PURPOSE: To analyze the characteristics of the interface membrane around loose Cementless Self-Cutting Titanium(CST) acetabular components. MATERIALS AND METHOD: The authors reviewed radiographs of one hundred and thirty-four hips which underwent total hip arthroplasty using Cementless Self-Cutting Titanium(CST) acetabular components, and performed histomorphological analysis on thirteen periprosthetic membranes which were taken out at the time of revision. RESULTS: After a mean follow-up of 82 months, thirteen hips(10%) underwent revision for acetabular loosening and migration. Histologic evaluation of the periprosthetic membranes showed evidence of abundant polyethylene and metal wear particles. The interface membrane was composed of a well vascularized loose connective tissue with macrophages. Polarized microscopy revealed numerous polyethylene wear particles. Ultrastructurally, numerous, variable-sized, irregular-shaped phagosomes containing electron-dense material were seen within the cytoplasm. Tissue digestion of the periprosthetic tissue eluted numerous polyethylene and metal particles. Energy dispersive X-ray spectroscopic analysis for these wear particles revealed high concentration of titanium and carbon component suggesting that the majority of the metal particles were titanium component and polyethylene particle. CONCLUSION: This study supports the concept that wear particles in total hip arthroplasty can be a strong stimulus for a foreign body response and that this reaction causes periprosthetic osteolysis and loosening.
Acetabulum ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Carbon ; Connective Tissue ; Cytoplasm ; Digestion ; Follow-Up Studies ; Foreign Bodies ; Hip ; Macrophages ; Membranes* ; Microscopy ; Osteolysis ; Phagosomes ; Polyethylene ; Titanium*

PURPOSE: Communication skills are essential skills which medical students need to acquire in order to become a doctor. More attention is being given to the subject but not many studies have been done in the medical education field. As communication skills are provided to students as a subject in medical educational curriculum, the assessment of its effectiveness needs to be undertaken. METHODS: In the year 2005 and 2006, second year pre-medical students at The Catholic University College of Medicine took 'Communication Skills' course in total, 180 second year pre-medical students' survey results were used in the evaluation of the study question. The instrument used in the study was the modified and translated version of 'Beyer-Fetzer's Essential Elements of Communication Skills Assessment Sheet.' The assessment sheets were used as the pre-test and post-test to analyse the differences, which were put through the paired t-test. RESULTS: All categories of communication skills showed an improvement. For year 2005, meaningful differences were shown in 'opening the discussion (p=.005)' and 'sharing information (p=.008)', whereas in 2006, improvements were shown in all areas. CONCLUSION: From the result, it is clear that in order to create an effective communication skills program, the content should be more structured and focused on the program objectives.
Curriculum ; Education, Medical ; Humans ; Students, Medical

PURPOSE: The purpose of the study is to analyse the appropriateness of using standardized patients' (SPs) assessment scores of medical students in clinical performance examination (CPX). METHODS: 110 fourth year medical students in year four were divided into two large groups (group A and group B). Each group of students performed four different cases and overall, eight cases were tested. The examination were done by professors and the SPs using the same examination paper. Test scores were analysed per station and per each test domain. The differences between the two examiners were studied using paired t-test. RESULTS: There were significant differences in the scores given out by the professors' and the SP' s in four out of the eight stations. According to the examination results of each domain, four cases showed significant differences in the history taking category, three cases in the physical examination, one case in the information sharing, four cases in clinical courtesy, and two cases in physician-patient relationship category. Cronbach' s alpha scores of all stations were over 0.6, reflecting that the test items were appropriate for the examination. CONCLUSION: From the result of this study and according to many preceding studies, using SPs' evaluation scores in CPX is appropriate. Some limitation of this study and ideas for improvement in using SPs in CPX are suggested.
Humans ; Information Dissemination ; Physical Examination ; Students, Medical

Symptoms of a peritoneal progression from ovarian cancer are nonspecific such as abdominal pain, abdominal distention and more. Many imaging studies and serum CA-125 help diagnosis. However, it is difficult to exclude the instances of the diffuse peritoneal diseases that mimic carcinomatosis. The elevated CA-125 level usually correlates with the peritoneal carcimatosis, but it is often found in other peritoneal diseases. Therefore, the pathologic confirmation is necessary because of other mimicking diseases. In our case, CA-125 levels were elevated. Abdominal computed tomography finding was suspected a peritoneal tuberculosis but the pathologic result was the peritoneal carcimatosis, eventually.
Abdominal Pain ; Carcinoma* ; Diagnosis ; Ovarian Neoplasms ; Peritoneal Diseases ; Peritonitis, Tuberculous*

Visual disturbances are common among women with pre-eclampsia. The obstetricians should have an understanding of the various conditions associated with visual impairments. We report a case of Purtscher-like retinopathy developed after pre-eclampsia combined with acute pancreatitis. A 33-year-old primigravida with twin pregnancy was admitted to the department of obstetrics and gynecology for preterm labor and pre-eclampsia at 36+4 weeks gestation. After a cesarean section, she complained of abdominal pain and visual acuity loss. She was diagnosed with Purtscher-like retinopathy combined with acute pancreatitis after ophthalmologic examination and an abdominal computed tomography scan. Purtscher-like retinopathy, most often observed after trauma, is very rare in pre-eclampsia. In addition, while visual disturbances from other conditions are transient, it can result in persistent visual impairments. Thus, when a patient with pre-eclampsia complains of visual problems for a long period of time, obstetricians should consider an ophthalmologic evaluation and treatments during the earliest stage of the disease.
Abdominal Pain ; Cesarean Section ; Female ; Gynecology ; Humans ; Obstetric Labor, Premature ; Obstetrics ; Pancreatitis ; Pre-Eclampsia ; Pregnancy ; Pregnancy, Twin ; Retinal Diseases ; Vision Disorders ; Visual Acuity

This study aimed to determine the number of branches of the upper and lower subscapular nerves and to classify the spinal nerve compositions of each branch. Twenty sides of the brachial plexus extracted from Korean adult cadavers were used in this study. The upper subscapular nerve was composed of three branches in 16 sides (80.0%), composed of four branches in 4 sides (20.0%). The lower subscapular nerve arose from posterior cord with one branch, innervating the subscapularis and the teres major muscles. In case of the upper subscapular nerve, the first branch was comprised of C5 in 40.0%, C5 and C6 in 60.0%, the second branch was composed of C5 in 15.0%, C5 and C6 in 85.0%, the third branch was arisen from C5 and C6 in 75.0%, C6 in 25.0% and the forth branch appeared in four sided was derived from C6. The nerve branch innervating the subscapularis muscle was composed of C6 in 55.0%, C5 and C6 in 40.0%, C6 and C7 in 5.0%. The nerve branch innervating the teres major muscle was composed of C6 and C7 in 65.0%, C5, C6 and C7 in 25.0%, and C6 in 10.0%. The injury was often due to an accidental damage or lesion of the subscapular nerve, these anatomical results may be helpful to predict the involving area of the lesion.
Adult ; Brachial Plexus ; Cadaver ; Humans ; Muscles ; Spinal Nerves

Many anatomists and clinicians who investigate the peripheral nerve concern about the composition of the spinal roots of each terminal nerve of the brachial plexus. From this viewpoint, the spinal root composition of the ulnar nerve is still unclear. Several anatomy textbooks describe that the ulnar nerve is composed of the ventral rami of the C8, T1 and often C7. There is no literature regarding the frequency and contribution quantity of C7 to the ulnar nerve. The purpose of present study was to determine frequency and contribution quantity of the C7 to the ulnar nerve. Fifty cadavers of brachial plexus were obtained from cadavers of Korean adults. The brachial plexus containing the ulnar nerve were extracted from the axilla and the extracted samples were immersed in Guanidine-HCl (0.2 M) for 2 weeks to soften the connective tissue around the nerve bundles. C7 was contributed to the ulnar nerve in all sides (100%). The numbers of the myelinated axons of C7 participating to the ulnar nerve was 1,452+/-429 (mean+/-S.D.). Thus the C7 can be considered as always participating component of the ulnar nerve, not often participation, although numbers of the myelinated axons of C7 was lesser than those of the C8, but similar to those of the T1. The results of the study provide a reference for accurate diagnosis and treatment regarding ulnar nerve injury due to various accidents.
Adult ; Anatomists ; Axilla ; Axons ; Brachial Plexus ; Cadaver ; Connective Tissue ; Humans ; Myelin Sheath ; Peripheral Nerves ; Spinal Nerve Roots ; Ulnar Nerve

OBJECTIVES: This study sought to evaluate the efficacy of collagen graft materials, as compared to other graft materials, for use in healing calvarial defects in rabbits. MATERIALS AND METHODS: Ten mm diameter calvarial defects were made in ten rabbits. The rabbits were then divided into 4 groups: control, autogenous bone graft, SureOss graft, and Teruplug graft. Bone regeneration was evaluated using histological and radiographic methods. RESULTS: Based on visual examination, no distinct healing profile was observed. At 4 weeks after treatment, histological analysis showed there was no bone regeneration in the control group; however, at 8 weeks after treatment, new bone formation was observed around the margin of the defective sites. In the autogenous bone graft group, new bone formation was observed at 4 weeks after treatment and mature bone was detected around the grafted bone after 8 weeks. In the SureOss graft group, at 4 weeks after treatment, acute inflammatory and multinuclear cells were noted around the grafted materials; at 8 weeks after treatment, a decrease in graft materials coupled with new bone formation were observed at the defective sites. In the Teruplug graft group, new bone formation was detected surrounding the bone margin and without signs of inflammation. There were statistically significant differences observed between the graft and control group in terms of bone density as evidenced by radiographic analysis using computed tomography (P<0.05), particularly for the autogenous bone graft group (P<0.001). CONCLUSION: These results suggested that autogenous bone, SureOss and Teruplug have the ability to induce bone regeneration as compared to an untreated control group. The osteogenic potential of Teruplug was observed to be lower than that of autogenous bone, but similar to that of SureOss.
Bone Density ; Bone Regeneration ; Collagen ; Durapatite ; Inflammation ; Osteogenesis ; Porifera ; Rabbits ; Transplantation, Homologous ; Transplants

The purpose of this study was to classify the spinal nerve compositions of the terminal branches of the lumbosacral plexus, providing data of their participating quantities. Twenty-five sides of the lumbosacral plexus extracted from Korean adult cadavers were used in this study. The iliohypogastric nerve was mostly arisen from L1 (88.2%, thickness L1 0.7 mm). The ilioinguinal nerve was arisen from only L1 (100%, thickness L1 0.6 mm). The genitofemoral nerve was commonly arisen from L1 and L2 (62.5%, thickness L1 0.6 mm, L2 0.7 mm). The lateral femoral cutaneous nerve was classified into 4 types, and the most common type was that L2 and L3 composed this nerve (56.0%, thickness L2 0.8 mm, L3 0.4 mm). The femoral nerve was classified into 2 types, and it was usually composed of L2, L3 and L4 (88.0%, thickness L2 1.4 mm, L3 2.7 mm, L4 2.3 mm). The obturator nerve was arisen from L2, L3 and L4 in all cases (100%, thickness L2 0.5 mm, L3 1.3 mm, L4 1.1 mm). The common fibular component of sciatic nerve was mostly arisen from L4, L5, S1 and S2 (84.0%, thickness L4 0.9 mm, L5 2.0 mm, S1 2.1 mm, S2 1.2 mm). The tibial component of sciatic nerve was mainly arisen from L4, L5, S1 and S2 (96.0%, thickness L4 0.9 mm, L5 1.9 mm, S1 2.2 mm, S2 1.9 mm). The superior gluteal nerve was commonly derived from L4, L5 and S1 (56.0%, thickness L4 0.7 mm, L5 1.1 mm, S1 0.9 mm). The inferior gluteal nerve was comprised of L5, S1 and S2 in several cases (54.2%, thickness L5 0.9 mm, S1 1.3 mm, S2 0.8 mm). The posterior femoral cutaneous nerve was composed of S1 and S2 in higher freqeuncy (40.0%, thickness S1 0.9 mm, S2 1.0 mm, S3 0.8 mm). The perforating cutaneous nerve was arisen from S2 and S3 in higher frequency (56.0%, thickness S1 0.7 mm, S2 0.9 mm, S3 1.1 mm). The pudendal nerve was derived from S3 in many cases (52.9%, thickness S3 1.5 mm). These anatomical results may be helpful to predict the spinal nerve root lesions of the lumbosacral plexus.
Adult ; Cadaver ; Femoral Nerve ; Humans ; Lumbosacral Plexus ; Obturator Nerve ; Pudendal Nerve ; Sciatic Nerve ; Spinal Nerve Roots ; Spinal Nerves

PURPOSE: The purpose of this study was to compare the perception of learning outcomes between faculty and students in medical schools. METHODS: A total of 1,766 medical students and 436 faculty members participated in the survey. They responded to the perception of four learning outcomes: medical knowledge and problem solving, clinical skills, medical ethics, and clinical communication. The participants responded to the education and achievement levels of the learning outcomes. RESULTS: In all four learning outcomes, the student's perception of education level differed by educational system, and the students in mixed systems had the highest scores. Students differed significantly in achievement level of medical ethics between genders, wherein male students perceived their achievement level to be higher than females. Students perceived their achievement level to be lower than the education level. The students' clinical skills were the highest in the education and achievement levels. The faculty perceived the education level to be higher than the student's achievement level. In particular, the faculty's perception of education level of medical knowledge and problem solving was the highest, whereas the students' achievement level of it was lower. The faculty assessed the education level to be higher than students. The students showed higher perception of achievement level than faculty. CONCLUSION: There were perceptual differences in learning outcomes between students and faculty. The results of this study are expected to be used to design outcome-based learning methods.
Clinical Competence ; Education* ; Ethics, Medical ; Female ; Humans ; Learning* ; Male ; Problem Solving ; Schools, Medical* ; Students, Medical