PURPOSE: The purpose of this study was to examine the effects of change of polyethylene resin type and manufacturing method on the wear of polyethylene tibial component. MATERIALS AND METHODS: Thirteen MG I and 10 MG II components were retrieved at revision surgery. Each polyethylene tibial component was graded for surface wear damage. Density profiles of the polyethylene were measured to examine the extent of oxidative degradation of the polyethylene. RESULTS: The primary damage mode of the MG I retrievals was scratching and metallic debris, but the primary damage mode of the MG II was delamination (P<0.05). For the implants with implantation time of 5 years or more, the MG II polyethylene had a higher density value (0.959+/-0.002 g/cc, n=7) compared with the MG I (0.948+/-0.004 g/cc, n=11). Both delamination and polyethylene degradation increased with length of implantation time for the MG II components (P<0.01). Even after gamma sterilization, the directly molded 1900 MG I components experienced significantly less delamination and degradation than the machined GUR 415 MG II tibial components. CONCLUSIONS: This study suggests that delamination of polyethylene tibial components is influenced by resin type and/or manufacturing method
Fungi ; Polyethylene* ; Sterilization

No abstract available.
Peripheral Nerves* ; Regeneration*

We studied 600 normal lower extremities of Korean students of elementary school in order to establish normal values for the rotational profile and to define any differences between ethnic groups. Rotational profile examined at this study included medial and lateral rotation of the hip and thighfoot angle. The mean value of medial rotation of the hip was 48 degrees with a range of 35 to 64 degrees in male subjects, and 50 degrees with a range of 35 to 60 degrees in female subjects. The mean value of lateral rotation of the hip was 57 degrees with a range of 43 to 75 degrees, and 53 degrees with a range of 40 to 72 degrees in female subjects. Unlike medial rotation, lateral rotation of the hip was greater in male than in female subjects by a mean difference of 4 degrees(T-test, p<0.05). The mean value of thigh-foot angle was 10 degrees with a range of -2 to 23 degrees in male subjects, and 12 degrees with a range of 0 to 21 degrees in female subjects. The total range of hip rotation was slightly greater in Korean than in Caucasians or in Chinese, but, to conclude this, more large study by the same methods will be needed in other areas of Korea.
Asian Continental Ancestry Group ; Ethnic Groups ; Female ; Hip ; Humans ; Korea ; Lower Extremity* ; Male ; Reference Values

No abstract available.
Dyspnea* ; Hypothyroidism*

No abstract available.
Connective Tissue Diseases* ; Connective Tissue* ; Diagnosis*

Malposition of the extracorporeal membrane oxygenation (ECMO) venous cannula in the azygos vein is not frequently reported. We hereby present such a case, which occurred in a neonate with right-sided congenital diaphragmatic hernia. Despite ECMO application, neither adequate flow nor sufficient oxygenation was achieved. On the cross-table lateral chest radiograph, the cannula tip was identified posterior to the heart silhouette, which implied malposition of the cannula in the azygos vein. After repositioning the cannula, the target flow and oxygenation were successfully achieved. When sufficient venous flow is not achieved, as in our case, clinicians should be alerted so they can identify the cannula tip location on lateral chest radiograph and confirm whether malposition in the azygos vein is the cause of the ineffective ECMO.
Azygos Vein* ; Catheters* ; Extracorporeal Membrane Oxygenation* ; Heart ; Hernias, Diaphragmatic, Congenital* ; Humans ; Infant, Newborn* ; Oxygen ; Radiography, Thoracic

Purulent pericarditis is an infrequent but fulminant and frequently lethal disease. Purulent pericarditis tends to occur as direct extension of bacterial pneumonia or empyema in past. In recently, purulent pericarditis tends to occur in adult via contiguous spread from an early postoperative infection after thoracic surgery or trauma, infection related to infective endocarditis, extension from a subdiaphragmatic suppurative source, and hematogenous spread during bacteremia. Endogenous causes of purulent pericarditis are frequently characterized as esophageal perforations. Common causes of esophageal perforations related to purulent pericaditis which usually develop in association with mediastinitis, pneumonia and empyema include corrosive esophagitis, complication after esophageal and tracheal instrumentation and Boerhaave's syndrome. There is very little reference to the development of pericarditis in associated with esophageal perforation which does not directly communicate with the pericardium. while, although most uncommon, it is well documented that the esophagus can perforate directly into the pericardium and produce pericarditis. We experienced a case of acute purulent pericarditis after esophageal and pericardial perforation by a small fish bone in a previously healthy man. The patient was treated successfully with systemic antibiotics and pericardiotomy.
Adult ; Anti-Bacterial Agents ; Bacteremia ; Empyema ; Endocarditis ; Esophageal Perforation ; Esophagitis ; Esophagus ; Foreign Bodies* ; Humans ; Mediastinitis ; Pericardiectomy ; Pericarditis* ; Pericardium ; Pneumonia ; Pneumonia, Bacterial ; Thoracic Surgery

BACKGROUND: There were many studies about the changes of cognitive or non-cognitive domain and behavioral and psychological symptoms with the progression of Alzheimer's disease. But they assessed the changes individually so could not explain comprehensively the global change of disease progression. Also they studied by clinical dementia rating scale(CDR) which could not successfully explain the latest stage. So we have evaluated the cognitive, non-cognitive domain and behavioral and psychological symptoms at the same time and evaluated the changes with the expanded clinical dementia rating scale. Also we evaluated the relationship of each scale and assessed sensitivity change at the different stage of disease. METHODS: Twenty-three mild cognitive impairment(MCI) subjects and eighty-seven patients with Alzheimer's disease were recruited. The Korean version of Mini-Mental State Examination(K-MMSE), the Korean version of the neuropsychiatric inventory(NPI), the Extended version of the Korean Clinical Dementia Rating Scale(CDR), the Activity of Daily Living(ADL), the Severe Dementia Scale(SDS) and the Short form of Samsung Dementia Questionnaire(S-SDQ) were performed. RESULTS: It was found that all of them were well correlated each other(r>-0.73 and p<0.05) except NPI. Physical activity of daily living(P-ADL) was most related to Korean version of instrumental activity of daily living(K-IADL) (r=0.86 and p<0.01), SDS to K-MMSE(r=0.93 and p<0.01) and S-SDQ to K-IADL(r=0.86 and p<0.01). P-ADL and S-SDQ revealed the ceiling effect at CDR 4 and K-IADL at CDR 3. CONCLUSION: The cognitive and non-cognitive function were declined according to disease progression. The changes of behavioral and psychological symptoms were relatively independent of cognitive function. SDS, P-ADL and CDR were proved to be more sensitive in advanced stage of dementia and K-IADL, S-SDQ were more adequate in milder stage of dementia or MCI.
Alzheimer Disease ; Dementia ; Disease Progression ; Humans ; Motor Activity

The ability to distinguish between unipolar and bipolar depression and the knowledge to bring the appropriate effective treatment is particularly crucial to psychiatrists. Because the pharmacologic strategies indicated for each disorder differ. Failure to make the correct diagnosis may lead to a lack of response to treatment, or complications such as switches into mania or rapid cycling. Common mood symptoms are melancholy, tearfulness, and irritability; common cognitive and perceptual symptoms are self-deprecatory and self-accusatory thoughts, poor concentration, diminished clarity and speed of thought, and suicidal ideation. Absence of a history of hypomania or mania does not rule out a bipolar diagnosis. Retardation, hypersomnia, hyperphagia, suicide attempts, and psychotic symptoms are more frequently found in these patients than in patients with unipolar depression. Few studies have examined the efficacy of somatic treatments in acute bipolar depression. Less than 20 controlled pharmacological studies have been conducted for the depressive phase of bipolar disorder. In addition, these studies examined small sample sizes and with only a few of the available treatment options. Because there is very little data specific to treatment of bipolar depression, most of the approaches to bipolar depression are derived from experience with unipolar depression. The basic premise of treatment os that these patients frequently respond to mood stabilizing agents without antidepressants, and that antidepressants should be reserved for those cases in which mood stabilizers alone have not worked, because of the well-known risk of triggering manic episodes(switching) and rapid cycling. Antidepressants should not be continued any longer than necessary. Mood stabilizers should be considered as first-line agents in view of the fact that their efficacy is at lease equal to, if not greater than, treatment with antidepressant, and that their use is rarely associated with the complications of cycle acceleration or with manic switch. It is recommended to use bupropion or SSRI because of low risk of manic switch and rapid cycling. In the future, research and pharmaceutical communities will have to focus on the short- and long-term effectiveness of antidepressants, and the development of new drugs for the treatment of bipolar depression. More experience is needed with the anticonvulsant lamotrigine, gabapentin, topiramate. The preliminary studies of lamotrigine suggests the antidepressant effect and mood stabilizing efficacy.
Acceleration ; Antidepressive Agents ; Bipolar Disorder* ; Bupropion ; Depressive Disorder ; Diagnosis ; Disorders of Excessive Somnolence ; Excipients ; Humans ; Hyperphagia ; Psychiatry ; Sample Size ; Suicidal Ideation ; Suicide

Chronic mucocutaneous randidiasis is a clinical syndrome characte ized by chronic and reccurent superficial candidal infection of the skin, mucous membranes, and nails. This syndrome is frequently associated with immune deficiency or endocrinopathy, especially hypopar; thyroidism. We report a case of chrcinic mucocutaneous candidiasis associated with hypoparathyroidism in a 8- year-old girl.
Candidiasis ; Candidiasis, Chronic Mucocutaneous* ; Female ; Humans ; Hypoparathyroidism* ; Mucous Membrane ; Skin ; Thyroid Gland