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

No abstract available.
Hormone Replacement Therapy ; Humans ; Incheon* ; Osteoporosis* ; Physicians, Primary Care* ; Primary Health Care*

PURPOSE: To find the experience about clients with hypertension and to help them to care for themselves in the community. METHOD: All data was collected from August 1999 to October 1999, through in-depth interviews, observation, and telephone interview with 7 participants who have been diagnosed with hypertension for 1 to 10 years. According to Strauss and Corbin's Methodology, the data was continuously coded into concepts and categories, and then new data was analyzed simultaneously by a constant comparative method. RESULTS: There are 171 concepts, and then they were grouped into 34 the lower categories and 15 to the upper categories. The course of the coping of fear in hypertensive client consisted of 6 processes. The awareness of seriousness was context, and the fear was core phenomenon about the coping experience. We also found that hypertensive clients have 3 patterns, depending on the awareness degree of seriousness and the fear about hypertension. CONCLUSION: Our nurses should recognize the importance of effective management and seriousness about hypertension, offer clients the importance of family support and the information of etiology, symptoms and signs of hypertension, and provide the correct information on hypertensive medication. We should be able to guide their fear about hypertension to positive self-management, so that they may manage their disease thoroughly and effectively.
Humans ; Hypertension ; Interviews as Topic ; Self Care

Malignant peripheral nerve sheath tumors (MPNSTs) are malignant variants of peripheral nerve sheath tumors that develop at major or minor peripheral nerve branches or at the sheaths of peripheral nerve fibers. These tumors are derived from Schwann cells or pluripotent cells of a neural crest origin. Malignant tumors of the peripheral nerve sheath are most commonly seen in deeper soft tissues, and usually in the proximity of a nerve trunk. MPNSTs of the breast are very uncommon and they have rarely been reported on. We report here on a case of MPNST of the breast in a 59-year-old female who presented with a painless breast lump for two months. The excisional biopsy revealed a malignant peripheral nerve sheath tumor based on the microscopic findings and immunohistochemical staining. We performed wide excision of breast tissue around the biopsy site and thereafter the patient underwent radiation therapy. The patient remains well without signs of recurrence 1 year following surgery.
Biopsy ; Breast ; Female ; Humans ; Middle Aged ; Nerve Sheath Neoplasms ; Neural Crest ; Peripheral Nerves ; Recurrence ; Schwann Cells

BACKGROUND: Reperfusion injury often develops after cardiopulmonary bypass (CPB) during coronary artery bypass grafting (CABG), and MgSO4 is known to be related to such injury. The goal of this study was to determine the hemodynamic and oxygen metabolic effects of administering MgSO4 after cessating cardiopulmonary bypass during coronary bypass surgery in control and nicardipine infusion groups. METHODS: After obtaining hospital ethics committee clearance, we studied 29 patients with coronary artery disease scheduled for CABG, who were randomly assigned to receive nicardipine (0.5 microgram/kg/min, n = 11) or placebo (n = 18). All patients were administered MgSO4 (60 mg/kg) after the cessation of CPB. The hemodynamic variables and oxygen parameters were recorded and calculated by continuous cardiac output and mixed venous oxygen saturation monitoring, through a thermodilution Swan-Ganz catheter before and 20 minutes after MgSO4 administration. RESULTS: Heart rate was reduced after administering MgSO4 in both groups, and the mean arterial pressure was also reduced in the nicardipine group. The cardiac index, systemic vascular resistance index, pulmonary vascular resistance index, right and left stroke work indices were well-maintained after administering MgSO4. Mixed venous oxygen saturation and other oxygen parameters were maintained without change after MgSO4 administration. CONCLUSIONS: The present study shows that MgSO4 can be used without inducing any significant oxygen metabolism or hemodynamic derangements during CABG. But further work is needed to elucidate the myocardial protective effects of MgSO4.
Arterial Pressure ; Cardiac Output ; Cardiopulmonary Bypass ; Catheters ; Coronary Artery Bypass* ; Coronary Artery Disease ; Coronary Vessels* ; Ethics Committees, Clinical ; Heart Rate ; Hemodynamics* ; Humans ; Metabolism ; Nicardipine ; Oxygen ; Reperfusion Injury ; Stroke ; Thermodilution ; Vascular Resistance

BACKGROUND: Vestibular neuritis (VN) is a common peripheral vestibulopathy. VN is most likely a partial rather than a complete vestibular paralysis, It has a natural history of gradual recovery within 1-6weeks. The investigation of vestibulo-ocular reflex (VOR) change in acute and compensated VN are relatively few in Korea. We performed the vestibular function test including electronystagmography (ENG) and rotary chair test (RCT) in the patients with acute and compensated VN, and evaluated the efficacy of ENG and RCT to know the degree of compensation. METHODS: Tweenty-four patients with acute VN, 14 patients who had cllinically compensated VN during follow-up period and 30 normal controls were studied. Mean intervals from symptom onset to test were 3.6 days (acute) and 102.5 days (com-pensated). RESULTS: Eight patients had asymmetrically impaired pursuit, and ten patients had asymmetrcally impaired OKN during acute stage. The degree of side differences in pursuit and OKN gain was correlated with intensity of spon-taneous nystagmus. In the acute stage, the gain of the VOR was reduced at low frequency (0.01-0.16Hz), but it was normal at high frequency (0.32Hz). Prolonged phase lead and gain asymmetries were present at all range of frequency. In the compensated stage, the gain, phase and symmetry of the VOR at all range of frequency were not different from those of controls, except for prolonged phase lead and asymmetry at 0.01 Hz. The rate of the patients with unilateral canal paresis was 100% at acute stage and 50% at compensated stage in mono-thermal cold caloric stimulation. CONCLUSIONS: These results suggested that pursuit and OKN abnormalities may be found in acute peripheral vestibu-lopathy, in which coarse spontaneous nystagmus may contribute to the development of these abnormality. Absence of caloric response does not indicate an complete absence of vestibular function and RCT is a useful method in evaluation of VOR status in patients with acute and compensated VN.
Compensation and Redress ; Electronystagmography ; Follow-Up Studies ; Humans ; Korea ; Natural History ; Paralysis ; Paresis ; Reflex, Vestibulo-Ocular ; Vestibular Function Tests* ; Vestibular Neuronitis*

PURPOSE: Siewert's classification of adenocarcinoma of the esophagogastric junction (AEG) has been widely adopted, but there is a wide discrepancy of the clinicopathological features of AEG of the Asian patients as compared to that of the Western patients. The aim of this study was to investigate the clinicopathological characteristics of AEG according to the Siewert classification. MATERIALS AND METHODS: Among the patients who underwent surgery for gastric carcinoma in our institution between May 2004 and February 2008, the AEG patients were selected based on their operation records and the photographs according to Siewert's classification. RESULTS: There were 70 AEG patients (3.9%) among the total of 1,778 patients. There were 3 patients (4.3%) with type I, 30 patients (42.8%) with type II and 37 patients (52.8%) with type III. Curative resection (R0) was achieved in 68 cases (97.1%). No significant differences in gender, stage, Barrett's esophagus and the proximal margin were found between the patients with type II and type III AEG. The patients with type III were younger than the patients with type II (59 vs 64 years, respectively, P=0.049). Well differentiated histology (P=0.045) and the intestinal type (P=0.055) were significantly more frequent in the patients with type II as compared with that in the patients with type III. CONCLUSION: There was a striking difference of the Asian patients from the Western patients for the incidence of AEG (and especially type I). Some of the differences between type II and type III patients were similar to those of the previous Western studies. A large study is needed to investigate whether these features are typical in the Korean population.
Adenocarcinoma ; Asian Continental Ancestry Group ; Barrett Esophagus ; Esophagogastric Junction ; Humans ; Incidence ; Strikes, Employee

PURPOSE: The purpose of the study was to understand and describe the hospital workers' experience related to the hospital evaluation program implemented in Korea between 2004 and 2009. METHODS: During 2010, data were collected using focus group interviews. Four focus group interviews were held with a total of 28 hospital workers participating. All interviews were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis. RESULTS: Nine themes emerged from the analysis: 1) Positive change in the necessity of the evaluation; 2) Improvement in the hospital system, facilities, and human resources; 3) Unity through cooperation among departments; 4) Nursing work overload; 5) Lack of physicians' awareness and responsibilities; 6) Unfair and unrealistic evaluation items; 7) Lack of credibility of the outcome; 8) Shifting responsibility for negative outcomes to the workers; 9) Lack of pragmatic utility. CONCLUSION: The results of the study demonstrate that the hospital evaluation program played a key role in improving some work environments and communication among departments. At the same time, they show various negative themes resulting from the context of very authoritarian hospital systems and a connection-oriented society in Korea.
Adult ; Attitude of Health Personnel ; Female ; Focus Groups ; Hospitals/*standards/*statistics & numerical data ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Nursing Staff, Hospital/*statistics & numerical data ; Qualitative Research ; Tape Recording

Phenobarbital is a long-acting barbiturate causing generalized depression of neuronal activity in the brain. Its effect is primarily achieved through enhanced GABA-mediated synaptic inhibition. Its use as an antiepileptic agent was first described in 1912. Before the introduction of phenytoin, phenobarbital is used as sedative-hypnotics. It is used for the treatment of epilepsy and status epilepticus. All barbiturates, including phenobarbital, have a high potential far abuse. They were frequently used for suicide attempts in the past, but they have in large part been replaced by benzodiazepines. the onset of symptoms depends on the drug and the route of administration. Mild to moderate barbiturate intoxication resembles ethanol inebriation with slurred speech, ataxia, and lethargy. Severe acute barbiturate intoxication is life threatening. Early deaths are generally cardiovascular-related. Hypotension, shock, pulmonary edema, and cardiac arrest that occurs with large doses are caused by depression of central sympathetic tone and as well as by direct depression of cardiac contractility. The potentially fatal oral dose of phenobarbital is 6-l0g. We describe an 23-year-old woman with pulmonary edema and cardiac arrest after ingestion of 18 grams of phenobarbital. She was completely recovered by successful cardiopulmonary resuscitation and hemoperfusion. We report a case with literature review.
Ataxia ; Barbiturates ; Benzodiazepines ; Brain ; Cardiopulmonary Resuscitation ; Depression ; Eating ; Epilepsy ; Ethanol ; Female ; Heart Arrest* ; Hemoperfusion ; Humans ; Hypotension ; Lethargy ; Neurons ; Phenobarbital* ; Phenytoin ; Pulmonary Edema* ; Shock ; Status Epilepticus ; Suicide ; Young Adult

Isoniazid(Isonicotinic acid hydrazide) is an antimicrobial drug used since 1952 as a fast line agent for the prophylaxis and treatment of tuberculosis. Isoniazid is well known for problems in population having a high prevalence of isoniazid use for prophylaxis or treatment of tuberculosis. But intentional or accidental isoniazid overdose is uncommon. The ingestion of toxic amounts of isoniazid causes recurrent seizures, profound metabolic acidosis, coma and even death. In adults, toxicity can occur with the acute ingestion of as little as 1.5g of isoniazid. Doses larder than 30mg per kg often produce seizures. When ingested in amounts of 80-150mg per kg or more, isoniazid can be rapid fatal. 40-year-old woman having previous pulmonary tuberculosis ingested 7 gram of isoniazid(140mg/kg) to attempt suicide approximately 30 minutes prior to visit to our emergency medical center. She had recurrent generalized tonicclonic seizures and metabolic acidosis. We report one patient treated with pyridoxine, which was equivalent to the amount of isoniazid ingested and administered as a intravenous dose and oral dose.
Acidosis ; Adult ; Coma ; Eating ; Emergencies ; Female ; Humans ; Isoniazid* ; Prevalence ; Pyridoxine ; Seizures* ; Suicide ; Tuberculosis ; Tuberculosis, Pulmonary