Thromboembolism is the most common serious complication following total hip arthroplasty and most common cause of death after total hip arthroplasty. A prospective randomized study in 170 cases of elective cementless total hip arthroplasty was carried out to examine the incidence of deep vein thrombosis and pulmonary embolism after cementless total hip arthroplasty from Aug. 1993 to May 1995. Laboratory study, clinical symptoms and signs, chest roentgenograph and precipitating factors were analysed. Venography and lung perfusion scan using radionuclide scan were used for this study. The weight, height, sex, habitus of alcohol and smoking, hypertension, diabetes mellitus, previous operation history of ipsilateral lower extremity, etiology of hip joint disease, and transfusion of blood were not precipitating factors, but the age over 40 and previous history of pulmonary embolism had a significant effect on the incidence of deep vein thrombosis. There was no significant relationship between the incidence of deep vein thrombosis and the laboratory assay, clinical symptoms and signs. Deep vein thrombosis was detected in 29 cases(17.0%), pulmonary embolism in 22 cases(12.9%), and fatal pulmonary embolism in 1 case(0.6%). The most common location of deep vein thrombosis was the popliteal area.
Arthroplasty, Replacement, Hip* ; Cause of Death ; Diabetes Mellitus ; Hip Joint ; Hypertension ; Incidence ; Lower Extremity ; Lung ; Perfusion ; Phlebography ; Precipitating Factors ; Prospective Studies ; Pulmonary Embolism* ; Smoke ; Smoking ; Thorax ; Thromboembolism ; Venous Thrombosis*

No abstract available.
Breech Presentation* ; Female ; Fetus* ; Pregnancy

PURPOSE: To evaluate the primary indications, surgical outcomes, causes and risk factors for graft failure in patients with three or more penetrating keratoplasty (PKP) surgeries. METHODS: We retrospectively analyzed indications for the initial corneal graft, survival periods, causes and risk factors for failure in 25 patients (26 eyes) who had undergone three or more PKP with minimum follow-up periods of nine months. RESULTS: The most common primary indications were herpes simplex keratitis (26.9%), followed by fungal keratitis (19.2%) and bacterial keratitis (11.5%). The average survival period of graft in three or more PKP was 12.9 +/- 9.1 months. As the frequency of PKP increased, the survival period became shorter; the survival period was the longest in pseudophakic bullous keratopathy and the shortest in herpes simplex keratitis. The most common cause of graft failure was allograft rejection (82.8%), and the risk factors for graft failure were short interval between penetrating keratoplasties and corneal neovascularization. CONCLUSIONS: In three or more PKP, as the frequency of PKP increases, the survival period becomes shorter. Short interval between keratoplasties and cornel neovascularization were risk factors for graft failure; this results must be considered before surgery.
Corneal Transplantation ; Follow-Up Studies ; Humans ; Keratitis ; Keratitis, Herpetic ; Keratoplasty, Penetrating ; Methylmethacrylates ; Polystyrenes ; Rejection (Psychology) ; Retrospective Studies ; Risk Factors ; Transplantation, Homologous ; Transplants

PURPOSE: To present a rare case of idiopathic orbital myositis involving levator palpebrae superioris. CASE SUMMARY: A 27-year-old male presented with a 1-week history of redness, discomfort, swelling, and drooping of his left upper eyelid. A computed tomography scan showed isolated enlargement of the right superior rectus/levator muscle complex. On examination, there was a left blepharoptosis, although eye movements were normal. The authors treated the patient with 3rd-generation cephalosporin; however, after 3 days, the symptoms did not improve. Subsequently, the patient was diagnosed with idiopathic orbital myositis and treated with oral corticosteroids for 1 month; the symptoms gradually resolved. CONCLUSIONS: Idiopathic orbital myositis is a subtype of nonspecific orbital inflammation primarily involving the extraocular muscles. Although the exact cause of orbital myositis is unknown, an immune-mediated pathophysiologic mechanism appears to be one of the causes. Medial rectus myositis is the most common, and isolated levator muscle myositis is very rare. The authors of the present study reported a case of orbital myositis involving the levator palpebrae superioris which should be considered a differential diagnosis of blepharoptosis with eyelid swelling.
Adrenal Cortex Hormones ; Adult ; Blepharoptosis ; Diagnosis, Differential ; Eye Movements ; Eyelids ; Humans ; Inflammation ; Male ; Muscles ; Myositis ; Orbit ; Orbital Myositis

The incidence of intracranial complications of otitis media, including lateral sinus thrombophlebitis, has been significantly reduced since the advent of antibiotics. This entity is rarely encountered in clinical practice, and delay in its diagnosis and institution of appropriate therapy may lead to serious, or even fatal, consequences. The signs and clinical course of lateral sinus thrombophlebitis are non-specific and the final diagnosis rests upon radiological investigations including CT-scans and MRI. We have experienced a case of middle fossa and posterior fossa epidural abscess formation, lateral sinus thrombophlebitis that has developed secondary chronic otitis media with cholesteatoma in a 47 year-old female patient. We report this case which was successfully treated by middle fossa dura and posterior fossa dura drainage, lateral sinus thrombectomy with open mastoidectomy.
Anti-Bacterial Agents ; Cholesteatoma* ; Diagnosis ; Drainage ; Epidural Abscess* ; Female ; Humans ; Incidence ; Lateral Sinus Thrombosis* ; Magnetic Resonance Imaging ; Middle Aged ; Otitis Media* ; Otitis* ; Thrombectomy ; Transverse Sinuses*

Objectives: ：Screening of male depression is important since their symptoms differ from females, such as more common suicide attempts and aggression. Rutz et al. designed the Gotland Male Depression Scale (GMDS) to understand male depression and prevent suicide. The aim of this study is to translate the GMDS into Korean and assess the factor structure of K-GMDS. Methods: ：The K-GMDS was administered to 213 male office workers in one public institution. The current study used exploratory factor analysis to validate the factor structure and used confirmatory factor analysis to test the construct validity of five factor models from prior research. Results: ：The result indicated that the K-GMDS is characterized by a two-factor structure, different from originally proposed GMDS factor structure and other prior models. Fit indices demonstrated the prior five models to be a poor fit to the data. The internal consistency was demonstrated by a Cronbach’s α of 0.921. Conclusions ：This study can be used as a basis study of male depression, which has not been studied much in Korea. Though factor structure of GMDS reported discrepant findings with prior studies, it would help further development of the scale.

OBJECTIVE: The purpose of this study is to investigate the difference on regional volume in temporal lobe between Alzheimer's disease patients with psychosis (AD+P) and Alzheimer's disease patients without psychosis (AD-P). METHODS: Altogether, 24 AD+P and 25 AD-P matched age, gender, and clinical dementia rating sum of box (CDR-SOB) were include from a Memory impairment clinics of Pusan National University Hospital in Korea. AD+P were diagnosed according to Jeste and Finkel's proposed diagnostic criteria for psychosis of Alzheimer's disease. Grey matter volume of temporal lobe was measured with 3-tesla magnetic resonance imaging and freesufer analysis. Analysis of variance was used to investigate the association between temporal lobe and AD+P after controlling age, gender, education years, CDR-SOB and total intracranial volume. RESULTS: We found an association between AD+P and reduced grey matter volume in total temporal lobe as well as in specific temporal regions such as left middle temporal lobe, left inferior temporal lobe, both hippocampus and both fusiform. CONCLUSION: Our findings suggest that AD+P are associated with reduced grey matter volume of temporal lobe.
Alzheimer Disease* ; Atrophy* ; Busan ; Dementia ; Education ; Gray Matter ; Hippocampus ; Humans ; Korea ; Magnetic Resonance Imaging ; Memory ; Psychotic Disorders* ; Temporal Lobe*

PURPOSE: To evaluate the extent of macular microvascular changes in diabetic retinopathy according to progression of diabetic retinopathy using optical coherence tomography angiography (OCTA). METHODS: We retrospectively analyzed 46 diabetic patients and 10 normal patients who underwent OCTA. Diabetic patients were classified as mild, moderate, severe non-proliferative diabetic retinopathy (NPDR), and proliferative diabetic retinopathy (PDR) according to international clinical diabetic retinopathy severity classification fundus findings. OCTA was performed on a 3 × 3 mm region centered on the fovea and parafoveal areas to measure the width of the fovea avascular zone (FAZ) of the superficial and deep capillary plexuses. RESULTS: Among the control group, NPDR, and PDR, the superficial capillary plexus (SCP) and deep capillary plexus (DCP) of the FAZ increased with progression of diabetic retinopathy. In the SCP (p<0.001) and DCP (p<0.001), there was a significant difference in size between the NPDR and PDR groups. In the NPDR group, there were meaningful differences in SCP (p=0.011) and DCP (p=0.038) size between the moderate and severe NPDR groups. CONCLUSIONS: In this study, OCTA was used to measure the FAZ, and we aimed to determine if there was a significant difference in FAZ between the NPDR and the PDR groups and between the moderate and severe NPDR groups in terms of the degree of progression of diabetic retinopathy. The results suggest that the size of the FAZ could be a marker of progression of diabetic retinopathy, and noninvasive OCTA can be used to confirm such progression.
Angiography* ; Capillaries ; Classification ; Diabetic Retinopathy* ; Humans ; Retrospective Studies ; Tomography, Optical Coherence*

PURPOSE: Successful treatment of bladder cancer greatly depend upon the regular surveillance for early detection of persistent or recurrent cancer. We assessed the efficacy of urinary NMP22 test in screening and post-trearment follow-up for bladder cancer. MATERIALS AND METHODS: Urinary NMP22 test kit, which is based on an enzyme-linked immunosorbent assays, were used to measure the values of urinary NMP22 in 30 patients of transitional cell carcinoma of the bladder, 32 healthy volunteers, 12 patients of urinary tract infection and 13 patients of other urinary malignancy. RESULTS: Median values of urinary NMP22 in patients with bladder cancer were significantly greater than in healthy volunteers(p<0.05). With a cutoff value of 15units/ml, urinary NMP22 test had a 90.0% of sensitivity and a 90.6% of specificity in predicting bladder cancer. There was significant postoperative decrease of urinary NMP22 values in all patients with bladder cancer(p<0.05). CONCLUSIONS: These results suggest that urinary NMP22 test is useful for screening and postoperative surveillance of patients with transitional cell carcinoma of urinary bladder. Further comparative studies of urinary NMP22 test with the results of postoperative cystoscopy or cold cup biopsies are requested to enhance the practical utility of urinary NMP22 test.
Biopsy ; Carcinoma, Transitional Cell ; Cystoscopy ; Enzyme-Linked Immunosorbent Assay ; Follow-Up Studies* ; Healthy Volunteers ; Humans ; Mass Screening* ; Sensitivity and Specificity ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urinary Tract Infections

PURPOSE: This study was performed to evaluate the long-term effect of 0.05% cyclosporine A emulsion (Restasis, Allergan Inc. USA.) on dry eye associated with graft-versus-host disease (GVHD). METHODS: Sixteen eyes of 8 patients with severe dry eye associated with GVHD were treated with 0.05% cyclosporine A emulsion twice a day. Tear film parameters were evaluated before treatment and after 1, 3, 6, and 12 months of treatment. RESULTS: One month after treatment, tear break-up time improved from 3.88+/-1.78 s to 4.17+/-1.90 s (P=0.02). Three months after treatment, symptom score and basal secretion improved from 3.00+/-0.38 and 4.44+/-1.59 mm to 2.33+/-0.52 (P=0.04) and 5.42+/-2.50 mm (P=0.04), respectively. Twelve months after treatment, the keratoepitheliopathy score improved from 2.38+/-1.31 to 1.13+/-0.35 (P=0.02). CONCLUSIONS: Use of a 0.05% cyclosporine A emulsion is effective for dry eye associated with GVHD as it helps to increase tear secretion and to relieve symptoms. Treatment with 0.05% cyclosporine A emulsion for longer than 1 year may be necessary to improve keratoepitheliopathy.
Cyclosporine ; Dry Eye Syndromes ; Eye ; Graft vs Host Disease ; Humans ; Tears