Purpose: To analyze the causes and to prevent dislocations of the hip joint that occur in patients who underwent revisions of total hip arthroplasties by changing only the polyethylene liners and femoral heads, subsequent to primary total hip arthroplasties. Materials and Methods: We evaluated 28 patients who underwent acetabular component revisions of total hip arthroplasties subsequent to primary total hip arthroplasties. The average age of the patients was 55 years old and all 28 patients had operations through the posterolateral approach. In 17 of the cases, the acetabular cups, polyethylene liners, and femoral heads were changed; in 10 cases, just the polyethylene liners and femoral heads were changed; and in 1 case, only the polyethylene liner was changed. Results: We observed 7 cases of hip dislocations that occurred among a total of 28 cases after revisions of total hip arthroplasties. In all 7 cases, the polyethylene liners and femoral heads were changed, but not the acetabular cups. In additional, in all 7 cases of dislocation, the patients were non-compliant and started weight-bearing prematurely after revisions of the total hip arthroplasties Conclusion: We observed new dislocations in the 7 cases in which the polyethylene liners and femoral heads were changed. The main reasons were inadequate soft tissue tension and hip joint laxity. Therefore, it is necessary to increase the neck length, use elevated rim polyethylene liners, readjust the acetabular cups to their optimal positions, and apply hip abduction braces to patients early after revision of total hip arthroplasties in order to lessen the danger of dislocations.
Acetabulum* ; Arthroplasty ; Braces ; Dislocations* ; Head ; Hip ; Hip Dislocation ; Hip Joint ; Humans ; Neck ; Polyethylene ; Risk Factors* ; Weight-Bearing

After femur neck fracture, many techniques have been known for early detection of the viability of the femoral head which is very important to decide method of treatment. At the present time, bone scan with 99mTc-MDP is the best available radioistope for use in scanning, because it is very sensitive, non-invasive and simple, minimal radiation dose, easily reproducible. Bone scanning was carried out in 18 cases of femur neck fractures from July, 1981 to October, 1982 in Kyung Hee University Hospital. The results were as follows: l. In twelve cases in which radiological confirmation of viability of the femoral head was difficult to make, we could confirm the presence or absence of vascularity of femoral head using bone scan. 2. Six cases which were considered to have vascular impairment to the femoral head radiologically, were identified to have vascular impairment to the femoral head by bone scan and these were evidenced by operative findings and by histology of biopsy specimen. 3. In fresh fractures, we identified the vascular impairment by the bone scan minimally 5 days after injury. 4. In old fractures, we could confirm the viability of the femoral heads by bone scan. 5. Bone scan is considered to be the excellent technique for early detection of the vascular impairment to the femoral head after femur neck fractures.
Biopsy ; Femoral Neck Fractures ; Femur Neck ; Head ; Methods ; Technetium Tc 99m Medronate

Asymmetrical Septal Hypertrophy(ASH), Characterized by interventricular septal hypertrophy, is not an uncommon cardiac disease. Arrythmia occuring in ASH are supraventricular tachycardia, atrial premature beats, and ventricular premature beats. In about 10% of patients, there is a short P-R interval and a partial delta wave, suggestive of a variant of the Wolff-Parkinson-White syndrome. We reported here a case of ASH associated with W-P-W syndrome and paroxysmal atrial fibrillation with review of pertinent literatures.
Arrhythmias, Cardiac ; Atrial Fibrillation* ; Cardiac Complexes, Premature ; Heart Diseases ; Humans ; Hypertrophy* ; Tachycardia, Supraventricular ; Wolff-Parkinson-White Syndrome

Asymmetrical Septal Hypertrophy(ASH), Characterized by interventricular septal hypertrophy, is not an uncommon cardiac disease. Arrythmia occuring in ASH are supraventricular tachycardia, atrial premature beats, and ventricular premature beats. In about 10% of patients, there is a short P-R interval and a partial delta wave, suggestive of a variant of the Wolff-Parkinson-White syndrome. We reported here a case of ASH associated with W-P-W syndrome and paroxysmal atrial fibrillation with review of pertinent literatures.
Arrhythmias, Cardiac ; Atrial Fibrillation* ; Cardiac Complexes, Premature ; Heart Diseases ; Humans ; Hypertrophy* ; Tachycardia, Supraventricular ; Wolff-Parkinson-White Syndrome

PURPOSE: Extremely elderly patients who present with complicated gallstone disease are less likely to undergo definitive treatment. The use of laparoscopic cholecystectomy (LC) in older patients is complicated by comorbid conditions that are concomitant with advanced age and may increase postoperative complications and the frequency of conversion to open surgery. We aimed to evaluate the results of LC in patients (older than 80 years). METHODS: We retrospectively analyzed 302 patients who underwent LC for acute cholecystitis between January 2011 and December 2013. Total patients were divided into three groups: group 1 patients were younger than 65 years, group 2 patients were between 65 and 79 years, and group 3 patients were older than 80 years. Patient characteristics were compared between the different groups. RESULTS: The conversion rate was significantly higher in group 3 compared to that in the other groups. Hematoma in gallbladder fossa and intraoperative bleeding were higher in group 3, the difference was not significant. Wound infection was not different between the three groups. Operating time and postoperative hospital stay were significantly higher in group 3 compared to those in the other groups. There was no reported bile leakage and operative mortality. Preoperative percutaneous transhepatic gallbladder drainage and endoscopic retrograde cholangiopancreatography were performed more frequently in group 3 than in the other groups. CONCLUSION: LC is safe and feasible. It should be the gold-standard approach for extremely elderly patients with acute cholecystitis.
Aged* ; Bile ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy, Laparoscopic* ; Cholecystitis, Acute ; Conversion to Open Surgery ; Drainage ; Gallbladder ; Gallstones ; Hematoma ; Hemorrhage ; Humans ; Length of Stay ; Mortality ; Postoperative Complications ; Retrospective Studies ; Treatment Outcome ; Wound Infection

OBJECTIVES: This study was carried out to develop the Korean form of Yale Global Tic Severity Scale(YGTSS)-family & clinical rating version. The severity of motor and phonic tics was rated according to five separate dimensions : number, frequency, intensity, complexity,and interference. METHODS: The Korean form of YGTSS was applied to 100 children who visited psychiatric outpatient clinic with chief complaints of tic symptom. Together with YGTSS, Clinical Global Impression for Tourette's syndrome(CGI-TS), Obsessive-Compulsive disorder(CGI-OCD), At tention-Deficit/Hyperactivity Disorder(CGI-ADHD) were administered to all subjects for examining convergent and discriminant validities. RESULTS: We could confirm high internal consistency, convergent and discriminant validities and interrater reliability of YGTSS by analysing data from 100 children with tic disorder. In factor analysis, items were clusterd to 2 factors which were identical motor and phonic tic subscales. CONCLUSION : The results of this study indicate that the Korean form of YGTSS is a reliable and valid rating scale for rating tic symptom severity. It can be used to evaluate tic symptom objectively and to quantify the tic severity in the studies for tic disorder.
Ambulatory Care Facilities ; Child ; Humans ; Reproducibility of Results* ; Tic Disorders ; Tics*

We report the case of a 77-year-old woman who developed complete atrioventricular (AV) block during an episode of thiazide-induced hyponatremia. She was taking hydrochlorothiazide to treat essential hypertension; she had no definite organic disease of the heart or lungs. Generally, the serum sodium concentration does not have a marked effect on cardiac conduction. However, we experienced a case of complete AV block associated with hyponatremia. This was treated successfully by correcting the electrolyte imbalance. Complete AV block associated with hyponatremia is very rare. To our knowledge, this is the first reported case in Korea.
Aged ; Atrioventricular Block ; Female ; Heart ; Humans ; Hydrochlorothiazide ; Hyponatremia ; Korea ; Lung ; Sodium

A young woman who had a delivery history 3 months previously presented with dyspnea and orthopnea. Initial findings of physical examination, chest radiography, and echocardiogram showed typical congestive heart failure with severe left ventricular (LV) dysfunction. At first, we considered peripartum cardiomyopathy because she had given birth to a baby 3 months previously. However, even though we massively tried conventional drug therapy for 10 days, the patient still remained with refractory heart failure. We performed additional laboratory studies such as complement level and autoantibodies, of which the results supported systemic lupus erythematosus. We could make the diagnosis of acute lupus myocarditis and treated her with corticosteroid. The symptoms were dramatically disappeared and LV function also improved.
Acute Disease ; Administration, Oral ; Adult ; Echocardiography ; Female ; Glucocorticoids/administration & dosage ; Heart Failure/*diagnosis ; Humans ; Lupus Erythematosus, Systemic/complications/*diagnosis/radiography ; Methylprednisolone/administration & dosage ; Myocarditis/*diagnosis/etiology/radiography ; Prednisolone/administration & dosage

BACKGROUND AND OBJECTIVES: The time interval between the onset of the mitral inflow and the mitral annulus velocity (TE'-E) has been proposed as a new index for representing the left ventricular (LV) relaxation and this is related to the LV filling pressure. This index has been reported to be a preload independent parameter in an experimental canine model. However, the impact of the preload on this index has not been studied in humans. SUBJECTS AND METHODS: Forty-five patients (29 men, mean age: 51+/-14 years old) who had end-stage renal disease underwent echocardiography immediately before and after hemodialysis (HD). The two-dimensional and Doppler parameters were measured, including the peak early (E) and late (A) transmitral inflow velocity. The mitral annulus velocity (E') at the septal, lateral, anterior and inferior corners of the mitral annulus, as accessed by Doppler tissue imaging (DTI), and the flow propagation velocity (Vp), as accessed by color M-mode, were also measured. The time intervals between the peak of the R wave and the onset of the mitral E velocity and also between the peak R wave and the onset of E' at the four corners of the mitral annulus were measured. RESULTS: The mean ejection fraction was 62+/-16%. The average weight reduction by the HD was 2.9+/-1.1 kg. The dimensions of the LV end-diastole, left atrium and inferior vena cava were significantly reduced. After the HD, the peak E, A and E/A ratio, the average peak E' and the Vp were significantly decreased. The TE'-E did not change significantly after the HD regardless of the LV systolic function. CONCLUSION: A new parameter for the diastolic function, i.e., the time interval between the onset of mitral inflow and the mitral annulus velocity, appears to be preload-independent in the patients with a normal or decreased LV systolic function.
Diastole ; Echocardiography ; Echocardiography, Doppler ; Heart Atria ; Humans ; Kidney Failure, Chronic ; Male ; Relaxation ; Renal Dialysis ; Vena Cava, Inferior ; Weight Loss

OBJECTIVES: The aim of this study was to evaluate the reliability and validity of the Korean Version of the Diagnostic Interview Schedule for Children Version IV(DISC-IV), a highly structured diagnostic interview used to assess more than 30 psychiatric disorders in children and adolescents. METHODS: A total of 91 study subjects, including 67 subjects who visited the child and adolescent psychiatry outpatient clinic at our institution and 24 community-based subjects, were assessed using the Korean Version of the DISCIV. Clinical diagnosis was used as a gold standard for the examination of the validity of the DISC-IV. Forty-four of the study subjects were randomly selected for test-retest reliability measurement. RESULTS: The validity of the Korean Version of the DISC-IV showed kappa values ranging from 0.25 to 0.40 in the clinical sample and 0.65 to 1.00 in the community sample. The sensitivities varied according to the diagnostic categories, but the specificities were excellent for all diagnostic entities. CONCLUSION: The Korean Version of the DISC-IV showed good reliability and validity in Korean children and adolescents. The Korean Version of the DISC-IV might be a useful tool for assessing psychiatric disorders in children and adolescents.
Adolescent ; Adolescent Psychiatry ; Ambulatory Care Facilities ; Appointments and Schedules* ; Child* ; Diagnosis ; Humans ; Reproducibility of Results*