Ischemic optic neuropathy may occur in giant cell arteritis, hypertension, diabetes mellitus, atherosclerosis, various hematologic diseases, and rarely after sirgery. We performed tonometer, indirect ophthalmoscopy, fluorescein angiography(FAG), and visual evoked potential(VEP)on a 54-year-old malle who complained visual disturbance(visual acuity: finger count 30cm, OS) after gerneal anesthesia with prone position for ankylosing spondylitis corrective surgery. The aptient was diagnosed as ischemic optic neuropathy, and followed up for 10 months. It is mainly caused by ocular compression during operation and we should keep the patient`s eye uncompressed during prone position surgery.
Anesthesia ; Anesthesia, General* ; Atherosclerosis ; Diabetes Mellitus ; Fingers ; Fluorescein ; Giant Cell Arteritis ; Hematologic Diseases ; Humans ; Hypertension ; Middle Aged ; Ophthalmoscopy ; Optic Neuropathy, Ischemic* ; Prone Position* ; Spondylitis, Ankylosing

PURPOSE: This study was conducted to obtain anatomical data useful for transacetabular screw fixation in total hip arthroplasty. MATERIAL AND METHODS: Using 67 hemipelvises of Korean adults cadaver, the variations of external iliac vessels and obturator neurovascular bundle were observed. Forty-nine pelvises were used for the study of vulnerable structures to transacetabular screw inserted through 8 points and 25 pelvises for measuring the thickness of articular cartilage, cortical bone and cancellous bone at each screw penetration site. RESULT: The lengths of S-pin inserted at the inferior, posterior and posteroinferior portion of the acetabulum were more than 20mm. The length of entire bone and thickness of cortical bone measured at the mid point of the posterosuperior portion were longest. The external iliac vessels showed variations in their spatial relationship. At anterosuperior portion, the bone and muscle layer were very thin. The cortical bone of articular side became thicker from center to periphery. The thickness of cortical bone in the pelvic cavity showed different values at different sites. CONCLUSION: The authors suggest that the structural varieties can be injured when inserting the fixation screw of acetabular cup, and the thickness of cortical and cancellous bone may be useful in total hip replacement.
Acetabulum* ; Adult ; Arthroplasty, Replacement, Hip* ; Cadaver ; Cartilage, Articular ; Humans ; Pelvis

PURPOSE: To evaluate clinical and radiographic results associated with the use of autogenous bone graft with preservation of cortical bone in the patients with severe bone defect of the proximal medial tibia in total knee arthroplasty. MATERIALS AND METHODS: From January 2000 to June 2003, thirty three primary total knee arthroplasty were performed with autogenous bone graft for severe peripheral defect of the proximal medial tibia. After sclerotic bone of defect site was removed by the burr, reconstruction of medial wall was done by use of resected bone, which was fixed by wedge-shaped bone. Autogenous cancellous bone was grafted in the central type bone defect area. We reviewed the result using the HSS knee rating scores and observed the radiographic changes. RESULTS: The mean HSS knee rating score was 43.5 preoperatively and was 91.3 at last follow-up. Radiologically, union of the tibial bone grafts were impossible to determine, but there were no evidence of the displacement of grafted bone, osteolysis and loosening of the inserted implants. CONCLUSION: The method of autogenous bone graft applied with preservation of cortical bone and wedge bone graft could be supposed as useful in the reconstruction of the tibial bone defects as well as in the stability of the tibial component.
Arthroplasty* ; Follow-Up Studies ; Humans ; Knee* ; Osteolysis ; Tibia ; Transplants*

PURPOSE: To compare the roentgenographic results between Image-free navigation system-assisted total knee arthroplasty (TKA) using the OrthoPilot(R) and conventional TKA. MATERIALS AND METHODS: Of 120 primary TKA that operated by one surgeon, 60 cases were operated with a Image-free navigation system (OrthoPilot(R) 4.0, Aesculap, Tuttlingen, Germany) (group A) and 60 cases were operated with conventional method (manual alignment system) (group B). The alignment of the lower extremity and the position of the components were determined on postoperative long-leg standing anteroposterior radiogram and lateral radiogram. RESULTS: Mechanical axis was significantly more accurate in group A than group B(95% compared with 80%). The coronal inclination of femoral component to mechanical axis (theta) was significantly more accurate in group A than group B(96.7% compared with 80%). There were no significant differences between two groups in the sagittal inclination of femoral component(gamma), the coronal inclination of tibial component (beta) and the sagittal inclination of tibial component(delta). In all five measurements being excellently implanted, a significantly higher number was in group A(60% compared with 40%). CONCLUSION: Image-free navigation system-assisted TKA using the OrthoPilot(R) led to significantly increased precision of restoration of the alignment of the lower extremity and the position of the components compared with the conventional method. Potential benefits in long-term outcome and functional improvement require further investigation.
Arthroplasty ; Axis, Cervical Vertebra ; Knee ; Lower Extremity

BACKGROUND: It is generally accepted that the most spontaneously-arising epidermal cysts might be related to follicular infundibulum and palmoplantar epidermal cyst (PPEC) has been suggested to be caused from traumatic implantation of epidermal fragments. In addition there were several recent reports of human papillomavirus (HPV) implicating in formation of PPEC and also similar reports in Korean dermatologic literature. But the latter failed to reveal the presence of HPV in PPEC or a specific type of HPV by molecular biologic methods. OBJECTIVE: We tried to identify the presence of HPV and its subtype in PPEC. METHODS: After reviewing routine histopathologic findings recalling HPV infection in 8 PPECS, we undertook immunohistochemistry using polyclonal HPV antibody and polymerase chain reactions with 3 sets of HPV primers. To confirm the actual location of HPV in cyst in situ hybridization with HPV 60 probe was also done. RESULTS: All cases showed more than one feature of HPV infection. The positive reactions were 3 out of 8 on immunohistochemistry and 5 out of 8 on polymerase chain reaction. All cases (4 of 4) were positive on in situ hybridization and they were found in the horny layer and/or wall of cysts. CONCLUSION: PPEC in Korea may show similar typical histopathologic features with those reported in Japan. The HPV were detected in almost PPEC by molecular methods and their subtype was all HPV 60.
Epidermal Cyst* ; Gammapapillomavirus* ; Humans* ; Immunohistochemistry ; In Situ Hybridization ; Japan ; Korea ; Polymerase Chain Reaction

No abstract available.
Biomarkers* ; Propionibacterium acnes* ; Propionibacterium* ; Vitamin D* ; Vitamins*

No abstract available.
Biomarkers* ; Propionibacterium acnes* ; Propionibacterium* ; Vitamin D* ; Vitamins*

Achalasia can be provoked by organic causes, and it is called secondary achalasia. Sometimes it is very difficult to distingush secondary achalasia from primary achalasia. We report a case of secondary achalasia due to recurrence of stomach cancer. A 45-year-old man came to our hospital due to three months history of dysphagia and regurgitation. Barium esophagogram showed concentric narrowing at the distal esophagus and dilatation of proximal esophagus. The esophagogastroduodenoscopy showed stenosis of gastroesophageal junction and the endoscope could not pass through it, but there was no evidence of malignancy. Esophageal manometry showed aperistalsis, compatible with achalasia. Abdominal CT showed soft tissue density near the gastroesophageal junction. However it was not possible to differentiate whether it was due to adhesion or malignancy. For correct diagnosis and treatment, explorolaparotomy was performed and it was diagnosed as secondary achalasia due to recurrence of stomach cancer.
Barium ; Constriction, Pathologic ; Deglutition Disorders ; Diagnosis ; Dilatation ; Endoscopes ; Endoscopy, Digestive System ; Esophageal Achalasia* ; Esophagogastric Junction ; Esophagus ; Humans ; Manometry ; Middle Aged ; Recurrence* ; Stomach Neoplasms* ; Stomach* ; Tomography, X-Ray Computed

BACKGROUND AND OBJECTIVES: According to the MADIT II criteria, a low left ventricular ejection fraction (LVEF) is one of the most important predicting factors for sudden cardiac death (SCD) in post myocardial infarction (PMI) patients, and it is a reasonable indication for ICD implantation. The aim of this study is to reveal the incidence and the prognostic value of the non-invasive parameters and whether the MADIT II criteria for ICD implantation can be applied to Korean PMI patients. SUBJECTS AND METHODS: During the period from January 2001 to June 2005, 640 PMI survivors were included in this study. The incidence of an abnormal SAECG, premature ventricular complex (PVC) counts > or = 10/hr, non-sustained ventricular tachycardia (NSVT) on ambulatory ECG and a low (< or = 30%) LVEF were studied and used as risk stratification markers for later adverse arrhythmic events. RESULTS: The incidence of PVCs > or = 10/hr and NSVT on the ambulatory ECG was 14.3% and 7.5%, respectively. 29 patients (4.9%) had a LVEF of less than 30%. Arrhythmic events occurred in 9 of the 29 patients (31%). SCD or adverse arrhythmic events occurred in 42 of the 640 patients. The percentage of patients who were using beta-blocker was lower than that in the MADIT II study group (55% vs 70%, respectively). In the adverse arrhythmic event (+) group, the percentage of beta-blocker use was significantly lower than that in the arrhythmic event (-) group (32.5% vs 58%, respectively). CONCLUSION: The MADIT II criteria and PVCs > or = 10/hr or NSVT on the ambulatory ECG can be suggested as the indications for implanting an ICD in Korean PMI patients. The use of beta-blocker is important for preventing adverse arrhythmic events.
Death, Sudden, Cardiac* ; Electrocardiography ; Humans ; Incidence ; Myocardial Infarction* ; Risk Assessment ; Stroke Volume* ; Survivors ; Tachycardia, Ventricular ; Ventricular Premature Complexes

In this study, we investigated the effects of pelargonidin, an anthocyanidin found in many fruits and vegetables, on endothelium-independent vascular contractility to determine the underlying mechanism of relaxation. Isometric contractions of denuded aortic muscles from male rats were recorded, and the data were combined with those obtained in western blot analysis. Pelargonidin significantly inhibited fluoride-, thromboxane A2-, and phorbol ester-induced vascular contractions, regardless of the presence or absence of endothelium, suggesting a direct effect of the compound on vascular smooth muscles via a different pathway. Pelargonidin significantly inhibited the fluoride-dependent increase in the level of myosin phosphatase target subunit 1 (MYPT1) phosphorylation at Thr-855 and the phorbol 12,13-dibutyrate-dependent increase in the level of extracellular signal-regulated kinase (ERK) 1/2 phosphorylation at Thr202/Tyr204, suggesting the inhibition of Rho-kinase and mitogen-activated protein kinase kinase (MEK) activities and subsequent phosphorylation of MYPT1 and ERK1/2. These results suggest that the relaxation effect of pelargonidin on agonist-dependent vascular contractions includes inhibition of Rho-kinase and MEK activities, independent of the endothelial function.
Animals ; Anthocyanins ; Aorta* ; Blotting, Western ; Endothelium* ; Fluorides ; Fruit ; Humans ; Isometric Contraction ; Male ; Muscle, Smooth, Vascular ; Muscles ; Myosin-Light-Chain Phosphatase ; Phosphorylation ; Phosphotransferases ; Protein Kinases ; Rats* ; Relaxation ; rho-Associated Kinases ; Vasoconstriction* ; Vegetables