Purpose: To analyze the causes and to prevent dislocations of the hip joint that occur in patients who underwent revisions of total hip arthroplasties by changing only the polyethylene liners and femoral heads, subsequent to primary total hip arthroplasties. Materials and Methods: We evaluated 28 patients who underwent acetabular component revisions of total hip arthroplasties subsequent to primary total hip arthroplasties. The average age of the patients was 55 years old and all 28 patients had operations through the posterolateral approach. In 17 of the cases, the acetabular cups, polyethylene liners, and femoral heads were changed; in 10 cases, just the polyethylene liners and femoral heads were changed; and in 1 case, only the polyethylene liner was changed. Results: We observed 7 cases of hip dislocations that occurred among a total of 28 cases after revisions of total hip arthroplasties. In all 7 cases, the polyethylene liners and femoral heads were changed, but not the acetabular cups. In additional, in all 7 cases of dislocation, the patients were non-compliant and started weight-bearing prematurely after revisions of the total hip arthroplasties Conclusion: We observed new dislocations in the 7 cases in which the polyethylene liners and femoral heads were changed. The main reasons were inadequate soft tissue tension and hip joint laxity. Therefore, it is necessary to increase the neck length, use elevated rim polyethylene liners, readjust the acetabular cups to their optimal positions, and apply hip abduction braces to patients early after revision of total hip arthroplasties in order to lessen the danger of dislocations.
Acetabulum* ; Arthroplasty ; Braces ; Dislocations* ; Head ; Hip ; Hip Dislocation ; Hip Joint ; Humans ; Neck ; Polyethylene ; Risk Factors* ; Weight-Bearing

The gastric polyps may be premalignant lesions and they should be removed as possible. The gastric polyps can be remoued by various endoscopic methods. The safety and therapeutic effectiveness of snare polypectomy, neodymium YAG laser therapy and electrocutery were compared in a total number of 106 patients who were diagnosed as benign polyps by means of endoscopic biopsy.Safety was evaluated by the rate of complications such as perforation and bleeding, and therapeutic effectiveness was evaluated by the average numbers of treatment session of each modality. Average numbers of treatment session of snare polypectomy, laser therapy and electrocautery were 1.04, 1.38 and l.44, respectively. Average numbers of treatment session of snare polypectomy were significantly (p<0.05) lower than those of other two methods. Perforation was not occurred in any group. Bleeding rates after snare polypectomy, laser therapy and electrocautery were 17.4%, 1.0% and 3.8%, respectively. Bleeding was significantly (p<0,05) more frequent after snare polypectomy than after other two methods. In conclusion therapeutic effectiveness was best in snare polypectomy but complication was most frequent after snare polypectomy. There was no difference between laser therapy and electrocautery for therapeutic effectiveness and safety. Therfore, laser therapy and electrocautery caa be used for the removal of flat adenoma, alternatively.
Adenoma ; Electrocoagulation ; Hemorrhage ; Humans ; Laser Therapy ; Lasers, Solid-State ; Neodymium ; Polyps ; SNARE Proteins

The gastric polyps may be premalignant lesions and they should be removed as possible. The gastric polyps can be remoued by various endoscopic methods. The safety and therapeutic effectiveness of snare polypectomy, neodymium YAG laser therapy and electrocutery were compared in a total number of 106 patients who were diagnosed as benign polyps by means of endoscopic biopsy.Safety was evaluated by the rate of complications such as perforation and bleeding, and therapeutic effectiveness was evaluated by the average numbers of treatment session of each modality. Average numbers of treatment session of snare polypectomy, laser therapy and electrocautery were 1.04, 1.38 and l.44, respectively. Average numbers of treatment session of snare polypectomy were significantly (p<0.05) lower than those of other two methods. Perforation was not occurred in any group. Bleeding rates after snare polypectomy, laser therapy and electrocautery were 17.4%, 1.0% and 3.8%, respectively. Bleeding was significantly (p<0,05) more frequent after snare polypectomy than after other two methods. In conclusion therapeutic effectiveness was best in snare polypectomy but complication was most frequent after snare polypectomy. There was no difference between laser therapy and electrocautery for therapeutic effectiveness and safety. Therfore, laser therapy and electrocautery caa be used for the removal of flat adenoma, alternatively.
Adenoma ; Electrocoagulation ; Hemorrhage ; Humans ; Laser Therapy ; Lasers, Solid-State ; Neodymium ; Polyps ; SNARE Proteins

Primary idiopathic polymyositis is a condition of presumed autoimmune etiology in which the skeletal muscle is damaged by a nonsuppurative inflammatory process dominated by lymphocytic infiltration. We recently experienced a patient with primary idiopathic Polymyositis associated with hypoalbuminemia and thrombocytopenia. About 4 months prior to admission, he was diagnosed as primary idiopathic polymyositis, and improved by treatment with prednisolone 60 mg/day. During steroid tapering, muscle weakness was recurred and accompanied by hypoalbuminemia and thrombocytopenia. Despite retreatment with prednisolone 60 mg/day, muscle weakness, hypoalbuminemia and thrombocytopenia persisted. He was then started to administer methotrexate(MTX) 15 mg/week which resulted in prompt improvement of muscle weakness, hypoalbuminemia and thrombocytopenia. These findnigs suggest that primary idiopathic polymyositis is one of the cause of hypoalbuminemia and thrombocytopenia, and that the hypoalbuminemia and thrombocytopenia can be improved promptly by methotrexate treatment.
Humans ; Hypoalbuminemia* ; Methotrexate ; Muscle Weakness ; Muscle, Skeletal ; Polymyositis* ; Prednisolone ; Retreatment ; Thrombocytopenia*

Aspergillus tracheobronchitis (AT), an unusual form of invasive pulmonary aspergillosis (IPA), is characterized by pseudomembrane formation, ulcer or obstruction that is predominantly confined to tracheobronchial tree. Hematologic malignancies, neutropenia, solid organ transplantation, chronic corticosteroid therapy and acquired immunodeficiency syndrome (AIDS) are known to be major predisposing conditions. However, since the introduction of highly active antiretroviral therapy, there is only one reported case of AT in AIDS patient. After pandemic of influenza A/H1N1 2009, there are several reports of IPA in patient with influenza and most of them received corticosteroid or immunosuppressive therapy before the development of IPA. We present a 45 year-old AIDS patient with influenza A infection who developed pseudomembranous AT without corticosteroid use or immunosuppressive therapy.
Acquired Immunodeficiency Syndrome ; Antiretroviral Therapy, Highly Active ; Aspergillus* ; Bronchitis ; Coinfection* ; Hematologic Neoplasms ; Humans ; Influenza, Human* ; Invasive Pulmonary Aspergillosis ; Neutropenia* ; Organ Transplantation ; Pandemics ; Transplants ; Ulcer

PURPOSE: Nitric oxide (NO) synthesis has been known to be induced during interleukin-2 (IL-2) therapy. The present study was designed to elucidate mechanisms and roles of IL-2-induced NO synthesis in tumor cells. MATERIALS AND METHODS: Mechanisms of IL-2-induced NO synthesis were evaluated using in vitro culture systems of BALB/c mouse splenic lymphocytes and Meth-A tumor cells. Effects of IL-2-induced NO synthesis by Meth-A tumor cells on the tumor cell proliferation were also evaluated using an NO synthase inhibitor, N -monomethyl- L-arginine (MLA). RESULTS: Cultures of both lymphocytes alone and Meth-A tumor cells alone did not produce any significant amounts of nitrite, a stable metabolite of NO during IL-2 stimulation. In contrast, cocultures of lymphocytes and Meth-A tumor cells produced a large amount of nitrite during IL-2 stimulation. Addition of culture supernatants of lymphocytes incubated with IL-2 induced nitrite production in Meth-A tumor cell cultures. However, addition of culture supernatants of Meth-A tumor cells incubated with IL-2 did not induce nitrite production in lymphocyte cultures. Nitrite accumulation was markedly inhibited by addition of anti-interferon-y antibody, confirming the role of the cytokine in mediating tumor cell NO synthesis. MLA inhibited nitrite production by Meth-A tumor cells in a dose-dependent manner in the presence of culture supernatants of lymphocytes incubated with IL-2. Meth-A tumor cell nitrite production in the presence of increasing concentrations of MLA correlated inversely with tumor cell proliferation. CONCLUSION: NO synthesis can be induced by tumor cells by the secondarily released cytokines from lymphocytes during IL-2 stimulation. Autologous NO synthesized by tumor cells during IL-2 stimulation inhibits proliferation of tumor cells themselves.
Animals ; Arginine ; Cell Culture Techniques ; Cell Proliferation ; Coculture Techniques ; Cytokines ; Interleukin-2* ; Lymphocytes* ; Mice ; Negotiating ; Nitric Oxide Synthase ; Nitric Oxide*

OBJECTIVE: This study aimed to investigate antidepressant prescribing patterns, including initial choice, switching and combining, and concomitant use of non-antidepressant agents, for depressive disorders in naturalistic clinical care settings in Korea. METHODS: Patients with depressive disorder were recruited from both outpatient and inpatient settings in 18 hospitals from all over Korea. Treatment was performed in naturalistic patterns based on each clinician's decision. Data were collected on the prescription of antidepressants and concomitant agents from baseline to 12-week follow-up. RESULTS: Selective serotonin reuptake inhibitors (SSRIs) were the most commonly prescribed initial antidepressant (48.9%), followed by newer dual-action antidepressants (45.8%). When an SSRI was the initial antidepressant, 46.2% of patients whose medication was changed were moved to newer dual-action antidepressants, and 67.4% of combination cases were combined with newer dual-action ones. When a newer dual-action antidepressant was the initial antidepressant, 70.6% of patients whose medication was changed were moved to SSRIs, and other antidepressants including tricyclic antidepressants were most commonly added for combination treatment (50% of combination cases). During the treatment period, 20.6% of antidepressants prescribed were augmented by non-antidepressant agents, and 75.1% were used concomitantly with anxiolytics or hypnotics. The most commonly used concomitant non-antidepressant agent was quetiapine. CONCLUSION: The selection of antidepressants and the concomitant use of non-antidepressant agents are becoming increasingly diversified, and the results of this study reflect changes in the prescribing pattern in actual Korean practices.
Anti-Anxiety Agents ; Antidepressive Agents ; Antidepressive Agents, Tricyclic ; Depression ; Depressive Disorder ; Humans ; Hypnotics and Sedatives ; Inpatients ; Korea ; Outpatients ; Prescriptions ; Serotonin Uptake Inhibitors

Pneumoconiosis was the first reported occupational disease in Korea and was the most common one until 1990. In the past, most pneumoconiosis patients were found among underground workers in various mines. Recently this occupational disease has increasingly affected workers in manufacturing industries such as ship building, briquette, glass, foundry industries, and so on. In order to investigate the scale of pneumoconiosis in manufacturing industries, we evaluated the detailed medical examination records and insurance deliberation data from 1989 until 1994. Information about work history, medical history, and exposure dust type were collected for each member of the study population. All chest X-rays were interpreted and classified using the International Labor Organization(ILO) scale by three radiologist who have had extensive experience evaluation pneumoconiosis. For the calculation of the incidence rate of manufacturing pneumoconiosis, we analyzed the Specific Health Examination data and estimated the population at risk as a denominator of the incidence rate. We divided manufacturing industry into 9 subclasses by industrial classification and estimated the incidence rate of pneumoconiosis per 100,000 workers at risk respectively. The results were as follows, 1. 485 workers were newly diagnosed with pneumoconiosis during 6 years from 1989 to 1994. 482 workers had radiographs consistent with simple pneumoconiosis and three with progressive massive fibrosis. Among those with radiographs consistent with simple pneumoconiosis, 395 workers(81.4%) had category 1 profusion, 76 workers(15.7%) had category 2 profusion and 11 workers(2.3%) had category 3 profusion. 2. Almost all of them were male(97.9%) and their average age was 48.3 uears. Manufacturing pneumoconiosis patients were more common in their forties and fifties. 3. The average duration of dust exposure required for the occurrence of pneumoconiosis was 13.5 years. In the case of metal products manufacturing which is mostly related to welding, the average duration of dust exposure was 12.0 years. It was slightly shorter than other manufacturing industries. The average duration of dust exposure required for the occurrence of pneumoconiosis seemed to be shorter in welding operators, even though the welders lung has a weak tissue reaction and the condition is reversible. 4. According to the Industrial classification, 299 cases(61.6%) were found in workers of non-metal mineral products manufacturing, and 56 cases(11.5%) in basic metals industry. 5. The average annual incidence rate of pneumoconiosis in manufacturing industries from 1990 to 1994 was 56.6 per 100,000 workers at risk. On sub-classification, the average annual incidence rate of pneumoconiosis in non-metal mineral products manufacturing industry was the highest among them, showing 479 per 100,000 workers at risk. 6. Radiologic prevalence rate of tuberculosis in these cases was 6.6%. 7. X-ray category profusion in newly diagnosed manufacturing pneumoconiosis varied according to sub-classification. The proportion of category 1 profusion in metal products manufacturing is higher than that in non-metal mineral products manufacturing. 8. The type pattern of small round opacities varied according to sub-classification in manufacturing industry. In non-metal mineral products manufacturing, the small round opacity were observed 25.9% cases with p type, 72.1% with q type and 2.0% with r type respectively. But in metal products manufacturing, the small round opacity were observed 51.4% cases with p type and 48.6% with q type respectively. The cause might be that the exposed dust is different according to job. 9. The type pattern of small round opacities varied according to dust type. Metal dusts showed similar radiologic shape to the coal dusts, but welding fume showed more frequent p type(60.3%) and less frequent q type(377%). rock dust showed less frequent p types(18.3%) and more frequent q types(75.3%). Since the incidence rate of non-metal manufacturing workers showed higher rate than other manufacturing industry, Preventive measures and health care education should be carefully carried out in these workers.
Classification ; Coal ; Delivery of Health Care ; Dust ; Education ; Fibrosis ; Glass ; Humans ; Incidence ; Insurance ; Korea ; Lung ; Metals ; Occupational Diseases ; Pneumoconiosis* ; Population Characteristics ; Prevalence ; Ships ; Thorax ; Tuberculosis ; Welding