Component fixation on the acetabular side is not as much of a problem because of the simpler geometry and loading configuration. It is generally accepted that hemispheric component design is preferable and immediate implant stability can be achieved by using screws or spikes in the porous coated implants. The authors reviewed 130 primary noncemented porouscoated, press fit acetabular component in 110 patients; 84 were AML (Anatomical Medullary Locking) and 46 were HarrisGalante acetabular component. Radiologic analysis at a minimum of 3 years(average 4.5 years) was done with special regards to the vertical and medial migration, screw size and numbers, change of the radiolucent line and its zone with its fate and acetabular cup angles on the acetabular component by the 2 observers. Progressive radiolucent line at the component-bone intersurface were found in 14 cases(11%), frequently located in zone I and zone I & II. No significant vertical, medial migration and change of the acetabular cup angle were found. No screw and spike failure had occurred. No component had to be revised because of loosening. As a whole, in our 3-years experience we report excellent results with porous coated acetabular component although it dose not ensure long-term sucess.
Acetabulum ; Hip ; Humans

Antineutrophil cytoplasmic antibody-associated vasculitis (AAV) is a group of systemic necrotising vasculitides, which often involve small vessels, and which lead to few or no immune deposits in affected organs. According to clinical manifestations and pathological features, AAV is classified into three variants: microscopic polyangiitis, granulomatosis with polyangiitis (GPA), and eosinophilic GPA. The American College of Rheumatology 1990 criteria contributed to the classification of AAV, although currently the algorithm suggested by the European Medicines Agency in 2007 and the Chapel Hill Consensus Conference Nomenclature of Vasculitides proposed in 2012 have encouraged physicians to classify AAV patients properly. So far, there have been noticeable advancements in studies on the pathophysiology of AAV and the classification criteria for AAV in Western countries. However, studies analysing clinical features of Korean patients with AAV have only been conducted and reported since 2000. One year-, 5 year-, and 10 year-cumulative patient survival rates are reported as 96.1, 94.8, and 92.8%. Furthermore, initial vasculitis activity, prognostic factor score, age and specific organ-involvement have been found to be associated with either all-cause mortality or poor disease course. The rate of serious infection is 28.6%, and 1 year-, 5 year- and 10 year-cumulative hospitalised infection free survival rates range from 85.1% to 72.7%. The overall standardised incidence ratio of cancer in AAV patients was deemed 1.43 compared to the general Korean population.
Antibodies, Antineutrophil Cytoplasmic ; Classification ; Consensus ; Cytoplasm* ; Eosinophils ; Granulomatosis with Polyangiitis ; Humans ; Incidence ; Korea* ; Microscopic Polyangiitis ; Mortality ; Rheumatology ; Survival Rate ; Vasculitis*

Eosinophilic granulomatosis with polyangiitis (EGPA) is one form of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Identical to what has been called Churg-Strauss syndrome, EGPA exhibits both allergic and vasculitis features. EGPA was first described as a syndrome consisting of asthma, fever, eosinophilia, and organ involvement including heart failure, neuropathy, and kidney damage, by Churg and Strauss in 1951. On the basis of the 2012 Chapel Hill Consensus Conferences Nomenclature of Vasculitis, EGPA comprises three typical allergic components, including asthma, peripheral eosinophilia, and eosinophil-rich granuloma of the respiratory tracts. EGPA has three clinical and histological stages. The first is an allergic stage composed of asthma and sinusitis, and the second is an eosinophilic stage characterised by peripheral hypereosinophilia and intra-organ infiltration of eosinophils. The last is a vasculitic stage, including necrotising inflammation of small vessels and end-organ damage. In this review, we describe the classification criteria for EGPA and recommendations for the evaluation and management of EGPA with conventional and newly suggested drugs for EGPA. Also, we discuss a variety of clinical aspects such as predictive values for prognosis and associations with other Th2-mediated diseases and hepatitis B virus.
Antibodies, Antineutrophil Cytoplasmic ; Asthma ; Churg-Strauss Syndrome ; Classification ; Congresses as Topic ; Consensus ; Eosinophilia ; Eosinophils ; Fever ; Granuloma ; Granulomatosis with Polyangiitis ; Heart Failure ; Hepatitis B virus ; Humans ; Inflammation ; Kidney ; Prognosis ; Respiratory System ; Sinusitis ; Vasculitis

OBJECTIVE: This study was undertaken to evaluate the therapeutic results and complications after concurrent chemoradiation therapy and to investigate the prognostic factors for cervical cancer with para-aortic lymph node involvement. METHODS: From May 1999 to August 2005, thirty eight patients with cervical cancer, treated by combined platinum base chemotherapy and extended field radiation therapy in Gachon University Gil medical center. All patients were diagnosed as paraaortic lymphnode involvement with imaging studies. The radiation dose of external beam was 34.2-64.4 Gy to whole pelvis and 32.4-59.4 Gy to paraaortic area. Cisplatin based chemotherapy was done simultaneously. We evaluated the prognostic factors such as stage, tumor size, inguinal and supraclavicular lymphnode status, and radiation doses. RESULTS: Median follow-up period is 34 months (7-85 months). The 3 year overall and disease free survival rates were 63.6% and 56.4%, respectively. There was no case of recurrence after 3 years of treatment. In 2 patients, the treatment was not completed because of Grade III or IV gastroenteral complications; abdominal pain and diarrhea. Grade III or IV hematologic complications were occurred in fifteen patients, but all patients were recovered without serious complications. We could not find any significant prognostic factors in this study. CONCLUSION: Concurrent chemoradiation therapy for cervical cancer with paraaortic lymph node involvement is well tolerable and effective treatment.
Abdominal Pain ; Cisplatin ; Diarrhea ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Lymph Nodes* ; Pelvis ; Platinum ; Recurrence ; Uterine Cervical Neoplasms*

The axillary artery (AA) is often referred to as having three parts, with these divisions based on its location relative to the pectoralis minor muscle. In third part, AA gives off the subscapular (SSA), anterior circumflex humeral, and posterior circumflex humeral arteries (PCHA). However, variations in these arteries were extremely diverse. So, we observed actually some branching patterns of these arteries in this study. METHOD: We studied the pattern of SSA in 128 upper limbs from donated cadavers. RESULT: SSA was originated directly from the third and second parts of AA in 37.5% (48/128) and 4.7% (6/128), respectively. A PCHA made a common trunk with SSA in 25.8% (33/128), and these trunks arose from the third and second parts of AA in 21.1% (27/128) and 4.7% (6/128), respectively. A lateral thoracic artery (LTA) arose from SSA in 12.5% (16/128), and these were originated from the third and second parts of AA in 4.7% (6/128) and 7.8% (10/128), respectively. In 19.5% (25/128) of upper limbs, LTA, SSA, and PCHA have a common trunk, and these arose from the third and second parts of AA in 12.5% (16/128) and 7.0% (9/128), respectively. According to the branching pattern of the SSA, its origin was significantly different.
Arteries* ; Axillary Artery* ; Cadaver ; Methods ; Thoracic Arteries ; Upper Extremity

OBJECTIVE: This study was designed to investigate the clinical outcomes of proliferative lupus nephritis and to identify the predictive factors of remission and relapse of proliferative lupus nephritis after intravenous cyclophosphamide (IVCYC) pulse therapy. MEHTODS: Seventy-four patients with proliferative lupus nephritis that had been diagnosed by renal biopsy and treated with IVCYC pulse therapy were studied. Their demographic data, clinical manifestations, laboratory findings, disease activity index, damage index, activity and chronicity indices of renal pathology, and treatment modalities were evaluated. Clinical outcomes of lupus nephritis were assessed by defined criteria. RESULTS: Remission or response were achieved in 79.7% of patients with proliferative lupus nephritis (remission in 32.4% and response in 47.3%, respectively), and 30.5% of those with remission or response experienced relapse or flare of lupus nephritis (relapse in 20.8% of those with remission and flare in 37.1% of those with response) after IVCYC pulse therapy. High creatinine clearance at diagnosis of lupus nephritis, short lag time from diagnosis of lupus nephritis to initiation of immunosuppressive treatment, and long-term cyclophosphamide pulse therapy were the independent predictive factors for remission or response. Long lag time from completion of immunosuppressive treatment to onset of remission or response, and incomplete cyclophosphamide were the independent risk factors for relapse or flare of lupus nephritis. CONCLUSION: Good renal function and early initiation of long-term IVCYC pulse therapy are important in induction of remission or response, while delayed remission or response and incomplete immunosuppressive treatment is strongly associated with poor outcome.
Biopsy ; Creatinine ; Cyclophosphamide* ; Diagnosis ; Humans ; Lupus Nephritis* ; Pathology ; Recurrence* ; Remission Induction ; Risk Factors

OBJECTIVE: The prognosis of systemic lupus erythematosus (SLE) patients with pulmonary hypertension (PH) was reported to be very poor and the median duration of survival estimated to be within 2 years. This study was designed to assess the clinical outcome and risk factors for poor prognosis of patients with SLE combined with PH. MEHTODS: Two hundred ninety-two patients with SLE in whom echocardiography was performed were studied. The diagnosis of PH was made when the right ventricular systolic pressure (RVSP), measured by 2-dimensional echocardiography, was >30 mmHg. Demographic data, clinical manifestations, laboratory findings, and outcome of those with PH were evaluated. RESULTS: Twenty-one of 292 patients had PH. The mean age at diagnosis of PH was 33.8+/-12.5 years. The most frequent presenting symptoms were dyspnea on exertion and dyspnea. Eight of 21 patients died after 1.3+/-1.1 years from diagnosis of PH. Survival rate at first and third year were 86% and 66%, respectively, and the median duration of survival estimated 3.0 years. SLE disease activity index (SLEDAI) and damage index at diagnosis of PH were significantly higher in the deceased. Among the patients in whom sequential echocardiography was performed, RVSP were significantly lowered in the survivors. High SLEDAI and high damage index were independent risk factors for poor prognosis. CONCLUSION: The survival rates and the median duration of survival were slightly better than those of previous reports. The high SLEDAI and high damage index were risk factors for poor prognosis of patients with SLE combined with PH.
Blood Pressure ; Diagnosis ; Dyspnea ; Echocardiography ; Humans ; Hydrogen-Ion Concentration ; Hypertension, Pulmonary* ; Lupus Erythematosus, Systemic* ; Prognosis* ; Risk Factors* ; Survival Rate ; Survivors

Dermatomyositis (DM) is a connective tissue disorder characterized by inflammatory myopathy and prominent cutaneous features. Although cutaneous vasculitis has been noted frequently in child-onset DM, it rarely occurs in adult-onset DM. The clinical features of adult-onset DM showing cutaneous vasculitis have not been well characterized. A 60-year-old female patient presented with multiple deep cutaneous ulcers in both hands, elbows and foot. She was diagnosed as dermatomyositis 18 months before admission. Angiogram showed no definite arterial obstructive lesion and thrombus in both wrist and elbow, but decreased vascularity was seen in digits of both hands. Cutaneous ulceration was thought to be caused by vasculitis. Cutaneous ulceration was a rare manifestation of adult-onset DM patients, and we report this case with a review of literature.
Adult* ; Connective Tissue ; Dermatomyositis* ; Elbow ; Female ; Foot ; Hand ; Humans ; Middle Aged ; Myositis ; Thrombosis ; Ulcer* ; Vasculitis ; Wrist

PURPOSE: To evaluate the clinical outcomes of patients with diffractive aspheric trifocal intraocular lens (AT.LISA tri839 MP(R) IOL, Carl Zeiss Meditec, Jena, Germany) implantation. METHODS: Forty eyes of 53 patients received phacoemulsification and implantation of AT.LISA tri839 MP(R) IOL (Carl Zeiss Meditec). Uncorrected distant visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), refractive values, and defocus curve were evaluated at postoperative 1 month and 3 months. Optical quality was evaluated with the Optical Quality Analysis System (OQAS(R), Visiometrics, Castelldefels, Spain). RESULTS: At the 3-month postoperative follow-up, the mean spherical equivalent was 0.01 +/- 0.31 D and the mean UDVA, UIVA and UNVA were 0.023 +/- 0.020, 0.155 +/- 0.091, and 0.139 +/- 0.069, respectively. The means of the objective scatter index, modulation transfer function cut-off value, Strehl ratio measured by OQAS(R) (Visiometrics) were 1.83 +/- 0.52, 33.58 +/- 14.27 cycle per degree and 0.18 +/- 0.11, respectively. Intermediate visual acuity did not fall sharply at defocus curve. CONCLUSIONS: Implantation of the diffractive aspheric trifocal intraocular lens in patients with cataracts provided excellent distant, intermediate and near visual acuities with high visual quality.
Cataract ; Follow-Up Studies ; Humans ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Phacoemulsification ; Visual Acuity

In dermatomyositis, involvement of the skeletal muscles of upper esophagus has been reported in many literatures. However, a number of published reports have suggested that motility disturbances of distal esophagus may also be a cause of dysphagia in dermatomyositis and dysphagia in these cases are mainly caused by crico-pharyngeal obstruction or hypomotility of esophagus. The nutcracker esophagus is the one of common esophageal hypermotility disorders causing dysphagia which is characterized manometrically by high pressure in distal esophagus. Recently, we experienced a patient with dermatomyositis who had complained of dysphagia and was diagnosed as having nutcracker esophagus by mannometry. The association of nutcracker esophagus and dermatomyositis has not been reported in the literature. Moreover, the mechanism of nutcracker esophagus differs with that of esophageal involvement in dermatomyositis. Thereby, we report a patient with dermatomyositis who had nutcracker esophagus in the course of her disease.
Deglutition Disorders ; Dermatomyositis* ; Esophageal Motility Disorders* ; Esophagus ; Glycogen Storage Disease Type VI ; Humans ; Manometry ; Muscle, Skeletal