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*

BACKGROUND: Tuberculous pleurisy treatment improve symptoms such as fever, chest pain, cough, and prevents the progression to active pulmonary tuberculosis and the development of residual pleural thickening that decrease diaphragm and rib cage movement. This study investigated how the degree of residual pleural thidkening affects the pulmonary function. METHODS: Fifty seven patients who were initially diagnosed as having tuberculous pleurisy, were treated with anti-tuberculous medication for 6 months and had residual pleural thickening between May 1998 and January 2000 at the Eulji university hospital were reviewed. A chest X-ray and pulmonary function test(PFT, Sensormedics 2200) were perfored. The predicted value (%) of the forced vital capacity(FVC), forced inspiratory vital capacity(FIVC) and total lung capacity(TLC) were measured. The residual pleural thickening was defined the average of the summation in the lateral chest at the level of the imaginary line intersecting from the cardiophrenic angle to the diaphragmatic dome and the lowest part of the costophrenic angle between them. The results were sorted into three grades according to pleural thickness; <2mm(grade I), 2~10mm(grade II), 10mm(grade III). RESULTS: 1. FVC(% pred) and FIVC(% pred) were statistically different between grade I and III, and II and III. However, there was no difference between the TLC(% pred) between each of the groups. 2. The pleural thickness that cause restrictive dysfunction(FVC<80%) and a statisticall difference, is 3 mm. CONCLUSION: The larger the extent of the residual pleural thickness after antituberculous medication, the greater the reduction in the FVC, FIVC, TLC. A pleural thickness of 3 mm is recommended as a guideline for diagnosing a restrictive pulmonary dysfunction.
Chest Pain ; Cough ; Diaphragm ; Fever ; Humans ; Lung ; Respiratory Function Tests ; Ribs ; Thorax ; Tuberculosis, Pleural* ; Tuberculosis, Pulmonary

The authors reviewed 3145 pediatric patients who visited the emergecy room in this hospital during 3yrs period from Jan. 1989 to Dec. 1991. 1) Among the patients visiting the emergency room, the patients under 15 years of age were 26.4% (3145) of total emergency patients (11930). 2) yearly distribution of patients were decreased 17% between 1989 and 1991. 3) Monthly distribution of visits showed higher incidence in June and July. The male to female ratio was 1.5:1. 4) Weekly distribution of visits showed higher incidence on Sunday and Saturday, relatively. 5) Most popular time of visiting the emergency room was between 8:00 PM to 12:00 PM during which time 29.5% of all pediatric patient were seen. 6) Distribution of age showed peak incidence between 6 and 12 years of age (30.9%). 7) 65.18% of total emergency room isits were pediatric patients. 8) Distribution of cases was as follows: Respiratory disease 37%, accident, GI disease in turn listed respectively in ecreasing order of freqency. 9) The admission rate through emergency was 8.5% of total pediatric emergency patients. 10) 82.3% of total emergency visits had medical insurance coverage, 7% had no insurance and 10.7% were on medical aid program.
Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Incidence ; Insurance ; Insurance Coverage ; Male

A 31-year-old pregnant woman with pruritus in pregnancy was described; she presented with a one-week history of generalized pruritus at gestational age 6 weeks without primary skin lesion. She had no dermatologic problem before pregnancy. Her pruritic symptom was not con-trolled with conventional emollient and topical corticosteroids. Broadband Ultraviolet B(UVB) phototherapy successfully improved her pruritus. UVB phototherapy also worked well after recurrence of pruritus at pregnancy 23rd week. We report herein a case of pruritus in pregnancy successfully treated with broadband UVB phototherapy.
Adrenal Cortex Hormones ; Adult ; Female ; Gestational Age ; Humans ; Phototherapy* ; Pregnancy* ; Pregnant Women ; Pruritus* ; Recurrence ; Skin

BACKGROUNG AND OBJECTIVES: It was reported that low molecular weight heparin (LMWH) was more effective than unfractionated heparin in patients with acute coronary syndrome. Recent studies have shown that the pathophysiology of restenosis in stented lesions was different from those of nonstented lesions. Treatment strategies designed to limit cellular proliferation that were ineffective in nonstented lesions may be efficacious in reducing in-stent restenosis. This study was aimed to compare the clinical and angiographic results of LMWH (nadroparin) after coronary stenting with those of conventional ticlopidine regimen. MATERIALS AND METHODS: Patients were eligible for inclusion if they had angina and/or objective evidence of myocardial ischemia, and a significant (>50%) stenosis that was documented on a recent coronary angiogram. After stenting, prospective randomized comparison study was performed. Patients were randomly assigned to either nadroparin (200 IU/kg, sc, bid) or ticlopidine (250 mg bid) plus aspirin (200 mg qd) treatment groups. Repeat coronary angiography (KERN=*)was performed at 236+/-90days after stenting, and quantitative coronary angiographic analysis (QCA) was done. RESULTS: Intracoronary stent implantation was performed in eighty five lesions in eighty one patients (ticlopidine:40, nadroparin:41). There was no significant difference in any baseline clinical/angiographic variables between the two treatment groups. There were no subacute stent thrombosis, infarction and death in both groups. Six-month event-free survival was 36 (90%) in the ticlopidine group and 35 (85.4%) in the nadroparin group. Follow-up quantitative angiographic data such as late loss (1.35+/-0.70 vs 1.32+/-0.69), loss index (0.53+/-0.70 vs 0.56+/-0.23) and restenosis rate (36% vs 25.8%) were not different between ticlopidine and nadroparin groups. CONCLUSION: Effects of nadroparin were not different from those with ticlopidine therapy in the prevention of restenosis and subacute stent thorombosis after coronary stenting. Clinical outcomes between two strategies were similar. Low molecular weight heparin may be an alternative to ticlopidine in patients that ticlopidine cannot be administered because of severe adverse effects.
Acute Coronary Syndrome ; Aspirin ; Cell Proliferation ; Constriction, Pathologic ; Coronary Angiography ; Disease-Free Survival ; Follow-Up Studies ; Heparin ; Heparin, Low-Molecular-Weight ; Humans ; Infarction ; Myocardial Ischemia ; Nadroparin* ; Prospective Studies ; Stents* ; Thrombosis ; Ticlopidine*

OBJECTIVE: To investigate whether the serum levels of IL-10 in patients with rheumatoid arthritis are different from those of normal controls and SLE patients and to find out any correlation with disease activity parameters of rheumatoid arthritis. METHODS: Sera from 20 healthy normal persons, 16 rheumatoid arthritis patients and 16 patients with systemic lupus erythematosus were collected and measured for IL-10 and IL-6. Various disease activity parameters were measured in RA patients. RESULTS: The serum level of IL-10 in RA patients was significantly elevated compared to normal controls but lower than those of SLE patients. In RA patients there was no definite correlation between the disease activity parameters and serum IL-10 levels. Despite significant improvements in terms of various disease activity parameters, there was no significant change of serum IL-10 levels after treatment in RA patients. In seropositive RA patients, positive correlation was found between serun IL-10 and rheumatoid factor levels. CONCLUSION: Our findings show that the serum IL-10 levels in patietns with RA are elevated compared to normal controls but lower than those of SLE patients. There was no correlation between serum IL-10 levels and disease acivity parameters of RA.
Arthritis, Rheumatoid* ; Humans ; Interleukin-10* ; Interleukin-6 ; Lupus Erythematosus, Systemic ; Rheumatoid Factor

PURPOSE: Although alpha-fetoprotein is one of the most commonly used tumor markers in Korea, most of the radioimmunoassay kits for alpha-fetoprotein have been imported from foreign countries. The purpose of this study was to evaluate the performance of a recently developed domestic immunoradiometric kit for alpha- fetoprotein (Riakey AFP IRMA CTR, Sin-Jin Medics, Seoul, Korea). MATERALS AND METHODS: We evaluated intra- and inter-assay precision, recovery rate, parallelism, and sensitivity of serum alpha-fetoprotein measurement using Riakey AFP IRMA CTR kit. The values of alpha-fetoprotein measured by Riakey AFP IRMA CTR kit were compared with those measured by two foreign commercial kits (alpha-fetoproteina of Radim and alpha-feto.riabead of Abbott). RESULTS: Intra-assay coefficients of variation on three different levels were 5.3% for 18.9 ng/ml, 3.4% for 133 ng/ml and 1.6% for 330 ng/ml. Inter-assay coefficients of variation were 9.7% for 20.9 ng/ml, 3.2% for 137 ng/ml and 4.1% for 330 ng/ml respectively. Recovery rate tests on all three different levels showed within 100+/-10%. Parallelism was also good and the sensitivity was 0.63 ng/ml. There was strong correlation between the measurement of alpha-fetoprotein by Riakey AFP IRMA CTR and that by two foreign commercial kits(r=0.98). CONCLUSION: The first Korean domestic immunoradiometric kit for alpha-fetoprotein, Riakey AFP IRMA CTR, performed well for clinical use.
alpha-Fetoproteins* ; Fetal Proteins ; Immunoradiometric Assay* ; Korea ; Radioimmunoassay ; Seoul ; Biomarkers, Tumor

No abstract available.

No abstract available.
Spinal Stenosis*

So many modalities have been suggested for the treatment of servere pain and ankylosis of the elbow with destruction of the articular surfaces. Among them, two major methods which have been widely used are resection arthroplasty and prosthetic replacement arthroplasty. However prosthetic replacement arthroplasty has some problems. Its indications are limited in the elderly inactive subjects. And there have been many kinds of complications including loosening and infection. Also, resection arthroplasty in now rarely indicated due to severe instability. From July 1980 to July 1987, we tried distraction arthroplasty in 8 cases of elbow with severe destruction of its articular surfaces, mainly in the young active persons. The average follow-up period was 45 months. The effect of distraction arthroplasty on relief of pain was not remarkable. The average increase in ROM, including that of one reankylosed elbow, was 51 ±22 degrees in flexion-extension and 48 ±23 degrees in pronstion-supinstion. No deep wound infection and instability which was main complication of resection arthroplasty were observed with our method of distraction arthroplasty. On the basis of functional results, the the results were excellent in 4, good in 1, fair in 2 and poor in 1 cases. In conclusion, distraction arthroplasty of the elbow can be one of the of effective methods reconstruction for the young active patients with the destruction of the elbow, if they are intelligent and motivated.
Aged ; Ankylosis ; Arthroplasty ; Arthroplasty, Replacement ; Elbow ; Follow-Up Studies ; Humans ; Methods ; Wound Infection