OBJECTIVE: The purpose of this study is to evaluate the short term results of total hip arthroplasty (THA) for avascular necrosis in patients with systemic lupus erythematosus (SLE). METHODS: This is a retrospective case control, matched pair study. Ten patients (15 hips) with SLE and avascular necrosis of the femoral head (AVNFH) underwent THA. Eight patients (12hips) with a minimum follow up of 2 years were reviewed. To determine whether these patients had results similar to those of patients with other diagnosis, we formed a control group of 12 patients who had 12 THA. They were matched for age, sex, BMI, activity, follow-up period, and type of implant with SLE group. The clinical and radiographic results were evaluated by Harris hip score (HSS) and serial radiographic findings, respectively. RESULTS: There was no complication during the perioperative period. In the SLE group, HHS was from 67.3 preoperatively to 97.7 at last follow-up. In the control group, HHS was from 70.1 preoperatively to 97.8 at last follow-up. On the last roentgenograms, none of acetabular components demonstrated any evidence of migration, tilt, rotation or shedding of metal particles in both groups. All femoral components demonstrated no evidence of subsidence, pedestal, or shedding of metal particles in both groups. CONCLUSION: Patients with SLE and AVNFH had excellent results after THA. Results were not different from that of patients who had hip replacement for other diagnoses. Therefore, it is considered that uncemented THA was useful treatment method for the patient who had SLE and AVNFH.

BACKGROUND: Delayed entry of blood culture bottles is inevitable when microbiological laboratories do not operate for 24 hr. There are few studies reported for prestorage of these bottles. The growth dynamics of Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa were investigated with respect to various preincubation conditions. METHODS: Fifteen or 150 colony-forming units (CFU) of bacteria were inoculated into standard aerobic or anaerobic blood culture bottles. Bottles were preincubated at 25degrees C or 37degrees C for 0, 2, 4, 8, 12, 24, or 48 hr. The time to detection (TTD) then was monitored using the BacT/Alert 3D system (bioMerieux Inc., USA). RESULTS: Significant difference in TTD was observed following preincubation for 8 hr at 25degrees C vs. 4 hr at 37degrees C for S. aureus, 4 hr at 25degrees C vs. 4 hr at 37degrees C for E. coli, 12 hr at 25degrees C vs. 4 hr at 37degrees C for P. aeruginosa, compared to no preincubation (P<0.005). TTD values did not vary significantly with bacterial CFU or with aerobic or anaerobic bottle type. The BacT/Alert 3D system returned false negatives following preincubation of P. aeruginosa for 48 hr at 25degrees C or 24 hr at 37degrees C. CONCLUSIONS: TTD was mainly affected by preincubation temperature and duration rather than by input CFU quantity or bottle type for the 3 experimental bacteria.
Bacteriological Techniques/instrumentation/*methods ; Culture Media ; Escherichia coli/growth & development/*isolation & purification ; Pseudomonas aeruginosa/growth & development/*isolation & purification ; Staphylococcus aureus/growth & development/*isolation & purification ; Temperature ; Time Factors

BACKGROUND: The decision on whether or not to transfuse should be based on agreement from the patient's own understanding and free will. In Korea, the transfusion guideline first developed in 2009 specified that informed consent should be obtained before transfusion. The standard consent form has also been distributed since 2010. The purpose of this study was to evaluate the degree of improvement in obtaining informed consent for blood transfusion. METHODS: Prior to the development of the transfusion guideline in 2008, an e-mail survey was conducted on 105 clinicians. In 2015, questionnaires were sent to 1,179 clinicians, 32 academic societies, and 6 institutions. RESULTS: Forty-three and 374 answers were received in 2008 and 2015, respectively (response rate, 41.0% and 30.7%). Compared with 2008, the use of explanatory materials increased from 20.9% to 70.5%, and consent acquisitions using a written form increased from 27.9% to 81.7%. The number of respondents who answered that informed consent for transfusions is absolutely necessary also increased from 51.2% to 71.3%. Among the reasons why obtaining informed consent for transfusion can be difficult, the response that standardized consent form is unavailable decreased from 51.2% to 26.9%. CONCLUSION: The transfusion guideline and the standard consent form have contributed greatly to the improvement of obtaining informed consent before blood transfusion at medical institutions in Korea.
Blood Transfusion* ; Consent Forms ; Electronic Mail ; Informed Consent* ; Korea ; Personal Autonomy ; Surveys and Questionnaires

STUDY DESIGN: A prospective study. OBJECTIVES: To determine the usefulness of local bone obtained from laminectomy and decortication as graft bone instead of autogenous iliac bone in posterolateral lumbar spinal fusion. MATERIALS AND METHODS: Thirty-one patients underwent posterolateral lumbar spinal fusion with pedicle screw instrumentation. Local bone was inserted in the right side of intertransverse space and autogenous iliac bone was in the left side. We compared fusion rate in the radiographs at postoperative 6 week, 3 month, 6 month and 1 year. RESULTS: Radiographic fusion grading of local bone was 20 cases of grade 1, 8 cases of grade 2, 2 cases of grade 3 and 1 case of grade 4. Fusion grading of autogenous iliac bone was 24 cases of grade 1, 4 cases of grade 2 and 3 cases of grade 3. Bone fusion was complete after 9.1 months in local bone and 7.2 months in autogenous iliac bone. No significant differences was found between the two groups. CONCLUSION: The local bone in posterolateral lumbar fusion is appropriate for satisfactory fusion instead of autogenous iliac bone if the amount of local bone is sufficient and decortication of the fusion bed is proper.
Humans ; Laminectomy ; Prospective Studies ; Spinal Fusion ; Transplants*

BACKGROUND: Transfusion guidelines play an important role for the appropriate use and quality assurance of blood and transfusion services. The Korean national transfusion guideline was developed in 2009 and went under full amendment in 2016. The purpose of this study was to investigate the awareness and practicality of the transfusion guideline in Korea. METHODS: Questionnaires about the Korean national transfusion guideline were sent by traditional mail or e-mail to a total of 1,179 clinicians, 32 academic societies, and 6 institutions. RESULTS: Three hundred and seventy-four answers were received; a response rate of 30.7%. The proportion of respondents with good awareness of the guideline was 23.3%, which is a significant increase compared with 10.9% in 2008. Respondents with good awareness were more dependent on the transfusion guideline when making transfusion decisions. CONCLUSION: There was a considerable increase in the awareness of the national transfusion guideline in Korea.
Electronic Mail ; Korea* ; Postal Service ; Surveys and Questionnaires

PURPOSE: The purpose of this study is to analyze the clinical and radiological results of performing primary total hip arthroplasty (THA) in patients with a fused hip and to compare the results with that of patients with avascular necrosis of the femur head (AVNF). MATERIALS AND METHODS: 19 patients (21 hips) with a fused hip(s) were retrospectively reviewed. We analyzed them clinically with using the Harris hip score (HHS), and radiologically with performing serial radiograms and we then compared them with the results of the patients in the AVNF group. RESULTS: The mean HHS was improved from 59.2 to 85.8. The VAS improved from 6.5 to 2.2 and the leg length discrepancy (LLD) improved from 27.5 mm to 12.5 mm. As complications, wound infection occurred in 3 hips, heterotopic ossification occurred in 8 hips and recurrent dislocation occurred in one hip. Although a radiolucent line was found in 4 acetabular cups and 6 femoral stems, there was no progression. Osteolysis was found in 1 acetabular cup. CONCLUSION: The results of THA in patients with a fused hip were excellent. Comparing with the AVNF group, improvement of the hip motion and LLD were much better. The improvement of the VAS and HHS showed similar results between the groups. However, the final results of the HHS, VAS, LLD and the range of motion of the hip were worse, and the complication rate was higher.
Arthroplasty ; Dislocations ; Femur Head ; Femur Head Necrosis ; Hip ; Humans ; Leg ; Necrosis ; Ossification, Heterotopic ; Osteolysis ; Range of Motion, Articular ; Retrospective Studies ; Tacrine ; Wound Infection

BACKGROUND: High-risk group neuroblastoma (HRNB) is one of the most incurable diseases in pediatric oncology field. This report explores the effectiveness, safety and feasibility of triple high dose chemotherapy followed by autologous stem cell transplantation (HDCT/ASCT) in contrast with single HDCT/ASCT for HRNB.METHODS: From Jan. 2001 to Dec. 2009, 25 patients newly diagnosed as HRNB have been analyzed. This study is a retrospective analysis with the medical records of these 25 HRNB patients.RESULTS: Eleven (44%) and the other fourteen (56%) patients were treated with single HDCT/ASCT and triple HDCT/ASCT, respectively. The 5-year event-free survival (EFS) of the whole group in HRNB is 37.2+/-10.0%. The 5-year EFS of single HDCT/ASCT and triple HDCT/ASCT were 27.3+/-13.4% and 46.8+/-13.8%, respectively (P=0.38). Between two groups, there were no statistically significant differences including clinical features, outcome, transplantation-related toxicities, and short-term/long-term complications.CONCLUSION: Triple HDCT/ASCT group showed similar transplantation-related toxicities and long-term complications when compared to single HDCT/ASCT group. We need more exploration to conclude the triple HDCT/ASCT as an optimal treatment for HRNB patients.
Disease-Free Survival ; Humans ; Medical Records ; Neuroblastoma ; Retrospective Studies ; Stem Cell Transplantation ; Stem Cells

Background: Nurses play a central role in the process of blood transfusion because they have the closest interactions with patients. Providing nurses with the appropriate knowledge and competency through education can help ensure transfusion safety. This study investigated the effectiveness of the first nationwide transfusion-related education for nurses by analyzing questionnaires for a self-assessment of competency on transfusion-related knowledge before and after the education and general evaluation for the educational program. Methods: The education program was composed of four lectures and was conducted in seven regions in South Korea. One hundred and ninety-two nurses participated, and the questionnaires for 170 nurses were analyzed. Results: The participants consisted of 90 nurses (53.0%) from tertiary hospitals, 23 (13.5%) from general hospitals, and 57 (33.5%) from other hospitals. The majority of the participants (103/170, 60.6%) were from hospitals with ≥500 beds, and 69.4% had a work period of ≥10 years. The scores for pre-/post-education self-assessment of competency were as follows: blood components, 3.03/3.73; pretransfusion testing, 2.86/3.64; management of transfusion, 3.18/3.84; and transfusion reactions, 3.11/3.78. In all categories, there was a significant increase in the score after the education program. The majority of participants (99.4%) provided a positive response regarding the necessity of a transfusion-related education program. Conclusion South Korea’s first attempt at transfusion-related education for nurses showed a strong positive effect by improving participants’ transfusion-related competency. Considering the important role of nurses in blood transfusion, the educational program should continue and be expanded in the future.

Background: The Korean Blood Safety Commission established the Regional Networks for Blood Transfusion Management (RNBTM) Project which has operated in 14 regions across the country since 2017 to help blood transfusion management in small and medium-sized medical institutions. Since implementation of the RNBTM, participant’s satisfaction has not been evaluated, therefore in order to evaluate participant’s satisfaction and assist in future planning a survey was conducted. Methods: Fourteen facilitators participated in an anonymous on-line survey (5 questions). Laboratory Medicine (LM) doctors from small and medium-sized medical institutions from 14 regions also participated in a separate anonymous on-line survey (15 questions). Results: 14/14 (100%) facilitators responded to the survey. In addition to the RNBTM they were also in favor of establishing a Network of University Hospitals. 135 LM doctors responded to the survey. Of the RNBTM participants, 94.1% (111/118) replied that RNBTM was helpful in providing and exchanging blood transfusion information. Respondents indicated that they wished to remain part of RNBTM into the future because they felt that RNBTM not only helped improve quality of blood transfusions but also other aspects in the laboratory. In 70.4% (95/135) of participating medical institutions, LM doctors have been the Chairperson of the Hospital Transfusion Committee. Conclusion Extremely positive survey results were received from LM doctors. These survey results from LM doctors and facilitators will be helpful in developing and planning future projects related to RNBTM.

Purpose: We evaluated the use of three criteria to determine the need for additional treatment of cystic thyroid nodules after their recurrence following ethanol ablation (EA). Methods: In total, 154 patients (male:female=30:124; mean age, 53.4 years; range, 23 to 79 years) with 154 thyroid nodules (49 cystic and 105 predominantly cystic nodules) who presented between January 2014 and August 2017 were enrolled. All patients underwent follow-up ultrasonography (US) 1 month after EA, and were divided into therapeutic success and failure groups. Therapeutic success was defined as the absence of any residual fluid or sufficient volume reduction (≥50%) with improvement of nodule-related symptoms. The therapeutic failure was defined according to three previously suggested criteria for recommending additional treatment: nodules with ≥1 mL of remnant fluid (criterion 1), volume reduction <50% (criterion 2), and demonstration of a solid component with vascularity (criterion 3). Results: Thyroid nodules treated by EA showed significant volume reduction (18.4±21.6 mL to 4.2±6.5 mL [1-month follow-up] to 1.9±3.3 mL [final follow-up], P<0.001) and improvement in clinical problems. Therapeutic failure were 26 patients according to criteria 1, 14 patients according to criteria 2, and 35 patients according to criteria 3. Additional treatment was unnecessary in 81.3%, 70.0%, and 77.8% of patients deemed to need it according to criteria 1, 2, and 3, respectively. Conclusion The choice to perform additional treatment after EA should be made according to a combination of clinical problems and US features. Understanding this concept will be useful in planning further treatment following US-guided EA.