PURPOSE: The purpose of this study was to compare the clinical and radiological results between patients who underwent total knee arthroplasty using the conventional method and the navigation-assisted method. MATERIALS AND METHODS: A retrospective review of was performed on 32 patients (40 knees) who underwent total knee arthroplasty between February 2004 and December 2006 and were followed-up for 8 to 10 years. Mechanical axis deviation, range of motion, radiologic position of the implants, and subjective clinical scores were measured and compared between 20 navigation-assisted total knee arthroplasties and 20 conventional total knee arthoplasties. Change in the values (α, β, γ, and δ angles) from the immediate postoperative period to the last follow-up were also calculated and compared between the two groups. RESULTS: The mean range of motion in the navigation group was improved to 121.8°±16.3° (92°–140°) at the last follow-up, and the Western Ontario McMaster Universities osteoarthritis Index (WOMAC) score was 89.8±5.4 and the Knee Society score (KSS) was 91.5±7.5. The mean range of motion in the conventional group was 112.6°±25.6° (60°–140°) at the last follow-up. The WOMAC score was 84.2±10.6, and the KSS was 81.1±14.3. The α, β, γ, and δ angles of the implants were not significantly changed until the last follow-up. In the comparison between the two groups, only the mean range of motion (p=0.018) and the KSS (p=0.038) showed statistically better results in the navigation group than the conventional group. CONCLUSION: Navigation-assisted total knee arthroplasty showed better KSS and range of motion compared with the conventional group in a cross-sectional study with 8 to 10 years of follow-up results. However, only the KSS showed a significant difference between the two groups by the amount of changes in the clinical and radiological results.
Arthroplasty ; Arthroplasty, Replacement, Knee* ; Cross-Sectional Studies ; Follow-Up Studies* ; Humans ; Knee ; Magnets* ; Methods ; Ontario ; Osteoarthritis ; Postoperative Period ; Range of Motion, Articular ; Retrospective Studies

PURPOSE: The rotational alignment of the femoral and tibial components is closely related to the results after total knee arthroplasty (TKA). In this study, we measured the combined rotational alignment change (ΔCR) after TKA and compared the different influence of symmetric and asymmetric tibial component designs on the combined rotational alignment. MATERIALS AND METHODS: Eighty-four patients (mean age, 67.9 years) were included. A symmetric tibial component was used in 51 knees (group I), whereas an asymmetric tibial component was used in 50 knees (group II). We measured the angles of four anatomical landmarks by using preoperative and postoperative computed tomography images. The combined rotational alignment and the amount of change were calculated. The correlation between the isolated tibial component rotation (ITR) and ΔCR was analyzed by using the Spearman correlation coefficient. RESULTS: The mean ΔCR was −0.1°±6.3° in group I and −4.8°±5.7° in group II after TKA. Excluding the intercomponent rotation, the change was −1.0°±7.3° and −6.7°±6.7° in group I and group II, respectively. A correlation analysis between the ITR and tibial component rotation relative to the tibial tuberosity showed a statistically significant correlation. CONCLUSIONS: The combined lower limb rotational alignment was internally rotated in both symmetric and asymmetric tibial component designs after TKA. The asymmetric tibial component was better than the symmetric tibial component in achieving internally rotated combined lower limb rotational alignment. The internal rotation of the symmetric tibial component relative to the tibial tuberosity tip should fall within 20° to correct the externally deformed lower limb.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Humans ; Knee ; Lower Extremity ; Tibia

Using IC cards with powerful information processing capabilities, high level of security, and multi media capabilities to create health IC cards has the following merits: comprehensive management of individual medical information, highly secure access to information that may be stored in separate location and/or institutes, increasing the compatability of difference used by various institutes. In this research ,we have categorized the information stored in the health IC card into the following main categories: basic personal information, emergency medical information, medical informatics, nursing information, welfare information. This was based on international ISO standards and specifics of Japan and south eastern Asia. These main categories are further divided into sub-categories and care was taken to ensure that the format of each sub-category is compatible with international standards while being suitable for Koran conditions of actual use. So, these categories conform to international standards and we will continue our efforts update the international standard to include additional categories needed in Korea and update the Korea standard to conform more closely with the international standards.
Academies and Institutes ; Access to Information ; Automatic Data Processing ; Emergencies ; Far East ; Humans ; Japan ; Korea ; Medical Informatics ; Nursing

Recent developments in computer and communication technology were studied in relation to medical information network systems, using computers and IC cards, to solve problems in community health. Trial use of health IC card systems for personal health data management are already in existence in some countries. The health IC card system provides good quality information to the doctors, the hospital, the patients, and the insurance organizations. Emergency medical information card systems that take advantage of advanced information-related technologies such as computers and communication systems, in order to improve their emergency medical care systems may have many advantages. Emergency medical information card can provide a way to protect people during medical emergencies by providing physicians with their vital medical information during the critical seconds of emergency care if being unable to provide your vital medical information. Before introducing these systems, recognition that an important problems such as standardization of the data and code for the medical information systems, defining the access and usage rights by user profiles and the types of data for the security and data protection must be considered. We studied the emergency medical information card systems to clarify their purpose, analyse their present status, standardize the data and codes and define the access and usage rights and present the ideal system, in view of community health care requirements. Here the results of the research are examined, and there is a discussion of what is needed to use the emergency medical card system in the future.
Community Health Services ; Computer Security ; Emergencies* ; Emergency Medical Services ; Human Rights ; Humans ; Information Services ; Information Systems* ; Insurance

A carcinoid tumor of the stomach is uncommon, has no clinical symptoms, and is regarded as a benign. It is also incidentally found in most cases. 48-year-old woman with gastric carcinoid tumor was admitted. She had suffered from a anorexia and a dry mouth for 4-months. A gastroscopy revealed a polypoid mass on the greater curvature of the mid-body of the stomach which was subsequently thought to be an adenocarcinoma. An endoscopic mucosectomy revealed however, that it was a carcinoid tumor. A case of carcinoid tumor of the stomach is here by presented with a brief literature review.
Adenocarcinoma ; Anorexia ; Carcinoid Tumor* ; Female ; Gastroscopy ; Humans ; Middle Aged ; Mouth ; Stomach*

PURPOSE: This study aimed to identify stress levels due to end-of-life care, coping strategies, and psychological well-being among nurses in neonatal intensive care unit, and to investigate the effect of stress levels and coping strategies on their well-being. METHODS: A total of 128 nurses in the neonatal intensive care units of general hospitals in B city participated. The data were collected using a self-report questionnaire. The collected data were analyzed using descriptive statistics, the t-test, ANOVA, the Pearson correlation coefficient, and hierarchical regression with SPSS version 22.0. RESULTS: The coping strategy that nurses most often used was seeking social support. The factors affecting the well-being of the participants were wishful thinking, problem-focused coping and seeking social support, in order. Those 3 variables explained 21 % of the total variance in psychological well-being. Problem-focused coping and seeking social support were positively associated with psychological well-being, while wishful thinking showed a negative association. CONCLUSION: In order to improve the psychological well-being of nurses in neonatal intensive care units, it is necessary to provide nurses with a program to build a social support system and to improve their problem-based coping skills.
Adaptation, Psychological ; Hospitals, General ; Infant, Newborn ; Intensive Care Units, Neonatal* ; Intensive Care, Neonatal* ; Stress, Psychological ; Terminal Care ; Thinking

Various cell types in higher multicellular organisms are genetically homogenous, but are functionally and morphologically heterogeneous due to the differential expression of genes during development, which appears to be controlled by epigenetic mechanisms. However, the exact molecular mechanisms that govern the tissue-specific gene expression are poorly understood. Here, we show that dynamic changes in histone modifications and DNA methylation in the upstream coding region of a gene containing the transcription initiation site determine the tissue-specific gene expression pattern. The tissue-specific expression of the transgene correlated with DNA demethylation at specific CpG sites as well as significant changes in histone modifications from a low ratio of methylated H3- lysine 4 or acetylated H3-lysine 9, 14 to acetylated H4 to higher ratios. Based on the programmed status of transgene silenced in cloned mammalian ear-derived fibroblasts, the transgene could be reprogrammed by change of histone modification and DNA methylation by inhibiting both histone deacetylase and DNA methylation, resulting in high expression of the transgene. These findings indicate that dynamic change of histone modification and DNA methylation is potentially important in the establishment and maintenance of tissue-specific gene expression.
Transgenes/*genetics ; Swine ; Organ Specificity/genetics ; Methylation ; Lysine/*metabolism ; Histones/*metabolism ; Histone Deacetylases/metabolism ; Gene Silencing ; *Gene Expression ; Fibroblasts ; Ear ; *DNA Methylation ; Cells, Cultured ; Animals, Genetically Modified ; Animals ; Acetylation

BACKGROUND: There is increasing interest in the use of a very low calorie diet (VLCD) as a treatment regimen for weight loss in obese subjects. This study was designed to investigate the effects and safety of a traditional Korean very-low-calory diet. METHODS: Twelve hospitalized obese patients at Dong Eui hospital in Busan city from May 1998 to December 1998 were selected. Height, body weight, blood lipids, blood insulin level, body fat, lean body mass, subcutaneous fat and visceral fat were measured. A traditional Korean VLCD was supplied for 14 days. RESULTS: Patient's body weight was significantly decreased from 83.8 kg to 78.6 kg, body fat from 32.2 kg to 28.6 kg, lean body mass from 32.2 kg to 28.6 kg, and BMI from 31.4 to 29.5, respectively (p<0.05). Total fat was significantly decreased from 807 cc to 659 cc, subcutaneous fat from 567 cc to 473 cc, visceral fat from 273 cc to 185 cc, respectively. However there were no significant changes in minerals. After VLCD intervention, total cholesterol was significantly decreased from 199 mg/dL to 166 mg/dL, HDL-cholesterol from 42 mg/dL, to 35 mg/dL, triglyceride from 158 mg/dL, to 75 mg/dL (p<0.05). The insulin area under the curve was also significantly decreased from 205 micro International-Unit/mL x 2hr to 168 micro International-Unit/mL x 2hr (p<0.05). CONCLUSION: Above findings suggested that a traditional Korean VLCD is effective and safe for short term use in terms of reducing body fat and improving insulin resistance in obese patients.
Adipose Tissue ; Body Height ; Body Weight ; Busan ; Caloric Restriction ; Cholesterol ; Diet* ; Humans ; Insulin ; Insulin Resistance ; Intra-Abdominal Fat ; Minerals ; Subcutaneous Fat ; Triglycerides ; Weight Loss

BACKGROUNDNo clinical study has systematically analyzed and compared circumferential neointimal and plaque distribution of stent neointimal proliferation and in native atherosclerotic plaques. This study aimed to investigate and compare the pattern of instent neointimal formation and native atherosclerosis in the coronary bifurcation lesions by volumetric analysis using systematic intravascular ultrasound (IVUS).

METHODSWe examined bifurcation lesions in native coronary artery (plaque group, n = 102) and stented bifurcations at 9-month follow-up (neointima group, n = 51) using volumetric IVUS analysis of both the main vessel (MV) and side branch (SB). Three 5-mm segments were analyzed; the proximal MV (MVp), distal MV (MVd) and SB ostium (SBo). For each segment, volumetric analysis was performed in each of four quadrants (divided according to the branch takeoff and the geometric center of the lumen); carinal, epicardial, abcarinal, and myocardial. The eccentricity index was defined as the ratio of the abcarinal plaque (or neointimal) volume to the carinal plaque (or neointimal) volume.

RESULTSThe plaque distribution differed significantly between the four quadrants, with the largest in the abcarinal quadrant, followed by the myocardial, epicardial, and carinal quadrants. The distribution of neointima was similar in the MV, but the four quadrants in the SB did not differ significantly. The eccentricity indices of both the MVd (P < 0.001) and SBo (P = 0.001) were significantly higher for the plaque group than the neointima group.

CONCLUSIONSThe distribution of neointimal proliferation seems to have a similar pattern to that of atherosclerotic plaque in native coronary arteries, particularly in the main vessel, but the trend is less prominent.

Aged ; Coronary Artery Disease ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Neointima ; diagnostic imaging ; Plaque, Atherosclerotic ; diagnostic imaging ; Ultrasonography

Objective: To investigate the effects of a herb complex extract (HCE) prepared from Cornus officinalis Sieb. Et Zucc., Eriobotrya japonica Lindley, and olive leaves on immune response of mouse spleen NK cells in vitro and in vivo analysis. Methods: The activity of natural killer (NK) cells was measured in splenocytes and YAC-1 cells. Mice were immunosuppressed using cyclophosphamide (5 mg/kg body weight). Three different doses of HCE (200, 400, and 800 mg/kg body weight) and red ginseng extract (800 mg/kg body weight) which was used as standard immunomodulatory herb were administered orally for 4 weeks. The body weight, dietary, water intake, organs (liver, thymus, and spleen) weight, completed blood count, and cytokines (tumor necrosis factor alpha, interferon gamma, and interleukin-2) production was measured. Results: At the maximum concentration of HCE, the activity of NK cells was increased by 48.5%. HCE increased liver, spleen, and thymus weights without altering numbers of white blood cells, lymphocytes, and neutrophils in a cyclophosphamide-induced immunosuppression rat model. However, HCE recovered the inhibited cytokine expression; HCE (800 mg/kg) increased cytokines levels. The results indicate the immune enhancement potential of this HCE. Conclusion: The HCE enhances immunity by increasing NK cell activity, regulating cytokine levels, and maintaining spleen weight. Therefore, it may be used as a potential immunity enhancer.