Maximizing tibial coverage is an important consideration in total knee replacement arthroplasty to provide stability and even load transfer and to improve long term survival rate of the implants. We evaluated the coverage, underhang and overhang ratio for the proximal tibial resection surface during total knee replacement arthroplasty in Koreans. After cutting the proximal tibia, the outline of tibial resection surface was traced manually. We compared 5 tibial tray designs, AGC(Biomet, Warsaw, U.S.A.), Advantim(Wright medical technology, Arlington, U.S.A.), AMK(DePuy, Warsaw, U.S.A), MG II(Zimmer, Indiana, U.S.A.), Series 7000(Osteonics, New Jersey, U.S.A.), which have been commercially used in Korea for total knee replacement arthroplasty. The average percentage of coverage area were 83.3% in AGC, 81.6% in AMK, 80.3% in MG II, 80.2% in Advantim and 76.9% in Series 7000. The average percentage of underhang were 16.7% in AGC, 18.4% in AMK, 19.6% in MG II, 19.8% in Advantim and 23,1% in Series 7000. The average percentage of overhang were measured 7.97% in AGC, 7.86% in AMK, 8.01% in MG II, 8.77% in Advantim and 10.14% in Series 7000. So average coverage percentage of tibial cutting surface was 80.5% in Koreans. The factors which affect the optimal coverage, were the shape, dimensional interval of tibial trays and the number of practically useful tibial trays for Koreans.
Arthroplasty* ; Arthroplasty, Replacement, Knee* ; Indiana ; Korea ; New Jersey ; Survival Rate ; Tibia

BACKGROUND: Therapeutic plasma exchange (TPE) is used to remove antibodies from the blood stream, thereby preventing them from attacking their targets. We evaluated the strategies to increase the efficiency of TPE for renal allograft recipients with HLA antibody. METHODS: A total of 11 patients were evaluated from January 2002 to April 2004. All the patients had been diagnosed with end stage renal disease (ESRD) and then they were scheduled for renal transplantation from a living unrelated donor or a living related donor. TPE was performed for all lymphocyte cross-matching (LCM) positive recipients before renal transplantation. One to three sessions of TPE were performed in 8 patients and four to seven sessions of TPE were performed in 3 patients (mean: 2.81 times). We used normal saline and 4% albumin as a replacement solution. RESULTS: Eleven patients, after the patients' LCM positive serum converted to negative, received the renal transplantation. Of the 11 recipients, only 1 recipient suffered from chronic rejection. Ten recipients maintained normal renal function. Among the 11 recipients, 4 recipients were diagnosed with posttransplantation diabetes mellitus. 3 recipients had a past history of graft failure via acute or chronic rejection. Even these 3 recipients experienced successful renal allograft through pre-transplantation TPE. Also, all the recipients were followed up until June, 2005. CONCLUSION: For ESRD patients with positive LCM, pre-transplantation TPE dramatically decreases the incidence of acute or chronic rejections by converting positive LCM into negative LCM.
Allografts* ; Antibodies ; Diabetes Mellitus ; Humans ; Incidence ; Kidney Failure, Chronic ; Kidney Transplantation ; Lymphocytes ; Plasma Exchange* ; Plasma* ; Rivers ; Tissue Donors ; Transplants ; Unrelated Donors

Apical surgery for a mandibular molar is still challenging for many reasons. This report describes the applications of computer-guided cortical ‘bone-window technique’ using piezoelectric saws that prevented any nerve damage in performing endodontic microsurgery of a mandibular molar. A 49-year-old woman presented with gumboil on tooth #36 (previously endodontically treated tooth) and was diagnosed with chronic apical abscess.Periapical lesions were confirmed using cone-beam computed tomography (CBCT).Endodontic microsurgery for the mesial and distal roots of tooth #36 was planned. Following the transfer of data of the CBCT images and the scanned cast to an implant surgical planning program, data from both devices were merged. A surgical stent was designed, on the superimposed three-dimensional model, to guide the preparation of a cortical window on the buccal side of tooth #36. Endodontic microsurgery was performed with a printed surgical template. Minimal osteotomy was required and preservation of the buccal cortical plate rendered this endodontic surgery less traumatic. No postoperative complications such as mental nerve damage were reported. Window technique guided by a computer-aided design/computer-aided manufacture based surgical template can be considerably useful in endodontic microsurgery in complicated cases.

Apical surgery for a mandibular molar is still challenging for many reasons. This report describes the applications of computer-guided cortical ‘bone-window technique’ using piezoelectric saws that prevented any nerve damage in performing endodontic microsurgery of a mandibular molar. A 49-year-old woman presented with gumboil on tooth #36 (previously endodontically treated tooth) and was diagnosed with chronic apical abscess.Periapical lesions were confirmed using cone-beam computed tomography (CBCT).Endodontic microsurgery for the mesial and distal roots of tooth #36 was planned. Following the transfer of data of the CBCT images and the scanned cast to an implant surgical planning program, data from both devices were merged. A surgical stent was designed, on the superimposed three-dimensional model, to guide the preparation of a cortical window on the buccal side of tooth #36. Endodontic microsurgery was performed with a printed surgical template. Minimal osteotomy was required and preservation of the buccal cortical plate rendered this endodontic surgery less traumatic. No postoperative complications such as mental nerve damage were reported. Window technique guided by a computer-aided design/computer-aided manufacture based surgical template can be considerably useful in endodontic microsurgery in complicated cases.

Many transplant recipients believe that exercise or physical activity after transplantation will have adverse effects on the body and the grafted organ, and even more, some of them believe that the grafted organ will tear off from the vascular bed inside of the abdominal cavity. As a result, many recipients are isolated from social life even after successful recovery of the grafted organ function. However, rehabilitation by physical exercise and activity is essential to return to normal social life. In 1978, a transplantee's sport game known as the Transplant Olympics, which later changed to the World Transplant Games, was started to improve the quality of life and develop friendships between transplant recipients globally. This event promotes improvement of recipient's life quality while delivering an important message to the public. This is because by engaging in sports activities, transplantees can show their healthy life after transplantation to the public. This can also improve self-esteem of the family of organ donors and allow them to verify that their decision to donate was not in vain. Additionally, the public can realize the benefits of transplantation and necessity for organ donation. Finally, the early return to social life and normal family life after transplantation will also reduce the national budget for health insurance. Although sports clubs are located in all transplant centers in Korea, no continuous athletic meetings or transplant sport organization exist nationwide. This problem is exacerbated by the lack of concern that transplant physicians and surgeons show toward recipients' physical activity and exercise. Therefore, in this study, we reviewed the significance of physical activity after transplantation and describe the world transplant games and domestic games to enable development of a recipient rehabilitation plan.
Abdominal Cavity ; Budgets ; Exercise ; Exercise Therapy ; Friends ; Humans ; Insurance, Health ; Korea ; Motor Activity ; Quality of Life ; Rehabilitation* ; Sports ; Surgeons ; Tears ; Tissue and Organ Procurement ; Tissue Donors ; Transplant Recipients ; Transplants

The first author's affiliation should be corrected.

Recent developments in virtual, augmented, and mixed reality have introduced a considerable number of new devices into the consumer market. This momentum is also affecting the medical and health care sector. Although many of the theoretical and practical foundations of virtual reality (VR) were already researched and experienced in the 1980s, the vastly improved features of displays, sensors, interactivity, and computing power currently available in devices offer a new field of applications to the medical sector and also to urology in particular. The purpose of this review article is to review the extent to which VR technology has already influenced certain aspects of medicine, the applications that are currently in use in urology, and the future development trends that could be expected.
Biofeedback, Psychology ; Foundations ; Health Care Sector ; Urology*

Although numerous studies have been conducted on apexification using mineral trioxide aggregate (MTA), direct observation of extracted human teeth after the procedure has been rarely reported. This case report describes a mandibular premolar treated 2.5 years ago and extracted recently for orthodontic treatment. The tubercle of the right mandibular premolar of a 12-year-old boy with dens evaginatus was fractured and the pulp was exposed. The tooth was diagnosed with pulp necrosis and asymptomatic periapical abscess. During the first visit, copious irrigation was performed with 2.5% sodium hypochlorite. Calcium hydroxide paste was placed as an intracanal medicament. The sinus tract had disappeared at the second visit after 3 weeks. MTA was applied on to the bleeding point as a 4-mm-thick layer, followed by a 3-mm-thick gutta-percha filling and resin core build-up. After 2.5 years, the tooth and three other premolars were extracted for orthodontic treatment. The right and left mandibular premolars were scanned with micro-computed tomography to determine the root shape and canal anatomy. Irregular root growth was observed and the root outline of the right mandibular premolar differed from that of the contralateral tooth. Apexification with MTA leads to the formation of roots with irregular morphology, without any pulpal space.

All cells are equipped with intricate signaling networks to meet the energy demands and respond to the nutrient availability in the body. AMP-activated protein kinase (AMPK) is among the most potent regulators of cellular energy balance. Under ATP -deprived conditions, AMPK phosphorylates substrates and affects various biological processes, such as lipid/glucose metabolism and protein synthesis. These actions further affect the cell growth, death, and functions, altering the cellular outcomes in energy-restricted environments. AMPK plays vital roles in maintaining good health. AMPK dysfunction is observed in various chronic diseases, making it a promising target for preventing and alleviating such diseases. Herein, we highlight the different AMPK functions, especially in allergy, aging, and cancer, to facilitate the development of new therapeutic approaches in the future.