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Background: A high-flexion posterior-stabilized rotating-platform mobile-bearing prosthesis was designed in an attempt to improve the range of motion after total knee arthroplasty without compromising the theoretical advantages of the posterior-stabilized rotating-platform mobile-bearing system. The aim of this study was to compare the outcomes of standard and high-flexion posterior-stabilized rotating-platform mobile-bearing total knee arthroplasties.Methods: One hundred and seventy knees were randomly allocated to receive either a standard (n = 85) or a high-flexion (n = 85) posterior-stabilized rotating-platform mobile-bearing prosthesis and were followed prospectively for a minimum of two years. Ranges of motion, functional outcomes determined with use of standard scoring systems, and radiographic measurements were assessed. In addition, patients' abilities to perform activities requiring deep knee flexion and patient satisfaction were evaluated with use of questionnaires.Results: The average postoperative maximal flexion was 130° for the knees with the standard design and 128° for those with the high-flexion design, and the difference was not significant. The two prosthetic designs also did not differ significantly with regard to the Knee Society scores; Hospital for Special Surgery (HSS) scores; or the scores on the pain, stiffness, and function subscales of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). In addition, the numbers of knees able to perform deep-flexion-related activities and the rates of patient satisfaction were similar in the two study groups.Conclusions: This prospective randomized study revealed no significant differences between standard and high-flexion posterior-stabilized rotating-platform mobile-bearing total knee prostheses in terms of clinical or radiographic outcomes or range of motion at a minimum of two years postoperatively. [ABSTRACT FROM AUTHOR]

Specific materials used in the manufacture of dentures may enhance the removal of micro-organisms. The ultraviolet A (UVA) irradiation of acrylic resin containing titanium dioxide (TiO(2)) generates reactive oxygen species (ROS) by photocatalysis that shows antibacterial effects. In this study, we tested the hypothesis that TiO(2) coated with fluoridated apatite (FAp-TiO(2)) can generate ROS via photo-catalysis by using electron spin resonance (ESR), and that acrylic resin containing FAp-TiO(2) can show antifungal properties by measuring the viability of Candida albicans. We demonstrated that hydroxyl radicals (HO(*)) were generated through excitation of TiO(2), TiO(2) coated with apatite (HAp-TiO(2)), and FAp-TiO(2). The HO(*) generation through excitation of FAp-TiO(2) was higher than that of TiO(2) and HAp-TiO(2). Regarding antifungal activity, cell viability on acrylic resin containing FAp-TiO(2) was lower than that of TiO(2) and HAp-TiO(2). FAp-TiO(2) showed superior photocatalytic effects, and these characteristics may lead to novel methods for the clinical application of denture-cleaning treatments. [ABSTRACT FROM AUTHOR]

Objective: This study was performed to evaluate the clinical value of (18)F-fluorodeoxyglucose (FDG) positron-emission tomography (PET)/computed tomography (CT) for cancer screening in Korean asymptomatic people. Methods: Between February 2004 and December 2006, 1,587 asymptomatic individuals underwent FDG PET/CT as part of a cancer screening program with some other diagnostic tests at the healthcare center of our hospital. After excluding patients with a history of malignant tumor, 1,336 subjects were enrolled. All PET/CT images were visually analyzed. In subjects showing positive findings for PET/CT or other screening tests, further diagnostic tests and pathological confirmation were performed. Results: Of the 1,336 subjects, malignant tumors were found in 16 participants (1.2%, thyroid cancer: 9, lung cancer: 2, stomach cancer: 2, and others: 4). There were 47 cases (3.6%) of positive PET/CT findings--11 cases were true positive (thyroid cancer: 8, lung cancer: 1, renal cancer: 1, and invasive thymoma), and 36 false positive, and five cases were false negative. The overall detection rate of PET/CT was 0.8%, and the sensitivity, specificity, positive-predictive value, and negative-predictive value of PET/CT were 68.8, 97.2, 23.4, and 99.6%, respectively. Conclusions: Fluorodeoxyglucose positron-emission tomography has the potential to detect various kinds of malignant tumors in cancer screening test, and the overall detection rate of PET/CT was 0.8%. FDG PET/CT can be a useful cancer screening modality with the selection of high-risk group and appropriate combination with other screening modalities. [ABSTRACT FROM AUTHOR]

Pure akinesia with gait freezing (PAGF) has characteristic features, including freezing of gait and prominent speech disturbance without rigidity or tremor. The purpose of this study was to investigate changes in brain glucose metabolism and presynaptic dopaminergic function in PAGF. By using [(18)F] fluorodeoxyglucose (FDG) PET, 11 patients with PAGF were compared with 14 patients with probable progressive supranuclear palsy (PSP), 13 patients with Parkinson's disease (PD), and 11 normal controls. [(18)F] N-(3-fluoropropyl)-2beta-carbon ethoxy-3beta-(4-iodophenyl) nortropane (FP-CIT) PET was performed in 11 patients with PAGF and with 10 normal controls. The PAGF patients showed decreased glucose metabolism in the midbrain when compared with normal controls. PSP patients showed a similar topographic distribution of glucose hypometabolism with additional areas, including the frontal cortex, when compared with normal controls. The FP-CIT PET findings in patients with PAGF revealed severely decreased uptake bilaterally in the basal ganglia. These findings suggest that both PAGF and PSP may be part of the same pathophysiologic spectrum of disease. However, the reason why PAGF manifests clinically in a different manner needs to be further elucidated. [ABSTRACT FROM AUTHOR]

Unlabelled: Simultaneous bilateral TKAs subject patients to more arduous and painful functional recovery and increased risk of hemodynamic complications than staged bilateral TKAs. Minimally invasive TKA (MIS-TKA) reportedly results in more rapid return of function by limiting the amount of soft tissue disruption. We asked whether bilateral MIS-TKA had advantages over conventional TKA with respect to faster functional recovery. We prospectively randomized 30 patients into an MIS group (mini-medial parapatellar approach, 15 patients) and a conventional group (conventional medial parapatellar approach, 15 patients). We recorded range of motion and the time required to regain the ability to walk without assistance. Functional recovery in the MIS group was faster in rehabilitation milestones of walking without assistance and gain in range of motion. Minimally invasive TKA may benefit patients undergoing simultaneous bilateral procedures with faster functional recovery.Level Of Evidence: Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

Unlabelled: The bone-patellar tendon-bone has been widely used and considered a good graft source. The quadriceps tendon was introduced as a substitute graft source for bone-patellar tendon-bone. We compared the clinical outcomes of anterior cruciate ligament reconstructions using central quadriceps tendon-patellar bone and bone-patellar tendon-bone autografts. We selected 72 patients who underwent unilateral anterior cruciate ligament reconstruction using bone-patellar tendon-bone between 1994 and 2001 and matched for age and gender with 72 patients who underwent anterior cruciate ligament reconstruction using quadriceps tendon-patellar bone. All patients were followed up for more than 2 years. We assessed anterior laxity, knee function using the Lysholm and International Knee Documentation Committee scores, and quadriceps strength, the means of which were similar in the two groups. More patients (28 or 39%) in the bone-patellar tendon-bone group reported anterior knee pain than in the quadriceps tendon-patellar bone group (six patients or 8.3%). Anterior cruciate ligament reconstruction using the central quadriceps tendon-patellar bone graft showed clinical outcomes comparable to those of anterior cruciate ligament reconstruction using the patellar tendon graft, with anterior knee pain being less frequent in the former. Our data suggest the quadriceps tendon can be a good alternative graft choice. Level Of Evidence: Level III Therapeutic study. [ABSTRACT FROM AUTHOR]

Background: There is a growing need to educate physicians about complementary and alternative medicine (CAM). Few introductory courses in CAM have been described. Purpose: To develop and evaluate an introductory course in CAM for medical students and residents. Method: We conducted a controlled study evaluating a case-based, Web-based course in CAM, making comparison to no intervention. Participants were 123 internal medicine residents, family medicine residents, and 3rd- and 4th-year medical students at academic residency programs in internal medicine and family medicine and two U.S. medical schools. Outcomes included knowledge of CAM, attitudes toward CAM, and course evaluation information. Results: Eighty-nine learners completed the course. Test scores among a subset of these (n = 57) were higher (M +/- SD = 78.7 +/- 10.1) than scores (50.9 +/- 8.5, p < .001) among a no-intervention control group (n = 34), and remained higher (64.9 +/- 11.4) 3 months later. After the course participants felt more comfortable discussing CAM with patients, recognized a greater role for CAM, and knew better where to find information on CAM (ps < .001 compared to baseline). Course ratings were high, although 26% of learners desired greater feedback. Conclusions: This brief course in CAM improved knowledge, changed attitudes, and was well received. [ABSTRACT FROM AUTHOR]

There has been a dramatic increase in the number of persons with dementia in Korea, and the number is expected to continue to increase. Dementia is increasingly a condition for which there are effective treatments and services. Because most adults work full-time in addition to having other family responsibilities, the government of Korea and the community are more involved in helping persons with dementia, than in the past. Nurses are needed to help with dementia research, public policy, education, and healthcare in Korea and elsewhere. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine whether persons attending a community health fair had different health concerns and booth visitation patterns based on their risk factor profiles. All fairgoers were encouraged to complete an anonymous survey of demographic information, top 4 health concerns, and selected cardiac risk factors. Over the five-hour duration of the fair, 329 surveys were collected from about 450 fairgoers. There were no exclusion criteria for the survey. The fair was sponsored by the Maryland Chapter of the American College of Physicians, organized by medical students from the University of Maryland and Johns Hopkins University, and included 23 booths on a variety of health topics. Older fairgoers and fairgoers with a self-reported history of high blood pressure or elevated cholesterol showed an increased interest. in hypertension and heart disease (p < 0.05). Older fairgoers also showed an increased interest in health topics related to aging, such as estrogen replacement therapy and geriatric medicine. Older, hypertensive and hypercholesterolemic fairgoers visited an increased mean number of total booths when compared to other respondents (p < 0.05). Most booths reported a higher percentage of older, hypertensive, and hypercholesterolemic visitors than the overall percentage of fairgoers who reported these risk factors. These results suggest that booth visitation patterns of health fair participants may be viewed as a deliberate attempt by at-risk populations to access health information particular to their needs. [ABSTRACT FROM AUTHOR]

A randomized prospective study was undertaken to compare the accuracy of rotational alignment of the femoral component in total knee arthroplasty using a nonimage-based navigation system and a conventional method. The authors randomly used two methods and implants in 55 patients and measured the angles between posterior condylar lines and transepicondylar axes on computed tomography images before and after surgery. Analysis showed no significant differences between the two techniques in mean errors (P>.05), but the navigation system showed higher accuracy than the 3 degrees external rotation method by reducing outliers. [ABSTRACT FROM AUTHOR]