Venous thromboembolic disease is a frequent complication after total hip arthroplasty. However, in Korea, the low incidence of deep vein thrombosis after total hip arthroplasty was reported. In this study, we present the results of 82 consecutive patients(90 hips) who had a cementless total hip replacement with a Anatomic Medullary Locking Component(AML: Depuy, Warsaw, Indiana, USA) between August 1995 and September 1996 at Inha University Hospital, Korea. Postoperatively, none of the patients were treated with any known prophylatic method for deep vein thrombosis except elastic stockings. Both preoperatively and six weeks after surgery, all patients were studied by an radiologist using a portable Doppler ultrasonic velocity detector with a transmission frequency of 5 megahertz. Contrast phlebography was also done in all patients at the same time as the Doppler ultrasound. In addition, coagulation assays, a complete blood count, blood typing, and serum chemical-profile tests were done for all patients. In comparing the results of these laboratory tests from the DVT group and from the non-DVT group, we found that only eight patients(9.8%) out of eighty-two patients had DVT after total hip arthroplasty. Thrombi were found in the superficial femoral vein in five cases and in the common femoral vein in three cases. Though two(2.4%) patients showed suspicious symptoms of pulmonary embolim, their perfusion lung scans were negative. The DVT group show a significantly shorter activated partial thromboplastin time than did the non-DVT group(P<0.05). In addition, the DVT group showed significantly higher serum total protein than the total protein level of the non-DVT group(P<0.01). In this two groups, there was no difference between the results of Doppler ultrasound and the results of contrast phlebography. Consequently, the incidence of deep vein thrombosis after total hip replacement arthroplasty in Korean patients is significantly lower than incidence in patients from countries other than Korea. Doppler ultrasound was a non-invasive and the most reliable diagnostic technique for deep vein thrombosis.
Arthroplasty* ; Arthroplasty, Replacement, Hip* ; Blood Cell Count ; Blood Grouping and Crossmatching ; Femoral Vein ; Humans ; Incidence ; Indiana ; Korea ; Lung ; Partial Thromboplastin Time ; Perfusion ; Phlebography ; Stockings, Compression ; Ultrasonics ; Ultrasonography* ; Venous Thromboembolism ; Venous Thrombosis*

A case of 68 years old(Korean) male patient who has had a malignant melanoma of the iris in his left eye with sudden decreased visual acuity of duration of one month is reported. The left eye was enucleated and prepared for histopathological examination, Histopathological examination revealed a malignant melanoma, amelanotic epithelioid type, without extraocular metastasis, involving the iris of "Left eye".
Humans ; Iris* ; Male ; Melanoma* ; Neoplasm Metastasis ; Visual Acuity

Crohn's disease of the perineum is notably resistant to treatment. We describe our experiences of tacrolimus ointment application in three patients with intractable perianal Crohn's disease. At the time of diagnosis patients showed anal fissure with ulcer, anal fistula, or perianal abscess, respectively. These lesions did not respond to steroid, metronidazole, mesalazine, or azathioprine, though the pediatric Crohn's disease activity index was markedly improved during the treatment period (4 to 12 months). Topical tacrolimus was applied and resulted in marked healing and a rapid granulation of cavity edges within 6 weeks to 3 months. Topical tacrolimus at a low dose shows a promise for the management of childhood perianal Crohn's disease. Further controlled studies are required to assess the efficacy and safety of this treatment.
Abscess ; Azathioprine ; Child ; Crohn Disease* ; Diagnosis ; Fissure in Ano ; Fistula ; Humans ; Mesalamine ; Metronidazole ; Perineum ; Tacrolimus*

This report describes a rare case of primary rectal mature teratoma in a 56-year-old woman. She was referred to the outpatient clinic with a large pedunculated rectal mass, which was found during a regular health check-up. Polypectomy was performed and microscopic findings showed various structures derived from all three germ cell layers. Epidermis, hair follicles, sebaceous glands, eccrine glands, and apocrine sweat glands, with some scattered melanophages and lymphocytes were present as ectodermal derivatives. Smooth muscle fibers, blood vessels, and fibrous and adipose tissues were found as mesodermal derivatives. In addition, thyroid follicles, mucinous glands, and bronchial respiratory epithelium with peribronchial glands were detected as endodermal derivatives. She is healthy and has shown no evidence of recurrence or distant metastasis for 25 months post-surgical resection. Primary rectal teratomas are generally benign and primarily affect women. Therefore, minimally invasive surgical procedures, such as endoscopic polypectomy for a pedunculated polyp and segmentectomy for a larger mass, are satisfactory in most cases. Induction of primary rectal teratomas has been suggested to occur mainly by errors in a single germ cell after the end of meiosis I; in addition, it has also been suggested that the difference in gender incidence may be associated with differences in sex chromosomes between males and females rather than with anatomical proximity between ovary and rectum.
Ambulatory Care Facilities ; Blood Vessels ; Dermoid Cyst ; Eccrine Glands ; Ectoderm ; Endoderm ; Epidermis ; Female ; Germ Cells ; Hair Follicle ; Humans ; Incidence ; Lymphocytes ; Male ; Mastectomy, Segmental ; Meiosis ; Mesoderm ; Middle Aged ; Mucins ; Muscle, Smooth ; Neoplasm Metastasis ; Ovary ; Polyps ; Rectum ; Recurrence ; Respiratory Mucosa ; Sebaceous Glands ; Sex Chromosomes ; Surgical Procedures, Minimally Invasive ; Sweat Glands ; Teratoma* ; Thyroid Gland

OBJECTIVES: Exposure to light at night has become pervasive in modern society. The impact of dim artificial light at night (dALAN) exposure on sleep and fatigue is not well recognized. We aim to study the impact of dALAN exposure during sleep on human fatigue. METHODS: 30 healthy young male volunteers from 21 to 29 years old were enrolled in the study. They were randomly divided into two groups depending on light intensity (Group A : 5 lux and Group B : 10 lux). Data were gathered from each participant after each night with no light (Night 1) followed by the next night (Night 2) with two different dim light conditions (5 or 10 lux) by means of self-reported fatigue scale. RESULTS: Exposure to dALAN during sleep was significantly associated with increased overall fatigue (F = 19.556, p < 0.001) and ocular discomfort (F = 5.671, p = 0.028). CONCLUSION: We found that dALAN during sleep likely affects human fatigue in some aspects. These findings indicate that dALAN during sleep exerts a negative effect on human fatigue.
Fatigue* ; Humans* ; Male ; Volunteers

Cloacal anomalies are very rare congenital malformations with the incidence of 1/50,000-250,000 births. Hydrocolpos involves the dilatation of the vagina due to obstruction of the genital tract, leading to accumulation of secretions. Because of wide spectrum of abnormal anatomy involving urogenital and gastrointestinal systems, prenatal diagnosis is difficult. As ultrasound becomes more and more reliable, prenatal diagnosis is possible as early as in the second trimester. The presence of prenatally detected hydro (metro) colpos warrants a systematic evaluation of fetal and neonatal anatomy to rule out a large variety of possibly associated malformations or syndromes. We present a case of urogenital sinus maldevelopment which was initially presented as a fetal ascites.
Ascites ; Dilatation ; Female ; Humans ; Hydrocolpos ; Incidence ; Parturition ; Pregnancy ; Pregnancy Trimester, Second ; Prenatal Diagnosis ; Ultrasonography* ; Vagina

Septic artiritis is a disease that causes a rapid joint destruction by various kinds of bacteria such as Staphylococcus aureus. It affects more frequently the patients with rheumatoid arthritis, diabetes, immunocompromised patients, and chronic steroid users. In patients with rheumatoid arthritis, 1 to 12% of patients are affected by septic arthritis. In these patients, it is very difficult to distinguish between an acute exacerbation of rheumatoid arthritis and a development of septic arthritis if the latter affects more than one joint. Septic arthritis usually affects single joint, especially the knee joint. If the diagnosis and treatment are delayed, it would cause sepsis resulting in high mortality and morbidity. Thus early diagnosis by arthrocentesis, prompt drainage, and antibiotics therapy are essential. We experienced a 46 years-old woman with rheumatoid arthritis who abused the steroids for 10 years and complaining recent aggravation of bilateral knee joint swelling, warmth, and tenderness. Large amount of pus from both knees showed Gram positive cocci. The immediate open surgical drainage of both knees was done. The patient recovered from septic arthritis after 6 weeks of antibiotics therapy. The synovial fluid microbiology study should be done in all joints of the patients with the risk factors of joint infection.
Anti-Bacterial Agents ; Arthritis, Infectious ; Arthritis, Rheumatoid* ; Bacteria ; Diagnosis ; Drainage ; Early Diagnosis ; Female ; Gram-Positive Cocci ; Humans ; Immunocompromised Host ; Joints ; Knee Joint ; Knee* ; Middle Aged ; Mortality ; Risk Factors ; Sepsis ; Staphylococcus aureus ; Steroids ; Suppuration ; Synovial Fluid

PURPOSE: p53 mutations are one of the most common genetic alterations in human lung cancer. Although the prognostic value of mutant p53 is still debated, it is widely accepted as a relatively early genetic event in the development and progression of lung cancer. Moreover, there are growing reports about an association between smoking and p53 mutation, suggesting that the p53 gene could be a target of the smoking associated carcino- genesis in the lung cancer. MATERIALS AND METHODS: Surgically resected 89 primary non-small cell lung cancers were obtained from May of 1995 to May of 1997. p53 expression and Ki-67 expression were measured by immunohistochemistry, and each p53 expression and smoking amount were compared with Ki-67 expression and other clinical prognostic factors. RESULTS: Positive p53 expressions were found in 52 (58%) specimens, including 38 (69%) squamous cell carcinomas, 11 (39%) adenocarcinomas, and 3 (50%) large cell carcinomas, and closely associated with male and squamous cell carcinoma. Also close correlation was observed between smoking amount and p53 expression by the regression analysis. But p53 and Ki-67 expression showed no associations in pathologic stage and survival, and there was no association between p53 expression and survival after adjuvant radiotherapy. CONCLUSION: Smoking seems to affect p53 mutations in non-small cell lung cancer, and additional efforts are needed to evaluate the carcinogesis of lung cancer.
Adenocarcinoma ; Carcinoma, Large Cell ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Genes, p53 ; Humans ; Immunohistochemistry ; Lung Neoplasms ; Male ; Radiotherapy, Adjuvant ; Small Cell Lung Carcinoma* ; Smoke* ; Smoking*

OBJECTIVES: The retinoid-related orphan receptor A (RORA) gene has been reported to have an impact on circadian rhythm regulation. In this study, we analyzed the relationship between the RORA gene polymorphism and diurnal preference in Korean young adults. METHODS: A population of 504 young adults was included in the study. All subjects were given and completed a 13-item composite scale for morningness (CSM). The RORA gene rs11071547 single-nucleotide polymorphism (SNP) was genotyped by PCR-based methods. RESULTS: CSM score was not associated with genotype or allele carrier status of the RORA rs11071547 SNP. CONCLUSION: This result indicates that the RORA rs11071547 SNP does not play a role in diurnal preference.
Alleles ; Child ; Child, Orphaned ; Circadian Rhythm ; Genotype ; Humans ; Young Adult

PURPOSE: The aim of this study was to identify the clinical features and natural history of dietary protein induced proctocolitis (DPIPC) and to detect the causative foods of DPIPC, and to evaluate the effect of elimination of the foods on the course of the disease. METHODS: Between March 2003 and July 2004, data from 30 consecutive patients with DPIPC who were followed for over 6 months, was reviewed. The diagnostic criterion used for DPIPC was an increase in the number of eosinophils in the lamina propria (> or =60 per 10 high-power fields). In breast feeding mothers, 5 highly allergenic foods were eliminated from the maternal diet for 7 days, namely, allergenic food groups such as dairy products, eggs, nuts and soybean, fish and shellfish, and wheat and buckwheat. We observed the disappearance or appearance of hematochezia after elimination or challenge with the offending foods. RESULTS: Before diagnosis infants were breast-fed (93.3%) or formula-fed (6.7%). Mean age at symptom onset was 11.5+/-5.1 (5~24) weeks, and mean age at diagnosis was 17.8+/-9.5 (8~56) weeks. Duration from symptom onset to diagnosis was 6.3+/-6.7 (0~36) weeks. Mean peripheral blood eosinophil count was 478+/-320 (40~1,790)/mm3 and eosinophilia (>250/mm3) was observedin 90.0% of patients. None of patients were found to have an increased serum IgE level. Of 15 patients that received sigmoidoscopy, nodular hyperplasia with erosion was observed in 93.3%. Of 27 patients whose mother ate the diet eliminated the 5 food groups, hematochezia diappeared in 74.1% of patients. Offending foods were identified as dairy products (37.5%), wheat and buckwheat (27.5%), fish and shellfish (20.0%), nuts and soybean (7.5%) and eggs (7.5%). A free maternal diet without patient's clinical symptoms was achieved at 29.4+/-8.7 (9~44) weeks of patient's age, and a free baby diet without blood in stools was achieved at 37.5+/-9.7 (12~56) weeks of age. CONCLUSION: DPIPC commonly occurs in exclusively breast-fed babies. Elimination of the above-mentioned 5 hyper-allergenic food groups from the maternal diet for 7days enables the detection of the offending foods. DPIPC is a transient disorder and 96.0% of patients can tolerate the offending foods at 12 months of age.
Breast Feeding ; Dairy Products ; Diagnosis ; Diet* ; Dietary Proteins* ; Eggs ; Eosinophilia ; Eosinophils ; Fagopyrum ; Gastrointestinal Hemorrhage ; Humans ; Hyperplasia ; Immunoglobulin E ; Infant ; Mothers ; Mucous Membrane ; Natural History* ; Nuts ; Ovum ; Proctocolitis* ; Shellfish ; Sigmoidoscopy ; Soybeans ; Triticum