The purpose of this study was to investigate the gaps of bone-acetabular component interface, the initial mechanical stability and the effects of adjuvant screw fixation in the press-fitted two different shaped porous-coated acetabular components. Semi-hemispherical Harris-Galante II cup and full hemispherical Trilogy cup were press-fitted with or without adjuvant screw fixation in 40 bovine femur. The gaps of bone-implant interface were measured in each radiography of all specimen and axial compression tests and rotational stability tests were performed using servohydraulic tension-compression machine. There was significantly smaller gap at polar 1/3 region in the specimen implanted with Trilogy cup. But the adjuvant screw fixation did not affect the amount of gap. There was no significant statistical difference in axial load and rotational stability test in each situations of fixation. This study demonstrates that the initial mechanical stability is not influenced by the shape of semi-hemispherical Harris-Galante II cup and full hemispherical Trilogy cup and also independent of adjuvant screw fixation. But smaller gap of Trilogy cup at the polar 1/3 region indicates the possibility that less amout of wear debris of polyethylene or metal will be deposited and therefore less osteolysis or cup loosening will occur, but this hypothesis should be confirmed by the long-term clinical follow-up.
Acetabulum* ; Arthroplasty, Replacement, Hip* ; Femur ; Follow-Up Studies ; Osteolysis ; Polyethylene ; Radiography

Congenital fibrous bands may be found at the gluteus maximus, the gluteus medius,thequadriceqs,the triceps and the deltoideus muscles. Congenital fibrous bands of both gluteus maximus muscles are rare and cause extension contracture of the hip joints. We experienced a case of congenital fibrous bands of both gluteus maximus muscles associated with severe limited flexion of both hips. Almost full flexion of both hips was obtained by excision of the congenital fibrous bands.
Contracture ; Hip Joint ; Hip ; Muscles

No abstract available.
Ankle*

BACKGROUND: Recent studies revealed that inhalational anesthetics (IA) attenuate NO production. But the hemodynamic changes produced by IA in septic syndrome patient are still sufficient to threaten patient, surgeon and anesthesiologist. So we examined which IA is proper to maintain vascular contractile force and evaluated the effects of NOS inhibitors on contractile force of septic rat aorta under IA. METHODS: Aortic ring preparation was obtained from LPS-treated (1.5 mg/kg, i.p. for 18h) rats. The development of sepsis was confirmed by iNOS activity and iNOS expression using RT-PCR. Contractile responses of aorta to phenylephrine admministation in the presence or absence of halothane, enflurane and isoflurane were evaluated. We also evaluated the effects of NOS inhibitors, one is NG-nitro-L-arginine methyl ester (L-NAME) and the other is aminoguanidine. Statistical significances (p<0.05) were analyzed according to data characteristics by unpaired t-test and paired t-test. RESULTS: The contractile responses to phenylephrine admministration were attenuated in LPS-treated rings. Isoflurane, even at the dose of 2 MAC, didn't affect the contractile response while both halothane and enflurane decreased the contractile response even at the dose of 1 MAC. The potentiation of contractile responses by NOS inhibitors were not affected during administeration of IA. CONCLUSIONS: From these results, it is suggested that isoflurane is the safest inhalational anesthetic and NOS inhibitors, especially L-NAME, may be very useful in the therapy of septic shock patients during general anesthesia.
Anesthesia, General ; Anesthetics* ; Animals ; Aorta ; Enflurane ; Halothane ; Hemodynamics ; Humans ; Isoflurane ; NG-Nitroarginine Methyl Ester ; Nitric Oxide Synthase* ; Nitric Oxide* ; Phenylephrine ; Rats* ; Sepsis ; Shock, Septic

No abstract available.
Animals ; Mice*

OBJECTIVES: REM sleep behavior disorder (RBD) has received little attention in epidemiologic studies. This study aimed to determine the prevalence of probable REM sleep behavior disorder (pRBD) in the elderly population and its clinical features. METHODS: A random sample of 1,588 was selected from a roster of 14,050 elderly population living in Osan city. The subjects were asked to fill out the REM sleep behavior disorder screening questionnaire (RBDSQ). Subjects whose score were 5 or higher on RBDSQ underwent a diagnostic phase of person-to-person assessment by experts in RBD. RESULTS: Among 1,588 subjects, 886 elderly subjects participated in the screening phase and 123 subjects were assessed in the diagnostic phase. Eleven subjects were diagnosed as having pRBD, so prevalence was 1.5% (95% CI=0.70-2.30%). The frequency of depression and cognitive decline was significantly increased in patients with pRBD compared to subjects without pRBD, and there was no difference in sleep disturbances between two groups. CONCLUSIONS: Probable REM sleep behavior disorder is not rare in the elderly but frequently under-recognized. More attention should be paid to evaluation and treatment of RBD.
Aged ; Depression ; Epidemiologic Studies ; Humans ; Mass Screening ; Prevalence ; Surveys and Questionnaires ; REM Sleep Behavior Disorder ; Sleep, REM

No abstract available.
Hepacivirus* ; Hepatitis C Antibodies* ; Hepatitis C* ; Hepatitis* ; Prevalence*

According to previous reports, ankle arthrodesis is regarded as the best reconstructive procedure after limb salvage surgery for osteosarcoma of the distal tibia. Of the many arthrodesis options, vascularized fibular graft (VFG) is widely accepted as the most successful method. However, reconstruction using VFG is not always possible, because VFG is a complicated surgical procedure and is associated with high rates of morbidity at donor sites. The authors devised a novel reconstructive surgical procedure that exploits the osteogenic potential of the periosteum. A 10-year-old female patient with osteosarcoma of the distal tibia underwent limb salvage surgery and the ipsilateral distal fibula and periosteal sleeve were transported to the defect for ankle arthrodesis. The transported fibula and periosteal new bone formation acted as a dual strut bone graft providing better stronger stability than fibula alone transfer. The authors believe the proposed procedure is an easier alternative to the surgically demanding VFG method.
Animals ; Ankle ; Arthrodesis ; Child ; Durapatite ; Female ; Fibula ; Humans ; Limb Salvage ; Osteogenesis ; Osteosarcoma ; Periosteum ; Reconstructive Surgical Procedures ; Tibia ; Tissue Donors ; Transplants

OBJECTIVE: The patients with spinal cord injury (SCI) suffered by a lot of complications that influence the quality of life both physically and mentally. The purpose of this study was to evaluate the epidemiology of patients with spinal cord injury in incidence of the complication according to the injury level and period. METHOD: Retrospective study was done in 554 patients with SCI who discharged from Yonsei University Medical Center from January, 1987 to December, 1996. We investigated the incidence of each complication such as respiratory, cardiovascular, genitourinary, musculoskeletal, and dermatologic complications according to the neurologic level and each period (1987~1991, 1992~1996). RESULTS: Among the 554 cases, urologic complication (40.3%) was the most common complication followed by dermatologic (39.0%), musculoskeletal (33.6%), cardiovascular (27.1%) and so on. The most common complications of each system were autonomic dysreflexia (13.2%) in cardiovascular, pneumonia (9.6%) in respiratory, contracture (27.8%) in musculoskeletal, urinary tract infection (34.3%) in urologic, hemorrhoid in gastrointestinal, and central pain (24.0%) in neurogenic complications. The most common site of pressure sore was sacral area (58.9%). There was no significant difference in each complication according to the injury period. CONCLUSION: Urologic complication was the most prevalent in patients with SCI followed by dermatologic, musculoskeletal and so on. These basic results would be helpful for prevention and management of the complication of SCI.
Academic Medical Centers ; Autonomic Dysreflexia ; Contracture ; Epidemiologic Studies* ; Epidemiology ; Hemorrhoids ; Humans ; Incidence ; Pneumonia ; Pressure Ulcer ; Quality of Life ; Retrospective Studies ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Tract Infections

BACKGROUND: The red cell distribution width(RDW) has been reported to be of value in discriminating iron deficiency anemia(IDA) from the anemia of the other causes(non-IDA). The combination of a low MCV and a high RDW may indicate iron deficiency anemia. The purpose of this study was to discriminate IDA from anemia, using automated blood cell count alone. METHODS: We collected 139 cases of anemia in outpatients, with 80 cases of IDA and 59 cases of anemia due to other causes, from July 1995 to September 1996 in department of family medicine, Pusan Paik hospital. RESULTS: The sex distribution was 39(28.1%) in male, 100(71.9%) in female. The age distribution was 15 to 79 year. The hemoglobin level and MCV in IDA(9.5+/-1.6g/dl, 77.5+/-8.9fl) was significantly lower than those in non-IDA(10.1+/-1.5g/dl, 87.6+/-10.5fl)(P=0.042, P<0.001, respectively). And mean RDW in IDA(16.9+/-3.3%) was significantly higher than that in non-IDA(15.1+/-3.2%)(P<0.001). In discriminating IDA from anemia, we drew receiver operating characteristic curves (ROC curves) with each value of MCV and RDW. The cut-off value of MCV was 83fl, and in that value, the sensitivity and specificity were 75.9% and 72.9%, respectively. The cut-off value of RDW was 14.3%, and the sensitivity and specificity were 78.2% and 57.6 %, respectively. We combined each value of MCV with RDW, the cut off value were 83fl of MCV and 14.3% of RDW, and the sensitivity and specificity were 76.3% and 71.3%, respectively. CONCLUSIONS: The sensitivity and specificity of MCV, RDW and combination of MCV and RDW were not so high in discriminating IDA from the anemia of the other causes in ambulatory patients.
Age Distribution ; Anemia* ; Anemia, Iron-Deficiency ; Blood Cell Count ; Busan ; Female ; Humans ; Iron ; Male ; Outpatients ; ROC Curve ; Sensitivity and Specificity ; Sex Distribution