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

Acute arterial occlusion of the extremity may result from obstruction of an artery by embolism or by thrombosis in situ. This results in the sudden cessation of blood flow to an extremity. So immediate managements are required to prevent propagation of the clot and to restore blood flow to the ischemic extremity promptly. We report a case of a acute arterial occlusion which was developed during prolonged fasting. A 59-year-old male was transferred due to severe ischemic pain, coldness and loss of pulse in left lower extremity during fast. The arteriogram shows a complete obstruction of external iliac artery and non-visualization of femoral artery and popliteotibial artery in the left lower extremity. Selective intra-arterial urokinase thrombolytic therapy and percutaneous transluminal angioplasty resulted in recannulation of obstructed artery and relief of symptoms.
Angioplasty ; Arteries ; Embolism ; Extremities ; Fasting* ; Femoral Artery ; Humans ; Iliac Artery ; Lower Extremity* ; Male ; Middle Aged ; Thrombolytic Therapy ; Thrombosis ; Urokinase-Type Plasminogen Activator

Bone injuries of the extremities can be found in 0.2-2% of all living newborns. The most common location of the fracture was clavicle, and followed by humerus, femur in orders. Fractures of the femur are relatively rare. Authors have analyzed 9 cases of the femoral shaft fractures in the newborns, treated at Severence Hospital from January 1985 to March 1992. Seven cases were born by Cesarean section, two cases were by normal spontaneous vaginal delivery. Vertex presentation were three cases, breech presentation were five cases, and transverse presentation was one case. The mean birth weight was 2.93kg and four cases were born in prematurity. The location of fracture were seven cases in proximal shaft, one case in mid shaft, and one case in distal shaft. The type of fracture were all spiral fracture except two fractures. Five cases were treated by splint and 4 cases were treated by traction method. No further immobilization was needed for 8 cases but two weeks long leg cast after splint was applied for one case. Two cases of complication were noted. Skin necrosis developed due to the traction to the popliteal fossa and minimal anterior angulation of femora, and no functional deficit were found, but bony protrusion of proximal femora were palpated.
Birth Weight ; Breech Presentation ; Cesarean Section ; Clavicle ; Extremities ; Female ; Femur ; Humans ; Humerus ; Immobilization ; Infant, Newborn ; Leg ; Methods ; Necrosis ; Parturition ; Pregnancy ; Skin ; Splints ; Traction

OBJECTIVES: This study was conducted to investigate that the chronic noise exposure is associated with decreased serum magnesium concentrations and evaluate whether decreased serum magnesium is associated with noise induced hearing loss. METHODS: One hundred seventy-eight male workers exposed to noise were selected and classified three groups by the degree of hearing loss. Hearing threshold levels were less than 30 dB at 1,000 Hz or less than 40 dB at 4,000 Hz in group I, more than 30 dB at 1,000 Hz or more than 40 dB at 4,000 Hz and 15 dB and less of pure tone average(PTA: (500 Hz+1,000 Hz+2,000 Hz)/3) in group II, more than 30 dB at 1,000 Hz or more than 40 dB at 4, 000 Hz and over 15 dB of PTA in group III. RESULTS: Serum magnesium concentrations were 2. 42+/-0. 26 nc/dt in group I, 2. 35+/-0.23 mg(dl in group II, 2.26+/-0.24 ne/dl in group III, respectively and significantly different between group I and group III (p<0. 01). It was negatively correlated with duration of the noise exposure as correlation coefficient(r) of -0.194 (p<0.05). Analysis of the multiple regression on hearing threshold levels showed that serum magnesium, diastolic blood pressure, duration of the noise exposure were statistically significant at 4,000 Hz(p<0.05). While only age was statistically significant at 1,000 Hz(p<0.05). CONCLUSIONS: These results suggest that chronic noise exposure may induces decrease in serum magnesium concentrations and that its decreased concentration is related with noise induced hearing loss.
Blood Pressure ; Hearing Loss* ; Hearing* ; Humans ; Magnesium* ; Male* ; Noise*

Neurologic complications of Epstein-Barr virus (EBV) infection are diverse including a number of neurologic diseases such as encephalitis, encephalomyelitis, Guillain-Barre syndrome, optic neuritis, acute disseminated encephalomyelitis, cerebellitis, and Alice-In-Wonderland syndrome. In general encephalitis caused by EBV in children has been considered a self-limited disease with few or no sequelae. Occasionally it leaves a severe neurologic sequela and complications. Therefore administration of high dose acyclovir and steroid in early stages of EBV encephalitis is recommended currently. In this case, the patient of a 8-year-old boy was admitted because of generalized tonic seizure of 2 times. He showed 16% of atypical lymphocytosis in peripheral blood smear and positive findings in VCA-IgM and EA-IgM tests. EBV DNA Antibody, and virus PCR in CSF was not evaluated. He also showed hepatosplenomegaly in abdominal sonography. Brain MRI revealed a bilateral increased signal intensity at lenticular nucleus and caudate nucleus, multiple high signal intensity at cortical layer of both gyrus reti, both frontal, inferior parietal, and dorsal aspect of the right paracentral lobue. As mentioned in serologic and imaging study, he was diagnosed as the EBV- associated encephalitis. Although we administered high dose acyclovir and corticosteroids, he showed clinical deterioration with confusion, delirium, and ataxia. Therefore, we administered additional high dose intravenous immunoglobulin, and finally he was recovered. We report the case of improvement of EBV-associated encephalitis after high-dose Intravenous immunoglobulin therapy.
Acyclovir ; Adrenal Cortex Hormones ; Ataxia ; Brain ; Caudate Nucleus ; Child ; Corpus Striatum ; Delirium ; DNA ; Encephalitis* ; Encephalomyelitis ; Encephalomyelitis, Acute Disseminated ; Guillain-Barre Syndrome ; Herpesvirus 4, Human* ; Humans ; Immunization, Passive* ; Immunoglobulins* ; Lymphocytosis ; Magnetic Resonance Imaging ; Male ; Optic Neuritis ; Polymerase Chain Reaction ; Rabeprazole ; Seizures

Neurologic complications of Epstein-Barr virus (EBV) infection are diverse including a number of neurologic diseases such as encephalitis, encephalomyelitis, Guillain-Barre syndrome, optic neuritis, acute disseminated encephalomyelitis, cerebellitis, and Alice-In-Wonderland syndrome. In general encephalitis caused by EBV in children has been considered a self-limited disease with few or no sequelae. Occasionally it leaves a severe neurologic sequela and complications. Therefore administration of high dose acyclovir and steroid in early stages of EBV encephalitis is recommended currently. In this case, the patient of a 8-year-old boy was admitted because of generalized tonic seizure of 2 times. He showed 16% of atypical lymphocytosis in peripheral blood smear and positive findings in VCA-IgM and EA-IgM tests. EBV DNA Antibody, and virus PCR in CSF was not evaluated. He also showed hepatosplenomegaly in abdominal sonography. Brain MRI revealed a bilateral increased signal intensity at lenticular nucleus and caudate nucleus, multiple high signal intensity at cortical layer of both gyrus reti, both frontal, inferior parietal, and dorsal aspect of the right paracentral lobue. As mentioned in serologic and imaging study, he was diagnosed as the EBV- associated encephalitis. Although we administered high dose acyclovir and corticosteroids, he showed clinical deterioration with confusion, delirium, and ataxia. Therefore, we administered additional high dose intravenous immunoglobulin, and finally he was recovered. We report the case of improvement of EBV-associated encephalitis after high-dose Intravenous immunoglobulin therapy.
Acyclovir ; Adrenal Cortex Hormones ; Ataxia ; Brain ; Caudate Nucleus ; Child ; Corpus Striatum ; Delirium ; DNA ; Encephalitis* ; Encephalomyelitis ; Encephalomyelitis, Acute Disseminated ; Guillain-Barre Syndrome ; Herpesvirus 4, Human* ; Humans ; Immunization, Passive* ; Immunoglobulins* ; Lymphocytosis ; Magnetic Resonance Imaging ; Male ; Optic Neuritis ; Polymerase Chain Reaction ; Rabeprazole ; Seizures

PURPOSE: To analyze related factors of retinopathy of prematurity by comparing between premature twins in which retinopathy developed on one twin. METHODS: A retrospective survey consisting of 13 premature twins in which retinopathy of prematurity (stage 1 or more) developed on one twin was performed. All twins were born in Kosin University Gospel Hospital. The twins were separated into two groups according to whether they had retinopathy of prematurity: the retinopathy of prematurity (ROP) group and non-ROP group. The twins' gestational age, weight, sex, Apgar score, treatments, blood tests, and neonatal complications were investigated. RESULTS: There were no significant differences between the twins except platelet count and aspartate aminotransferase. Platelet count was 191 (±46) ×10³/µL in the ROP group and 240 (±77) ×10³/µL in the non-ROP group, a significant difference (p = 0.046). Aspartate aminotransferase was 36 (±26.6) IU/L in the ROP group and 22 (±5.9) IU/L in the non-ROP group, a significant difference (p = 0.019). CONCLUSIONS: In conclusion, we found platelet count and aspartate aminotransferase to be significant factors related to development of retinopathy of prematurity. It is thought that these factors should be considered when screening for ROP, although a larger prospective study is be needed before the results can be applied in clinical practice.
Apgar Score ; Aspartate Aminotransferases ; Blood Platelets ; Gestational Age ; Hematologic Tests ; Humans ; Mass Screening ; Platelet Count ; Prospective Studies ; Retinopathy of Prematurity ; Retrospective Studies ; Twins*

Krukenberg tumor of the primary breast carcinoma is rare and this is almost invasive lobular carcinoma. They are usually bilateral and frequent in premenopausal women. Diagnosis of symptomatic Krukenberg tumor is reported to be 1 or 2 year after the diagnosis of primary neoplasm. But sometimes it is discovered prior to the detection of the primary breast carcinoma. Unexpected ovarian micrometastasis was recognized after oophorectomy of normally appearing ovaries in breast cancer patients. Existence of Krukenberg tumor means advanced primary disease and possible metastasis to other organs, and have a poorer prognosis. We report a case of Krukenberg tumors occurred 3 years after the diagnosis of primary ductal type breast carcinoma.
Breast Neoplasms* ; Breast* ; Carcinoma, Lobular ; Diagnosis ; Female ; Humans ; Krukenberg Tumor* ; Neoplasm Metastasis* ; Neoplasm Micrometastasis ; Ovariectomy ; Ovary* ; Prognosis

PURPOSE: To help predict the severity of ocular complications in orbital blunt trauma by analyzing clinical features of ocular complications and orbital wall fracture. METHODS: A retrospective survey consisting of 169 eyes of 168 patients with orbital blunt trauma who visited Kosin University Gospel Hospital was performed. The patients' age, gender, height, weight, cause of accident, and ocular complications were investigated. The patients were imaged using computer tomography and divided into two groups according to whether they had orbital wall fracture: the orbital contusion group and the orbital wall fracture group. Variables of orbital wall fracture, including the location, length, width, and area were measured using computer tomography in the orbital wall fracture group. RESULTS: The incidence of ocular complication was 27 of 67 eyes (40.2%) in the orbital wall fracture group and 75 of 102 eyes (73.5%) in the orbital contusion group; ocular complications were found significantly more often in the orbital contusion group than in the orbital wall fracture group (p < 0.001). Among causes of the accident, 'flying object' showed the highest incidence of ocular complication at 40 of 48 eyes (85.1%). In the orbital wall fracture group, there was no significant difference in orbital fracture location, length, width or area between the ocular complication group and the non-ocular complication group. CONCLUSIONS: Ocular complications were found significantly more often in the orbital contusion group than in the orbital wall fracture group, and 'flying object' showed the highest incidence of ocular complication among causes of the accident.
Contusions ; Humans ; Incidence ; Orbit* ; Orbital Fractures ; Retrospective Studies

OBJECTIVE: Recently, the cases about successful regional anesthesia using combined superficial cervical plexus block and interscalene brachial plexus block for clavicle surgery have been reported. The aim of this study was to compare regional anesthesia using combined superficial cervical plexus block and interscalene brachial plexus block with general anesthesia. METHODS: In this prospective randomized study, 26 patients scheduled for elective clavicle surgery were divided into two groups: the first group was general anesthesia group (GA group, n=13) and the second group for peripheral nerve block group (PNB group, n=13). Standardized general anesthesia was done to the patients assigned to the GA group and ultrasonography-guided combined superficial cervical plexus block and interscalene brachial plexus block was done to the patients assigned to the PNB group. Postoperative sedation scale was assessed at post-anesthesia care unit, and pain scale using 10-cm Visual Analog Scale (VAS) was assessed at immediate postoperative, 30 minutes, 1 hour, 6 hours, and 24 hours. Patients needed additional analgesics, and time for first analgesic demand and duration from surgery to discharge was recorded. RESULTS: The pain VAS scales were less in PNB group than GA group from immediate postoperative time to 6 hours. The patients' immediate postoperative sedation scale less than 4 were significantly less in PNS group than GA group. The duration from surgery to discharge was shorter in PNS group than GA group. CONCLUSION: Regional anesthesia using combined superficial cervical plexus block and interscalene brachial plexus block is a successful alternative to general anesthesia for clavicle surgery.
Analgesics ; Anesthesia, Conduction ; Anesthesia, General ; Brachial Plexus Block ; Brachial Plexus ; Cervical Plexus Block ; Cervical Plexus ; Clavicle ; Humans ; Peripheral Nerves ; Prospective Studies ; Visual Analog Scale ; Weights and Measures