No abstract available.
Dizocilpine Maleate* ; Dopamine* ; Methamphetamine*

Purpose: We wanted to evaluate the clinical and radiologic results of acetabular revision using the acetabular reinforcement ring and also the allograft impaction in the acetabulum having deficient bone stock. Material and Methods: Nineteen hips revision arthroplasty were performed in 18 patients (9 males and 9 females) with using an acetabular reinforcement ring and allograft between July 1993 and December 2003. The patients were followed for an average of 64 months (range: 24-153). The mean age at the time of arthroplasty was 59 years old (range: 34-76). The causes of revision were aseptic loosening of the acetabular component in 16 cases, severe progressive osteolysis around the acetabular component in 2 cases and Girdlestone state after infected total hip arthroplasty in one case. The acetabular deficiency was type II in 5 hips, type III in 13 hips, and type IV in one hip according to the AAOS classification. The clinical results were evaluated using the modified Harris hip score, and the radiologic results were evaluated by assessing the preoperative and serial follow-up radiographs. Results: The mean preoperative Harris hip score of 47 was improved to 86 points at the latest follow-up. Periacetabular osteolysis was found in 2 cases, which did not progress at follow-up. The anatomic hip center was restored after revision arthroplasty (p<0.05). Complications were dislocation in 2 cases, breakage of the hook of the Ganz ring in one case, heterotopic ossification in one case and femoral artery injury in one case. All cases showed stable fixation of the acetabular component and good remodelling of the impacted allograft. There was neither recurrence of dislocation nor progression of the acetabular component loosening on the radiographs. Conclusion: Acetabular revision with acetabular reinforcement ring and allograft impaction showed satisfactory clinical and radiologic results with restoration of the hip center and consolidation of the allograft.
Acetabulum* ; Allografts* ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Classification ; Dislocations ; Femoral Artery ; Follow-Up Studies ; Hip ; Humans ; Male ; Ossification, Heterotopic ; Osteolysis ; Recurrence

STUDY OBJECTIVE: determine the level of medical care required for mass gatherings and describe the types of medical problems encountered in a religious mass gathered ceremony. DESIGN: Standard charts and a four-tiered triage system(minor, moderate, urgent, and emergent) were developed before the event. The triage system was applied to each chart retrospectively by a single emergency physician. SETTING: Medical staff(10 physicians,13 nurses,1 pharmacist, and 54 first-aid attendants) were based in 8 advanced life support (ALS) clinics. INTERVENTIONS: First-aid attendants referred patients to the clinics, where nurses conducted initial assessments and referred patients to physicians at the venue. Three ambulances were stationed at the venues. RESULT: 22 trauma patients were developed and 183 medical complaints were encountered. Only 7 urgent medical problems were encountered.
Ambulances ; Emergencies* ; Humans ; Pharmacists ; Retrospective Studies ; Triage

Microfluidic systems can be used to control picoliter to microliter volumes in ways not possible with other methods of fluid handling. In recent years, the field of microfluidics has grown rapidly, with microfluidic devices offering possibilities to impact biology and medicine. Microfluidic devices populated with human cells have the potential to mimic the physiological functions of tissues and organs in a three-dimensional microenvironment and enable the study of mechanisms of human diseases, drug discovery and the practice of personalized medicine. In the field of otorhinolaryngology, various types of microfluidic systems have already been introduced to study organ physiology, diagnose diseases, and evaluate therapeutic efficacy. Therefore, microfluidic technologies can be implemented at all levels of otorhinolaryngology. This review is intended to promote understanding of microfluidic properties and introduce the recent literature on application of microfluidic-related devices in the field of otorhinolaryngology.

Objectives: . Multiple minimally invasive techniques for chronic rhinitis treatment focus on posterior nasal nerve ablation. We conducted a systematic review and meta-analysis to evaluate the efficacy of cryotherapy and radiofrequency ablation for alleviating symptoms in patients with allergic and nonallergic rhinitis. Methods: . We retrieved studies from PubMed, Scopus, Embase, Web of Science, and Cochrane Database up to July 2023. Data on the impact of cryotherapy and radiofrequency ablation on quality of life and symptom ratings of rhinitis were extracted and evaluated. Results: . An analysis of 12 studies involving 788 patients demonstrated significant improvements in quality of life and rhinitis-related symptoms (nasal obstruction, itching, rhinorrhea, and sneezing) in patients treated with cryotherapy or radiofrequency ablation (symptom score at 24 months and quality of life score at 3 months). However, radiofrequency ablation had a more positive effect on nasal symptoms after 3 months than cryotherapy. Nonallergic rhinitis patients responded more favorably to posterior nerve ablation than patients with allergic rhinitis. Both techniques enhanced disease-specific quality of life during the initial 3 months of treatment (cryotherapy, 84.6%; radiofrequency, 81.6%; P=0.564). After 3 months of treatment, a clinical improvement in all nasal symptoms (minimal clinically important difference in the total nasal symptom score: >1.0 points) was seen in 81.8% and 91.9% of patients who underwent cryotherapy and radiofrequency ablation, respectively (P=0.005), suggesting that radiofrequency is more likely to lead to clinical improvement. Conclusion . Rhinitis-associated subjective symptom scores and quality of life may be improved by both cryotherapy and radiofrequency ablation. Ablation was more efficacious than cryotherapy for nasal symptoms in patients with nonallergic rhinitis. To corroborate these findings, further randomized controlled studies directly comparing these two techniques are warranted.

Nasal valve compromise (NVC) is a common source of nasal airway obstruction, with multiple effective methods for correction. However, there has been the absence of a gold standard test to diagnose the specific source of NVC. Currently, history and physical exam are key measures for distinguishing the NVC from the other anatomical abnormalities. However, there remain ambiguities and disparities in the clinically effectiveness regarding the nasal endoscopy, physiologic measurements (acoustic rhinometry and rhinomanometry), and anatomical measurement (CT). Ideally, an objective preoperative test would be able to determine the cause for NVC and therefore guide the patient specific surgical strategy. The aim of this study was to make a clinical recommendation to solve these issues in the diagnosis of NVC and we review the methods concerning the various diagnostic tools and NVC.

PURPOSE: To compare clinical outcomes of infective and non-infective groups in revision total knee arthroplasty. MATERIAL AND METHODS: From December 1993 to December 2001, 29 cases of revision total knee arthroplasty were performed in 27 patients. The mean age at the time of surgery was 64.2 years (48~74). The average follow-up was 45.4 months (24~90). All cases were divided into two groups (fourteen noninfective and fifteen infective groups). The clinical results were evaluated according to range of motion, Hospital of Special Surgery score, Knee Society score and tibiofemoral angle. The causes of revision in noninfective group were aseptic loosening in eleven, instability in two, and femoral periprosthetic fracture in one. RESULTS: There was a significant improvement of range of motion, Hospital for Special Surgery Knee score and Knee Society score at the final follow-up compared with the pre-operative status. The above three evaluation criteria showed no significant difference between the two groups except higher further flexion in non-infective than infective group. Preoperative average tibiofemoral angle was varus 1.4degrees in non-infective group and valgus 2.6degrees in infective group (P<0.05). Postoperatively, the angles changed to be valgus 6.7degrees in non-infective group and valgus 6.8degrees in infective group(P>0.05). There were three complications in infective group, which were two reinfections, and one avulsion of osteotomized tibial tubercle. CONCLUSION: Preoperative planning, choice of proper implants, meticulous management of bony defect and soft tissue enabled successful results in infective group as well as non-infective group except less further flexion in infective group.
Arthroplasty* ; Follow-Up Studies ; Humans ; Knee* ; Periprosthetic Fractures ; Range of Motion, Articular

PURPOSE: To evaluate the results of the medial gastrocnemius muscle flap to cover the wound necrosis and dehiscence caused by repeated surgery in the reconstruction of infected total knee arthroplasty (TKA). MATERIALS AND METHODS: Out of forty three reconstructions of infected TKA performed between 1995 and 2002, eleven cases (25.6%)underwent medial gastrocnemius flap to cover the anterior skin defects at the time of reimplantation in two cases and in an average 3.3 weeks after reimplantation in seven cases. Two cases which refused reimplantation were treated by arthrodesis and delayed flap coverage and by flap surgery only resulting in pseudarthrosis respectively. They were five male and six female patients of 61 years (range, 56-77 years)of age in average. Clinical and radiological assessments were done for minimum two years of follow-up. RESULTS: Nine cases (81.8%)maintained TK prostheses with less range of motion (77 degrees in average)than ordinary TKAs of primary healing. Two patients refused TKA which resulted in one arthrodesis and one pseudarthrosis. There was no case of recurrence of wound dehiscence or infection. CONCLUSION: Medial gastrocnemius flap can salvage the prostheses by providing good soft tissue coverage for compromised operative wounds caused by infected TKA and repeated surgical interventions.
Arthrodesis ; Arthroplasty* ; Female ; Follow-Up Studies ; Humans ; Knee* ; Male ; Muscle, Skeletal ; Necrosis ; Prostheses and Implants ; Pseudarthrosis ; Range of Motion, Articular ; Recurrence ; Replantation ; Skin ; Wounds and Injuries

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD), one of the components of Agent Orange, has been reported to be a deadly poison despite its presence at extremely small doses. TCDD is reported to cause various kinds of cancers and other harmful effects on humans. However, a correlation between exposure to TCDD and acute coronary syndrome (ACS) is not yet proven. Thus, we examined the correlation between exposure to TCDD and ACS through an analysis of coronary angiograms from veterans of the Vietnam War. Two hundred fifty-one consecutive men undergoing coronary angiograms owing to ACS between April 2004 and May 2009 at Gwangju Veterans Hospital were analyzed. Included subjects were between 50 and 70 years of age. The patients were divided into two groups: 121 patients who had been exposed to TCDD (Group I) and 130 patients who had not been exposed to TCDD (Group II). Clinical and coronary angiographic findings were evaluated. Baseline clinical characteristics, inflammatory markers, and echocardiographic parameters were not significantly different between the two groups. The incidence of hypertension (71.1% vs. 60.0%, p=0.039) and hyperlipidemia (27.3% vs. 16.9%, p=0.038) was higher in Group I than in Group II. Total occlusion, stent length, stent use, and coronary lesion characteristics were not significantly different between the two groups. The rate of major adverse cardiovascular events (MACE) had no relationship with exposure to TCDD. Exposure to TCDD might not affect severity or the rate of MACE in persons with ACS.
2,4,5-Trichlorophenoxyacetic Acid ; 2,4-Dichlorophenoxyacetic Acid ; Acute Coronary Syndrome ; Angiography ; Citrus sinensis ; Hospitals, Veterans ; Humans ; Hyperlipidemias ; Hypertension ; Incidence ; Male ; Stents ; Tetrachlorodibenzodioxin ; Veterans ; Vietnam

PURPOSE: To evaluate the necessity of lateral translation and the primary stability of the fixation devices in a closed wedge high tibial osteotomy. MATERIALS AND METHODS: The authors studied four pairs of high tibial osteotomy: Pair I, lateral translation with blade plate fixation; Pair II, lateral translation with staple fixation; Pair III, no translation with blade plate fixation; Pair IV, no translation with staple fixation. Four models of bovine tibia were taken and analyzed for stress distribution at the osteotomy site under axial loading. After axial loading, information recorded in pressure sensitive film was transformed to image file. After, by using image analysis software, the mean stress value and maximum stress value was calculated. RESULTS: The mean stress calculated at each osteotomy site is as follows; 3.89 MPa in the first pair; 4.55 MPa in the second pair; 4.62 MPa in the third pair; and 4.67 MPa in the fourth pair. In Group I, stress value was distributed evenly. But in group II, III, IV, the stress was concentrated at posteromedial area of the osteotomy site. CONCLUSION: The primary in the high tibial osteotomy was dependent more on the rigid fixation than on the continuity of the medial cortex. The pairs on which blade plate fixation was used more stable than the pairs on which staple fixation was used regardless of lateral translation.
Osteotomy* ; Tibia