Acetabular erosion, intrusion of the prosthesis into the pelvis, is the most serious late complication of hemiarthroplasty. For the detailed observation on this lesion, the authors reviewed 55 patients who underwent femoral head replacement and were followed up to at least 1 year after operation. The acetabular erosion were present in 18 patients(32.7%) out of the total 55 patients. Based on the results of this study, the authors presented a new classification of acetabular eorsion: Stage I(erosion of the cartilage only) was seen in 11 patients, stage II (evidence of the initial bony erosion) in 4 patients,and stage III(intraosseous intrusion of the metallic head) in 3 patients. Revision arthroplasty was obligatory in two of the three stage III patients. The severity of symptoms did not always correspond with the radiological changes. The acetabular erosion was more common in younger patients, in male patients and in patients with avascular necrosis of femoral head than in older patients, in female patients, and in patients with femoral neck fracture. The tendency of acetabular erosion occurring mainly in younger and male patients is probably attributed to their better survival and greater activity.
Acetabulum ; Arthroplasty ; Cartilage ; Classification ; Female ; Femoral Neck Fractures ; Head ; Hemiarthroplasty ; Humans ; Male ; Necrosis ; Pelvis ; Prostheses and Implants

Generally the clinical results of Legg-Calvé-Perthes disease were evaluated until the time of disease healing. However, it is well known that the deformities of the proximal femur progress to the period of skeletal maturity. The purpose of this study was to evaluate the progression of the deformities in the proximal femur. In a retrospective study of 60 patients with Legg-Calvé-Perthes disease, who visited Chonnam National University Hosipital 1974 and 1995 and who were followed until the skeletal maturity, the bony changes of the proximal femur were compared between disease healing stage and skeletal maturity. The results were as follow; 1. More bony deformities were identified in skeletal maturity than in disease healing. 2. The quotient of inferior border of medial femoral neck decreased from 60% in disease healing to 45% in skeletal maturity (P < 0.001). 3. The femoral shortening increased from 4.9mm in disease healing to 10mm in skeletal maturity (P < 0.001). 4. The femoral neck-shaft angle decreased from 128 degrees in disease healing to 125 degrees in skeletal maturity (P < 0.001). 5. The proximal migration of greater trochanter increased from 13.8mm in disease healing to 21.3mm in skeletal maturity (P < 0.001). 6. There were no significant statistical differences in clinical results between operative and conservative treatment groups. 7. The spherical quotient of femoral head and Stulberg rate revealed no differences between disease healing and skeletal maturity. These results revealed that there were considerable differences of the deformities in the proximal femur at the time of disease healing and skeletal maturity.
Congenital Abnormalities ; Femur Neck ; Femur ; Head ; Humans ; Jeollanam-do ; Legg-Calve-Perthes Disease ; Retrospective Studies

Torsades de pointes is characterized by paroxysms of ventricular tachycardia at rates typically greater than 200 beats/min in which QRS morphology shows alternating polarity in an undulating pattern so that the complexes appear to be twisting about the beseline;this arrhythmia is virtually always associated with prolongation of the QT interval. Its importance lies not in its unusual structure but in the potentially fatal outcome if conventional treatment is administred. Torsades de pointes was diagnosed in 4 patients;the first with hypokalemia, the second with congenital QT prolongation syndrome, the third with amiodarone, the fourth with organophosphorous and hypokalemia. Treatment of these patients consisted of potassium supply, isoproterenol, lidocaine, phenobarbital, tenormin, phenytoin, cardioversion, atropine. Three patients improved successfully, but one patient died, as a direct result of the ensuing ventricular fibrillation and cardiac arrest on one hour after admission.
Amiodarone ; Arrhythmias, Cardiac ; Atenolol ; Atropine ; Electric Countershock ; Fatal Outcome ; Heart Arrest ; Humans ; Hypokalemia ; Isoproterenol ; Lidocaine ; Phenobarbital ; Phenytoin ; Potassium ; Tachycardia, Ventricular ; Torsades de Pointes* ; Ventricular Fibrillation

PURPOSE: To evaluate the efficacy and safety of primary intravitreal bevacizumab injection in stage 3 retinopathy of prematurity with plus signs. METHODS: We reviewed retrospectively the medical records of 30 eyes of 16 patients diagnosed with stage 3 retinopathy of prematurity with plus signs treated with primary intravitreal bevacizumab injection between March 1, 2011 and February 28, 2013 and followed up for at least 9 months. RESULTS: Mean gestational age was 26 + 4 weeks +/- 11 days and mean birth weight was 822 +/- 251.4 g. The locations of disease were zone II in 24 eyes and zone III in 6 eyes. Intravitreal bevacizumab injection was performed after the mean 1.3 +/- 1 day after plus signs were detected. Mean postconceptional age at treatment was 38 + 2 weeks +/- 16 days. Mean follow-up period was 16.6 +/- 6.9 months. Plus signs started to regress after the mean 4.6 +/- 2.3 days after injection and completely regressed after the mean 24.3 +/- 12.4 days. Cataract extraction was performed in 1 eye due to a cataract that appeared not associated with the injection procedure, but was regarded as a treatment failure. There were no local or systemic complications. CONCLUSIONS: Primary intravitreal bevacizumab injection in stage 3 retinopathy of prematurity with plus signs demonstrated excellent short-term efficacy and safety.
Birth Weight ; Cataract ; Cataract Extraction ; Follow-Up Studies ; Gestational Age ; Humans ; Medical Records ; Retinopathy of Prematurity* ; Retrospective Studies ; Treatment Failure ; Bevacizumab

PURPOSE: To assess the association between decreased visual acuity (VA) and diagnosis of depressive disorder by a physician or experience of depressive mood using self-report questionnaires. METHODS: We conducted a cross-sectional analysis using nationally representative data from the Korean National Health and Nutrition Examination Survey (KNHANES, 2008-2012). A total of 28,919 adults who had sociodemographic and health behavioral risk factors available were included. An association between decreased VA and depression was identified using multivariate logistic regression analysis after adjusting for possible confounders. Depression was defined as a depressive disorder with a diagnosis by a physician or depressive mood lasting more than 2 weeks using self-report questionnaires. RESULTS: The prevalence of depressive disorder and depressive mood in Koreans was 1,160 (4.0%) and 4,063 (14.1%), respectively. In univariable logistic regression, there was significant association between VA and depressive disorder or depressive mood. However, in multivariable logistic regression analysis, this study found no statistically significant association between VA status and the prevalence of depressive disorder or depressive mood in Koreans. CONCLUSIONS: No association between decreased VA and a depressive disorder/depressive mood in Korean adults after adjusting for possible confounders was found. Therefore, further longitudinal cohort studies examining the causal relationship between decreased VA and depression in Korean adults are necessary.
Adult ; Cohort Studies ; Cross-Sectional Studies ; Depression ; Depressive Disorder* ; Diagnosis ; Health Behavior ; Humans ; Logistic Models ; Nutrition Surveys ; Prevalence ; Risk Factors ; Vision, Low ; Visual Acuity*

A 26-year-old woman had an ovarian Sertoli-Leydig cell tumor (SLCT) associated with an elevated level of serum alpha-fetoprotein (AFP). The tumor had a heterologous element of intestinal-type mucinous epithelium, retiform and intermediately differentiated tubules of the Sertoli cells, and AFP-producing Leydig cells. AFP was demonstrated within the Leydig cells by an immunohistochemical technique. After surgery, the serum AFP level of the patient fell to the normal range. The present case is the first documented case of AFP producing a SLCT of the ovary reported in Korea.
Adult ; alpha-Fetoproteins* ; Epithelium ; Female ; Humans ; Korea ; Leydig Cells ; Male ; Mucins ; Ovary* ; Reference Values ; Sertoli Cells ; Sertoli-Leydig Cell Tumor*

PURPOSE: The Gleason score is an important predictor of outcome that is used in conjunction with clinical stage and prostate-specific antigen to guide clinical decision making. The prostate biopsy Gleason grade frequently differs from the radical prostatectomy grade. The aim of this study was to determine the risk factors of Gleason upgrading in patients with low-risk prostate cancer after radical prostatectomy. MATERIALS AND METHODS: We retrospectively analyzed the medical records of 146 patients who underwent radical prostatectomy between 1998 and 2008 in two hospitals of Jeonbuk province in Korea. Pathological Gleason score upgrading was defined as an increase in the Gleason score from < or =6 to > or =7 between the biopsy and radical prostatectomy specimen. Pretreatment clinical and pathological parameters were used to identify predictors of pathological upgrading. RESULTS: Of the total 146 patients, 51 (34.9%) were upgraded postoperatively. Small prostate volume (p=0.008), abnormality on the digital rectal examination, and positive surgical margin (p=0.001) were significantly and positively associated with upgrading after radical prostatectomy. A total of 17 of 65 patients with low-risk prostate cancer (26.2%) were upgraded postoperatively. Small prostate volume (<30 ml) was significantly (p=0.026) and positively associated with upgrading after radical prostatectomy in patients with low-risk prostate cancer. CONCLUSIONS: Overall, 26% of patients with low-risk disease were upgraded postoperatively. Small prostate volume was associated with an increased risk for pathological upgrading after radical prostatectomy. These conclusions should be kept in mind when making treatment decisions for men with low-risk prostate cancer.
Biopsy ; Decision Making ; Digital Rectal Examination ; Humans ; Korea ; Male ; Medical Records ; Neoplasm Grading ; Prostate ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms ; Retrospective Studies ; Risk Factors

PURPOSE: To identify cataract awareness in the Korean population. METHODS: The present study included 3,662 subjects who were diagnosed with a cataract by ophthalmic examination out of 11,058 subjects in the fourth Korea National Health and Nutrition Examination Survey (KNHANES IV). Among the 3,662 participants, 944 were aware that they already had a cataract. The socio-demographic disparities in cataract awareness were identified using multivariate analysis. RESULTS: The mean age of the study population was 65.6 years (standard deviation, 0.2). The awareness calculated based on total weighted population was 24.6% in people over 19 years of age (95% confidence interval, 22.5-26.6%). In multivariate logistic analysis, subjects with higher income, living in a rural area, having a spouse, and binge alcohol use were less likely to be aware of their cataract. In multivariate linear regression analysis after adjusting for confounding factors, there were statistically significant differences of mean in age and monthly house income. Deajeon (11%), and Gwangju (16%) were the lower ranked regions for cataract awareness in Korea. CONCLUSIONS: The cataract awareness in Korea was lower than in other developed countries. Public education and strategies to improve cataract awareness in susceptible people are necessary. More effort is needed to improve cataract awareness based on the Korean society's acceptance of ophthalmologists as in other countries.
Cataract* ; Daejeon ; Developed Countries ; Education ; Gwangju ; Humans ; Korea ; Linear Models ; Multivariate Analysis ; Nutrition Surveys ; Spouses

PURPOSE: To evaluate the health-related quality of life (QOL) in Koreans according to visual acuity. METHODS: The fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) is a nationwide survey. The present study included 11,022 Koreans who completed the KNHANES IV. The relation of visual acuity and QOL was verified, and EuroQoL 5D (EQ-5D) was identified using the adjusted mean based on linear regression analysis. RESULTS: As visual acuity decreased, QOL decreased. QOL in mobility, usual activities, and pain/discomfort were affected by the vision gradient, while self-care and anxiety/depression were less influenced by the vision gradient. In particular, QOL in usual activities was significantly affected by the visual gradient. Subjects with a visual acuity of 1.6-3.0 were less likely to have a low QOL in usual activities compared to subjects with a visual acuity of 0.0-0.5 as a reference group (adjusted Odds Ratio = 23.6, 95% CI, 4.8-115.5). QOL in usual activities was statistically low in subjects older than 65 years of age, with low household monthly income, low education, and living without a spouse. CONCLUSIONS: As visual acuity decreased, QOL in the aspect of mobility, usual activities, and pain/discomfort decreased severely, which resulted from activity limitation. Considering that the risk group with increasing age, low income, low education, and living without a spouse had lower QOL, the most important is to increase activity, which can induce the improvement of QOL in Koreans who have low visual acuity and related risk factors is.
Education ; Family Characteristics ; Humans ; Korea ; Linear Models ; Nutrition Surveys ; Odds Ratio ; Quality of Life* ; Risk Factors ; Self Care ; Spouses ; Visual Acuity*

Productivity analysis of physician is one of essential factors for the optimal health manpower planning. Among 690 physicians operating clinic and registered on the Kyeongsangnamdo Medical Association, 623 physicians were studied with a structural questionnaire from April 1 to May 31, 1990. This study covers the general characteristics and productivity of physicians and attempts to find relevant determinants of their productivity through stepwise multiple regression analysis based on collected data. The major results were as follows. First, physicians were more prevalent 35~44 group (38.2%) in age, male (95.8%) in sex, specialist (76.5%) in specialization, city (78.0%) in geographical location. Age group of 35-54 and specialist were more prevalent in cities than in counties, while age group of 25-44 and 55 over and general practitioner in counties (p<0.001). Second, daily outpatient load of all physician were 77.1 persons on average. Age group of 35~44 had the most outpatient load (90.3 persons) among all age group, 6~10 years group (94.2 persons) in years of duration of practice, 11 hours per day group (83.4 persons) in working hours per day. Specialists had more outpatient load (82.6 persons) than general practitioners (61.1 persons) and physicians in cities had more (80.2 persons) than physicians in counties (66.3 persons). Daily average outpatient load of physicians were significantly different by their age, speciality, number of assistants and years of practice (p<0.001) and working location (p<0.05), but not significantly different by working hours per day of physician (p>0.1). Third, the productivity of physicians operating clinic were significantly affected by the three factorsnumber of assistants of physician, age of physician and duration of practice at the current clinic. Age of physician had negative regression coefficient.
Efficiency* ; General Practitioners ; Health Manpower ; Humans ; Male ; Outpatients ; Surveys and Questionnaires ; Specialization