A case of severe osteoarthritic patient of both hip treated with McKee-Farrar total endoprosthesis on one hip is reported. The introduction, indication, procedure of the surgery and the use of the self curing acrylic cement were reviewed briefly. The hip following the surgery, even though the follow-up duration is short, showed exceIlent result.
Follow-Up Studies ; Hip ; Humans

BACKGROUND/AIMS: We identified reports in the literature regarding the diagnostic accuracy of hepatic vein arrival time (HVAT) measured by contrast-enhanced ultrasonography (CEUS) to assess hepatic fibrosis in cirrhosis. METHODS: The Ovid MEDLINE, Embase, and Cochrane databases were searched for all studies published up to 23 July 2015 that evaluated liver status using CEUS and liver biopsy (LB). The QUADAS-II (quality assessment of diagnostic accuracy studies-II) was applied to assess the internal validity of the diagnostic studies. Selected studies were subjected to a meta-analysis with MetaDisc 1.4 and RevMan 5.3. RESULTS: A total of 12 studies including 844 patients with chronic liver disease met our inclusion criteria. The overall summary sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of the HVAT measured by CEUS for the detection of cirrhosis compared to LB were 0.83 (95% confidence interval [CI], 0.77 to 0.89), 0.75 (95% CI, 0.69 to 0.79), 3.45 (95% CI, 1.60 to 7.43), and 0.28 (95% CI, 0.10 to 0.74), respectively. The summary diagnostic odds ratio (random effects model) was 15.23 (95% CI, 3.07 to 75.47), the summary receiver operator characteristics area under the curve was 0.74 (standard error [SE]=0.14), and the index Q was 0.69 (SE=0.11). CONCLUSIONS: Based on a systematic review, the measurement of HVAT by CEUS exhibited an increased accuracy and correlation for the detection of cirrhosis.
Biopsy ; Fibrosis* ; Hepatic Veins* ; Humans ; Liver ; Liver Diseases ; Odds Ratio ; Sensitivity and Specificity ; Ultrasonography*

Statistical analysis according to W.H.O. classification for the patients admitted the Ped. Dept. of Han-Il Hospital was carried out during 4 years from Jan. 1974 to Dec. 1977. The following results were observed. 1. Total No. of patient during 4 years period were 1955, of which 1199 were male(61.33%, 756 were female(38.67%) and male to femal ratio was 1.57:1. 2. There was no significant variation. 3. According to age, preschool aged group as the most frequent group consistin of 488 cases(24.49%), school aged group and adolescent in the order of frequency. 4. On monthly distribution, there was no significant variation 5. Most frequent diseases in pediatric age group were respiratory tract one, 851 cases(39.29%) : infectious and parasitic ones, 553(25.53%) and neonatal disease, 204 cases(9.42%) in the order of frequency. 6. Among respiratory tract disease, pneumonia was the most frequent one, 587 cases(27.10%). 7. Among infectious and parasitic disease group, gastrointestinal infectious one was the most frequent, 224 cases(10.34%) : other viral disease and tuberculosis in the order of frequency. 8. Among neonatal diseases, prematurity was the most frequent one, 82 cases(3.79%).
Adolescent ; Classification ; Humans ; Male ; Parasitic Diseases ; Pneumonia ; Respiratory System ; Respiratory Tract Diseases ; Tuberculosis ; Virus Diseases

Currently, the most effective treatment for end-stage liver fibrosis is liver transplantation; however, transplantation is limited by a shortage of donor organs, surgical complications, immunological rejection, and high medical costs. Recently, mesenchymal stem cell (MSC) therapy has been suggested as an effective alternate approach for the treatment of hepatic diseases. MSCs have the potential to differentiate into hepatocytes, and therapeutic value exists in their immune-modulatory properties and secretion of trophic factors, such as growth factors and cytokines. In addition, MSCs can suppress inflammatory responses, reduce hepatocyte apoptosis, increase hepatocyte regeneration, regress liver fibrosis and enhance liver functionality. Despite these advantages, issues remain; MSCs also have fibrogenic potential and the capacity to promote tumor cell growth and oncogenicity. This paper summarizes the properties of MSCs for regenerative medicine and their therapeutic mechanisms and clinical application in the treatment of liver fibrosis. We also present several outstanding risks, including their fibrogenic potential and their capacity to promote pre-existing tumor cell growth and oncogenicity.
Animals ; Cell Differentiation ; Cell Proliferation ; Hepatocytes/immunology/metabolism/pathology/*transplantation ; Humans ; Liver/immunology/metabolism/pathology/physiopathology/*surgery ; Liver Cirrhosis/diagnosis/immunology/metabolism/physiopathology/*surgery ; Liver Regeneration ; *Mesenchymal Stem Cell Transplantation/adverse effects ; *Mesenchymal Stromal Cells/immunology/metabolism/pathology ; Phenotype ; Regenerative Medicine/*methods ; Risk Factors ; Signal Transduction ; Treatment Outcome

The exercise ECG gives a valuable indirect evidence of insufficient myocardial perfusion during stress, but it has been impossible with ECG data alone to localize the site or sites of partial or complete arterial occlusion. The coronary angiography has proved to be valvuable as a technique for identifying anatomical lesions. However, arteriography alone dose not provide evaluation of the underlying myocardium. The two tests are complementary, one supplying indirect physiologic data and the other providing anatomical licalization of obstruction. The author reviewd 58 patients out of 86 patients who performed treadmill test and coronary angiography at the cardiac laboratory of Yonsei University Severance Hospital from January, 1981 through December, 1983. The following results were obtained. 1) Among the 58 patients in this study, 33 had negative exercise test and 25 had positive test. 2) Among the 14 patients who ended exercise test due to chest pain,2patients had negative exercise test. Coronary angiography on all the 14 patients showed significalt coronary artery stenosis. 3) With this multigraded treadmill test, the sensitivity was 68.8% and spedccificity was 88.7%. 4) The appreance of ischemic change during the early stage of exercise, the deeper ST segment depression and the downsloping ST segment have the higest specificity as indicators of coronary artery disease. 5) Four patients showed ST segment elevation in the exercise ECG, and their coronary angiogram showed 1-vessel disease in 1 patientts, 2-vessel dosease in 2 and 3-vessel disease in 3. All of them had multiple stenosis or complete obstruction of the left anterior descending artery on coronary angiogram and ventricualar dyskinesia on the left ventriculogram.
Angiography ; Arteries ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Depression ; Dyskinesias ; Electrocardiography ; Exercise Test* ; Humans ; Myocardium ; Perfusion ; Sensitivity and Specificity ; Thorax

The contour of mandibular angle is important for facial esthetics in the oriental population, because the wide and square face is thought to have had an unhappy life. A prominent mandibular angle produces a characteristics quardrangle, coase, and muscular appearance. So, uni- or bi-lateral mandibular angle reduction is usually performed. However, there is little guideline for bi-lateral angle reduction. So, this study was to investigate the pattern of Korean mandibular angle for bi-lateral mandibular angle reduction as guideline. This study was included 66 adult men and women over 19 years old who are having the normal mandibular angle. We measured the posterior border, angle, and inferior border of mandible using cephalometric view. The results of study was as followed : 1. The ratio of posterior mandible was 96.6, 97.3% in male, and 103.0, 106.0% in female. 2. The ratio of mandibular angle(R1-Go/R1-R2) was 120.2% in male, and 117.3% in female. 3. The ratio of inferior mandible(D5, 6, 7, E, F, G/D4) was 97. 3, 90.9, 79.5, 65.2, 57.8, 46.9% in male, and 98.5, 91.2, 80.5, 67.6, 59.1, 50.2 % in female. The results of this study should be useful to decide accurate amount of reduction.
Adult ; Esthetics ; Female ; Humans ; Male ; Mandible ; Young Adult

BACKGROUND: Patients with centrally recurred bronchogenic carcinoma make a complaint of many symptoms like hemoptysis, cough & dyspnea. At these conditions, the goal of treatment is only to relieve their symptoms. High dose rate brachytherapy(HDR-BT) is the palliative treatment modality of centrally located endobronchial tumor regardless of previous external irradiation(XRT) on the same site in symptomatic patients. METHOD: We studied the effects of HDR-BT in 26 patients with symptomatic recurrent lung cancer. Patients(male: 24, mean age: 54yrs)were treated with HDR-BT underwent bronchoscopic placement of 192Ir HDR after loading unit(Gammamed(R), Germany) to deliver 500cGY intraluminal irradiation at a depth of 1cm every 1wk on 3 occasions. Evaluation at base line and 4wks after HDR brachytherapy included chest X-ray, bronchscopy, symptoms (Standadized Scale for dyspnea, cough, hemoptysis), and Karnofsky performance scale. RESULTS: Endobronchial obstruction was improved in 11/26 patients(37%). Atelectasis in chest X-ray was improved in 5/15 patients(33%). Hemoptysis, dyspnea & cough were improved in 5/10 patients (50%), 5/8 patients (62%) & 10/18 patients (56%) respectively. Karnofsky performance status was changed from 76.4 scores in pretreatment to 77.6 scores after treatment. During HDR-BT, massive hemoptysis (2 patients) and pneumothorax(1 patient) were occurred as complications. CONCLUSION: We concluded that HDR-BT gave additional benefits for the control of symptoms and general performance and endobronchial obstruction & atelectasis. And HDR-BT will be an additional treatment for the recurrent and endobronchial obstructive lung cancer.
Brachytherapy* ; Carcinoma, Bronchogenic ; Cough ; Dyspnea ; Hemoptysis ; Humans ; Karnofsky Performance Status ; Lung Neoplasms ; Palliative Care ; Pulmonary Atelectasis ; Thorax

The facial patterns were expressed by the interrelation of variable factors such as heredity, function and environment. Such variable factors have an effect on the growth and development of maxillofacial bones. The malocclusions with skeletal discrepancies are caused by abnormal forms, sizes and positions of cranial base, maxilla and mandible. For the proper diagnosis and treatment planning, the analysis of such structures is necessary. Lateral cephalograms of 54 adults with class III malocclusion patients (test group) and 61 adults with normal occlusion (control group) were analyzed. Anteroposterior relations and sizes of cranial base, maxilla, mandible were estimated to compare with those of normal ones. In test group, the anterior cranial base length was within normal range, but posterior cranial base, maxilla and mandibular body were longer than those in control group, significantly. Based on the cranial base, the location of maxilla in test group was normal, but the location of mandible was more anterior than that in control. Based on the maxilla, the location of mandible was more anterior in test group than that in control. Both mandibular body and ramus anteroposterior lengths in test group were larger than those in control. Both mandibular plane angle and upper gonial angle were within normal range, but lower gonial angle was significantly high in test group.
Adult ; Diagnosis ; Growth and Development ; Heredity ; Humans ; Malocclusion ; Mandible* ; Maxilla* ; Reference Values ; Skull Base*

BACKGROUND: Opioid based patient-controlled analgesia (PCA) effectively provides adequate pain control after spine surgery, often at the expense of high incidence of postoperative nausea and vomiting (PONV). This study was designed to compare the effect of ramosetron with ondansetron for preventing PONV in highly susceptible patients using PCA following spine surgery under general anesthesia. METHODS: Seventy female patients, aged 18 to 65, scheduled for elective lumbar spine surgery, were randomly allocated into either ondansetron group (Group O, n = 35) or ramosetron group (Group R, n = 35). In patients assigned to group O, ondansetron 4 mg was injected and 12 mg was added to the PCA regimen. In patients assigned to group R, ramosetron 0.3 mg was injected and 0.3mg was added to the PCA regimen. The PCA regimen consisted of fentanyl 25microgram/kg (total volume including saline: 100 ml) and was programmed to deliver 2 ml/hr as background infusion and 0.5 ml per demand with a 15 min lockout. The incidence and severity of PONV, pain score, total amount of administered rescue analgesic and rescue antiemetic were assessed following 48 hrs after surgery. RESULTS: The incidence of PONV showed no significant differences between groups during 48 hrs after surgery. There were no differences in the severity of nausea, pain score, total amount of administered rescue analgesic and rescue antiemetic between groups. CONCLUSIONS: Ramosetron prophylaxis for preventing PONV is as effective as ondansetron in highly susceptible patients using fentanyl based PCA following spine surgery under general anesthesia.
Aged ; Analgesia, Patient-Controlled ; Anesthesia, General ; Benzimidazoles ; Female ; Fentanyl ; Humans ; Incidence ; Nausea ; Ondansetron ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Spine

Kawasaki disease (KD) is an acute, self-limiting, small-vessel vasculitis with an unknown cause that affects children between the ages of 6 months and 5 years. Its important acute complication is coronary artery aneurysm. Myocardial infarction caused by thrombus formation inside the aneurysm or by organic obstructive lesion following the regression of aneurysm is the principal cause of death in KD. However, coronary artery aneurysms and stenosis requiring surgery are rare in KD. We report an our experience about anesthetic management of child undergone off-pump coronary artery bypass grafting surgery because of coronary artery aneurysm associated with KD.
Anesthesia ; Aneurysm ; Cause of Death ; Child ; Constriction, Pathologic ; Coronary Artery Bypass, Off-Pump ; Coronary Disease ; Coronary Vessels ; Humans ; Infarction ; Mucocutaneous Lymph Node Syndrome ; Myocardial Infarction ; Thrombosis ; Transplants ; Vasculitis