In this study noise source in a ward at four general hospitals in Seoul area has investigated and analysed. The degree of reaction against noise by 171 randomly has also been examined. The results of the study have shown that the source of noise is the speakers of wired broadcasting or from visiting guests in two hospitals located in residential area. The patients at the two other hospitals located at commercial site have been suffered more from traffic noise, However, because of their separated living at hospital from their ordinary houselife, sixty on percent of the inpatients have wished a music sound of around 60 dB (A). After having considered the results of the investigation and wishes of the inpatients, following suggestions have been made: 1. Reduce the number of guests or their length of stay. 2. Wired bodadcasting system should be substitued by sireless one, or if it's unavoidable, it should be used in office rooms only. 3. Since the stops and starts of vehicles induce much noise, Seoul City Government be requested to prepare an appropriate administrative measure for the vehicles around hospital area and ti should prevent the establishment of new hospitals along high way site. 4. By using earphone, inpatients can choose a wireless channel according to each individual's taste. This through the masking effect, would cover up the noise source. 5. Rooms along the streets should be utilized as offices, otherwise double windows should be set up for inpatient's wards.
Hospitals, General ; Humans ; Inpatients ; Length of Stay ; Local Government ; Masks ; Music ; Noise* ; Seoul

The rate of acetabular cup revision arthroplasty is gradually rising along with an increased risk of osteolysis and prosthesis loosening over time and an increase in life expectancy. The goals of revision total hip arthroplasty are: i) implant stability through reconstruction of large bone defects, ii) restoration of range of motion and biomechanics of the hip joint, and iii) normalization of uneven limb lengths. In acetabular cup revision arthroplasty, stable fixation of acetabular components is difficult in the presence of severe bone loss (e.g., evidence suggests that it is challenging to achieve satisfactory results in cases of Paprosky type 3 or higher bone defects using conventional techniques). The author of this study performed acetabular revision to manage patients with large areas of defective bones by filling in with morselized impaction allografts. These allografts were irradiated frozen-stored femoral heads acquired from a tissue bank, and were applied to areas of an acetabular bone defect followed by insertion of a cementless cup. When this procedure was insufficient to obtain primary fixation, a tri-cortical or structural allograft using a femoral head was carried out. Structural stability and bone incorporation were confirmed via long-term follow-up. This study aims to review conventional surgical techniques and verify the utility of surgical procedures by analyzing the author's surgical methods and discussing case reports.
Acetabulum ; Allografts ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Extremities ; Follow-Up Studies ; Head ; Hip Joint ; Humans ; Life Expectancy ; Osteolysis ; Prosthesis Failure ; Range of Motion, Articular ; Tissue Banks

In the present study, we investigated the differences in the levels of expression of virulence factors between blood isolates of Candida albicans and commensal strain isolated from the oral cavities of health volunteers, and correlations between virulence factors. Blood isolates of 33 and commenal isolates of 71 were characterized by putative virulence factors such as proteinase production (PROT), an ability to adhere to epithelial cells (ADH), cell surface hydrophobicity (CSH), phospholipase production (PLASE), and hyphal transition (GERM). In PROT, ADH, CSH, and PLASE, the means of expression of blood isolates were higher compared with those of commensal isolates, however statistical significance was only shown in CSH (p=0.036). On the contrary, mean expression of GERM of blood isolates was lower than that of commensal isolates. Of relationships between virulence factors, although a negative correlation of PROT with CSH was obtained, the correlation was relatively low (r=-0.316, p=0.001). These results suggest that higher expression of CSH is a more distinguishing character in virulent blood isolates of C. albicans and that the expression of virulence factors are independent.
Candida albicans* ; Candida* ; Epithelial Cells ; Healthy Volunteers* ; Hydrophobic and Hydrophilic Interactions ; Phospholipases ; Virulence Factors ; Virulence* ; Volunteers

PURPOSE: This study was performed to assess potential improvements in clinical outcomes when applying recent advanced hip arthroplasty surgical techniques and understand the potential relationship between bone mineral density (BMD) and surgical outcomes. MATERIALS AND METHODS: Among 37 cases of periprosthetic femoral fractures after hip arthroplasty treated between March 2014 and September 2016, all included a follow-up of at least one year and were included in this study. Outcomes were evaluated using the Beals and Tower's criteria. BMD was examined in 27 of 37 cases and the relationship between osteoporosis and treatment outcomes was analyzed. Advanced hip arthroplasty surgical approaches varied depending on the fracture type: i) open reduction with wiring for Vancouver A, ii) open reduction with double plate fixation for Vancouver B1, iii) revision THA with long stem for Vancouver B1-Nonunion, B2 and B3, and iv) open reduction with double plate fixation for Vancouver C. RESULTS: When assessed using the Beals and Tower's criteria, 33 out of 37 (89.2%) patients were excellent and 4 (10.8%) were poor. These outcomes were an improvement compared with series I (81.8%). When analyzed according to the Vancouver classification, patients with type A (n=8), type B1 (n=16), and type B2 (n=2) were all excellent, the patients with type B3 were excellent (n=1) and poor (n=1), and the patients with type C were excellent (n=6) and poor (n=3). The mean BMD was −2.6 (T-score) in 27 of 37 cases and −4.4 in 4 cases with poor prognosis. Osteoporosis was statistically correlated to those classified as poor by Beals and Tower. CONCLUSION: The results of the analysis suggest that applying new surgical hip arthroplasty treatment approaches leads to improved outcomes compared with the author's previous study. When treating periprosthetic femoral fractures following total hip arthroplasty, an appropriate internal fixation method should be selected, at least in part based on the Vancouver classification. In addition, osteoporosis may be a major prognostic factor for the outcomes of surgical treatment.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Bone Density ; Classification ; Femoral Fractures ; Follow-Up Studies ; Hip ; Humans ; Methods ; Osteoporosis ; Periprosthetic Fractures ; Prognosis

Non-specific periventricular white matter lucencies on computed tomography(leukoaraiosis) were found in 130(40%) of 324 patients with ischemic or hemorrhagic strokes. Patients with leukoaraiosis were significantly older than those without it and correlated with hypertension and lacunar infarction but not with cortical infarction. In patients with hemorrhage, leukoaraiosis occurred sinigificantly more often when aneurysm or arteriovenous malformation were not demonstrated. Our fiindings suggest that leukoaraiosis in cerebrovascular disease is associated with small vessel disease.
Aneurysm ; Arteriovenous Malformations ; Hemorrhage ; Humans ; Hypertension ; Infarction ; Leukoaraiosis* ; Stroke ; Stroke, Lacunar

The discovery of C-T scan have facilitated the detection of post-traumatic hydrocephalus cases. Of those, 6 cases of hydrocephalus of non-parenchymatous in origin, in other words, normal pressure hydrocephalus were presented. They were diagnosed by repeated brain C-T and cisternography with Iodine 131-labeled human serum albumin. The symptomatology, diagnosis procedure and surgical results were discussed. Followings are the results. 1) The RIHSA cisternogram taken after 6 hrs, 12 hrs, 24 hrs and 48 hrs from lumbar injection showed abnormal features in all cases. 2) Surgical results were thought that there is much correlation with the age and improvement of mental impairments were seen, more or less, in all cases and improvement of gait disturbance and incontinence were seen in 5 cases and 4 cases respectively. 3) In those who sustained severe head injury with delayed recovery, the authors think, repeated check of brain C-T and cisternography is necessitated to perform the V-P shunt or V-A shunt to relieve the symptomatology of normal pressure hydrocephalus.
Brain ; Cerebrospinal Fluid Pressure ; Craniocerebral Trauma ; Diagnosis ; Gait ; Humans ; Hydrocephalus ; Hydrocephalus, Normal Pressure* ; Iodine ; Serum Albumin ; Ventriculoperitoneal Shunt

Optic chiasmal syndrome due to arteriosclerotic vascular changes is rate. To our knowledge, there has been no report of arteriosclerotic chiasmal syndrome in Korea. In our two cases, other causes of chiasmal syndrome were not detected by MRI, four-vessel cerebral angiography, CSF study, and special laboratory examinations including ANA test, RA factor, and LE cell. With conservative treatment, the visual fields of the two patients are showing progressive improvement. We report here two cases of suspected arteriosclerotic optic chiasmal syndrome.
Adult ; Arteriosclerosis/diagnosis/*physiopathology/radiography ; Humans ; Korea ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Optic Chiasm/*physiopathology ; Syndrome ; Tomography, X-Ray Computed ; *Visual Fields

Creutzfeldt-Jakob disease (CJD) is presumably caused by a slow infectious pathogen or prion. The principal clinical features of Creutzfeldt-Jakob disease are dementia, pyramidal and extrapyramidal symptoms and signs, cerebellar dysfunction, and myoclonus. The patient rapidly deteriorates, declines to a vegetative state, becomes comatous, and is ultimately dead within several months. The authors present a case of Creutzfeldt-Jakob disease, proved by clinical findings, typical serial EEG, and pathologic features.
Creutzfeldt-Jakob Syndrome/*diagnosis/pathology/radiography ; Electroencephalography ; Female ; Humans ; Middle Aged ; Tomography, X-Ray Computed

Primary malignant lymphoma of the central nervous system which is characterized by high radiosensitiveness is rarely reported in the literature. We have experienced a case of recurred cerebellar lymphoma whose criginal site was septal area. Though septal tumor disappeared completely after radiation, a large cerebellar tumor was found 2 years thereafter. After decompressive suboccipital craniectomy and partial tumor removal the patient's general condition improved so secondary radiation and chemotherapy were started. In the course of port-op therapy, the patient abruptly deteriorated and succumbed.
Central Nervous System ; Cerebellar Neoplasms ; Cerebellum* ; Drug Therapy ; Humans ; Lymphoma* ; Septum of Brain

The diagnostic possibility and the incidence of ectopic pregnancy are increasing due to several factor. Furthermore, radioimmunoassay of serum β-HCG and US make it possible to diagnose early before the tubal rupture. A conventional surgical approach has been considered as a choice of treatments. Until recent years, however, surgery may have considerable risk of infertility and sugical hazard. In view of the natural tendency of some ectopic pregnancies to terminate in tubal abortion or complete resorption, we tried to cure ectopic pregnancy with nonsurgical transcervical intervention. Five of 8 patients with unruptured tubal pregnancies, it was possible to inject PGF2a into the tubes or gestational sac. 4 of them were ended up with satisfactory reduction of serum β-HCG level and improvement of symptoms & signs. In only one patient, β-HCG level remained a high level continuously, so salpingectomy was done. As a result, we consider that fluoroscopy-guided transcervical interventional procedure is a useful treatment modality for early unruptured ectopic pregnancy.
Abortion, Spontaneous ; Female ; Gestational Sac ; Humans ; Incidence ; Infertility ; Pregnancy ; Pregnancy, Ectopic* ; Pregnancy, Tubal ; Radioimmunoassay ; Rupture ; Salpingectomy