PURPOSE: Surface finishing of a cemented femoral stem is a subject of controversy even though the contemporary cementing techniques have improved results. Using the Versys Heritage femoral stem, we evaluated the outcome of using a polished surface. MATERIALS AND METHODS: The subjects of this study were 95 hip arthroplasties in 82 patients and we used a cemented polished femoral stem with the 3rd generation cement technique and all the surgeries were done between October 2000 and August 2003. There were 58 male patients (64 hips) and 24 female patients (31 hips). The mean age at the time of the index arthroplasty was 52.3 years (26~74 years), and the average body mass index was 24.2+/-2.75 (19.1~29.8). The average follow up period was 80.7 months (64~109 months). All the hips were evaluated clinically by the Harris hip score and the thigh pain, and they were radiologically assessed by the cement grade and the presence of osteolysis around the femoral stem, as well as the presence of stress shielding of the proximal femur. RESULTS: At the final follow up, the Harris hip score for all the patients had improved from preoperative 58.9 (17-83) to post operative 91.7 (72~100). The cement grade was measured using Barrack's method. Of the 95 hips, 45 (47.3%) cases were grade A, 48 (50.5%) cases were grade B and 2 (2.1%) cases were grade C1 at the final follow up. There was 1 case of definite loosening. Stress shielding was noted in 65 (68.4%) cases of the zero grade and 19 (20.0%) cases of the 1st grade. CONCLUSION: In this study, the cemented polished femoral stem showed excellent results at the mid term with a minimum follow up of 5 years. But a longer-term follow-up study will be needed for further understanding the implications of cemented polished femoral stem.
Arthroplasty ; Body Mass Index ; Female ; Follow-Up Studies ; Hip ; Humans ; Male ; Osteolysis ; Thigh

Wernicke's encephalopathy is a reversible but potentially critical disease caused by thiamine deficiency. Most patients complain of symptoms such as ophthalmoplegia, ataxia and confusion. Heavy alcohol drinking is commonly associated with the disease, but other clinical conditions also can provoke it. In pregnant women, hyperemesis gravidarum can lead to the depletion of body thiamine due to poor oral intake and a high metabolic demand. We report a case of Wernicke's encephalopathy following hyperemesis gravidarum in a 36-year-old female at 20 weeks of pregnancy, who visited our hospital because of shock with vaginal bleeding. This case suggests that although the initial presentation may include atypical symptoms (e.g., shock or bleeding), Wernicke's encephalopathy should be considered, and thiamine replacement should be performed in pregnant women with neurologic symptoms and poor oral intake.
Acute Kidney Injury ; Adult ; Alcohol Drinking ; Ataxia ; Female ; Humans ; Hyperemesis Gravidarum* ; Neurologic Manifestations ; Ophthalmoplegia ; Pregnancy ; Pregnant Women ; Shock ; Thiamine ; Thiamine Deficiency ; Uterine Hemorrhage ; Wernicke Encephalopathy*

Maple syrup urine disease is an autosomal recessive disease caused by a deficiency of the branched-chain alpa-ketoacid dehydrogenase complex. The disease is often suspected because of the peculiar odor of maple syrup in urine. Maple syrup urine disease is usually confirmed by amino acid analysis and urine organic acid analysis showing marked elevations of leucine, isoleucine, valine, and respective ketoacids in blood and urine. We experienced a case of a newborn patient with maple syrup urine disease, who suffered from poor feeding, irritability, hypotonicity and generalized convulsions. She was promptly treated with peritoneal dialysis and branched-chain amino acid free diet. The patient was controlled successfully and discharged.
Acer* ; Diet* ; Humans ; Infant, Newborn ; Isoleucine ; Leucine ; Maple Syrup Urine Disease* ; Odors ; Oxidoreductases ; Peritoneal Dialysis* ; Seizures ; Valine

In this study, we describe our diagnosis and treatment of two patients who presented with femoral vessel compression caused by a cystic lesion in the groin. One case was diagnosed as adventitial cystic disease (ACD) of the common femoral artery resulting in leg claudication and the other was diagnosed as a ganglion cyst (GC) causing femoral vein compression and unilateral leg swelling. The operative findings differed between these two cases with respect to the dissection of the cyst and femoral vessel, but the postoperative histological examination results were similar. The pathogenesis of ACD and GC is not fully understood, and further investigation is needed to delineate the exact pathology of these uncommon conditions.
Adventitia ; Diagnosis ; Femoral Artery ; Femoral Vein ; Ganglion Cysts ; Groin* ; Hip ; Humans ; Leg ; Pathology

PURPOSE: We investigated the effect and duration of hyaluronic acid (HA) on the bladder of rats with cyclophosphamide (CYP)-induced cystitis. MATERIALS AND METHODS: CYP (250 mg/kg) was injected intraperitoneally in female Sprague-Dawley rats to induce cystitis. HA (0.5%) was instilled intravesically. First, the rats were separated into 2 groups for urodynamic study (CYP group, CYP+HA group), and we assessed the inter-contraction interval, maximal voiding pressure (MVP), and pressure threshold of the 2 groups. Second, the rats were separated into 3 groups to assess the duration of effect of HA (CYP group; HA-1 group: HA was instilled 1 day before injection of CYP; HA-3 group: HA was instilled 3 days before injection of CYP), and we assessed the voiding interval for 7 days after confining the rats in metabolic cages. RESULTS: The inter-contraction interval of the CYP+HA group (236.0+/-18.3 min) was significantly longer than that of the CYP group (178.0+/-13.4 min; p<0.03), but the MVPs of both groups did not differ significantly (32.3+/-1.2 vs. 34.0+/-2.4 cmH2O, respectively; p=0.56). The pressure threshold of the CYP+HA group (9.9+/-0.5 cmH2O) was significantly longer than that of the CYP group (13.2+/-0.7 cmH2O; p=0.002). The voiding interval decreased in each of the 3 groups according to the time after cystitis had been induced. The voiding interval was maximally decreased on the second day and returned to the pre-CYP injection level on the fifth day in each group. There was a significant difference in voiding interval among the 3 groups on the second day (p<0.05). There was no significant difference between the CYP+HA-1 and CYP+HA-3 groups on the second day (p>0.05). CONCLUSIONS: HA has an effect of increasing the voiding interval in rats with CYP-induced cystitis, and the duration of effect is concluded to be 5 days.
Animals ; Cyclophosphamide ; Cystitis ; Female ; Humans ; Hyaluronic Acid ; Rats ; Rats, Sprague-Dawley ; Urinary Bladder ; Urodynamics

Functional dyspepsia (FD) and irritable bowel syndrome (IBS) are common gastrointestinal (GI) diseases; however, there is frequent overlap between FD and IBS patients. Emerging evidence links the activation of corticotropin releasing factor (CRF) receptors with stress-related alterations of gastric and colonic motor function. Therefore, we investigated the effect of peripheral CRF peptide and water avoidance stress (WAS) on upper and lower GI transit in guinea pigs. Dosages 1, 3, and 10 µg/kg of CRF were injected intraperitoneally (IP) in fasted guinea pigs 30 minutes prior to the intragastric administration of charcoal mix to measure upper GI transit. Colonic transits in non-fasted guinea pigs were assessed by fecal pellet output assay after above IP CRF doses. Blockade of CRF receptors by Astressin, and its effect on GI transit was also analyzed. Guinea pigs were subjected to WAS to measure gastrocolonic transit in different sets of experiments. Dose 10 µg/kg of CRF significantly inhibited upper GI transit. In contrast, there was dose dependent acceleration of the colonic transit. Remarkably, pretreatment of astressin significantly reverses the effect of CRF peptide on GI transit. WAS significantly increase colonic transit, but failed to accelerate upper GI transit. Peripheral CRF peptide significantly suppressed upper GI transit and accelerated colon transit, while central CRF involved WAS stimulated only colonic transit. Therefore, peripheral CRF could be utilized to establish the animal model of overlap syndrome.
Acceleration ; Animals ; Charcoal ; Colon* ; Corticotropin-Releasing Hormone ; Dyspepsia ; Guinea Pigs* ; Guinea* ; Humans ; Irritable Bowel Syndrome ; Models, Animal ; Receptors, Corticotropin-Releasing Hormone ; Water*

PURPOSE: The purpose was to evaluate outcomes according to different operative strategies of type A esophageal atresia (EA). METHODS: All patients who underwent surgery for type A EA between 1980 and 2011 were included. Patients were divided into 2 groups: E-E group included patients who received esophageal end-to-end anastomosis, whereas E-G group included patients who received esophago-gastric tube anastomosis. RESULTS: Twenty-two patients were included. The median gestational age was 37.5 weeks. The median birth weight was 2.5 kg. Twenty-one patients underwent gastrostomy as initial procedures, and one patient underwent primary esophageal end-to-end anastomosis. The median gap between both esophageal ends was six vertebral distance (VD). Seven patients underwent primary anastomosis of the esophagus, and 14 patients underwent gastric replacement. Three patients (13.6%) had anastomotic leakage and 10 patients (45.5%) had anastomotic stenosis. Most of the patients (90.9%) had gastroesophageal reflux, but only two patients required antireflux surgery. The median VD was significantly shorter in E-E group than in E-G group (3 VD vs. 6 VD). Stenosis was significantly more often in E-E group, but there was no significant difference in leakage and reflux symptoms. CONCLUSION: The treatment for type A EA can include E-E anastomosis or E-G anastomosis, depending on the length of the end-to-end interval after performing gastrostomy. Appropriate tension and blood flow in the anastomosis site are essential for preventing postoperative stenosis and leakage, and esophageal replacement with gastric tube is believed to be feasible and safe in cases where excessive tension is present.
Anastomotic Leak ; Birth Weight ; Constriction, Pathologic ; Esophageal Atresia* ; Esophagus ; Gastroesophageal Reflux ; Gastrostomy ; Gestational Age ; Humans

PURPOSE: This study was to evaluate the wear resistance of 3D printed, milled, and conventionally cured provisional resin materials. MATERIALS AND METHODS: Four types of resin materials made with different methods were examined: Stereolithography apparatus (SLA) 3D printed resin (S3P), digital light processing (DLP) 3D printed resin (D3P), milled resin (MIL), conventionally self-cured resin (CON). In the 3D printed resin specimens, the build orientation and layer thickness were set to 0° and 100 µm, respectively. The specimens were tested in a 2-axis chewing simulator with the steatite as the antagonist under thermocycling condition (5 kg, 30,000 cycles, 0.8 Hz, 5℃/55℃). Wear losses of the specimens were calculated using CAD software and scanning electron microscope (SEM) was used to investigate wear surface of the specimens. Statistical significance was determined using One-way ANOVA and Dunnett T3 analysis (α = .05). RESULTS: Wear losses of the S3P, D3P, and MIL groups significantly smaller than those of the CON group (P < .05). There was no significant difference among S3P, D3P, and MIL group (P > .05). In the SEM observations, in the S3P and D3P groups, vertical cracks were observed in the sliding direction of the antagonist. In the MIL group, there was an overall uniform wear surface, whereas in the CON group, a distinct wear track and numerous bubbles were observed. CONCLUSION: Within the limits of this study, provisional resin materials made with 3D printing show adequate wear resistance for applications in dentistry.
Clothing ; Dentistry ; In Vitro Techniques ; Mastication ; Methods ; Printing, Three-Dimensional

BACKGROUND: In March 1999, six children who attended a nursery school became ill with acute gastroenteritis by Shigella sonnei. The majority of the children became sick one day after sharing a snack which was served from one of the children's home. By the time the outbreak of dysentery was recognized, the rest of family members of the children became also sick. The nursery school was located in a crowded residential area. EPIDEMIOLOGIC INVESTIGATION: After active and passive surveillance was established on patients with diarrhea, 438 patients were registered. Among them, 252 patients were considered to have simple diarrhea, but the rest (186 patients) suffered from more than three consecutive diarrheas. Shigella sonnei was isolated from 75 patients. The first attack rate was estimated at 50.0%, the second, 25.6%-34.3% and the third, 13.5%. The epidemic lasted for two months spreading further from person to person in the highly populous area. The active surveillance was implemented after the occurrence of the secondary attack of dysentery among the residents, who had no obvious direct contact with people associated with the nursery school. CONCLUSION: This investigation demonstrates the need for prompt implementation of active surveillance when Shigella infection is recognized in a highly populous city.
Child ; Diarrhea ; Dysentery* ; Gastroenteritis ; Humans ; Schools, Nursery ; Shigella ; Shigella sonnei ; Snacks

Aortoenteric fistula is a rare but potentially fatal condition causing massive gastrointestinal bleeding. In particular, double primary aortoenteric fistulae are vanishingly rare. We encountered a 75-year-old male patient suffering from abdominal pain, hematochezia, hematemesis, and hypotension. His computed tomography images showed abdominal aortic aneurysm and suspected aortoenteric fistulae. During surgery, we found two primary aortoenteric fistulae. The one fistula was detected between the abdominal aorta and the third portion of the duodenum, and the other fistula was detected between the abdominal aorta and the sigmoid colon. We conducted the closure of the fistulae, the exclusion of the aneurysm, and axillo-bifemoral bypass with a polytetrafluoroethylene graft. The patient was discharged with no complications on the 21st postoperative day.
Abdominal Pain ; Aged ; Aneurysm ; Aorta ; Aorta, Abdominal ; Aortic Aneurysm, Abdominal ; Colon, Sigmoid ; Duodenum ; Fistula ; Gastrointestinal Hemorrhage ; Hematemesis ; Hemorrhage ; Humans ; Hypotension ; Male ; Polytetrafluoroethylene ; Stress, Psychological ; Transplants