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*

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 socio-demographic factors in cataract surgery in Korea and expect future effect of the bundle of service system. METHODS: We analyzed the number of people undergoing cataract surgery and associated factors such as surgery ratio, region, age, income, and insurance status of 28,980 patients older than 40 years using data from the fifth Korea National Health and Nutrition Examination Survey 2008-2012 (KNHANES). RESULTS: Among total population in 2012, 47.5% of elderly aged 80 years and older have received cataract surgery. According to region in patients older than 40, Jeollanam-do showed the highest proportion of patients undergoing cataract surgery, at 12%, Daejeon showed the lowest proportion of 3.6%, and Seoul showed 6.8%. Regional analysis was also performed by analyzing the number of cataract patients per ophthalmologist. Jeollanam-do showed the highest with 40,115 patients per ophthalmologist, and Seoul showed the least with 1,094 patients per ophthalmologist. The sociodemographic factors such as education or income, were not associated with cataract surgery after adjusting for age and regional difference. On the other hand, subjects with medicaid were associated with 1.6-fold (95% confidence interval, 1.3-2.0) higher rate of cataract surgery than subjects with national health insurance. CONCLUSIONS: Regional disparity was found in the cataract surgery rate and surgery rate per an ophthalmologists, whereas sociodemographic factors were not significant in receiving benefits of cataract surgery. Before the amount of bundled payment is changing, down-leveling of quality of care and deepening of disparities among health care provider should be considered.
Aged ; Cataract* ; Education ; Hand ; Health Personnel ; Humans ; Insurance Coverage ; Jeollanam-do ; Korea ; Medicaid ; National Health Programs ; Nutrition Surveys ; Seoul

PURPOSE: To identify socio-demographic factors in cataract surgery in Korea and expect future effect of the bundle of service system. METHODS: We analyzed the number of people undergoing cataract surgery and associated factors such as surgery ratio, region, age, income, and insurance status of 28,980 patients older than 40 years using data from the fifth Korea National Health and Nutrition Examination Survey 2008-2012 (KNHANES). RESULTS: Among total population in 2012, 47.5% of elderly aged 80 years and older have received cataract surgery. According to region in patients older than 40, Jeollanam-do showed the highest proportion of patients undergoing cataract surgery, at 12%, Daejeon showed the lowest proportion of 3.6%, and Seoul showed 6.8%. Regional analysis was also performed by analyzing the number of cataract patients per ophthalmologist. Jeollanam-do showed the highest with 40,115 patients per ophthalmologist, and Seoul showed the least with 1,094 patients per ophthalmologist. The sociodemographic factors such as education or income, were not associated with cataract surgery after adjusting for age and regional difference. On the other hand, subjects with medicaid were associated with 1.6-fold (95% confidence interval, 1.3-2.0) higher rate of cataract surgery than subjects with national health insurance. CONCLUSIONS: Regional disparity was found in the cataract surgery rate and surgery rate per an ophthalmologists, whereas sociodemographic factors were not significant in receiving benefits of cataract surgery. Before the amount of bundled payment is changing, down-leveling of quality of care and deepening of disparities among health care provider should be considered.
Aged ; Cataract* ; Education ; Hand ; Health Personnel ; Humans ; Insurance Coverage ; Jeollanam-do ; Korea ; Medicaid ; National Health Programs ; Nutrition Surveys ; Seoul

Ceramic-on-polyethylene components have better wear characteristics than metal-on-polyethylene components in total hip arthroplasty (THA), and thus, extensive wear resulting in penetration of the femoral head through the acetabular cup is rare after ceramic-on-polyethylene THA. However, several reports have been issued regarding catastrophic polyethylene failure in ceramic-on-polyethylene systems. Here, the authors report the first case of bilateral complete polyethylene wear failure with acetabular cup perforation after ceramic-on-polyethylene THA.
Arthroplasty ; Ceramics ; Head ; Hip ; Polyethylene ; Tacrine

Ceramic-on-polyethylene components have better wear characteristics than metal-on-polyethylene components in total hip arthroplasty (THA), and thus, extensive wear resulting in penetration of the femoral head through the acetabular cup is rare after ceramic-on-polyethylene THA. However, several reports have been issued regarding catastrophic polyethylene failure in ceramic-on-polyethylene systems. Here, the authors report the first case of bilateral complete polyethylene wear failure with acetabular cup perforation after ceramic-on-polyethylene THA.
Arthroplasty ; Ceramics ; Head ; Hip ; Polyethylene ; Tacrine