Purpose: Dislocation is the second most common cause of failure, after implant loosening, in revisional THA (Total hip arthroplasty), and its evaluation and treatment still remain controversial issue. This study was undertaken to evaluate the risk factors after THA using the posterolateral approach and posterior soft tissue repair. Materials and Methods: Between January 1998 and May 2003, 211 consecutive primary total hip replacement arthroplasties using the posterolateral approach and posterior soft tissue repair were performed by the same surgeon. To compare the dislocation groups (6 cases) with the non-dislocation groups (205 cases), we randomized 120 of the non-dislocation cases. The risk factors for hip dislocation were categorized into patient factors and surgical factors. Patient factors included gender, age, preoperative diagnosis, underlying systemic disease, and alcoholic history. Surgical factors included position of the component (acetabular version and inclination, femoral anteversion), leg length discrepancy, and sum of anteversions of the cup and stem. Their parameters were measured on postoperative radiographs. Statistics were performed with Fishe`s Exact test and T test. Results: Dislocations occurred at an overall incidence rate of 2.8% (6/211cases). There were 4 (1.9%) cases of anterior dislocations and 2 (0.9%) cases of posterior dislocations. Dislocations occurred on average at postoperative day 6.1 and all dislocated hips were reduced with the closed method, except for one case that was treated surgically. There was no statistical significance in patient factors between the two groups, except for neurologic disease and alcoholic history. However, the sum of the acetabular and femoral anteversions in the anterior dislocation group was larger than that of the non-dislocation group by approximately 19 degrees. Conclusion: Our results demonstrated that by using the posterior approach and repair of soft tissue, the posterior dislocation rate after total hip replacement arthroplasty can be reduced and the sum of the acetabular and femoral anteversions had more influence on dislocations after THAs than did either anteversion alone.
Acetabulum ; Alcoholics ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Diagnosis ; Dislocations ; Hip Dislocation* ; Hip* ; Humans ; Incidence ; Leg ; Risk Factors*

Thirty-nine patients with fixed drug eruption who visited the Department of Dermatology in National Medical Center from January 1g7g to December 1982 were selected. Among them, twentyseven patients performed skin biopsy and were evaluated histopathologically on the basis of duration. The results were as follows; ].In the early stage less than 1 week of duration, hydropic degeneration of basal cells, necrotic keratinocytes with eosinophilic cytoplasm and pknotic nucleus in the epidermis, and mixed cell infiltration with eosinophlis in the upper dermis were prominently. In the late stage more than 20 days of duration, acanthosis, an increased amount of melanin in the basal cell layer and presence of melanophages were found more prominent, however, hydropic degeneration of basal cells, papillary dermal ederna, inflammatory infiltration of mononuclear cells were found less prounced or absent.
Biopsy ; Cytoplasm ; Dermatology ; Dermis ; Drug Eruptions* ; Eosinophils ; Epidermis ; Humans ; Keratinocytes ; Melanins ; Skin

We report a case of acrodermatitis enteropathica-like syndrome after long-term parenteral nutrition in a 19-year-old female with a choriocarcinoma metastasized to the lung. Skin lesions consisted of vesicopustular periorificial eruptions, psoriasiform plaques on the knees and elbows, eczamatoid patches on the acral regions, paronychia, alopecia, and of poor wound healing, Severe diarrhea was accompanied. Zinc sulphate was administered 200mg three times daily for one week with improvement of the skin eruptions and diarrhea. The patient, however, died on the 7th day of zinc therapy with the poor general condition.
Acrodermatitis* ; Alopecia ; Choriocarcinoma ; Diarrhea ; Elbow ; Female ; Humans ; Knee ; Lung ; Parenteral Nutrition ; Paronychia ; Pregnancy ; Skin ; Wound Healing ; Young Adult ; Zinc

We present a case of warty dyskeratoma in a 51-year-old man. He had two, discret, well-defined, skin-colored papules with central depression on the scalp for about 5 to 6 months. Histopathological findings showed hyperkeratosis, acantholytic and dyskeratotic cells in the dilated follicular infundibulum with the villi formation and suprabasilar cleft around them, typical of warty dyskeratoma.
Depression ; Humans ; Middle Aged ; Scalp

Verrucous carcinoma is a slow growing, low grade squamous cell carcinoma, which usually occurs on oropharynx, genitalia and soles. When it occurs on feet, it is known as epithelioma cuniculatum. Epithelioma cuniculatum is characterized by its histologic sinuses and cystic formations in a cuniculate(rabbit burrow-like) pattern. A 59-year-old man was consulted to our department for a well circumscribed, 5 × 5 cm sized, round, hyperkeratotic, verrucous plaque on the right great toe. He suffered from diabetes mellitus for 16 years and was managed by peritoneal dialysis three times a week due to chronic renal failure for last two years. The plaque had gradually increased in size. The biopsy specimen taken from the tumor mass showed chronic ulcerative inflammation with atypical squamous cell proliferation. We herein report a case of verrucous carcinoma occurring in a patient with diabetes melli-t tus and chronic renal failure.
Biopsy ; Carcinoma ; Carcinoma, Squamous Cell ; Carcinoma, Verrucous* ; Cell Proliferation ; Diabetes Mellitus* ; Foot ; Genitalia ; Humans ; Inflammation ; Kidney Failure, Chronic* ; Middle Aged ; Oropharynx ; Peritoneal Dialysis ; Toes ; Ulcer

Submucosal infiltration and the topical application of epinephrine as a vasoconstrictor produce excellent hemostasis during surgery. The hemodynamic effects of epinephrine have been documented in numerous studies. However, its metabolic effects (especially during surgery) have been seldom recognized clinically. We report two cases of significant metabolic effects (including lactic acidosis and hyperglycemia) as well as hemodynamic effects in healthy patients undergoing orthognathic surgery with general anesthesia. Epinephrine can induce glycolysis and pyruvate generation, which result in lactic acidosis, via β2-adrenergic receptors. Therefore, careful perioperative observation for changes in plasma lactate and glucose levels along with intensive monitoring of vital signs should be carried out when epinephrine is excessively used as a vasoconstrictor during surgery.
Acidosis, Lactic* ; Administration, Topical ; Anesthesia, General ; Anesthesia, Local ; Epinephrine ; Glucose ; Glycolysis ; Hemodynamics ; Hemostasis ; Humans ; Lactic Acid ; Orthognathic Surgery* ; Plasma ; Pyruvic Acid ; Vital Signs

No abstract available.

PURPOSE: In this longitudinal study, we examined the moral judgment level and its related factors, such as individual characteristics. The result of this study will provide baseline data to establish policy of ethics education for college students and healthcare professionals. METHOD: We enrolled 37 nursing students and 20 medical students as the subjects in a university in Suwon, Korea. We conducted a questionnaire on the subjects using Korean version of Defining Issues Test(DIT) to analyze the subjects' moral judgment level. Collected data was coded using ASCII document and scored using Fortran program for computer. Then the data was statistically analyzed by SPSS Version 10.0. RESULT: Nursing students' moral development score at each stage were consistently higher at stage 5A across 4-years rather than other stages. On the other hand, medical students' moral development score were consistently higher at stage 4 than other stages. There was no significant difference in the change P(%) score at each academic year in both groups. In the perspective of the subjects' general characteristics, P(%) score showed no significant in both groups. CONCLUSION: Based on the results of this study, further studies will examine the correlation between curriculum and moral judgment development in detail. Moreover, we suggest that the current ethics education should be developed and evaluated in more realistic manner.

No abstract available.
Ectopia Cordis*