Purpose: We hereby would like to compare on the basis of the initial 12 hips and latter 18 hips by analyzing the initial results of the minimal incision total hip arthroplasty of 30 hips we experienced. Materials and Methods: For the period of December 2004 through June 2005, we performed the total hip arthroplasty with minimal incision in 10cm or shorter using the posterolateral approach on 25 patients (30 hips) whose BMI(body mass index) is 30 or lower. We compared by analyzing results of the initial 12 cases and 18 latter cases. Results: The average BMI was 23.7. There weren`t statistically meaningful differences the change in the hemoglobin value of pre-op and post-op, necessity of blood transfusion, position of component, and the Harris hip score 6 weeks after operation. But, the average initial operation time of 124 minutes was remarkably reduced to 65 minutes in average in the latter operation and the length of a skin incision was reduced from the average 9.2 cm in the initial operation to an average of 8.1cm in the latter operation. There wasn't the malposition of acetabular cup and femoral stem. Conclusion: Although we need more statistical data through more cases and the analysis of long-term results, we think that, to surgeons with much experience in the conventional total hip arthroplasty, the total hip anthroplasty using minimal incision for patients with BMI of 30 or below would be a useful approach having the advantage in a cosmetic aspect.
Acetabulum ; Arthroplasty, Replacement, Hip* ; Blood Transfusion ; Hip ; Humans ; Learning Curve* ; Learning* ; Skin

Many drugs can result in a variety of pathologic reactions in the lung, especially the cytotoxic drugs. Amongcytotoxic drugs bleomycin is a prototype. Bleomycin-related pulmonary toxicity is usually known as dose-dependent and can be enhanced with concurrent oxygen therapy, irradiation, or other chemotherapeutic agents. The incidence of bleomycin-induced pulmonary toxicity has been reported as varying from 2 to 46%, and 1% of fatal lung disease. We describe the radiographic and HRCT findings of bleomycin-related pulmonary toxicity developed in two patients: one in ovarian teratocarcinoma, the other malignant lymphoma patient. Chest radiographs and HRCT of these patients showed ground-glass opacities, consolidation, linear and reticular opacities, and interlobular septal thickening. These abnormalities were bilateral, and symmetrical and were found predominantly in the area of mid-and lower-lung zone.
Bleomycin ; Humans ; Incidence ; Lung Diseases ; Lung* ; Lymphoma ; Oxygen ; Radiography, Thoracic ; Teratocarcinoma

Primary pulmonary amyloidosis is a rare disease, and is classified as either tracheobronchial or parenchymal ; the latter is also divided into nodular and diffuse alveolar septal forms. The alveolar form is extremely rare and usually produces reticular and nodular opacities. We describe a case of alveolar septal pulmonary amyloidosis manifested as multiple small nodules on chest radiograph and disseminated micronodules mainly in centrilobular and subpleural location without reticular opacities, on HRCT.
Amyloidosis* ; Radiography, Thoracic ; Rare Diseases

Purpose: In medical education, peer assessment is considered to be an effective learning strategy. Although several studies have examined agreement between peer and faculty assessments regarding basic life support (BLS), few studies have done so for advanced resuscitation skills (ARS) such as intubation and defibrillation. Therefore, this study aimed to determine the degree of agreement between medical students’ and faculty assessments of ARS examinations. Methods: This retrospective explorative study was conducted during the emergency medicine (EM) clinical clerkship of fourth-year medical students from April to July 2020. A faculty assessor (FA) and a peer assessor (PA) assessed each examinee’s resuscitation skills (including BLS, intubation, and defibrillation) using a checklist that consisted of 20 binary items (performed or not performed) and 1 global proficiency rating using a 5-point Likert scale. The prior examinee assessed the next examinee after feedback and training as a PA. All 54 students participated in peer assessment. The assessments of 44 FA/PA pairs were analyzed using the intraclass correlation coefficient (ICC) and Gwet’s first-order agreement coefficient. Results: The PA scores were higher than the FA scores (mean±standard deviation, 20.2±2.5 [FA] vs. 22.3±2.4 [PA]; P<0.001). The agreement was poor to moderate for the overall checklist (ICC, 0.55; 95% confidence interval [CI], 0.31 to 0.73; P<0.01), BLS (ICC, 0.19; 95% CI, -0.11 to 0.46; P<0.10), intubation (ICC, 0.51; 95% CI, 0.26 to 0.70; P<0.01), and defibrillation (ICC, 0.49; 95% CI, 0.23 to 0.68; P<0.01). Conclusion Senior medical students showed unreliable agreement in ARS assessments compared to faculty assessments. If a peer assessment is planned in skills education, comprehensive preparation and sufficient assessor training should be provided in advance.

Purpose: In medical education, peer assessment is considered to be an effective learning strategy. Although several studies have examined agreement between peer and faculty assessments regarding basic life support (BLS), few studies have done so for advanced resuscitation skills (ARS) such as intubation and defibrillation. Therefore, this study aimed to determine the degree of agreement between medical students’ and faculty assessments of ARS examinations. Methods: This retrospective explorative study was conducted during the emergency medicine (EM) clinical clerkship of fourth-year medical students from April to July 2020. A faculty assessor (FA) and a peer assessor (PA) assessed each examinee’s resuscitation skills (including BLS, intubation, and defibrillation) using a checklist that consisted of 20 binary items (performed or not performed) and 1 global proficiency rating using a 5-point Likert scale. The prior examinee assessed the next examinee after feedback and training as a PA. All 54 students participated in peer assessment. The assessments of 44 FA/PA pairs were analyzed using the intraclass correlation coefficient (ICC) and Gwet’s first-order agreement coefficient. Results: The PA scores were higher than the FA scores (mean±standard deviation, 20.2±2.5 [FA] vs. 22.3±2.4 [PA]; P<0.001). The agreement was poor to moderate for the overall checklist (ICC, 0.55; 95% confidence interval [CI], 0.31 to 0.73; P<0.01), BLS (ICC, 0.19; 95% CI, -0.11 to 0.46; P<0.10), intubation (ICC, 0.51; 95% CI, 0.26 to 0.70; P<0.01), and defibrillation (ICC, 0.49; 95% CI, 0.23 to 0.68; P<0.01). Conclusion Senior medical students showed unreliable agreement in ARS assessments compared to faculty assessments. If a peer assessment is planned in skills education, comprehensive preparation and sufficient assessor training should be provided in advance.

BACKGROUND: It is controversial that an electrocardiography (EEG) is valuable in evaluation of patients with headache. The purpose of this study was to determine whether EEG brain mapping can be a useful indicator for evaluating the analgesic efficacy of treatment on the patient with an occipital headache. METHODS: We did an EEG on 20 patients with occipital headaches at the peri-laser application period. The laser was radiated for 3 minutes a third of the total distance from the external occipital protuberance to the mastoid process on the superior nuchal line. An EEG was taKen before laser radiation as control use, and at 10, 30 and 60 minutes after laser radiation by 32 channel electrodes (international 10 20 system). The EEG mapping was red for the high electric potential and blue for the low electric potential. RESULTS: Compared with control group, the alpha wave increased significantly in parieto-occipital and occipital region at 60 minutes after laser radiation (P < 0.05). DarK red color was increased especially in occipital region at 60 minutes after laser radiation, compared with EEG mapping before laser radiation. Good and Fair improvements were observed in 55% of the patients with occipital headaches. CONCLUSIONS: We conclude that EEG can be a valuable indicator in the evaluation of analgesic efficacy of treatment in the patients suffering from occipital headaches. Pain scores were assessed by the patient with the visual analogue scale (VAS).
Brain Mapping ; Electrocardiography ; Electrodes ; Electroencephalography* ; Headache* ; Humans ; Mastoid

A retrospective analysis of CT and MR findings was performed in five patients with histologically proved chordoma including one with chondroid chordoma. All tumors were mostly isodense to gray matter on unenhanced CT, and the single intensities were iso or low and high on T1 and T2-wgighted MR iages, respectively. The tumors had an increase in their density on enhanced CT and MR in four patients, but a chondroid chordoma was poorly enhanced after injection of contrast medicum on CT. Four tumors contained calcifications in CT images and two lesions showed hemorrhage in MR images. Cavernous sinus was involved in all patients, and brain stem and basilar artery were compressed by the tumors in three cases. Pituitary gland was only displaced upward in three patients. Clivus was destroyed in all cases, and sella turcica and sphenoid bone were involved in three patients. CT is better than MR in demonstrating calcifications and bone destruction. In defining the extension of tumor, MR appears to be superior to CT in evaluation of the relationship between the tumor and the surrounding structures.
Basilar Artery ; Brain Stem ; Cavernous Sinus ; Chordoma* ; Cranial Fossa, Posterior ; Gray Matter ; Hemorrhage ; Humans ; Pituitary Gland ; Retrospective Studies ; Sella Turcica ; Sphenoid Bone

BACKGROUND: A ring implantation in the tricuspid annulus requires many interrupted mattress sutures for correction of tricuspid regurgitation (TR). In this study, tricuspid ring annuloplasty was performed by 2-0 polypropylene continuous suture instead of multiple interrupted 2-0 polyester mattress sutures, and the efficacy of the method was evaluated. MATERIALS AND METHODS: This study included 20 patients who underwent tricuspid ring annuloplasty by continuous suture between May 2009 and July 2010. Four of the patients had an isolated TR, and the rest had a left-sided cardiac lesion. The concomitant tricuspid annuloplasty was performed after the left-sided heart surgery was completed and a Duran flexible ring prosthesis was used. RESULTS: There was no perioperative mortality or conduction problem. More than a moderate degree of TR was improved to less than a mild degree after the procedure. After the ring annuloplasty, the right atrial volume decreased from 123.7+/-69.2 mL to 74.5+/-37.4 mL, and the mean right atrial pressure was lowered from 18.7+/-12.2 mmHg to 8.9+/-5.5 mmHg. CONCLUSION: The continuous "over and over" suture may be a useful procedure for fixing the ring to the annulus and making an intentional annular placation in performing tricuspid ring annuloplasty.
Atrial Pressure ; Humans ; Polyesters ; Polypropylenes ; Prostheses and Implants ; Sutures ; Thoracic Surgery ; Tricuspid Valve ; Tricuspid Valve Insufficiency

Doxazosin is an adrenergic alpha-1 receptor antagonist used to treat lower urinary tract symptoms that are common in prostatic hyperplasia. To our knowledge, few cases of gynecomastia and mastodynia, as a complication of adrenergic alpha-1 receptor antagonist, have been reported to date; no cases have been reported in Korea. We describe a case involving a 78-year-old man treated for prostatic hyperplasia with 13 months of doxazosin. He complained about unilateral gynecomstia and mastodynia. Five months after the discontinuation of doxazosin, the gynecomastia was significantly improved. This is the first reported case of gynecomastia and mastodynia associated with doxazosin use in Korea.
Aged ; Doxazosin* ; Gynecomastia* ; Humans ; Korea ; Lower Urinary Tract Symptoms ; Male ; Mastodynia ; Prostatic Hyperplasia

BACKGROUND AND OBJECTIVES: Many neurologists are unaware of the drop attack that may occur from an inner ear dysfunction especially in elderly. We performed this study to investigate the clinical features and results of quantitative audiovestibular tests in six elderly patients (> or =65 years of age) who presented with drop attacks attributable to an inner ear pathology. MATERIALS AND METHOD:Group was divided into Meniere's syndrome (4) or non-Meniere peripheral vestibulopathy (2). Standard dizziness questionnaire and quantitative audiovestibular function testing were performed. RESULTS:Episodes were described as a sudden push to the ground in four or a violent illusionary movement of environment leading to a fall in two. All cases gave a history of prior vertiginous episodes and vestibular testing revealed unilateral caloric paresis. Ipsilateral hearing loss was documented in four cases. CONCLUSIONS:Our results suggest that otologic causes should be considered in the differential diagnosis of the drop attack in elderly, even if the symptoms and signs were not consistent with Meniere's syndrome.
Aged* ; Diagnosis, Differential ; Dizziness ; Ear, Inner ; Hearing Loss ; Humans ; Meniere Disease ; Paresis ; Pathology ; Surveys and Questionnaires ; Syncope*