy of human blastocysts. METHOD: The transfer of the frozen-thawed blastocysts by the slow freezing or vitrification was performed between January 1998 and July 1999. The zygotes derives from IVF were cocultured with cumulus cells in YS medium containing 20% hFF for 5days. Two or three of the best balstocysts produced on day 5 were transferred into the uterus, and then supernumerary blastocysts were randomly divided into two groups. One was frozen by slow freezing and the other was frozen by vitrification method. The slow freezing procedure was performed in two steps (5% glycerol and 9% glycerol + 0.2 M sucrose for 10 min, respectively) using programmed freezer (-2degrees C/min to -7degrees C, 0.3degrees C and plunged into LN2). The blastocysts frozen by slow freezing were thawed at 36degrees C then removed glycerol in 7 steps. The vitrification procedure was performed in three steps (10% glycerol for 5 min, 10% glycerol + 20% ethylene glycol for 5 min, 25% glycerol + 25% ethylene glycol and directly LN2 within 1 min). The blastocysts frozen by vitrification were thawed at 20degrees C water then removed cryoprotectant in 3 steps. In each group, thawed blastocysts were cocultured with cumulus cells in YS medium containing 20% hFF for 18h and transferred into the uterus. The implantation rate was evaluated per transferred blastocysts and the pregnancy rate was evaluated per transfers. RESULTS: The survival rate of vitrified group (74.5%) was higher than slow freezing group (68.0%), but not significant. When 98 thawed blastocysts of vitrification were transferred in 40 cycles, 19 pregnancies (clinical pregnancy rate; 47.5%) were established. One miscarriage occurred in the eighth week of pregnancy (ongoing pregnancy rate; 45.0%). 7 pregnancies were ongoing, 11 pregnancies went to term, and 16 healthy infants were born. The Implantation rate was 31.6%. These results were higher than those obtained by the slow freezing (clinical pregnancy rate; 40.3%, ongoing pregnancy rate; 32.5% and implantation rate; 25.3%), but not significant. CONCLUSION: Vitrification is a simple, quick and economical method when compared to slow freezing. It will be chosen as a good method of human embryo freezing in IVF-ET programs.
Abortion, Spontaneous ; Blastocyst* ; Cumulus Cells ; Embryonic Structures ; Ethylene Glycol ; Female ; Freezing ; Glycerol ; Humans ; Infant ; Pregnancy Rate ; Pregnancy* ; Sucrose ; Survival Rate ; Uterus ; Vitrification* ; Water ; Zygote

The in vivo effects of ethrane and single intravenous injection of hydrocortisone 250 mg on T-cell subsets (T3, T4 and T8), s-cortisol, s-Na+ and K+, polymorphonuclear leukocytes, lymphocytes and HSR (T-helpers to T-suppressors ratio) has been studied. Six healthy volunteers and 16 patients was selected and observed. Sixteen patients has been done surgery under ethrane anesthesia, and single dose of hydrocortisone 250 mg was injected intravenously to eight patients among them. The result is as follows; 1) Serum cortisol level was increased after surgery under ethrane anesthesia and was decreased bellow control value at 24 hours after injection of hydrocortisone 250 mg. 2) After surgery under ethrane anesthesia, PMN's counts and monocyte counts in peripheral blood were increased, but absolute number of lymphocytes and T-cell subsets were decreased. 3) After surgery under ethrane anesthesia with hydrocortisone 250 mg, there was the most elevation of PMN's counts and the most redution of absolute number of T-cell subsets at 5 hours and was somewhat tended to return to control values, but remained changed at 24 hours, and monocyte counts was unchanged. 4) Adding hydrocortisone 250 mg compared with ethrane anesthesia alone, the increasing rate of PMN's counts and the decreasing rate of lymphocytes and absolute number of T-cell subsets were higher at 5 hours, and were lower at 24 hours. 5) Relative percentage of T-cell subsete and HSR were unchanged after surgery under ethrane anesthesia alone and adding hydrocortisone 250 mg.
Anesthesia* ; Enflurane* ; Healthy Volunteers ; Humans ; Hydrocortisone* ; Injections, Intravenous* ; Lymphocytes ; Monocytes ; Neutrophils ; T-Lymphocyte Subsets* ; T-Lymphocytes*

BACKGROUND: Although a laparoscopic cholecystectomy results in less pain than an open cholecystectomy, it is not a pain-free procedure. A controversy exists over the effectiveness and clinical value of intraperitoneal local anesthetics for treating pain after a laparoscopic cholecystectomy. We investigated the effects of intraperitoneal lidocaine on pain after a laparoscopic cholecystectomy. METHODS: Forty patients were randomly assigned to receive 200 ml saline containing 200 mg lidocaine or the same volume of saline instilled under the right hemidiaphragm and cholecystectomy site at the end of surgery. Intensity of abdominal and shoulder pain were assessed 0, 1, 6, 12, 24 and 48 hours after surgery and recorded on a visual analog scale (VAS) and verbal rating scale (VRS). RESULTS: The abdominal pain scores (VAS and VRS) were significantly lower in the lidocaine group than the control group at 0 - 24 hours after surgery (P < 0.05). The shoulder pain scores and incidence were significantly lower in the lidocaine group than the control group at 6 - 12 hours after surgery. In the lidocaine group, the incidence of epigastric and right flank pain were significantly lower than the control group. CONCLUSIONS: Intraperitoneal instillation of lidocaine significantly reduces shoulder and abdominal pain for 24 hours after a laparoscopic cholecystectomy.
Abdominal Pain ; Anesthetics, Local ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Flank Pain ; Humans ; Incidence ; Lidocaine* ; Pain, Postoperative ; Shoulder Pain* ; Shoulder* ; Visual Analog Scale