1.Short - Term Results of Hydroxyapatite - coated Total Hip Arthroplasty.
Kuen Tak SUH ; Seong Ho HWANG ; Chong Il YOO
The Journal of the Korean Orthopaedic Association 1997;32(4):993-1004
The cement-free hip prosthesis coated with hydroxyapatite was developed to obtain primary firm fixation by an enhanced anatomic design and secondary biologic stable fixation by hydroxyapatite which is bioactive and has the same chemical and structural components with those of human bone tissue in total hip arthroplasty. Between January 1992 and June 1994, we used ABG cement free hip prosthesis (Anatomique Benoist Giraud, Howmedica Europe, Staines, England) in 28 hips (avascular necrosis of femoral head; 17, osteoarthritis; 6, posttraumatic arthritis; 3, rheumatoid arthritis; 2) of 25 patients in Pusan National University Hospital. Those cases had a minimum of two years and maximum of four years and five months (average three years and six months) of follow up, including analysis of the clinical and radiological data. The results were obtained as follows: 1. The average Modified Harris Hip Score increased from 51 points preoperatively to 96 points at last follow up. Almost all cases (97%) were excellent or good results in Modified Harris Hip Score. 2. In radiologic results, no migration of the cup, no change in the inclination of the cup, ar.d no oste-olysis around the cup and the stem were observed. Endosteal bone apposition around the cup was found in 54% of the cases and subcortical cancellous densification around the stem was found in 89%. This results indicate that we obtained direct and biologic firm fixation without fibrous tissue interposition between bone and metallic component by inducing on-growth of bone. 3. In the radiologic follow up according to the initial bone quality, it was demonstrated that the incidences of cortical hypertrophy, calcar resorption, and radiolucent line in type B and type C were higher than those in type A. The early clinical and radiological results of the cement-free hip prosthesis coated with hydroxyapatite are encouraging, although a longer follow up period is necessary.
Arthritis
;
Arthritis, Rheumatoid
;
Arthroplasty, Replacement, Hip*
;
Bone and Bones
;
Busan
;
Durapatite*
;
Europe
;
Follow-Up Studies
;
Head
;
Hip
;
Hip Prosthesis
;
Humans
;
Hypertrophy
;
Incidence
;
Necrosis
;
Osteoarthritis
2.The Patients With Headache in Emergency Department.
Wen Joen CHANG ; Tae Sik HWANG ; Ho Sik SHIM ; Hahn Shick LEE ; Seong Joong KIM
Journal of the Korean Society of Emergency Medicine 1997;8(3):380-384
BACKGROUND: Headache is a common complaint in patients presenting to the emergency department(ED). Many patients suffered sustained headache even after presenting to the ED. This study investigate whether the patients were received analgesics and timely adequate. METHOD: We analyzed 131 adolescent and adult patients with non-traumatic headache without any neurologic deficit in two emergency department during 6 months period retrospectively. RESULTS: The positive and negative predictive value according to primary impression were 47% and 74% respectively. The mean time to take brain computed tomography(CT) after ED presentation was 120 minutes. The patients with primary impression of intracranial hemorrhage(mainly SAH) were the most fast(mean time 88+/- 70 minutes). 28(21%) patients were received analgesics before taking brain CT(after ED presentation), and 70(53%) patients after CT, 27(54%) patients after cerebrospinal fluid examination. The mean time interval were 43, 126 and 149 minutes on each group being received the analgesics. CONCLUSION: According to this study many patients suffered sustained headache before being classified to certain type of disorder. It may due to the reasons that there were no definite guidelines treating headache, the pain itself, or the physician treats patients as physician's way.
Adolescent
;
Adult
;
Analgesics
;
Brain
;
Cerebrospinal Fluid
;
Emergencies*
;
Emergency Service, Hospital*
;
Headache*
;
Humans
;
Neurologic Manifestations
;
Retrospective Studies
3.Comparison of Sodium Nitroprusside and Esmolol Induced Hypotension for Total Hip Arthroplasty.
Hyun Hee EUN ; Ho Yong HWANG ; Hong Hyun RYU ; Yong Woo LEE ; Seong Wan BAIK
Korean Journal of Anesthesiology 1997;33(2):324-329
BACKGROUND: Esmolol is a short acting sympathetic beta receptor antagonist, and it was successfully applied to induced hypotension. Esmolol lowers blood pressure by decreasing cardiac output, and does not cause vasodilation. This property of esmolol may help to decrease bleeding during induced hypotension. In this study, we tried to elucidate the effect of esmolol on induced hypotension for total hip arthroplasty. METHOD: Twenty patients receiving total hip arthroplasty were randomly divided to two groups. Esmolol group (10 patients) received esmolol as a hypotensive agent, and sodium nitroprusside (SNP) group (10 patients) received SNP as a hypotensive agent. We measured arterial blood gas analysis, vital sign, amounts of bleeding, amounts of transfusion and administered fluid, and various laboratory findings. RESULTS: Induced hypotension was successfully performed in either esmolol and SNP group. Heart rate increased by SNP, and decreased by esmolol. There were no statistically significant differences between the two groups in amounts of bleeding, amounts of transfusion or administered fluid, and laboratory findings. Arterial oxygen tension was relatively constant in esmolol group, but decreased in SNP group. CONCLUSION: Esmolol can be used as a single hypotensive agent during induced hypotension without significant side effects during total hip arthroplasty.
Arthroplasty, Replacement, Hip*
;
Blood Gas Analysis
;
Blood Pressure
;
Cardiac Output
;
Heart Rate
;
Hemorrhage
;
Humans
;
Hypotension*
;
Nitroprusside*
;
Oxygen
;
Sodium*
;
Vasodilation
;
Vital Signs
4.Serum IGF-I, Free IGF-I, IGFBP-1, IGFBP-3 Levels in Children with Intrauterine Growth Retardation.
Il Tae HWANG ; Eun Ae PARK ; Gyung Hee KIM ; Ho Seong KIM
Journal of Korean Society of Pediatric Endocrinology 1999;4(2):186-194
PURPOSE:Most but not all intrauterine growth retardation(IUGR) children has catch-up growth postnatally. However, nothing is known about the predictive parameters on the catch-up growth. The aim of this study was to describe serum IGF-I, free IGF-I, IGFBP-1, and IGFBP-3 levels in IUGR children and to correlate these hormone values with auxologic parameters to investigate their value on the postnatal growth pattern. METHODS:Among children with IUGR born at Ewha Womans University from Jan. 1995 to Aug. 1998, 16 children with IUGR at 3 years of age and 12 age-matched normal controls were studied for auxologic and biologic parameters. We measured height, weight, and serum levels of insulin-like growth factor(IGF)-I, free IGF-I, IGF binding protein(BP)-1, IGFBP-3 using immunoradiometric kits. RESULTS: 1)Among 16 children with IUGR at 3 years of age, 13 children had catch-up growth(81.3%), but 3 children remained short stature(18.7%). The height standard deviation score(SDS) in children with IUGR and control were -0.3+/-0.8 and 0.8+/-0.7, respectively(P<0.05) and weight SDS were -0.7+/-0.9 and 1.1+/-1.1, respectively(P>0.05). 2)Serum IGF-I levels in children with IUGR at 3 years of age and normal control were 90.9+/-35.4ng/mL and 68.4+/-24.4ng/mL, respectively(p>0.05) and free IGF-I were 0.9+/-0.5ng/mL and 0.6+/-0.3ng/mL(p>0.05), IGFBP-1 were 50.5+/-30.5ng/ mL and 52.3+/-23.2ng/mL(p>0.05), IGFBP-3 were 4,116.7+/-1,062.2ng/mL and 4,058.4+/-808.5ng/mL(p>0.05), respectively. 3)In children with IUGR at 3 years of age, height SDS in IUGR children with catch-up growth and those without catch-up growth were 0.002+/-0.6 and -1.5+/-0.7, respectively(P<0.001), but there were no differences in weight SDS, body mass index, IGF-I, free IGF-I, IGFBP-1 and IGFBP-3. 4)There were no significant correlations between height gain and any growth factors. CONCLUSION: The results show that there is no difference in the levels of IGF-I, free IGF-I, IGFBP-1 and IGFBP-3 in IUGR children at 3 years of age compared to age-matched normal control, suggesting that other factors rather than IGF-I, free IGF-I, IGFBP-1, IGFBP-3 may cause short stature in IUGR.
Body Mass Index
;
Child*
;
Female
;
Fetal Growth Retardation*
;
Humans
;
Insulin-Like Growth Factor Binding Protein 1*
;
Insulin-Like Growth Factor Binding Protein 3*
;
Insulin-Like Growth Factor I*
;
Intercellular Signaling Peptides and Proteins
6.Dislocation after Hip Arthroplasty: Analysis of the Cause Factors.
Deuk Soo HWANG ; Seung Ho YUNE ; Hyeong Seong KIM ; Jae Gie SONG
The Journal of the Korean Orthopaedic Association 1997;32(4):968-976
We reviewed 174 total hip arthroplasty (25 were revision procedure) and 65 bipolar hemiarthroplasty procedure followed by more than 6 months at Chungnam National University Hospital from July, 1992 to March, 1995. These were performed on 189 male and 50 female patients. We have followed up average 45.8 months and obtained following results; The dislocation rate is 3.76% (9 of 239 cases) and the dislocation rate of revision arthroplasties (16%: 4 of 25 cases) is higher than those of primary hip arthroplasties (2.6%: 5 of 214 cases). Among Nine dislocations, 8 cases (89%) were between fifth and seventh decade and all cases are men. All dislocations occured within 5 weeks postoperatively. Because 6 of 9 cases were due to poor compliance, the patient's cooperation during postoperative recovery is essential to prevent postoperative dislocation. The capsulectomy, surgical approach, or immobilization of patients after operation are unrelated to dislocaton. For the prosthetic factors, 7 cases dislocated posteriorly is appeared that the plane of the cup was between 3 and 9 degrees of anteversion, and also less than the normal range. Stable outcome without surgical operation was achieved in 7 of 9 dislocation. Among 2 patients who had recurrent dislocation after optimum conservative treatment, one had infected arthroplasty and the other had a impinged anterior thick capsule formation around the head. We concluded that the predisposing factors for dislocation after hip arthroplasty is multifactorial.
Arthroplasty*
;
Arthroplasty, Replacement, Hip
;
Causality
;
Chungcheongnam-do
;
Compliance
;
Dislocations*
;
Female
;
Head
;
Hemiarthroplasty
;
Hip*
;
Humans
;
Immobilization
;
Male
;
Reference Values
7.The Role of Intraoperative Frozen Section as a Guide to Sepsis in Hip Arthroplasty for Teatment of painful Hip Disease.
Seung Ho YUNE ; Deuk Soo HWANG ; Hyeong Seong KIM ; Jae Gie SONG ; Jin Man KIM
The Journal of the Korean Orthopaedic Association 1997;32(5):1214-1223
We performed a retrospective analysis of twenty-four consecutive hip arthroplasties (Total Hip Arthroplasty 18, Bipolar Arthroplasty 1, Cup revision 5) during which intraoperative frozen sections were analyzed to identify the occult active infection. We also reviewed the data such as laboratory findings (ESR, CRP), intraoperative culture, hip joint sonographic evaluation and permanent histologic section. Among the twenty-four patients those who received hip arthroplasties, 10 cases received revisional hip arthroplasties due to painful hip prosthesis loosening, 9 cases with infected hip prosthesis, 3 cases with infection after open reduction and internal fixation due to hip fracture and 2 cases with septic hip sequelae. Intraoperative frozen section had been obtained during staged revisional hip arthroplasties to determine the presence of active infection. We considered positive for infection if it shows more than 10 PML/HPF (Polymorphonuclear leukocyte /high power field) in at least 5 distinct microscopic fields from intraoperative tissue frozen section and postponed implantation of prosthesis. If it shows less than 5 PML/HPF, we performed revisional hip prosthesis implantation. We decided the implantation based on patient's condition, laboratory findings and intraoperative tissue conditions if it shows between 5 and 10 PML/HPF from intraoperative frozen section. At last follow up, 20 of 21 patients who had a revisional hip arthroplasties as below 10 PML/HPF from intraoperative frozen section remained free of infection (Specificity; 95%). We concluded that analysis of the intraoperative frozen sections is a reliable predictor as a guide to sepsis for the successful hip joint arthroplasties.
Arthroplasty*
;
Arthroplasty, Replacement, Hip
;
Follow-Up Studies
;
Frozen Sections*
;
Hip Joint
;
Hip Prosthesis
;
Hip*
;
Humans
;
Leukocytes
;
Prostheses and Implants
;
Retrospective Studies
;
Sepsis*
;
Ultrasonography
8.Clinical study of noncemented using AML femoral stem hip arthroplasty.
Seong Ho YUNE ; Kwang Jin RHEE ; June Kyu LEE ; Deuk Soo HWANG ; Dae Sik JEON
The Journal of the Korean Orthopaedic Association 1993;28(5):1495-1504
No abstract available.
Arthroplasty*
;
Hip*
9.Myotonia Dystrophica: A Case Report
Joon Young KIM ; Young Joe KIM ; Byeong Yeon SEONG ; Moon Ho HWANG
The Journal of the Korean Orthopaedic Association 1985;20(1):195-199
Myotonia dystrophica(Synonym: Myotonia atrophica, Dystrophia myotonia, Steinert's disease) is a autosomal dominant hereditary multisystemic disorder involving several organs besides skeletal muscle, and commonly called with myotonia congenita, paramyotonia congenita as myotonia. Although most cases are of adult onset, where a mother has the disease, neonatal dystrophia myotonia can occur in her offspring. The main feature is a steadily progressive muscle dystrophy, complicated by myotonia, which is a failure of muscles to relax normally after a forceful contraction. Steinert in 1909 was the first to report the finding of atrophic testes and baldness in patients with myotonia dystrophica, and the other clinical feature of myotonia dystrophica were reported by many authors after that time. We are reporting a case of myotonia dystrophica, which showing familial history with brief review of literature.
Adult
;
Alopecia
;
Humans
;
Mothers
;
Muscle, Skeletal
;
Muscles
;
Myotonia Congenita
;
Myotonia
;
Myotonic Disorders
;
Myotonic Dystrophy
;
Testis
10.Prevalence of the Nonalcoholic Fatty Liver Disease in Obese Children.
Sung Woog HWANG ; Duk Hee KIM ; Ho Seong KIM
Korean Journal of Pediatrics 2005;48(1):13-20
PURPOSE: Obesity is, along with metabolic syndrome, closely related with nonalcoholic fatty liver disease. This study tried to evaluate the prevalence of nonalcoholic liver disease in obese children and verify the factors associated with the disease. METHODS: Two hundred and seventy nine children who showed a body mass index of 95 percentile over the baseline in health examinations of surrounding schools were evaluated. Questionnaires, body measurements, blood examinations, and ultrasonographic measurements of abdominal fat were examined. RESULTS: Out of 279 children enrolled for the study, 27 children were found to possess nonalcoholic liver disease(9.7%). Among those found to be positive for nonalcoholic liver disease, it's prevalence increased to 15.2%(22 out of 144 children) among children with severe obesity. Factors known to be involved with metabolic syndrome, namely waist/hip circumference ratio and thickness of abdominal fat, were found to be closely related to nonalcoholic fatty liver as well. CONCLUSION: The prevalence of nonalcoholic fatty liver in obese children was 9.7%, with higher incidence observable in severer obesity. Factors responsible for metabolic syndrome were closely associated with nonalcoholic fatty liver disease, and the level of insulin resistance, which is an useful index in both diseases, can be utilized in evaluation of the effect of treatment and control of risk factors.
Abdominal Fat
;
Body Mass Index
;
Child*
;
Fatty Liver*
;
Humans
;
Incidence
;
Insulin Resistance
;
Liver
;
Liver Diseases
;
Obesity
;
Obesity, Morbid
;
Prevalence*
;
Surveys and Questionnaires
;
Risk Factors