In order to observe the differences in fixability and stability of the acetabular cup through the differences in cup size in relation to the size of acetabular reaming, we analyzed 75 cases of porous coated acetabular cup of Harris-Galante type which be followed up more that two years. All cases were divided into two group ; the first group (On line fit :45 cases) used with acetabular cup equal in size to the last reaming size and the second group (Press fit : 30 cases) used with acetabular cup 2mm larger than the last reaming size. For initial stability, all cases were fixed with acetabular screws. Both groups were analyzed for presence of gap, change of acetabular inclination, presence of radiolucent line, degree of displacement of vertical distance, stability and clinical results. The results were as follows; 1. The average Harris hip score was improved from 55.8 points preoperatively to 90.2 points postoperatively in the first group, from 56.9 points to 91.2 points in the second group, Clinical results are excellent in 39 cases, good in 4 cases, fair in 2 cases in the first group, and excellent in 29 cases and good in 1 case in the second group. 2. The gap between the acetabular cup and acetabulum was found initially at 17 zones in the first group but no gap at final follow up. In the second group, the gap was found at 23 zones and finally remained less that 1 mm gap was found at 3 cases in zone B1. 3. No radiologic instability of acetabular cup by Martell evaluation was noted in both 1st and 2nd group. Our data suggests that initial gap between acetabular cup and acetabulum in microporous coated acetabular cup were replaced with new bone and also, radiologic stability and good clinical results could be obtained in the second group used with acetabular cup 2 mm larger than the last reaming size.
Acetabulum ; Arthroplasty, Replacement, Hip ; Clinical Study ; Follow-Up Studies ; Hip

Livedoid vasculitis is characterized clinically by smooth or depressed ivory-white scars surrounded by hyperpigmentation and telangiectasia with or without preceding purpuric in-filtrated papules and plaques and histologically by intravascular deposition of fibrin. Its pathophysiology is still obscure. Many treatment modalities have been used, but results are not satisfactory. Recently, there have been experiences of successful treatments with danazol, a synthetic androgen. We used danazol in three patients who presented with livedoid vasculitis and were relatively resistant to treatments with aspirin and/or pentoxifylline. After 4 to 8 weeks, there was remarkable clinical improvement in all three patients.
Aspirin ; Cicatrix ; Danazol* ; Fibrin ; Humans ; Hyperpigmentation ; Pentoxifylline ; Telangiectasis ; Vasculitis*

Adolescence is the period in which physical, mental and social maturation occurs and it is an important transit stage, changing from childhood to adulthood. This is a period in which important changes occur physically such as rapid growth in height and weight gain but significant differences in growth may occur for the same age. Therfore, the degree of sexual maturation may be an important indicator in evaluating growth in adolescence. Six thousand five hundred and eighty six male and female students from grade 4 to senior high from Seoul, district town and countryside were evaluated for sexual maturity using Tanner staging, weight, height and body mass index and compared for growth. There was a rapid growth in height of 6.7cm in boys between the ages of 11 and 14 years and 6.3 cm in height for girls between the ages of 10 and 12 years, showing earlier growth in height for girls. Growth in height according to sexual maturation showed the greatest growth during stages 2~3 for boys and girls. Boys grew an average of 18.94 cm and girls an average of 18.03 cm in height during the whole sexual maturation period. There was an increase of 5.5 kg in weight for boys during the same age as for growth in height, that is between 11 and 14 years of age. In girls, an average weight gain of 5.1 kg occurred between 11 and 13 years of age, slightly later than that of growth in height. Rapid gain in weight occurred during Tanner stages 2~3 for girls. Total gain of 20.70 kg for boys occurred during the whole sexual maturation period while girls gained total 19.73 kg. Body mass index increased gradually during the whole adolescent period. It was greater in boys during the ages of 9 and 12 years and greater in girls the age of 13 years and again in boys after 17 years of age. During the whole maturation period, boys gained 3.24 and girls, 4.05 of body mass index showing more gain in girls. Height, weight and body mass index showed normal variations during the sexual maturation index showed normal variations during the sexual maturation period and the results may bring an increased understanding that adolescent physical growth was closely related to sexual maturation.
Adolescent* ; Body Mass Index ; Female ; Humans ; Male ; Seoul ; Sexual Maturation* ; Weight Gain

BACKGROUND: Noninvasive measurements that relate to the extent and severity of coronary atherosclerosis have long been sought for clinical screening of patients with chest pain syndromes and for use in clinical trials. Intima-media thickeness (IMT) of the carotid artery has been suggested to be associated with coronary artery atherosclerosis. In this study, we tried to assess the relation of carotid artery atherosclerosis by B-mode ultrasonography with presence and severity of coronary artery disease. METHOD: We studied 57 patients (36 men, 21 women) with ischemic heart disease, mean age 65+/-8 yrs (48 to 83 yrs), who underwent both coronary angiography and carotid ultrasonography with 10 MHz transducer. The patients who had received revascularization procedure were excluded. We classified the patients into two groups, the control group without significant coronary stenosis (18 patients) and the coronary artery disease (CAD) group (39 patients) with significant luminal stenosis (> or =50%). The CAD group was divided into single vessel disease group (SVD, 19 patients) and multivessel disease group (MVD, 20 patients). IMT was measured in far wall of common carotid artery (CCA) at 10 mm proximal to carotid bulb and abnormal IMT was defined if the measurement was greater than mean IMT+2SD of control group. Serum total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL), triglyceride (TG), Lipoproteinp (a)(Lp(a)) were measured and history of hypertension, diabetes mellitus, and smoking were investigated. RESULTS: A significant difference in IMT of the CCA was found between control and CAD group (0.76+/-0.09 mm vs. 0.97+/-0.20 mm; p<0.0001). Also a significant difference in the number of atherosclerotic plaque was found between the two groups (control; 0.67+/-1.14 vs. CAD; 1.87+/-1.75; p<0.005). In the CAD group, both mean IMT and numbers of athero-sclerotic plaque tended to increase in MVD group compared with SVD group (1.03 mm vs. 0.91 mm; p=NS, 2.65 vs. 1.05; p<0.05). The sensitivity of IMT for prediction of significant CAD was 66.7%, the specificity 83.3%, the positive predictive value 89.7%, and the negative predictive value 53.6%. The sensitivity of plaque presence on the carotid artery for prediction of CAD was 71.8%, the specificity 61.3%, the positive predictive value 80.3% and the negative predictive value 50.5%. Among risk factor, diabetes mellitus and Lp (a) were correlated well with IMT of CCA, Hypertension was correlated with atherosclerotic plaque. History of smoking was correlated with coronary artery disease. CONCLUSION: Increases in IMT and plaque of the carotid artery, as measured noninvasively by ultrasonography, can be used as a predictor of significant coronary artery stenosis.
Atherosclerosis ; Carotid Arteries* ; Carotid Artery, Common ; Chest Pain ; Cholesterol ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis* ; Coronary Vessels* ; Diabetes Mellitus ; Humans ; Hypertension ; Lipoproteins ; Male ; Mass Screening ; Myocardial Ischemia ; Phenobarbital ; Plaque, Atherosclerotic* ; Risk Factors ; Sensitivity and Specificity ; Smoke ; Smoking ; Transducers ; Triglycerides ; Ultrasonography

Acoustic stimulation test(AST), is currently being used as an alternative tool of nonstress test (NST). However, there are no standard guideline for analysis of AST. Computerized numerical analysis of AST would be helpful for development of diagnostic criteria of AST. Fifty-one normal pre-term pregnancies entered to this study after conventional 20-minutes NST and 10-minutes AST. Acoustic stimulations were performed using Fetal Acoustic Stimulator (Model 146, Corometrics, US). We analyzed the FHR response after acoustic stimulation using our on-line computerized FHR analysis system, HYFM-I & II software. The changes of loss of signal, baseline FHR, variability, number of fetal movements, and number of FHR accelerations were analyzed numerically. The loss of signal was increased about 2 fold(122.61%). The baseline FHR was increased from 144.57bpm to 156.81bpm(8.5%) after acoustic stimulation. Number of fetal movements was increased about 2 fold(from 2.1 to 4.12/10 minutes). FHR variability was also increased from 17.81 bpm to 26.37 bpm. After AST, number of FHR accelaration was increased 55.47%(10sec 10bpm) and 68.42%(15sec 15bpm), respectively. In this study, we acrumulated elemental FHR data using computerized system after AST. These data would be helpful in the accurate analysis of AST and also enable us to develop the objective interpretation system for AST.
Acceleration ; Acoustic Stimulation* ; Acoustics* ; Female ; Fetal Heart* ; Fetal Movement ; Heart Rate, Fetal* ; Pregnancy ; Pregnancy*

Autonomic dysreflexia is a syndrome characterized by severe hypertension, headache, sweating that is seen in spinal cord injury population. It can be a life-threatening problem if not promptly recognized and treated. Since the most common cause is bladder distention, it is essential that the urologist sh6fild be familiar with this syndrome. Two hundred ninety four patients with spinal cord injury were reviewed for the prevalence rate and clinical manifestations of autonomic dysreflexia. The time of onset post-injury, precipitating causes, presenting symptoms and management were analyzed. 42 patients (34.4%) of 122 patients with lesion above T6 level exhibited autonomic dysreflexia. The majority of patients (61.9%) had manifested signs and symptoms of autonomic dysreflexia within the first year. The precipitating causes were bladder distention (69.0%), bowel distention (23.8%) and urinary tract infection (7.1%). The presenting symptoms of autonomic dysreflexia were headache (88.1%), sweating (88.1%), hot flushing (28.6%), chest discomfort, hyperpnea and spasm. The management of autonomic dysreflexia include prompt bladder erupting, bed rest and appropriate bowel preparation. In conclusion, prompt recognition and appropriate management of autonomic dysreflexia are essential to prevent life-threatening sequelae.
Autonomic Dysreflexia* ; Bed Rest ; Flushing ; Headache ; Humans ; Hypertension ; Prevalence ; Spasm ; Spinal Cord Injuries* ; Spinal Cord* ; Sweat ; Sweating ; Thorax ; Urinary Bladder ; Urinary Tract Infections

Glycopyrrolate is frequently administered in combination with neostigmine to reverse a neuromus- cular blockade. The dosage was well established at 1/5 of neostigmine. But the authers have often observed a delayed manifestation of relative bradycardia after such a recommended dosage. This is not mentioned in the literature, but this may be due to an insufficient observation period. The authors monitored the change of pulse rate for 1 hour after the administration of the recom. mended dose. Further, the data wIns compared with that obtained after studies of lower and higher doses. The doses were 0.004, 0.008 and 0.012mg/kg of glycopyrrolate with 0.04mg/kg of neostigmine. 1) At all doses, bradycardia relative to the pre-reversal pulse rate was progressive until 30 minutes after injection. 2) As the glycopyrrate dose was increased the degree of bradycardia decreased (-24.7, -20.5, - 15.0 at 30 min.). 3) There was no difference in the immediate change in the pulse rate between the dcsages of 0.008 and 0.012 mg/kg. Change occured at 9 mins. 4) At dosages of 0.004 and 0.008 mg/kg, the pulse rates at 60 min were comparable to their ward pulses, but at a dosage of 0.012 mg/kg, the pulse rate was 8.5 beats/min higher.
Bradycardia ; Glycopyrrolate* ; Heart Rate* ; Neostigmine*

PURPOSE: The aim of this study was to identify the effect of video programs of cardiopulmonary cerebral resuscitation (CPCR) education of cardiopulmonary cerebral resuscitation of nurses. METHODS: The subjects of the study were 64 nurses working in a university hospital. Nurse's CPCR performance have been measured four times (pre-test, post-test at immediately, 3 months and 6 months after intervention). Data were collected from February to August 2013. RESULTS: There were significant differences in knowledge, attitude, self-efficacy, and performance between groups by measure time. And there were significant interactions in knowledge, self-efficacy, and performance between groups, within groups, except for the attitude. The video programs of CPCR interventions appear to be effective in the improvement of knowledge, self-efficacy, and performance, as compared to the control group. CONCLUSION: The video programs of CPCR education was an effective intervention to improve and retain the level of knowledge, attitude, self-efficacy and performance. And the video program of CPCR education have an advantage of self-learning effect for nurses with shift work. Therefore video programs of CPCR education will be utilized for continuing nurse's education.
Education* ; Resuscitation*

No abstract available.
Delivery of Health Care* ; Family Practice* ; Humans ; Inpatients* ; Insurance* ; Korea*

BACKGROUND: Stellate ganglion block (SGB) is known to increase blood flow to the innervations area of the stellate ganglion. Near infrared spectroscopy reflects an increased blood volume and allows continuous, non-invasive, and bedside monitoring of regional cerebral oxygen saturation (rSO2). We investigated the influence of SGB on bilateral cerebral oxygenation using a near infrared spectroscopy. METHODS: SGB was performed on 30 patients with 1% lidocaine 10 ml using a paratracheal technique at the C6 level and confirmed by the presence of Horner's syndrome. The blood pressure (BP), heart rate (HR) and rSO2 were measured before SGB and 5, 10, 15 and 20 minutes after SGB. Tympanic temperature of each ear was measured prior to SGB and 20 minutes after SGB. RESULTS: The increments of the rSO2 on the block side from the baseline were statistically significant at 5, 10, 15 and 20 minutes. The rSO2 on the non-block side compared with the baseline, however, decreased at 15 and 20 minutes. The difference between the block and the non-block sides was significant at 15 and 20 minutes. The BP at 10, 15 and 20 minutes was increased and the HR was increased at 10 and 15 minutes. CONCLUSIONS: We observed an increment of the rSO2 on the block side from the baseline; however, the rSO2 on the non-block side decreased.
Blood Pressure ; Blood Volume ; Ear ; Heart Rate ; Horner Syndrome ; Humans ; Lidocaine ; Oxygen ; Spectrum Analysis ; Stellate Ganglion