From Jan. 1987 to May 1994, we carried out cementless total hip arthroplasties using hydroxyapatite-coated Omnifit system, and among these, 63 cases in 49 patients were followed up more than 24 months. The average Harris Hip Score was 46.3 points preoperatively, 95.4 points at POD 1 year and 96.2 points at POD 2 years. Two patients (3%) complained thigh pain at POD 2 years. On the radiologic findings, endosteal bone formation was noted in 34 cases (53,9 %), radiolucent lines were seen at the non-coating region of distal stem in 41 cases (65.3%), which were less than 2mm and not progressive. Cortical hypertrophy was noted in 5 cases (8.4%), and calcar atrophy was observed in 31 cases (49 %).
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Atrophy ; Durapatite* ; Hip ; Humans ; Hypertrophy ; Osteogenesis ; Thigh

No abstract available.
Arthroplasty, Replacement, Hip* ; Ossification, Heterotopic*

Transient osteoporosis of the hip is a self-limited condition of uncertain etiology and pathogenesis that affects young and middle aged adults. Even its clinical features are similar to the features of osteonecrosis the prognosis and clinical end result are quite different. So differential diagnosis between the two is very important. We present a case of transient osteoporosis of the hip in middle aged man, which was completely reeovered after conservative treatment.
Adult ; Diagnosis, Differential ; Hip ; Humans ; Middle Aged ; Osteonecrosis ; Osteoporosis ; Prognosis

BACKGROUND: Methemoglobinemia(MetHb) induced by dapsone overdose is not uncommon in Korea, especially in rural area. For treatment of dapsone-induced methemoglobinemia, methylene blue(MB) and activated charcoal(AC) should be used. To date, no reports have compared the amount of MB used between MB alone with MB & AC combined group(MB+AC). And also between moderate (MetHb<35%) and severe (MetHb>35%) intoxicated group defined by initial MetHb level. Authors hypothesized that less amount of MB can be used if MB and AC was used together and larger amount of MB is necessary to reduce MetHb level to asymptomatic level in severely intoxicated group. METHODS: From Jan 1990 to Dec 1996, a total of 54 patients who received treatment for dapsone intoxication were subject of study, The study was done retrospective chart analysis for initial MetHb level, total amount of MB and AC. Wilcoxon rank sum test and Chi-sqiare test was used to compare the total dosage of MB used for each group. Linear regression analysis was used between initial MetHb and the total amount of MB. Results were considered statistically significant when p<0.05. RESULTS: For MB alone and MB+AC group, the differences in total amount of MB used were statistically significant with mean dosage of 7.14+/-1.1mg/kg and 4.28+/-0.7mg/kg, respectively. And total amount of MB used between moderate and severe intoxicated group, the differences were statistically significant with mean dosage of 5.16+/-1.1mg/kg vs. 10.98+/-1.9mg/kg, respectively. There was significant correlation between initial MetHb level (X) and the amount of methylene blue (Y), Y=0.3X-2.42 (r2=0.41, p=0.0001) in MB alone, Y=0.186X-1.95(r2=0.21, p=0.034) in MB+AC respectively. CONCLUSION: For methemoglobinemia induced by dapsone, total amount of MB can be reduced especially in severe Intoxicated group if AC use was combined in treatment modality. There was significant correlationship between initial MetHb level and total amount of MB used.
Charcoal* ; Dapsone* ; Humans ; Korea ; Linear Models ; Methemoglobinemia ; Methylene Blue* ; Retrospective Studies

PURPOSE:Mutations of the PROP1 (Prophet of PIT1) gene lead to combined pituitary hormone deficiency (CPHD), which is characterized by a deficiency of growth hormone (GH), thyroid stimulating hormone (TSH), luteinizing hormone (LH)/follicle stimulating hormone (FSH), prolactin (PRL) and adrenocorticotropic hormone (ACTH). We studied the PROP1 mutations in Korean children with hypopituitarism. METHODS:Twelve patients with congenital hypopituitarism were recruited from the Ajou University Hospital, Korea. The pituitary phenotype ranged from isolated growth hormone deficiency (IGHD) to CPHD. Clinical data, including endocrine and neuroradiological data were obtained from the medical records, and the DNA was collected and screened for mutations within PROP1 using polymerase chain reaction (PCR). The PCR products were sequenced directly. RESULTS:Nine patients had abnormal pituitary gland and three patients showed normal pituitary gland in magnetic resonance imaging (MRI). Endocrinologically, seven patients had IGHD and five had CPHD. Three of CPHD had GHD and hypogonadotrophic hypogonadism and the other two had GHD, central hypothyroidism, and ACTH deficiency. We identified no mutations in the PROP1 gene. However, three known polymorphisms were identified: The 27T->C (Ala9Ala) and the associated IVS1+3A->G in exon 1 were found in 25% of patient alleles sequenced. The 424G->A (Ala142Thr) in exon 3 change was identified in 4% of those sequenced. CONCLUSION:This study corresponds to the previous reports that PROP1 mutations are rare in sporadic cases of CPHD. The low mutation frequency in Korean patients may be due to ethnic-specificity or other candidate genes causing this disease. It is necessary to study PROP1 gene and the involved genes in more Korean patients.
Adrenocorticotropic Hormone ; Alleles ; Child ; DNA ; Exons ; Growth Hormone ; Humans ; Hypogonadism ; Hypopituitarism ; Hypothyroidism ; Korea ; Luteinizing Hormone ; Magnetic Resonance Imaging ; Medical Records ; Mutation Rate ; Phenotype ; Pituitary Gland ; Polymerase Chain Reaction ; Prolactin ; Thyrotropin

We report a 36-year-old male with the bilateral visual field defect following LASIK was observed. Preoperatively, patient had high myopia(right. -7.25 0.75x18, left. -7.5-0.5x12), normal intraocular pressure(IOP)(right/left: 16/14 mmHg), normal visual field(Humphrey 30-2 visual field)and revealed the tilted discs with symetric optic nerve head cupping(cup-to-disc ratio, 0.70), parapapillary atrophy. Bilateral LASIK keratorefractive surgery was on the same day and intraoperative complication was not noted. After the first operative visit day, examination revealed uncorreted visual acuity right 0.8 and left 0.6 but scotoma was reported. Three months later, Humphrey 30-2 visual field revealed a near-superior altitudinal defect in the right eye and nasal side visual field defect in the left eye. Best corrected visual acuity was 1.0 in the right eye, 0.8 in the left eye. Repeated visual fields over a 11-month period postoperatively showed stability of the defect, with IOP of 12 mmHg to 15 mmHg in each eye. We considered LASIK uses a microkeratome vaccum ring to make a corneal flap, transient elevation of IOP alters the microcirculation of optic nerve head and may have precipitated visual field defect.
Adult ; Atrophy ; Humans ; Intraoperative Complications ; Keratomileusis, Laser In Situ ; Male ; Microcirculation ; Optic Disk ; Scotoma ; Visual Acuity ; Visual Fields*

The antiphospholipid antibody syndrome is an acquired multisystemic disorder characterized by persistent elevated antiphospholipid antibodies and/or hypercoagulation in veins or arteries, or both. The clinical manifestations of the antiphospholipid antibody syodrome are recurrent thrombosis, fetal loss, thrcenbocytopenia, and various cutaneous lesions. Skin lesions are the first sign of this syndrome in 41% of patients and systemic thrombosis develops in 40% of them. Livedo reticularis is the most common cutaneous finding of the antiphosphotipid antibody syndrome. Although vasculitis has not been frequently noted in antiphospholipid antibody syndrome, some vasculitis such as polyarteritis nodosa, giant cell arteritis, and other nonspecific vasculitides have been found in association with antiphospholipid antibody syndrome. We present a male patient with typical manifestations of leukocytoclastic vasculitis with deep vein thrombosis and positive antiphospholipid antibodies. It suggests that a case of antiphospholipid antibody syndorme was accompanied with cutaneous leukocytoclastic vasculitis.
Antibodies, Antiphospholipid* ; Antiphospholipid Syndrome ; Arteries ; Giant Cell Arteritis ; Humans ; Livedo Reticularis ; Male ; Polyarteritis Nodosa ; Skin ; Thrombosis ; Vasculitis* ; Vasculitis, Leukocytoclastic, Cutaneous ; Veins ; Venous Thrombosis

No abstract available.
Myocardial Infarction*

Zonisamide was administered to 20 patients with refractory epileptic seizures. The mean duration of the administration was 6 months, and the mean dosage was 7.2 mg/kg/day. The efficacy of zonisamide was rated remarkable in 15% of the cases, improvement in 40%, and no change in 45%. The response rates of zonisamide were 62.5% for myoclonic seizures, 50% for tonic-clonic seizures, 80% for atonic seizures and 33.3% for atypical absence seizures. There was no correlation between the clinical response and dose or serum concentration of the drug. The adverse effects were observed in 35% of the cases which were drowsiness, dizziness, ataxia, nausea, and vomiting. In all cases, however, the administration of zonisamide could be continued.
Ataxia ; Child* ; Dizziness ; Epilepsy* ; Epilepsy, Absence ; Humans ; Nausea ; Seizures ; Sleep Stages ; Vomiting

No abstract available.
Pregnancy*