Total Hip Replacement is well documented and widely used procedure for painful arthritic hip in past two decades and each year still seems to be increased in numher of total hip replacement. And recently, there is a few reports of follow-up study on total hip arthroplasty in our country. The aim of this study was to present the clinical material which was performed on 27 hips of 21 patients who were treated at Dept. of Orthopedic Surgery. College of Medicine, Chungnam university from jan, 1979 to Jan. 1982. The longest follow up was 4 years, shortest was 8 months, average time was 2 years and 8months The results were obtained as follow; 1. The age incidence ranged from 26 to 69 years old, and average were 47 years old. 2. There were 17 males (81%) and 4 females (19%). 3, The causes of hip disease were mostly avascular necrosis of the femoral head (67%). 4, The most commonly used prosthesis were Muller type with trochanteric ostcotomy approaches. 5. Several complications were found: perforation of acetabulum with bone cenent in pelvis, postperative pneumonia wire breakage and painful bursitis around the trochanteric area which was on osteotomy sites. 6. Postoperative functional evaluation was evaluated by method of d'Aubigne and Postel, and improved from 10.0 scores to 15.8 scores. Relief of the pain is the most effect of the total hip replacement in this study, But case are not enough to more detail evaluation, especially, the problem of loosening of stem, acetabular cup wearing and heterotopic bone formation after total hip replacement.
Acetabulum ; Arthroplasty, Replacement, Hip ; Bursitis ; Chungcheongnam-do ; Female ; Femur ; Follow-Up Studies ; Head ; Hip ; Humans ; Incidence ; Male ; Methods ; Necrosis ; Orthopedics ; Osteogenesis ; Osteotomy ; Pelvis ; Pneumonia ; Prostheses and Implants

Klebsiella pneumoniae is an unusual cause of brain abscess. Among the few cases of Klebsiella pneumoniae brain abscess that have been reported, most were associated with another underlying primary focus of infection. Endogenous endophthalmitis caused by Klebsiella pneumoniae is an infrequent but often devastating septic metastatic infection. We report a rare case of Klebsiella pneumoniae brain abscess and endophthalmitis after acute epiglottitis.

Hyperreflexic bladder is a disease manifested in patients with spinal cord lesions above the sacral segment. The treatments for hyperreflexic bladder are medical therapy, interruption of innervation, argumentation cystoplasty, etc. We treated four hyperreflexic bladder patients with 12% a phenol injection into the subarachnoid space for sacral nerve block. Before treatment the average bladder capacity was about 100 ml, and there was one case of autonomic dysreflexia. After the subarachnoid block the average bladder capacity increased above 300 ml and maximal intravesical pressure decreased below 30cmH2O, autonomic dysreflexia disappeared in one patient. The decreased bladder compliance after nerve block was managed by repetitive bladder overdistention. We suggest that subarachnoid block is easier and more effective than sacral nerve block individually, and is a treatment for hyperreflexic bladder refractory to medical therapy.
Autonomic Dysreflexia ; Compliance ; Humans ; Nerve Block ; Phenol ; Spinal Cord ; Subarachnoid Space ; Urinary Bladder*

BACKGROUND: Studies on herpes zoster have been extensively reported in Korea. However, few reports have dealt with herpes zoster in children and adolescents. OBJECTIVE: The purpose of this study was to investigate the epidemiological features and clinical characteristics of herpes zoster in children and adolescents. METHODS: During a 10-year period (2005~2014), 95 herpes zoster patients, aged 18 years and younger, were evaluated in regard to the annual, monthly, and seasonal incidences; the age distribution; and the gender ratio. The children and adolescents with herpes zoster were further assessed on the accompanying symptoms, dermatomal distribution, associated diseases, treatments, and complications. RESULTS: Among all the patients with herpes zoster, 2.41% were children and adolescents. The highest incidence was in summer (35.8%). The age group of 10 to 14 years had the highest incidence (40.0%). The male to female ratio was 1.4:1. The common accompanying symptoms were pain (77.9%) and pruritus (22.1%). The most common dermatomal distribution was the thoracic dermatome (50.5%), followed by the cervical (21.1%), the trigeminal (16.8%), the lumbar (7.4%) and the sacral (4.2%) dermatomes. Associated diseases including atopic dermatitis, bronchial asthma, allergic rhinitis, chronic sinusitis, and epilepsy were observed in 23.2%. There was no case with immunosuppression. The most common complication was secondary bacterial infection (5.2%), followed by herpes zoster ophthalmicus or herpes zoster generalisatus (4.2%), Ramsay Hunt syndrome (2.1%), meningitis and recurrent herpes zoster (1.1%). No patient developed postherpetic neuralgia. CONCLUSION: Herpes zoster is rare and relatively mild in healthy immunocompetent children and adolescents. Pruritus was observed in some pediatric patients, but there was no occurrence of postherpetic neuralgia.
Adolescent* ; Age Distribution ; Asthma ; Bacterial Infections ; Child* ; Dermatitis, Atopic ; Epilepsy ; Female ; Herpes Zoster Ophthalmicus ; Herpes Zoster Oticus ; Herpes Zoster* ; Humans ; Immunosuppression ; Incidence ; Korea ; Male ; Meningitis ; Neuralgia, Postherpetic ; Pruritus ; Retrospective Studies* ; Rhinitis, Allergic ; Seasons ; Sinusitis

OBJECTIVE: The objective of this study is to determine whether the club foot of the affected fetus is related to the location, size, and rupture state of the spinal neural tube defect lesion. METHODS: Ultrasound and medical records of 21 fetuses with spinal neural tube defect were reviewed. At the time of diagnosis 7 fetuses had clubfoot and 14 fetuses didn't have. All the fetuses with spinal neural tube defect were divided into two groups, one with clubfoot fetuses, and the others without clubfoot. RESULTS: The mean lesion size of the clubfoot group was significantly larger than normal foot group (4.1+/-1.22 cm vs 2.1+/-1.59 cm). And the level of lesion is significantly higher in club foot group. But the rate of sac rupture is lower in club foot group. CONCLUSION: The fetuses with clubfoot detected at the time of diagnosis had larger size and higher level of lesion.
Clubfoot ; Diagnosis ; Fetus* ; Foot* ; Medical Records ; Neural Tube Defects* ; Neural Tube* ; Rupture ; Ultrasonography ; Ultrasonography, Prenatal*

The treatment of choice for Cushing's disease is surgical removal of tumor, the source of ACTH overproduction. In occasional patients in whom a surgical approach including total adrenalectomy is not feasible or surgical removal of tumor is not complete, medical treatment may be necessary because pituitary irradiation requires a long 1ag time to remission. Although ketoconazole, an imidazole derivative with inhibitory activity on adrenal steroidogenesis has been reported to be effective in the treatment of Cushing's disease, the limited effectiveness in lowering very high level of cortisol and occasional hepatotoxicity restrains its wide use. In this report, we describe a woman with Cushing's disease due to pituitary microadenoma. Transsphenoidal pituitary adenomeetomy followed by ketoconzole treatment had been unsuccessful in achieving remission of the disease, but combined treatment with ketoconazole and octreotide accomplished successful reduction in cortisol production.
Adrenalectomy ; Adrenocorticotropic Hormone ; Female ; Humans ; Hydrocortisone ; Ketoconazole* ; Octreotide* ; Pituitary Irradiation

The widespread presence of large-scale genomic variations, termed copy number variation (CNVs), has been recently recognized in phenotypically normal individuals. Judging by the growing number of reports on CNVs, it is now evident that these variants contribute significantly to genetic diversity in the human genome. Like single nucleotide polymorphisms (SNPs), CNVs are expected to serve as potential biomarkers for disease susceptibility or drug responses. However, the technical and practical concerns still remain to be tackled. In this review, we examine the current status of CNV DBs and research, including the ongoing efforts of CNV screening in the human genome. We also discuss the characteristics of platforms that are available at the moment and suggest the potential of CNVs in clinical research and application.
Coat Protein Complex I ; Disease Susceptibility ; Genetic Variation ; Genome, Human ; Humans ; Mass Screening ; Polymorphism, Single Nucleotide ; Biomarkers

The widespread presence of large-scale genomic variations, termed copy number variation (CNVs), has been recently recognized in phenotypically normal individuals. Judging by the growing number of reports on CNVs, it is now evident that these variants contribute significantly to genetic diversity in the human genome. Like single nucleotide polymorphisms (SNPs), CNVs are expected to serve as potential biomarkers for disease susceptibility or drug responses. However, the technical and practical concerns still remain to be tackled. In this review, we examine the current status of CNV DBs and research, including the ongoing efforts of CNV screening in the human genome. We also discuss the characteristics of platforms that are available at the moment and suggest the potential of CNVs in clinical research and application.
Coat Protein Complex I ; Disease Susceptibility ; Genetic Variation ; Genome, Human ; Humans ; Mass Screening ; Polymorphism, Single Nucleotide ; Biomarkers

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer death in Korea. Curative treatment is only possible when the disease is diagnosed at the early stage. The prognosis of patients with HCC is even dismal in advanced stages. No systemic cytotoxic chemotherapy has proven to be beneficial in overall survival. Recently, the understanding of the molecular pathogenesis led to the development of new therapies. With the evidence of dysregulation of critical genes associated with cellular proliferation, growth factor signaling, cell cycling, apoptosis, and angiogenesis in HCC, a number of molecular target agents are under clinical trials. Sorafenib is the first systemic anticancer drug which has proven to gain survival benefit in the global as well as Asia-Pacific trials. However, the survival gain is still modest, and further efforts to improve outcomes in patients with HCC are necessary by developing novel drugs or combining other forms of therapies. This article will review signaling pathways in HCC and introduce molecular target agents under investigation currently.
Antineoplastic Agents/therapeutic use ; Carcinoma, Hepatocellular/*drug therapy/metabolism/pathology ; Humans ; Liver Neoplasms/*drug therapy/metabolism/pathology ; Mitogen-Activated Protein Kinase Kinases/antagonists & inhibitors/metabolism ; Molecular Targeted Therapy ; Niacinamide/analogs & derivatives/therapeutic use ; Phenylurea Compounds/therapeutic use ; Protein Kinase Inhibitors/therapeutic use ; Proto-Oncogene Proteins c-akt/antagonists & inhibitors/metabolism ; Receptor, IGF Type 1/antagonists & inhibitors/metabolism ; Signal Transduction ; TOR Serine-Threonine Kinases/antagonists & inhibitors/metabolism ; Wnt Proteins/antagonists & inhibitors/metabolism