No abstract available.
Arthritis, Rheumatoid* ; Elbow Prosthesis* ; Elbow*

No abstract available.
Arthroplasty* ; Knee*

This is a long term follow-up study to clarify whether arthroscopic synovectomy would be able to prevent further destruction of the articular cartilage in rheumatoid joints. Three hundred and eighteen rheumatoid joints of 94 patients who had surgery in the multiple joints(average 3.4 joints per person) and was followed for an average 39.9 months (range, 24-126 months) were selected. Diagnosis of rheumatoid arthritis was made according to the 1987 revised criteria of the American College of Rheumatology. The preoperative roentgenographic narrowing of cartilage space (modified classification of ARA) and the arthroscopic findings (grading of Outerbridge) were recorded. The points of investigation were 1) further destruction of articular cartilage on X-ray, postoperatively, and 2) reaccumulation of effusion. The results were as follows; 1) Knee Joint: Among 103 knee joints there were 92 (89.3%) Stage I, G-0 knees, 8 Stage II (G-2: 1, G-3: 3, G-4: 4 joints), and 3 Stage IIIB, G-4, preoperatively. The 3 Stage IIIB, G-4 knees showed progression of narrowing of joint space and were replaced by artificial joints two years after the synovectomy. 2) Wrist joint: Fifteen joints (28.3%) out of 53 joints were Stage II, G-4, and 2 joints joints (3.8%) were Stage I, G-3, preoperatively. They were progressed to Stage IIIB at final follow-up. 3) Other Joints: There was no further narrowing of the joint space following surgery in 22 fingers, 2 toes, 34 elbows, 34 shoulders and 70 ankles. 4) Prognosis seemed to depend upon postoperative medication. From these results it would be suggested that the rate and severity of recurrence of synovitis and further destruction of articular cartilage can be decreased with early synovectomy so long as proper anti-rheumatic medication is followed, although the surgery can not halt the disease process.
Ankle ; Arthritis, Rheumatoid ; Cartilage ; Cartilage, Articular ; Classification ; Diagnosis ; Elbow ; Fingers ; Follow-Up Studies ; Humans ; Joints ; Knee ; Knee Joint ; Prognosis ; Recurrence ; Rheumatology ; Shoulder ; Synovitis ; Toes ; Wrist Joint

BACKGROUND: A fully automated enzyme-immunoassay (EIA) analyzer, Enzymun System, ES-300 (Boehringer Mannheim, Germany) uses streptavidin technology and performs single test or panels of up to 12 tests per run. We evaluated the results of ES-300 for anti-HCV by comparing the results with microplate-EIA, radioimmunoassay (RIA), and confirmatory test. METHODS: Total 79 sera (51 positive, 24 negative, 4 indeterminate results confirmed by Lucky HCD Confirm) were analysed. ES-300 with Enzymun-Test(R) Anti-HCV (Boehringer Mannheim, Germany) and microplate-EIA (Green Cross Center Innotest HCV 3.0(R)) were used. Fifty one sera were examined additionally by 2nd-generation RIA method, NANBDINE 125C(General Biologicals Corp., R.O.C.). And all results were compared to the results of Lucky HCD Confirm. RESULTS: The overall concordance rate of ES-300 and Innotest(R) was 72/79 (91.1%). The results of Lucky HCD Confirm on seven discrepant samples were five negative and two indeterminate. The results of ES-300 and NANBDINE 125C showed concordance rate of 90.2%. The sensitivity and specificity of ES-300 with regard to Lucky HCD Confirm were 94.5%, and 87.5%, respectively, and that of Innotest(R) were 98.2% and 66.7%, respectively. Clear distinction of positive and negative results by signal/cut off ratio was available in both EIAs. The positive predictive values of ES-300 and Innotest(R) were 94.5%, and 87.1%, respectively. CONCLUSIONS: ES-300 showed relatively good results in sensitivity and positive predictive value with regard to confirmatory test. In EIA-positive persons, however, follow-up study would be necessary for reliable evaluation of HCV infection.
Humans ; Radioimmunoassay ; Sensitivity and Specificity ; Streptavidin

STUDY DESIGN: A retrospective review of the patients who have a fixation failure of instrumentalion for the spinal fusion in lumbar region. OBJECTIVES: To assess the incidence and different types of the mechanical failure of fixation and to evaluate their managements and their influences on the progression of a spinal fusion and to the clinical outcomes. SUMMARY OF LITERATURE REVIEW: Most of the spine surgeons have been experiencing the mechanical failures after instrumentations for a spinal fusion, eden though the incidence is decreasing with a modification of the implants. Reports on this problem are sporadic in conjunction with the other topics, rarely focusing on their management and their influences on the final outcomes. MATERIALS AND METHODS: 338 consecutive patients who had a lateral fusion in the lumbar region with an instrumentation of pedicle screws and rods, mostly with decompression, were reviewed to analyse the fixation failures of instrumentation after surgery. RESULTS: There were 26 patients (7.7%) who had the fixation failures of instrumentation, in terms of loosening around the pedicle screws in 18 patients (5.3%), the breakage of the pedicle screws in fide patients (1.5%), and the migration of a rod in three patients (0.9%). They were managed by prolonged use of brace and ergonomic back cares. Even with the fixation failures, 19 patients (73.1%) disclosed solid union uneventfully, but one patient had re-operation to obtain solid fusion. The final outcomes were satisfactory in 22 patients (84.6%), including four of six patients who had pseudoarthrosis. CONCLUSIONS: The fixation failure of instrumentation after a spinal fusion in lumbar region was not rare, but the progression of a spinal fusion usually quite well achieved and the final outcomes were not so bad, even with the implant failures and pseudoarthrosi s. Except for the persistently symptomatic pseudoarthrosis, only a prolonged use of brace and the ergonomic back cares are recommended for symptomatic patients.
Braces ; Decompression ; Humans ; Incidence ; Lumbosacral Region* ; Pseudarthrosis ; Retrospective Studies ; Spinal Fusion* ; Spine

No abstract available.
Humans ; T-Lymphocyte Subsets*

STUDY DESIGN: A retrospective analysis of the patients who had cauda equina syndrome caused by a herniated lumbar disc. OBJECTIVES: To assess the clinical debates concerning the diagnosis, treatment, and results of treatment. SUMMARY OF LITERATURE REVIEW: This syndrome has been considered as an absolute indication of surgical treatment in the herniated lumbar disc and poor prognosis after surgery were reported. Although there are debates on the timing of surgery, early recognition early surgical treatment are recommended for a better results of treatment. MATERIALS AND METHODS: 23 consecutive patients having a cauda equina syndrome caused by herniated lumbar disc were reviewed retrospectively. They were 14 males and 9 females having ages of 41.6 in average. The incidence of this syndrome was 3.8% of the patients who had surgical treatment of herniated lumbar disc. RESULTS: All patients had bladder dysfunction in addition to the low back pain and radicular pain in the leg, but five patient did not recognize their urinary retention which were shaded by severe leg pain. A surgical treatment were performed for all patients at 6.8 days in average after onset of the bladder dysfunction. At follow-up of 3 years and 3 months in average after surgery, 20 patients(86.9%) had satisfactory resolution of the low back pain and leg pain, and all patients had complete recovery of motor weakness except one patients who had residual foot drop. Bladder function recovered satisfactorily in 18 patients (78.3%), but 4 patients had some difficulty of urination and one patient needed a sphinterotomy for urination. CONCLUSIONS: The cauda equine syndrome in herniated lumbar disc was often not recognized early and a poor result of treatment was not rare, particularly in the patients who had acute onset and severe bladder dysfunction. So, early diagnosis and active surgical treatment are recommended for a better results of treatment.
Cauda Equina* ; Diagnosis ; Early Diagnosis ; Female ; Follow-Up Studies ; Foot ; Humans ; Incidence ; Leg ; Low Back Pain ; Male ; Polyradiculopathy* ; Prognosis ; Retrospective Studies ; Urinary Bladder ; Urinary Retention ; Urination

No abstract available.

No abstract available.
Animals ; Capsaicin* ; Goblet Cells* ; Rats*

No abstract available.
Osteoarthritis*