PURPOSE: Long-term follow-up results of concurrent bilateral or unilateral cementless hip arthroplasty were compared. MATERIALS AND METHODS: Forty eight and 49 patients with concurrent bilateral and unilateral hip artrhoplasties who had more than a 17-year follow-up time were selected. At final follow-up, mean ages were 69.1 and 66.7 years old in the bilateral and unilateral groups, respectively. Mean follow-up times were 21.5 and 22.4 years in the bilateral and unilateral groups, respectively. Clinical results were attained using Harris hip score and standardized anteroposterior and lateral view X-rays. RESULTS: The bilateral group had mean Harris scores of 44.3(standard deviation 3.78) preoperatively, and 81.2 (10.75) at final follow-up. For the unilateral group, the mean scores were 46.5(3.27) preoperatively, and 80.1 (12.05) at final follow-up. At final follow-up, an acetabular cup was securely located in 78.9% and 82.8% of the bilateral and unilateral groups, respectively, and all cases showed firm fixation of the femoral stem in both groups. Osteolysis around the cup and stem were found in 26.3% and 31.4% of the bilateral group and 16.6% and 17.1% of the unilateral group, respectively. Polyethylene wear rate was 0.17 mm/yr and 0.16 mm/yr in the unilateral and bilateral groups, respectively. Using the Kaplan-Meier method, 17-year survival rates for cup and stem were 78% and 89% in the bilateral group, respectively, and 78% and 86% in the unilateral group, respectively. CONCLUSION: In 17-year long-term follow-up, concurrent bilateral hip arthroplasty was insignificantly different clinically and radiologically from the result of unilateral hip arthroplasty.
Arthroplasty ; Follow-Up Studies ; Hip ; Humans ; Osteolysis ; Polyethylene ; Survival Rate

Human papillomavirus(HPV) has implicated in the development of cervical cancer. Several studies has suggested a strong correlation between HPV 16, 18 and cervical intraepithelial neoplasia(CIN). For detecting and typing HPV DNA in cervical tissues, recently the chemiluminescent molecular hybridization assay method has been widely used. This study was performed to determine the usefulness of hybrid capture assay for detecting high-risk HPV in cervical epithelial cells, and to compare the correlation among cervical cytology, biopsy finding and HPV infection, and to determine whether the addition of the hybrid capture assay to cytologic test would improve the ability to identify significant lesions. This study included 267 patients who visited the colposcopic clinic of the department of obstetrics and gynecology, Chonbuk University Hospital from May, 1997 to October 199S. Pap smears hybrid capture assays, and colposcopically directed biopsy were performed concurrently on al1 women. The results obtained were as follow; l. Using hybrid capture assay, the detection rate of high-risk HPV of all patients was 37.1%(99/267). There was no statistical significance in the detection rate of HPV between the age groups. 2. The false negative rate of Pap Smear was 53.3% and showed significant discrepancies between the cytologic and histologic diagnosis. 3. According to the cytologic diagnosis, the detection rates of high-risk HPV were 7.1% in normal, 25.3% in ASCUS or LSIL, and 61.6% in HSIL. In each cytologic group, the patients who had positive results for high-risk HPV showed higher incidence rate of high grade lesions than those with negative results(P<0.05). 4. According to the histologic diagnosis, the detection rates of high-risk HPV were 0.1% in normal, 11.1% in CIN I, and 72.7% in CIN II or CIN III. In each histologic group, the patients who had positive results for high-risk HPV showed higher incidence rate of high grade lesions than those with negative results(P<0.05). 5. According to the comparison of histologic diagnosis between positive and negative results of high-risk HPV test due to each cytology, there was no statistical significance in the incidence rate of cervical neoplasia, Above results suggest that high-risk HPV test using hybrid capture assay may be a useful method in supplement the pitfalls of cervical cytology. This test might also have prognostic value in the management of patients with CIN.
Biopsy ; Diagnosis ; DNA ; Epithelial Cells* ; Female ; Gynecology ; Human papillomavirus 16 ; Human Papillomavirus DNA Tests* ; Humans ; Incidence ; Jeollabuk-do ; Obstetrics ; Uterine Cervical Neoplasms

OBJECTIVE: To evaluate quality of life (QOL), upper extremity function and the effect of lymphedema treatment in patients with breast cancer related lymphedema. METHOD: The basic data comprised medical records (detailing age, sex, dominant side, location of tumor, cancer stage, operation record, cancer treatment and limb circumferences) and questionnaires (lymphedema duration, satisfaction, self-massage). Further to this, we measured upper extremity function and QOL, administered the DASH (Disabilities of Arm Shoulder and Hand outcome measure) and used the EORTC (European Organization for Research and Treatment of Cancer)-QLQ-C30 and the EORTC-QLQ-Br23. Results of these were calculated as main outcome variables. RESULTS: The questionnaire responses and arm circumferences of 59 patients with breast cancer related lymphedema were analyzed. In the DASH questionnaire, it was found that the older the lymphedema patient was, the lower their upper extremity function. On the EORTC-QLQ, patients with metastasis had significantly lower scores in physical functioning and role functioning. In terms of upper extremity circumference, there was a significant upper extremity size reduction after lymphedema treatment. CONCLUSION: There were several dissociations between some subscales of quality of life questionnaires and those of upper extremity functions. Upper extremity function was correlated with the age of breast cancer patients and QOL was influenced by M-stage. Lymphedema treatment was found to be effective in reducing edema in patients with breast cancer related lymphedema.
Arm ; Breast ; Breast Neoplasms ; Edema ; Extremities ; Hand ; Humans ; Lymphedema ; Medical Records ; Neoplasm Metastasis ; Quality of Life ; Shoulder ; Upper Extremity ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to investigate the incidence of curet fracture and its contributing factors. MATERIAL AND METHODS: Fifty-eight periodontal curets which were broken during periodontal treatment in Kangnung National University Dental Hospital for 1 year were used as study materials. The blade thickness of new curets and broken ones was measured using a digital micrometer. Types of treatment procedures, clinical experience of operators, point of breakage, and method of removal of broken fragments were recorded for each broken curet. RESULTS: The incidence of curet fracture in root planing (16.4 curets per 1,000 procedures) was higher than those in flap surgery (7.5) or supragingival scaling (2.7). No curet was broken during supportive periodontal treatment. The incidence of fracture did not seem to be related with clinical experience of operators. The most frequent breakage point of the curets were upper 1/3 of blades. Fifty-six of 58 broken fragments were removed by non-surgical methods. Two broken tips which could not removed non-surgically were left in the pockets, and proved to be removed spontaneously 1 week later. CONCLUSION: Root planing showed higher incidence of curet fracture than any other type of periodontal treatment. Most of the fractured fragments were removed by non-surgical method. Further study is needed to develop methods of removal of the fragments which can not be removed non-surgically.
Dental Scaling ; Incidence ; Root Planing

This retrospective study was undertaken to investigate the current clinical trend in the management of ectopic pregnancy. 562 patients of ectopic pregnancy were admitted and managed at the Department of Obstetrics and Gynecology, Chonbuk National University Hospital from Jan. 1. 1985 to Dec. 31. 1996. All cases had a reliable medical record and were divided into two groups, of which group A includes patients admitted from Jan. 1. 1985 to Dec. 31. 1990, group B from the Jan. 1. 1991 to Dec. 31. 1996. The results were obtained as follows. 1. The number of cases of ectopic pregnancy were 248 in group A and 314 in group B. 2. The age group of 20 to 29 years of age was top ranked in group A(49.6%) as well as in group B(46.8%). The age group of 30 to 39 years was 43.2% in group A and 46.6% in group B, respectively. 3. In group A, the case who experienced two deliveries was 31.9%, and nulliparous woman was 30.6%. In group B, the case who experienced two deliveries was 33.1%, nulliparous woman was 33.1%. 4. On reviewing the past medical history, ectopic pregnancy was 11.2% in group A, 10.8% in group B, respectively. Pelvic inflammatory disease was 8.1% in group A and 11.0% in group B, respectively. 5. The interval between the last menstrual period and the onset of symptoms was prevalently in 4 to 8 weeks(64.5% in group A, 61.8% in group B). The terval of 12 weeks or more was 2.0% in group A and 6.0% in group B, respectively. 6. In considering the chief complaints, low abdominal pain was 85.9% and vaginal spotting was 69.0% in group A. On the other hand, low abdominal pain was 91.4% and vaginal spotting was 76.4% in group B, meanwhile nausea and vomitting was 8.6% and dizziness was 3.5% in group A, there were 23.4% of nausea and vomitting and 9.7% of dizziness in group B,7. In relation of the diagnostic methods, the positive rate of culdocentesis in group B was lower than the rate in group A. Diagnostic laparoscopy was done in 5.6% of group A and 14% of group B. The detection rate of adnexal mass and fluid collection in the pelvic cavity was higher in group B than in group A on the ultrasonographic examination. 8. Initial hemoglobin value of 10.1mg/dl or more was 70.9% in group A and 73.2% in group B. The value of 8.0gm/dl or less was 6.4% in group A and 7.0% of group B, respectively. Initial systolic pressure of 110mmHg or more was 74.6% in group A and 66.6% in group B. The systolic pressure of 90mmHg or less was 3.6% in group A and 8.3% in group B.9. The conceptus was almost implantd in the fallopian tube. The ampullary portion was the most common site of ectopic implantation in both groups. 10. Intraabdominal hemorrhage of 500ml or less in amount was 52.4% in group A and 61.1% in group B, individually. However transfusion was not given in 55.6% of group A and in 71.0% of group B. 11. In the therapeutic modalities, laparotomy was performed in 96.8% of group A and in 82.8% of group B, respectively. The pelviscopic operation was done in 2.4% of group A and in 22.3% of group B. In conclusion, ectopic pregnancy was diagnosed increasingly prior to the onset of the hypovolemic symptoms according to developement of high-resolution ultrasonogram, diagnostic laparoscopy and beta-hCG test, therefore the use of minimally invasive techniques in the management of ectopic pregnancy was increasing.
Abdominal Pain ; Blood Pressure ; Diagnosis* ; Dizziness ; Fallopian Tubes ; Female ; Gynecology ; Hand ; Hemorrhage ; Humans ; Hypovolemia ; Jeollabuk-do ; Laparoscopy ; Laparotomy ; Medical Records ; Metrorrhagia ; Nausea ; Obstetrics ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Ectopic* ; Retrospective Studies ; Ultrasonography

BACKGROUND: Mycobacterium tuberculosis is a facultative intracellular pathogen which persists and multiplies within macrophage. Competent cell mediated immunity by cooperation of both T lymphocyte and macrophage of the host is required to kill the Mycobacterium tuberculosis. But a precise understanding of the pathogenesis of tuberculosis infection in pulmonary alveolar macrophage has not been achived. Research on the macrophage's basic microbicidal mechanism has elucidated the importance of oxygen-dependent or oxygen-independent components. Oxygen dependent processing begins with the reduction of oxygen by NADPH oxidase and generation of superoxide. In this study, the oxidative metabolic status of blood monocyte and pulmonary alveolar macrophage in patients with active pulmonary tuberculosis was accessed and compared with that of healthy control subjects to know whether there was a basic difference in superoxide generation by mononuclear cells between two groups. METHODS: Pulmonary alveolar macrophage was purified after performing BAL(bronchoalveolar lavage) through the bronchi of infected lesion by Plastic adhesion method. Blood monocyte was purified by Ficoll-Hypaque method. Superoxide generation by blood monocyte and pulmonary alveolar macrophage was measured by ferricytochrome-C reduction method after either stimulated with PMA(phorbol myristate acerate) or non-stimulated states. We also measured the effect of pulmonary tuberculosis patent's serum on superoxide generation by monocyte. RESULTS: 1) Generation of superoxide by alveolar macrophage obtained from patients with pulmonary tuberculosis was little higher than those of controls, and PMA enhanced the generation of 2) Generation of superoxide by blood monocyte obtained from patients with pulmonary tuberculosis was little higher than those of control(P>0.05), and PMA more enhanced the generation of superoxide in patientswith pulmonary tuberculosis than those in controls(p<0.02). 3) Patient's serum enhanced the generation of superoxide by blood monocyte obtained from patients with pulmonary tuberculosis and controls, but not in the case of PMA stimulated blood monocyte. CONCLUSION: The present study suggest that the phenomenon of M. tuberculosis escape the microbicidal action of macrophage was not result of suppressed superoxide generation by blood monocyte and pulmonary alveolar macrophage, rather there might be a factor to stimulate the generation of superoxide by blood monocyte in pulmonary tuberculosis patient serum, but the comparision with effect of control's serum on superoxide generation needs further elucidation.
Bronchi ; Humans ; Immunity, Cellular ; Lymphocytes ; Macrophages ; Macrophages, Alveolar* ; Monocytes* ; Mycobacterium tuberculosis ; Myristic Acid ; NADPH Oxidase ; Oxygen ; Plastics ; Superoxides* ; Tuberculosis ; Tuberculosis, Pulmonary* ; United Nations

In hypertrophic cardiomyopathy, the distribution and extent of left ventricular hypertrophy is known to be variable. Among the subtypes of hypertrophic cardiomyopathy, midventricular obstruction is a rare variant of obstructive hypertrophic cardiomyopathy. This variant is at higher risk of apical wall motion abnormality and/or infarction. We report 4 patients with midventricular obstructive hypertrophic cardiomyopathy who presented with chest pain. Significant systolic pressure gradients between basal and apical chamber of left ventricle were documented by cardiac catheterization and Doppler echocardiography in all patients, and left ventricular apical infarction was noted in one of them. During mean follow-up period of 32 months(21 months to 5 years), one patient with apical infarction died of malignant ventricular arrhythmia.
Arrhythmias, Cardiac ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomyopathy, Hypertrophic* ; Chest Pain ; Echocardiography, Doppler ; Follow-Up Studies ; Heart Ventricles ; Humans ; Hypertrophy, Left Ventricular ; Infarction

In hypertrophic cardiomyopathy, the distribution and extent of left ventricular hypertrophy is known to be variable. Among the subtypes of hypertrophic cardiomyopathy, midventricular obstruction is a rare variant of obstructive hypertrophic cardiomyopathy. This variant is at higher risk of apical wall motion abnormality and/or infarction. We report 4 patients with midventricular obstructive hypertrophic cardiomyopathy who presented with chest pain. Significant systolic pressure gradients between basal and apical chamber of left ventricle were documented by cardiac catheterization and Doppler echocardiography in all patients, and left ventricular apical infarction was noted in one of them. During mean follow-up period of 32 months(21 months to 5 years), one patient with apical infarction died of malignant ventricular arrhythmia.
Arrhythmias, Cardiac ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomyopathy, Hypertrophic* ; Chest Pain ; Echocardiography, Doppler ; Follow-Up Studies ; Heart Ventricles ; Humans ; Hypertrophy, Left Ventricular ; Infarction

Amlodipine, nifedipine, and felodipine are calcium channel blocking agents, which are cause of unwanted gingival overgrowth around natural teeth. Many studies has been performed about this unwanted effects. However, the exact etiology remains uncertain.Few reports and investigations can be found in the literature on drug-induced gingival overgrowth around dental implants. The present case reports that amlodipine-induced gingival overgrowth occurred in peri-implant sites, confirms clinical and histological features in hyperplastic peri-implant tissues. Clinical and histological features of amlodipine-induced gingival overgrowth around dental implants were similar to that of tissue around natural teeth.

Amlodipine, nifedipine, and felodipine are calcium channel blocking agents, which are cause of unwanted gingival overgrowth around natural teeth. Many studies has been performed about this unwanted effects. However, the exact etiology remains uncertain.Few reports and investigations can be found in the literature on drug-induced gingival overgrowth around dental implants. The present case reports that amlodipine-induced gingival overgrowth occurred in peri-implant sites, confirms clinical and histological features in hyperplastic peri-implant tissues. Clinical and histological features of amlodipine-induced gingival overgrowth around dental implants were similar to that of tissue around natural teeth.