Although joint infection with severe destruction remains a serious problem and severe bone loss is relative contraindication of arthrodesis, knee arthrodesis is most commonly a salvage procedure. Its goals are to relieve pain and restore the patient to functional level of activity. The purpose of this study is to evaluate the results and complications of Ilizarov method for knee arthrodesis in the presence of infection. We retrospectively reviewed the records of twelve patients who had managed with knee arthrodesis with Ilizarov method. Indications for the operation included a infected skeletal defect secondary severe open trauma in four patients, an infection at the site of an arthroplasty in three (with failure of previous arthrodesis with monofixator in one), an infected charcot joint in four and one pyogenic arthritis spreading from osteomyelitis of proximal tibia. The average age of the patients at the time of operation was fifty-three years (range twenty-two to eighty years). Follow-up averaged 17 months. The minimum follow up periods was 9 months. Average duration of Ilizarov fixator application was 7.2 months. In 3 cases we performed corticotomy and internal bone transport to treat large bone defect (17cm, 8cm, 6.5cm). Autoiliac bone graft was done in fusion site in two cases, and in three cases we performed bone graft at the docking site. Solid osseous union occured in each patient. There was no reinfection and nonunion. Average shortening was 3.4 cm. Complications were related to pin tract. When last seen, all patients were free of pain and could walk without cruthes or cane. Despite its pin tract problems, bulky cumbersome and expensive apparatus, the Ilizarov method is one of effective method for knee arthrodesis in the presence of infection and large bone loss especially.
Arthritis ; Arthrodesis* ; Arthropathy, Neurogenic ; Arthroplasty ; Canes ; Follow-Up Studies ; Humans ; Ilizarov Technique* ; Joints ; Knee Joint* ; Knee* ; Osteomyelitis ; Retrospective Studies ; Tibia ; Transplants

No abstract available.
Eustachian Tube*

Thirty patient with essential hypertension were administered Manidipine, a new calcium antagonist, 10~20mg once daily to evaluate the hypotensive efficacy and safety for 8 weeks. And the followings were the result. 1) Patients were consists of 14 male, 16 female, aged 53 in average and classified as mild in 21 and moderate in 9 patients. 2) Optimum intial dose was 10mg and 10 to 20mg were the doses recommended. 3) Blood pressure dropped after 8 weeks 24/13mmHg in average, rewarding 80% effectiveness and normalized in 87%. 4) Most frequent side reaction was facial flushing in 5 patiens followed by palpitation and dizziness, all of which did not disturb the continuation of medication. 5) Most of routine laboratory parameter were normal and unchanged between before and after the trial. 6) Overall rating of usefulness was 77%. In conclusion, Manidipine 10 to 20mg once daily regimen is well tolerated and effective in the treatment of mild to moderate essential hypertension.
Blood Pressure ; Calcium ; Dizziness ; Female ; Flushing ; Humans ; Hypertension* ; Male ; Reward

The clinical entity of Dysplasia Epiphyseal Multiplex was first descrihed by Fairbank in 1935, characterized by the disturbance of endochondral ossification in hoth epiphyseal centers and regions of physeal growth. It manifests itself radiologically as late appearance and mottling of the ossification centers and clinically as short stature, stubby digits and painful stiffness of multiple joints. It is typically transmitted as an autosomal dominant trait though recessive forms have been described. The spine is normal apart from a mild increased lumbar lordosis. Many patients are referred to an orthopaedic surgeon for bilateral Perthes disease, as was one of the authors cases. This Paper reports four cases of multiple epiphyseal dysplasia which affected one family.
Animals ; Hip ; Humans ; Joints ; Knee ; Legg-Calve-Perthes Disease ; Lordosis ; Osteochondrodysplasias* ; Spine

PURPOSE: This study was performed to examine the serial alteration of the optic nerve in chronic ischemia-induced brain injury of albino rat, which might be an experimental model of ischemia-induced optic nerve disease and vasogenic glaucoma in human. METHODS: We ligated bilateral common carotid arteries so that the brain and optic nerve had permanent ischemic injuries. Serial alteration of the optic nerve was studied on postoperative 1 day, 3 day, 5 day, 1 week, 2 week, 4 week and 9 week. After fixing the brain by perfusing formaline through the left ventiricle, we dissected the brain and optic nerve and then made specimen for Hematoxilin-Eosin (HE) stain to observe the histopathology of the optic nerve. Kluiver-Barrera (KB) stain was performed to qualify the myelin injury and optic nerve injury status. RESULTS: The HE stain specimen showed increased spaces in the nerve fiber layer and increased number of vacuoles three days after the operation. The optic neve injury became augmented with time. The KB stain showed better-defined configuration of HE stain. CONCLUSIONS: We were able to notice that optic nerve injury was induced by the bilateral common carotid ligation in this chronic ischemic experimental model, which might be an help to the studies of ischemic optic nerve disease, neurodefensive mechanism, and the hemodynamic mechanism of glaucoma in human.
Animals ; Brain ; Brain Injuries ; Carotid Arteries* ; Carotid Artery, Common ; Formaldehyde ; Glaucoma ; Hemodynamics ; Humans ; Ligation ; Models, Theoretical* ; Myelin Sheath ; Nerve Fibers ; Optic Nerve Diseases ; Optic Nerve Injuries ; Optic Nerve* ; Rats* ; Vacuoles

To determine effects of the direction of the rotational work shifting on the circadian rhythm and adaptation of physiological and psychological components were investigated with nursing students. Two groups of seven volunteers participated as experimental subjects, and eight nursing students participated as a control group. The directions of rotation work shift were as follows : CW(clockwise)-shift system rotation in the direction of day shift(3 lays), evening shift(3days), off duty(1day) and night shift(5days). and CCW(counterclockwise)-shift system rotation in the reverse direction. Urinary free cortisol and 17-hydroxycorticoster oids in the urine were measured by the solid-phase radioimmunoassay and the colorimetry methods, re spectively. Plasma melatonin was measured by radioimmunoassay. The urinary free cotisol rhythm changed to ir-regular on the evening and night shift in the CCW shift system, whereas the rhythm seems to adapt on night shift in the CW shift system. The daily rhythms of urinary 17-OHCS indicate that they are well synchronized to shift work. These results show that the rotation of shift in the CW direction is more acceptable in terms of the adaptation of hormonal rhythms. These results indicate that the CCW rotation of shift work makes it more difficult for the workers to adapt on a physiological level, and has many more negative effects on nurses when compared with the CW rotation. Thus, a clockwise rotating shift systern seems to be more desirable for the optimal health and performance of nurses.
Circadian Rhythm* ; Colorimetry ; Humans ; Hydrocortisone* ; Melatonin ; Plasma ; Radioimmunoassay ; Students, Nursing ; Volunteers

PURPOSE: To evaluate the therapeutic efficacy of intravitreal bevacizumab (IVB) in the treatment of branch retinal vein occlusion (BRVO) in eyes with normal tension glaucoma (NTG). METHODS: We included 16 NTG eyes and 48 age- and sex-matched eyes without NTG that had received IVB for BRVO with more than 6 months of follow-up. The main outcome measures were log MAR best-corrected visual acuity (BCVA) and central macular thickness (CMT) at baseline and 1, 3, and 6 months after IVB. We compared the results according to the comorbidity associated with NTG. RESULTS: The obstruction site of BRVO was significantly closer to the optic disc in eyes with NTG than in eyes without NTG. Baseline log MAR BCVA and CMT were similar between the two groups. After IVB, postoperative BCVA was significantly improved and CMT was significantly reduced, irrespective of the comorbidity associated with NTG. However, vision improvement was more limited in eyes with NTG, while CMT was similarly reduced compared with that in eyes without NTG. The mean numbers of injections were similar between the two groups, and there were no injection-related complications. CONCLUSIONS: IVB may have therapeutic efficacy in the treatment of BRVO associated with NTG. However, the comorbidity associated with NTG may limit vision improvement, although anatomic recovery of CMT is achieved.
Antibodies, Monoclonal, Humanized ; Comorbidity ; Eye ; Follow-Up Studies ; Low Tension Glaucoma ; Macular Edema ; Outcome Assessment (Health Care) ; Retinal Vein ; Retinal Vein Occlusion ; Retinaldehyde ; Vision, Ocular ; Visual Acuity ; Bevacizumab

PURPOSE: The study was conducted to investigate the effect of career barrier, satisfaction, and career decision making pattern on career search behaviors in male nursing students. METHODS: Data were collected through structured questionnaires that included general characteristics, career barrier, satisfaction, career decision making pattern and career search behaviors and were analyzed by descriptive statistics, ANOVA, t-test, Pearson correlation coefficient and multiple regression using SPSS/PC+ program. RESULTS: The results of the research suggest the two aspects of career search behaviors as being self-exploration and environmental exploration. The rational pattern, among the types of satisfaction and career decision making pattern, was found to have a meaningful effect on self-expression. On the other hand, dependent pattern, among the satisfaction and career decision making pattern, was found to have an effect on career search patterns. CONCLUSION: It is considered that, based on the results of this study, diversified approaches that consider individual career decision making patterns such as rational pattern and dependent pattern as well as the methods to enhance the satisfaction of male nursing college students for career guidance are needed.
Decision Making* ; Hand ; Humans ; Male* ; Nursing* ; Students, Nursing*

No abstract available.
Magnetic Resonance Spectroscopy ; Magnetics ; Magnets

BACKGROUND: Severe or massive postpartum hemorrhage (PPH) has remained a leading cause of maternal mortality for decades across the world and it results in critical obstetric complications. Recombinant activated factor VII (rFVIIa) has emerged as a gold standard adjunctive hemostatic agent for the treatment of life-threatening PPH refractory to conventional therapies although it remains off-licensed for use in PPH. We studied the effects of rFVIIa on coagulopathy, transfusion volume, prognosis, severity change in Korean PPH patients. METHODS: A retrospective review of medical records between December 2008 and March 2011 indicating use of rFVIIa in severe PPH was performed. We compared age, rFVIIa treatment, transfusion volume, and Sequential Organ Failure Assessment (SOFA) score at the time of arrival in the emergency department and after 24 hours for patients whose SOFA score was 8 points or higher. RESULTS: Fifteen women with SOFA score of 8 and above participated in this study and eight received rFVIIa administration whereas seven did not. Patients' mean age was 31.7 ± 7.5 years. There was no statistically significant difference in initial and post-24 hours SOFA scores between patients administered rFVIIa or not. The change in SOFA score between initial presentation and after 24 hours was significantly reduced after rFVIIa administration (P = 0.016). CONCLUSIONS: This analysis aimed to support that the administration of rFVIIa can reduce the severity of life-threatening PPH in patients. A rapid decision regarding the administration of rFVIIa is needed for a more favorable outcome in severe PPH patients for whom there is no effective standard treatment.
Emergency Service, Hospital ; Factor VIIa* ; Female ; Humans ; Maternal Death ; Maternal Mortality ; Medical Records ; Organ Dysfunction Scores ; Postpartum Hemorrhage* ; Postpartum Period* ; Prognosis ; Recombinant Proteins ; Retrospective Studies