Purpose: This study examined the changes in the body mass index (BMI) and the effects of BMI on the knee function and risk factors for an increase in BMI after total knee arthroplasty (TKA) in Asians. Materials and Methods: A prospective observational study was conducted on 100 cases of TKA performed by one surgeon. Obesity was defined as BMI ≥25 kg/m 2 . The BMI and Knee Society Score, consisting of the Knee Score and Function Score, were measured on the day before surgery and one year after surgery. Results: The BMI decreased or was maintained in 34 cases (34%) and increased in 66 cases (66%) one year after surgery. An increase in BMI of 5% or more was considered a clinically significant increase in BMI and occurred in 28 cases (28%). The patients with an increased BMI by more than 5% showed a significantly lower knee function score. The age and preoperative function score were significantly associated with an increased BMI by more than 5%. As the age increased by one year, the odds ratio at which the BMI would increase by more than 5% one year after surgery was 0.905. Moreover, as the preoperative function score increased by one point, the odds ratio that the BMI would increase by 5% one year after surgery was 0.902. In other words, a younger preoperative age and a lower preoperative function score mean a higher risk of a more than 5% postoperative increase in BMI. Conclusion The BMI increased by more than 5% one year after surgery in 28% of the TKA patients examined. They had a lower functional score. The risk factors for a more than 5% increase in BMI after TKA were young age and a low preoperative function score. Therefore, surgeons should educate patients, particularly those who are young or have a low preoperative function score, so that the patient’s BMI would not increase after surgery.

With the development of body sensor technology, wearable health monitoring systems have been an emerging information technology in the 'ubiquitous health care' system. Wearable sensors enable long-term continuous physiological monitoring important in health promotion and management of many chronic disorders. In this paper, we present several wearable health monitoring systems developed by different countries and discuss emerging opportunities, as well as, existing challenges such as standardization, administration, validation, and discrepancy issues between technology and clinical implication.
Health Promotion ; Monitoring, Physiologic ; Telemedicine

Hemorrhagic cystitis is potentially life-threatening sequellae of chemotherapy using oxazaphosphorine alkylating agents (cyclophosphamide and ifosfamide). Mesna contains a sulfhydryl group that is believed to bind acrolein within the urinary collecting system and reduce the hemorrhagic cystitis without affecting the chemotherapeutic potential. To date, about thirty cases of hypersensitivity or allergic reactions of the delayed and urticarial type associated with mesna have been reported. We reported two patients with systemic lupus erythematosus who developed facial rash and flushing associated with mesna which imitate malar rash.
Acrolein ; Alkylating Agents ; Cyclophosphamide ; Cystitis ; Drug Therapy ; Exanthema* ; Flushing ; Humans ; Hypersensitivity* ; Lupus Erythematosus, Systemic ; Mesna*

BACKGROUND: Prostaglandin system is known to participate in manifestation of the renin-angiotensin system. However, role of prostaglandins on the renin-angiotensin system in development of hypertension is not well established. This study was to examine whether the role of prostaglandins is altered in experimental hypertension. METHODS: Two-kidney, one-clip(2KIC) renal hypertension was made by clipping the left renal artery with a silver clip(internal gap of 0.2mm) and deoxycorticosterone acetate (DOCA)-salt hypertension by subcutaneous implantation of DOCA(200mg/kg) strip plus saline(1%) drinking. They were used 3 weeks later. Age-matched normal rats served as a control. Femoral artery was cannulated and arterial blood pressure and heart rate were monitored continuously. RESULTS: 1) In normotensive rats, saralasin infusion(20 microg/kg/min, IV) caused a decrease in mean arterial pressure without significant alterations in heart rate. Indomethacin-pretreatment(10mg/kg, IP) abolished the depressor response to saralasin. 2) The depressor response to saralasin was more marked in renal hypertensive rats than in normotensive rats. The magnitude of maximum decrease in blood pressure, however, was comparable between the hypertensive and normotensive rats. Indomethacin-pretreatment did not affect the depressor response to saralasin in renal hypertensive rats. 3) In DOCA-salt hypertensive rats, saralasin infusion rather caused an increase in mean arterial pressure without significant alterations in heart rate. The pressor response to saralasin was not affected by indomethacin-pretreatment. CONCLUSION: These results indicate that prostaglandin system may modify renin-angiotensin system in normotensive rats. It is suggested that mechanisms other than prostaglandin system participate in the full-blown manifestation of renin-angiotensin system in 2KIC renal hypertensive rats.
Animals ; Arterial Pressure ; Blood Pressure ; Desoxycorticosterone ; Drinking ; Femoral Artery ; Heart Rate ; Hypertension ; Hypertension, Renal ; Prostaglandins I ; Prostaglandins* ; Rats* ; Renal Artery ; Renin-Angiotensin System* ; Saralasin ; Silver

Uniform mixing of liquid substances is difficult to attain. Recently, mixtures of fat and platelet-rich plasma (PRP) have been used extensively in autologous fat transfer. Although various methods have been utilized to mix the fat and PRP involved in this procedure, these methods still carry disadvantages in the time taken and the potential for cell damage, and it is questionable whether effective mixing can occur using these techniques. To facilitate mixing that is as uniform as possible, the authors of this study invented a special cannula. Use of the conventional luer-lock-to-luer-lock connector method has been found to cause cell damage and makes it difficult to achieve uniform mixing, while random injection-type mixing has been shown to have limited accuracy and effectiveness. We expect that the newly designed cannula will solve the problem detailed above.
Catheters ; Clothing ; Methods ; Platelet-Rich Plasma ; Stress, Mechanical

BACKGROUND: The aim of this study was to investigate the relationship between heart rate variability (HRV), the Framingham risk score (FRS), and the 10-year risk of coronary heart disease (CHD) development among Korean adults. METHODS: The subjects were 85 healthy Korean adults recruited from a health check-up center. The FRS and 10-year risk of CHD development were calculated. RESULTS: The FRS in men was inversely correlated with the standard deviation of all normal to normal RR-intervals (SDNN); the root mean square successive difference (RMSSD); the percentage of successive normal cardiac inter-beat intervals greater than 20 ms, 30 ms, and 50 ms (pNN20, pNN30, pNN50); the low frequency (LF); and the high frequency (HF) (P < 0.05). There was no significant relationship between the FRS and HRV in women. Overall, in the receiver operating characteristic (ROC) analysis, the RMSSD, HF, SDNN, LF, LF/HF ratio, and pNN30 predicted an increased 10-year CHD risk. After adjusting for sex and body mass index, those with greater than one standard deviation in the RMSSD, HF, and LF had a 52-59% reduction in their 10-year risk of CHD development > or = 10%. CONCLUSION: This study therefore indicates that the HRV indices, particularly SDNN, RMSSD, pNN30, LF, and HF may be useful parameters for the assessment of CHD risk. Most notably, the usefulness of these HRV measures as indicators for CHD risk evaluation may be greater among men than among women.
Adult ; Body Mass Index ; Coronary Disease ; Electrocardiography ; Female ; Heart ; Heart Rate ; Humans ; Male ; Risk Assessment ; ROC Curve

BACKGROUND: Infarct size determines left ventricular (LV) systolic and diastolic dysfunctions after acute myocardial infarction, and also may affect the recovery from functional impairment. We studied the differences of LV remodeling and changes of systolic and diastolic functions of LV during two weeks after acute myocardial infarction, according to Killip class at admission. METHODS: Echocardiographic examinations were performed within two days (23.9+/-2.3 hours), and two weeks after the attack in 27 patients with acute myocardial infarction, and the results were compared with those of 19 controls. Patients were divided into two groups according to Killip class at admission; 18 patients in Killip class I (group I) and 9 patients in Killip class II to IV (group II). Group II had larger infarct, reflected by higher levels of peak serum cardiac enzymes. RESULTS: LV systolic function was more depressed in group II. Regional wall motion score index decreased in group I after two weeks, but not in group II. LV systolic and diastolic volume indexes increased after two weeks in group II but not group I. E/A ratio of mitral inflow was less than 1, and isovolumic relaxation time was prolonged in group I immediately after the attack. Group II had E/A>1 and shorter deceleration time (DT) of mitral inflow, and higher peak reverse flow velocity associated with atrial contraction (AR) of pulmonary venous flow than those of controls immediately after the attack. In group II, E/A ratio was greater, DT was shorter, peak systolic/diastolic flow velocity ratio of pulmonary venous flow was less, and AR was higher than those of controls after two weeks. CONCLUSION: Infarct size affected remodeling and changes of systolic and diastolic functions of LV after acute myocardial infarction. In patients with large infarct, LV was dilated and regional wall motion was not improved during two weeks. Restrictive pattern of LV filling, which was more aggravated during two weeks, was noted immediately after the attack. In patients with small infarct, LV was not dilated and regional wall motion was improved during two weeks. LV filling pattern showed relaxation abnormality.
Deceleration ; Echocardiography ; Heart Ventricles* ; Humans ; Myocardial Infarction* ; Relaxation

BACKGROUND: The present study is undertaken to acquire normative data of health-related physical fitness(HRPF) of Republic of Korea Air Force(ROKAF) aircrews and to provide norm-referenced standard of HRPF. METHODS: From 15 May 1998 through 14 December 1999, 1284 KAF pilots are checked muscular strength, muscular endurance, flexibility, and body fat percentage. RESULTS: The grip strength was relatively maintained, but flexibility, back strength, and muscular endurance were declined according to promotion and aging. And the incidence of obesity determined by bioelectrical impedence analysis was higher than that assessed on the basis of height and weight. CONCLUSION: It is suggested that many pilots who were normal in BMI have abdominal or visceral obesity. Further studies must be made on the health promotion program for the pilots, on the changes in physical fitness, and on the criterion-referenced standard of HRPF of the pilots.
Adipose Tissue ; Aging ; Hand Strength ; Health Promotion ; Incidence ; Obesity ; Obesity, Abdominal ; Physical Fitness* ; Pliability ; Republic of Korea

PURPOSE: To investigate the prognostic factors and effectiveness of postoperative radiotherapy alone for endometrial carcinoma. MATERIALS AND METHODS: Sixty four patients with stage I-III endometrial cancer (EC) treated with postoperative radiotherapy alone between January 1989 and December 2008 at the Keimyung University Dongsan Medical Center were chosen for the present study. Typically, total hysterectomy, salpingo-oophorectomy and lymphadenectomy were performed on the patient's pelvis. Total dose from 50.4 Gy to 63 Gy was irradiated at pelvis or extended field. Thirteen patients were treated with Co-60 or Ir-192 intracavitary radiotherapy. Follow-up periods were from 7 to 270 months, with a median of 56 months. RESULTS: Five year overall survival (OS) rate was 58.7%, respectively. Five year disease-free survival (DFS) rate was 59.2%, respectively. In univariate analysis for OS and DFS, stage, menopausal age, type of operation, serosal invasion, and lymph node involvement were found to be statistically significant. Histologic type was marginally significant. In multivariate analysis for OS and DFS, stage, types of operation, histologic type were also found to be statistically significant. Treatment failure occurred in 14 patients. The main pattern of failure was found to be distant metastasis. Time to distant metastasis was from 3 to 86 months (median, 12 months). There were no grade 3 or 4 complications. CONCLUSION: Stage, types of operation, and histologic type could be the predictive prognostic factors in patients. We contemplated postoperative radiation as effective and safe treatment method for EC. Additional treatment would be needed to reduce distant metastasis.
Disease-Free Survival ; Endometrial Neoplasms ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Lymph Node Excision ; Lymph Nodes ; Menopause ; Multivariate Analysis ; Neoplasm Metastasis ; Pelvis ; Postoperative Care ; Prognosis ; Radiotherapy, Adjuvant ; Treatment Failure

OBJECTIVE: We investigated the long-term outcomes of autologous peripheral blood stem cell transplantation (PBSCT) to treat refractory rheumatic diseases. METHODS: Patients who underwent PBSCT for refractory rheumatic diseases at our institution between 2002 and 2005 were assessed for outcomes including treatment response, adverse events, damage accrual, and survival at 6 months and last follow-up. RESULTS: Eleven patients, including six with systemic lupus erythematosus (SLE), four with systemic sclerosis (SSc), and one with Still's disease were treated with PBSCT. In SLE patients, two showed complete response, two partial response, and two expired. One patient who expired responded completely two months after transplantation but discontinued treatment by choice and expired at six months due to an SLE flare. Long-term, two patients went into remission without organ damage, one patient went into remission with organ damage, and one had low disease activity with organ damage. Of the four patients with SSc, two showed a complete response, one a partial response, and there was one transplantation-related death at six months. At the last record notation, two remained in remission without relapse and one was lost to follow-up. The Still's disease patient partially responded at six months and was in remission at the last record notation. CONCLUSION: The ten-year survival rate was 70% with a 40% recurrence rate and 20% treatment-related mortality rate.
Follow-Up Studies ; Humans ; Lost to Follow-Up ; Lupus Erythematosus, Systemic ; Mortality ; Peripheral Blood Stem Cell Transplantation* ; Recurrence ; Rheumatic Diseases* ; Scleroderma, Systemic ; Survival Rate