In the treatment of dislocations and subluxations of the hip in the older children, whether congenital or paralytic, orthopedic surgeons are blessed with a wide variety of commonly used surgical procedures; namely, Salters innominate osteotomy, acetabtloplasties, Pembertons pericapsular osteotomy, shelf operations, Chiaris pelvic displacement osteotomy. and Colonnas capsular arthroplasty. However, with increasing age and soft tissue contractures,these procedures become ineffective, leaving a wide range of age between older children and young adults subject to uncertain or unfavarable prognosis. Steels triple osteotomy (1973) is aimed at coverig this age group, when displacement or in nominate osteotomy is either technically infeasible or likely to fail. It consists of an open reduction with or without soft tissue release and skeletal traction, redirection of the acetabulum to cover the femoral head by osteotonmies of the pelvis that has lost its young cartilagenous resiliency, and preservation and physiological remodelling of the articular cartilage of the acetabulum. We performed Steels osteotomy on a 21-years-old female with a severe paralytic subluxation of the hip associated with pelvic obliquity and paralytized both lower extremities. One and a half year follow-up result was satisfactory with a stable and congruous joint despite paralysis and with the patient walking for the first time in her life.
Acetabulum ; Adult ; Arthroplasty ; Cartilage, Articular ; Child ; Dislocations ; Female ; Follow-Up Studies ; Head ; Hip ; Humans ; Joints ; Lower Extremity ; Orthopedics ; Osteotomy ; Paralysis ; Pelvic Bones ; Pelvis ; Prognosis ; Steel ; Surgeons ; Traction ; Walking ; Young Adult

We investigated the 1,004 workers who worked in a automobile factory to study the epidemiologic characterist of dermatoses due to cutting oils. Among the workers, 667(66.4%) answered the questionnaire. They are belong to 5 departments of the factory-the Engine-Work(86), Power train Assembly(17). We measured the oil mist concentration in air of the departments and examined the workers who had dermatologic symptoms. The results were follows; 1) Oil mist concentration; Of all measured points(52), 9 points(17.2%) exceeded 5mg/m3-the time-weighed PEL- and one department had a upper confidence limit(95%) higher than 5mg/m3. 2) Dermatologists examined 213 workers. 172 of them complained any skin symptoms at that time-itching(32.5%), papule(21.6%), scale(15.7%), vesicle(12.5%) in order. The abnormal skin site found by dermatologist were palm(29.3%), finger & nail(24.6%), forearm(16.2%), back of hand(8.4%) in order. 3) As the result of physical examination, we found that 160 workers had skin diseases. Contact dermatitis was the most common; 69 workers had contact dermatitis alone(43.1%), 11 had contact dermatitis with acne(6.9%), 10 had contact dermatitis with folliculitis(6.3%), 1 had contact dermatitis with acne & folliculitis, and 1 had contact dermatitis with abnormal pigmentation. Others were folliculitis(9 workers, 5.6%), acne(8, 5.0%), folliculitis & acne(2, 1.2%), keratosis(1, 0.6%), abnormal pigmentation(1, 0.6%), and non-specific hand eczema(47, 29.3%). 4) The prevalence of any skin diseases was 34.0 per 100 in cutting oil users, and 13.3 per 100 in non-users. Especially, the prevalence of contact dermatitis was 23.0 per 100 in cutting oil users and 4.3 per 100 in non-users. 5) We tried patch test(standard series, oil series, organic solvents) on 49 patients to differentiate allergic contact dermatitis from irritant contact dermatitis and found 20 were positive. 6) In a multivariate analysis(independent=age, tenure, kinds of cutting oil), the risk of skin diseases was higher in the water-based cutting oil user and both oil user than non-user or neat oil user(odds ratio were 2.16 and 2.78, respectively). And the risk of contact dermatitis was much higher at the same groups(odds ratio were 5.16 and 6.82, respectively).
Acne Vulgaris ; Automobiles ; Dermatitis, Allergic Contact ; Dermatitis, Contact ; Fingers ; Folliculitis ; Hand ; Humans ; Oils ; Physical Examination ; Pigmentation ; Prevalence ; Surveys and Questionnaires ; Skin ; Skin Diseases

BACKGROUND: Though AIDS is one of the most serious health problem in worldwide, there have been developed no effective control measure yet. Therefore, individual-based prevention is the only way to control AIDS. Because overseas seamen would be considered as a high risk group for HIV infection due to their life style, this study was conducted in order to provide some informations for preparing the control program fit for them. METHODS: The knowledges and attitudes on HIV infection among 201 Korean male overseas seamen - who were belonged to the one shipping company - were surveyed through questionnaire The survey was conducted for 2 months from October 1, 1997 and the results were analyzed by PC SAS (ver 6.12). RESULTS: The mean age of the subjects was 36.4 years old, and the average tenure was 10.6years. 69.2% of them were married. The information about AIDS was acquired mostly from television(40.3%) and newspapers or magazines(32.8%). 30.8% of them have not received any AIDS-related education, and 66.7% were not satisfied with the fidelity of education. About the knowledges on HIV infection, most of them knew relatively well about cause(84.1%), diagnosis(97.0%), epidemiology (94.5%) etc, however, they did not know about clinical spectrum and treatability well. With regard to the transmission of AIDS, most of them knew relatively well about needle(93.0%), longitudinal infection(92.5%), transfusion(91.0%), homosexuality(88.0%), trans plantation(81.6%), sexual contact (80.1%). However, they showed different responses about kiss, cough sneezing, mosquitos, and razor. With regard to the attitudes on HIV infection, they weighted 'isolation', for example, 'patients isolation'(65.7%), 'school-life isolation'(54.2%), 'divorce with his wife'(41.8%). There showed rather accurate knowledges and resonable attitudes in the educated group, and the response of 'will divorce with his wife' was higher in older group. With regard to the characteristics on sexual life, the possibility of future sexual contact was higher in the uneducated group, and intention to use of preventative condoms was higher in the seamanship group than the sailer group, but no difference by marrital status. CONCLUSIONS: It should be emphasized to get the accurate knowledge about HIV infection through health education, especially focused on the practical levels, eg, preventative use of condoms during sexual contacts. This study has also another meanings to reveal the positive effect and to recall the motive for individual-based prevention.
Condoms ; Cough ; Culicidae ; Divorce ; Education ; Epidemiology ; Health Education ; HIV Infections* ; HIV* ; Humans ; Intention ; Life Style ; Male ; Periodicals ; Ships ; Sneezing ; Surveys and Questionnaires

Recently, gender-affirming hormone therapy for gender incongruence has become an issue in various countries and organizations with various guidelines. In South Korea, several clinical treatments are also used with many possible options. These treatments include masculinizing (female-to-male [FTM]) or feminizing (male-to-female [MTF]) hormone therapies, with regimens usually driven by standards of hormonal replacement therapy for hypogonadism (i.e., hypogonadal natal men and postmenopausal women). This cross-sex hormone therapy can change patients’ physical appearance to better match their gender identity and expression. Regarding masculinizing therapy, injection and transdermal gel types of testosterone are used according to international guidelines. Progesterone is utilized in the form of oral pills, injections, or intrauterine devices to suppress menstruation and avoid pregnancy. Essentially, feminizing therapy uses androgen blockers along with estrogen. This is because estrogen alone cannot exert sufficient androgen-suppressing effects. In South Korea, the most commonly used androgen blockers are spironolactone and cyproterone acetate. Gonadotropin-releasing hormone (GnRH) agonist is also available. Regarding estrogen, oral pills, injections, and transdermal gels are utilized. This review introduces these gender-affirming hormone therapies in South Korea and discusses the side effects of each regimen.

This study was carried out to establish normal values and to compare the pattern reversal and light emitting diodes(LED) stimulating visual evoked potential(VEP) in 30 healthy volunteers (20 men and 10 women, age ranged from 24 to 56 years, with a mean age of 34 years). The result summarized in table 1, 2 and 3. VEP wave patterns were similar and easily reproducible with those different types of visual stimulation. As compared of normal values of pattern reversal and LED stimulating visual evoked responses, there are no significant variations of absolute latencies, amplitudes, absolute amplitude differences between two eyes, proportional amplitude differences between eyes, and duration differences between two eyes. Only differences were significant in latency differences between two eyes and duration of p. 100. These results suggest that pattern reversal and LED stimulating VEP test will be useful in clinical test according to various patient's conditions.
Evoked Potentials, Visual* ; Female ; Healthy Volunteers ; Humans ; Male ; Photic Stimulation ; Reference Values

Purpose: To assess the prevalence and progression of a stage 0 macular hole in the fellow eye of patients with an idiopathic full-thickness macular hole.
Methods: The fellow eyes of 189 patients who underwent idiopathic full-thickness macular hole surgery were examined by biomicroscopy and spectral domain-optical coherence tomography (SD-OCT). A subset of 21 fellow eyes with a stage 0 macular hole was observed. Changes in the macular hole were evaluated by biomicroscopy and SD-OCT for an average of 29 months.
Results: Among the 21 eyes, 15 showed no change in perifoveal vitreous detachment (71.4%). Two eyes (9.5%) developed complete vitreofoveal separation, and one of the two developed a separation after progression to stage 1A. Among 21 eyes, 5 (23.8%) developed above stage 1A, and one of the five progressed to stage 1B after five years, which was successfully treated with vitrectomy and gas tamponade.
Conclusions Perifoveal vitreous detachment in the fellow eye on SD-OCT, defined as a stage 0 macular hole, occurred at an earlier phase than stage 1A macular holes and may progress to an advanced stage. Therefore, patients who undergo macular hole surgery and have a stage 0 macular hole or perifoveal vitreous detachment in the fellow eye should be followed closely.

Purpose: To assess the prevalence and progression of a stage 0 macular hole in the fellow eye of patients with an idiopathic full-thickness macular hole.
Methods: The fellow eyes of 189 patients who underwent idiopathic full-thickness macular hole surgery were examined by biomicroscopy and spectral domain-optical coherence tomography (SD-OCT). A subset of 21 fellow eyes with a stage 0 macular hole was observed. Changes in the macular hole were evaluated by biomicroscopy and SD-OCT for an average of 29 months.
Results: Among the 21 eyes, 15 showed no change in perifoveal vitreous detachment (71.4%). Two eyes (9.5%) developed complete vitreofoveal separation, and one of the two developed a separation after progression to stage 1A. Among 21 eyes, 5 (23.8%) developed above stage 1A, and one of the five progressed to stage 1B after five years, which was successfully treated with vitrectomy and gas tamponade.
Conclusions Perifoveal vitreous detachment in the fellow eye on SD-OCT, defined as a stage 0 macular hole, occurred at an earlier phase than stage 1A macular holes and may progress to an advanced stage. Therefore, patients who undergo macular hole surgery and have a stage 0 macular hole or perifoveal vitreous detachment in the fellow eye should be followed closely.

PURPOSE: Past studies have reported that S-allylcysteine (SAC) inhibits the migration and invasion of cancer cells through the restoration of E-cadherin, the reduction of matrix metalloproteinase (MMP) and Slug protein expression, and inhibition of the production of reactive oxygen species (ROS). Furthermore, evidence is emerging that shows that ROS induced by radiation could increase Met activation. Following on these reports of SAC and Met, we investigated whether SAC could suppress Met activation. MATERIALS AND METHODS: Wound healing, invasion, 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium (MTT), soft agar colony forming, western blotting, and gelatin zymography assays were performed in the human nasopharyngeal cancer cell lines HNE1 and HONE1 treated with SAC (0, 10, 20, or 40 mM) and hepatocyte growth factor (HGF). RESULTS: This study showed that SAC could suppress the migration and invasion of HNE1 and HONE1 cell lines by inhibiting p-Met. An increase of migration and invasion induced by HGF and its decrease in a dose dependent manner by SAC in wound healing and invasion assays was observed. The reduction of p-Met by SAC was positively correlated with p-focal adhesion kinase (p-FAK) and p-extracellular related kinase (p-ERK in both cell lines). SAC reduced Slug, MMP2, and MMP9 involved in migration and invasion with the inhibition of Met-FAK signaling. CONCLUSION: These results suggest that SAC inhibited not only Met activation but also the downstream FAK, Slug, and MMP expression. Finally, SAC may be a potent anticancer compound for nasopharyngeal cancer treated with radiotherapy.
Agar ; Blotting, Western ; Cadherins ; Cell Line ; Emigration and Immigration ; Gastropoda ; Gelatin ; Hepatocyte Growth Factor* ; Hepatocytes* ; Humans ; Nasopharyngeal Neoplasms* ; Phosphotransferases ; Radiotherapy ; Reactive Oxygen Species ; Wound Healing

The prediction of acute kidney injury (AKI) is important in the management of neonates, and several renal biomarkers have been tested for clinical application. Cystatin C (CysC) is a promising marker of renal function, and its application in neonatal care showed several benefits. First, CysC levels are not affected by endogenous substances such as bilirubin, hemoglobin, and ketones in laboratory tests. Second, its level is not influenced by inflammation (e.g., sepsis), muscle mass, age, gender, or nutritional status. Third, CysC is not transmitted through the placenta. Fourth, standardized automated measurement methods are available. Fifth, CysC was shown to reflect renal maturation better than creatinine. Lastly, CysC was reported to change with a wider amplitude than creatinine, which allows a more sensitive detection of renal deterioration. Recently, several reference CysC levels for neonates, including premature infants, were reported. In the present review, we summarized information on serum CysC reference values from different studies. Few studies investigated the usefulness of CysC for predicting AKI in neonates with various diseases such as neonatal respiratory distress syndrome, sepsis, and neonatal asphyxia. Recent studies showed an association between serum CysC level and cardiovascular diseases or Alzheimer's disease, indicating that CysC may play a role as a marker for various diseases in the future. Although the use of CysC as a marker in neonatal care showed several benefits, reliable and detailed reference ranges need to be established, including those for neonates with diseases. In addition, other novel renal markers need to be tested in neonates.
Acute Kidney Injury ; Alzheimer Disease ; Asphyxia ; Bilirubin ; Biomarkers ; Cardiovascular Diseases ; Creatinine ; Cystatin C ; Hemoglobins ; Humans ; Infant, Newborn ; Infant, Premature ; Inflammation ; Ketones ; Muscles ; Nutritional Status ; Placenta ; Reference Values ; Respiratory Distress Syndrome, Newborn ; Sepsis

PURPOSE: The appropriate age and amount that whole cow's milk and commercial baby food can be introduced safely into the infant diet are unknown and remains an area of controversy. Early feeding of excessive amount of whole cow's milk has been associated with iron deficiency anemia and nutritional deficiency. We studied the present status and problems on the feedig of whole cow's milk and commercial baby food in children. METHODS: This survey was done through questionnaire to the 541 out patients who visited Seoul, Chun An and Eum Sung Soon Chun Hyang University Hospitals during the period from Jun. 1994 to Fab. 1995. RESULTS: 1) Feeding patterns according to age of children: Infants were fed prepared milk(63.6%), human milk(16.2%), whole cow's milk(8.1%), commercial baby food(7.1%) and rice(5.0%) in the order of frequency. Children between 1 and 2 years of age were fed rice(37.1%), whole cow's milk (34.3%), prepared milk(17.1%), commercial baby food(7.4%) and human milk(4.0%) in the order of frequency. 2) Whole cow's milk feeding was started at 3 to 6 months of age in 11.5%, at 7 to 12 months of age in 59.6% and after 12months of age in 28.9%. 3) The daily feeding amounts of whole cow's milk was less than 500 ml in 48.2%, 500 to 999 ml in 36.2%, and more than 1000 ml in 15.6%. Suprisingly 49.7% of them were fed more than 500 ml a day. 4) About iron content in whole cow's milk, only 25.9% of mothers gave the correct answer. 5) 62.5% of mothers considered that whole cow's milk was the best food in infant period. 6) Only 19.1% of subjects used commercial baby food properly in method and amount. CONCLUSIONS: Whole cow's milk was introduced during early months of life and fed in excessive amount. There was a lack of maternal knowledge about iron content in whole cow's milk. The improper use of commercial baby food produced the numerous nutritional problems. Thus, we need education about whole cow's milk and commercial baby food to mothers.
Anemia, Iron-Deficiency ; Child* ; Diet ; Education ; Feeding Behavior ; Hospitals, University ; Humans ; Infant ; Iron ; Malnutrition ; Milk* ; Mothers ; Outpatients ; Surveys and Questionnaires ; Seoul ; Weaning