Synovectomy of the knee in rheumatoid arthritis has been recommended as an effective procedure which improved symptoms such as pain, swelling, and limitation of motion. But some problems, such as limitation of range of motion, infection, long hospital days, occured in open synovectomy. Arthroscopic synovectomy yields reliable result compatible to open synovectomy with less invasiveness and postoperative morbidity. The authors analyzed 20 knees of 14 patients who has done synovectomy of knee in Kyung Hee University Hospital from September 1989 to October 1992. Of the 14 patients, thirteen were females and only one was male, ten knees were affected on the right and ten on the left respectively. Five knees were operated as open synovectomy and fifteen knees as arthroscopic synovectomy. In six patients, both knees were operated either open or arthroscopic synovectomies. The preoperative diagnosis of 20 knees were rheumatoid arthritis as clinically, serologically and radiologically, 13 knees are confirmed as pathologically. Average hospital days after operation were 19 days in open synevectomy and 11 days in arthroscopic synovectomy. Average operation time were 72 minutes in open synovectomy and 84 minutes in arthroscopic synovectomy. No complication occured as a result of these synovectomies. After average follow up of 19 monthes, 1 knee from 5 knees in open synovectomy and 3 knees from 15 knees in arthroscopic synovectomy had pain and intermittent swelling as postoperatively. And only 1 knee in open synovectomy had loss of range of motion. No other patients lost motion in their knees. Preoperatively 17 knees showed radiographic change of rheumatoid arthritis and 16 knees showed no progressive radiographic deterioration at final follow up. And patients overall showed a significiantly increased functional status postoperatively. In conclusion, the result obtained after arthroscopic synovectomy are comparable with those obtained after open synovectomy. In addition arthroscopic procedure had lessened postoperative morbidity as loss of range of motion, postoperative infection, long hospital days and useful as palliative surgery in advanced rheumatoid arthritis.
Arthritis, Rheumatoid ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Knee ; Male ; Palliative Care ; Range of Motion, Articular

No abstract available.
Erythropoietin* ; Humans* ; Renal Dialysis*

No abstract available.
Fractures, Open* ; Tibia*

The anterior cruciate ligament(ACL) is one of the most important structure for maintenance of the sta- bility of the knee joint. Chronic instability as a result of insufficiency can lead to functional disability, pain, meniscal tears, and degenerative change in articular cartilage. The incidence of injuries of this liga- ment is increasing tendency due to development of vehicle system, industrial system and sports activities. Different authors have recommended both operative and nonoperative treatment for anterior cruciate ligament injuries. Variable methods for functional recovery of anterior cruciate ligament were introduced and argued about ideal method. As arthroscopic techniques improve, surgeons are more inclined to rec- ommend surgical treatment. The methods of repair of acute rupture of the anterior cruciate ligament through the arthrotomy tech- nique have been used widely, but the arthroscopic repair is a relatively new technique. This arthroscopic technique is idealy applicable for rupture at femoral and tibial attachment site. A arthroscopic repair of anterior cruciate ligament was performed with use of the arthroscopy, in 15 consecutive, selected anterior cruciate ligaments that were ruptured at femoral or tibial attachment site, and within 2 weeks after injury. The 15 patients were followed for a minimum of one year(mean, eighteen months; maximum, thirty-eight months). The mean age of the 15 patients at the operation was thirty years(range, seventeen to forty-eight years). The results of arthroscopic repair of anterior cruciate ligament in 15 cases were satisfactory, and as fol- lows. l. All of the 15 cases, the laxity of repaired anterior cruciate ligaments were decreased. 2. The average Lysholm Knee Score Scale was increased from 16 points preoperatively to 89 points postoperatively. Five of the patients(33%) were rated as excellent, and ten patients(67%) were rated as good. 3. The range of motion of the repaired knee joints were from Oo to 135o that results were achieved at postoperative 6 months.
Anterior Cruciate Ligament* ; Arthroscopy ; Cartilage, Articular ; Humans ; Incidence ; Knee ; Knee Joint ; Range of Motion, Articular ; Rupture* ; Sports

Interlocking intramedullary nailing has many advantages for long bone fracture. However, we can meet many problems during the operative procedure. Among the patients who were treated with interlocking intramedullary nailing from March, 1990 to December, 1991, forty-eight patients(49 cases) of femur and tibia fracture who were followed up more than twelve months(average 14months: 12months 18months) were included in this study. 1) Forty-nine cases consisted of 20 cases(41%) of femur fracture and 29 cases(59%) of tibia fracture. 2) Two cases of proximal protrusion were developed because of inadequate implant length. 3) Operative complications were encountered with 3 cases of new fracture line, 1 case of new fragmentation, 1 case of reduction loss, 2 cases of failure of proximal targeting, 3 cases of failure of distal targeting, 2 cases of distraction of fracture site more than 3 mm, 1 case of sciatic nerve injury due to excessive traction and 1 case of tibial inlet error. 4) Postoperative complications were encountered with 1 case of distal targeting screw failure, 4 cases of infection and 8 cases of delayed union. 5) According to the result, sufficient planning and confirmations(preoperatively, intraoperatively and postoperatively) can diminish the complications. And then the interlocking intramedullary nailing will be useful method in the case of long bone fracture when the operator has extensive experiences.
Bays ; Femur ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Humans ; Methods ; Postoperative Complications ; Sciatic Nerve ; Surgical Procedures, Operative ; Tibia ; Traction

BACKGROUND: The aim of this study was to investigate the feasibility and efficacy of emergent carotid artery stenting (CAS) for occlusion or high-grade stenosis of the internal carotid artery (ICA) in patients with acute ischemic stroke. METHODS: From November 2004 to May 2007, 17 patients admitted to the hospital within 12 hours of symptom onset with occlusion or a high-grade stenosis of the proximal ICA underwent emergent CAS. We analyzed risk factors, imaging findings, functional outcome scales, and peri-procedural complication. The outcome was measured by the modified Rankin scale (mRS) 3 months later and classified into good (mRS score of 0 to 2) or poor (mRS score of 3 to 6). RESULTS: All patients were recanalized successfully. The median National Institutes of Health Stroke Scale (NIHSS) score was 12.6 (range 4 to 24) just before the emergent CAS, which decreased to 9.4 and 8.2 at 1 day and 7 days after the stenting. Three months later, 12 patients showed good outcome while three had poor outcome and two of them died. Two patients (11.8%) exhibited symptomatic hemorrhagic transformation following the emergent CAS. Smoking status, and initial and immediate post-procedural NIHSS scores were associated with the outcome. CONCLUSIONS: Emergent CAS is a feasible and effective method in acute treatment of selected stroke patients with steno-occlusion of the proximal ICA.
Carotid Arteries ; Carotid Artery, Internal ; Constriction, Pathologic ; Humans ; National Institutes of Health (U.S.) ; Risk Factors ; Smoke ; Smoking ; Stents ; Stroke ; Weights and Measures

OBJECTIVE: To investigate the association between evoked potentials and fractional anisotropy (FA) ratio in posterior limb of the internal capsule and hand movement scale (HMS) in post-stroke hemiplegic patients. METHOD: Thirty-six post-stroke hemiplegic patients with a lesion in the internal capsule were included in this study. Diffusion tensor imaging (DTI) was performed with a 3.0 tesla MR at about 1 month after stroke. FA ratio was measured in posterior limb of the internal capsule of the patients. Motor evoked potential (MEP) was obtained by magnetic stimulation of the motor cortex and recorded from the abductor pollicis muscle. Somatosensory evoked potential (SSEP) was obtained by electrical stimulation of the median nerve at the wrist and recorded from the somatosensory cortex. Hand movement scale was obtained at about 1 month and 3 months after stroke. RESULTS: Hand movement scale at about 1 month and 3 months after stroke and FA ratio were reduced significantly in patients who showed no response on MEP. However, no significant differences were observed between the patients who showed SSEP response and those who did not. FA ratio and hand movement scale were highly correlated to each other. CONCLUSION: MEP and FA ratio can be helpful in assessing the hand function at about 1 month and 3 months in post-stroke hemiplegic patients.
Anisotropy ; Diffusion ; Diffusion Tensor Imaging ; Electric Stimulation ; Evoked Potentials ; Evoked Potentials, Motor ; Evoked Potentials, Somatosensory ; Extremities ; Hand ; Humans ; Internal Capsule ; Magnetics ; Magnets ; Median Nerve ; Motor Cortex ; Muscles ; Somatosensory Cortex ; Stroke ; Wrist

No abstract available.
Female ; Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Renal Dialysis*

A 16-month-old boy swallowed accidentally a button type lithium battery with diameter 23 mm. The battery impacted at the upper esophagus was removed by endoscpy in 9 hours. At the time of removal, dark-crust and erythematous mucosal lesion was noted where the battery impacted. At the first hospital day, fever over 38.5 degrees C developed, and NPO, antibiotics and H-2 blocker started. At the third hospital day, he had melena, and endoscopy revealed huge active esophageal ulceration ranging from upper esophagus and lower body of the esophagus. Steroid started. At the 10th hospital day, endoscopy revealed much smaller-sized ulceration, but mucosa where the battery impacted initially showed deep depression which might imply developing diverticulum. At the 17th hospital day, endoscopy revealed complete diverticulum. At the 27th hospital day, endoscopy revealed complete resolution of diverticulum.
Anti-Bacterial Agents ; Child ; Depression ; Diverticulum ; Endoscopy ; Esophagus* ; Fever ; Humans ; Infant ; Lithium* ; Male ; Melena ; Mucous Membrane ; Ulcer*

The procedure that enhances osteogenesis and shortens the healing period is required for successful implant therapy. It has been introduced that osteogenesis is enhanced by the generation of electric field. Many researchers have demonstrated that application of electric and electromagnetic field promote bone formation. It also has been shown that electrical stimulation enhances peri-implant bone formation. Recently, several investigators have reported that noninvasive electrical stimulation using negatively charged electret such as polytetrafluoroethylene(PTFE) promotes osteogenesis. Therefore, we were interested in the effect of noninvasive electrical stimulation using negatively charged electret on the periimplant bone healing. After titanium implant were installed in the proximal tibial metaphysis of New Zealand white rabbit, negatively charged PTFE membrane fabricated by corana dischage was inserted into the inner hole of the experimental implant and noncharged membrane was applied into control implant. After 4 weeks of healing, histomorphometric analysis was performed to evaluate peri-implant bone response. The histomorphometric evaluations demonstrated experimental implant tended to have higher values in the total bone-to-implant contact ratio(experimental ; 49.9+/-13.52% vs control ; 37.5+/-19.44%) , the marrow bone contact ratio(experimental ; 34.94+/- 13.32% vs control ; 24.15+/-13.69%), amount of newly formed bone in the endosteal region(experimental ; 1.00+/-0.30mm vs control ; 0.61+/-0.24mm) and bone area in the medullary canal(experimental ; 13.55+/-4.98% vs control ; 9.03+/-3.05%). The mean values of the amount of newly formed bone(endosteal region) and bone area(medullary canal) of the experimental implant demonstrated a statistically significant difference as compared to the control implant(p<0.05). In conclusion, noninvasive electrical stimulation using negatively charged electret effectively promoted peri-implant new bone formation in this study. This method is expected to be used as one of the useful electrical stimulation for enhancing bone healing response in the implant therapy
Rabbits ; Animals