PURPOSE: The purpose of this study is to investigate to effect of adrenal insufficiency on the results of TKA. MATERIALS AND METHODS: A total of 89 patients (89 knees) treated with TKA from March, 2008 to October, 2008 were enrolled in this study. Levels of serum cortisol and adrenocorticotropic hormone (ACTH) were checked preoperatively. Hydrocortisone 50~75 mg was injected to adrenal insufficient group at 7:00 AM and 4:00 PM on operative day and the following day. We evaluated the range of motion, the knee society knee score and function score at preoperatively and 2 years follow up, and compared the results between non-adrenal insufficiency group (NAI) and adrenal insufficiency group (AI). RESULTS: Cortisol and ACTH levels were reduced in 36 of 89 patients. All of 36 patients of low cortisol level do not stimulated in ACTH stimulation test. In the adrenal insufficiency group the knee society score (KSS) improved from 49.8 to 86.8 and the knee society functional score (KSFS) from 42.6 to 89.5 at 2 years follow-up. In the control group KSS rose from 51.9 to 84.3 and KSFS from 49.4 to 88.6 during the same period. In adrenal insufficient patients, there were no postoperative complication to include mortality, infection, periprosthetic fracture except skin lesions during operation or postoperatively. There was a case of rupture of quadriceps tendon on the 10th postoperative day which was treated with primary repair. CONCLUSION: Based on our study, there was no increased operative and postoperative complications except skin lesions and 1 case quadricepse tendon rupture in patients with adrenal insufficiency group.
Adrenal Insufficiency ; Adrenocorticotropic Hormone ; Arthroplasty ; Follow-Up Studies ; Humans ; Hydrocortisone ; Knee ; Periprosthetic Fractures ; Postoperative Complications ; Range of Motion, Articular ; Rupture ; Skin ; Tendons

BACKGROUND: Pruritus is a common, unpleasant symptom in patients on maintenance hemodialysis (HD), however its pathogenesis remains unclear. The aim of this study was to evaluate the prevalence of pruritus in chronic renal failure patients on hemodialysis and to correlate its presence with several clinical and laboratory parameters. METHODS: One hundred seventy patients on maintenance HD were enrolled, Some relevant clinical and laboratory parameters (age, sex, duration of dialysis, type of membrane, underlying renal disease, medications, erythropoietin (EPO) and laboratory findings including hematocrit, creatinine, urea, calcium, phosphorus, parathyroid hormone (PTH), erythrocyte sediment rate (ESR), albumin, beta2-microglobulin (beta2MG) and lipid profile as well as parameters of adequate dialysis (Kt/Vurea, URR) were evaluated. RESULTS: Total 170 patients (80 males) were enrolled and pruritus was found in 60 patients (Group I, M:F=29:31). One hundred ten patients did not complain pruritus (Group II, M:F=51:59). Mean age was significantly higher in Group I (59.6+/-14.8 vs. 54.3+/-13.6 years, p<0.05). There was no difference in sex, type of membrane, primary renal disease, serum beta2MG, ESR, EPO dose, duration of dialysis and serum albumin level. The mean value of Kt/V was higher in Group II (1.39+/- 0.36 vs. 1.51+/-0.27, p<0.035). CONCLUSION: Pruritus was more common in older patients and low Kt/V, but other clinical characteristics and laboratory findings were not correlated with uremic pruritus.
Male ; Humans

BACKGROUND: Pruritus is a common, unpleasant symptom in patients on maintenance hemodialysis (HD), however its pathogenesis remains unclear. The aim of this study was to evaluate the prevalence of pruritus in chronic renal failure patients on hemodialysis and to correlate its presence with several clinical and laboratory parameters. METHODS: One hundred seventy patients on maintenance HD were enrolled, Some relevant clinical and laboratory parameters (age, sex, duration of dialysis, type of membrane, underlying renal disease, medications, erythropoietin (EPO) and laboratory findings including hematocrit, creatinine, urea, calcium, phosphorus, parathyroid hormone (PTH), erythrocyte sediment rate (ESR), albumin, beta2-microglobulin (beta2MG) and lipid profile as well as parameters of adequate dialysis (Kt/Vurea, URR) were evaluated. RESULTS: Total 170 patients (80 males) were enrolled and pruritus was found in 60 patients (Group I, M:F=29:31). One hundred ten patients did not complain pruritus (Group II, M:F=51:59). Mean age was significantly higher in Group I (59.6+/-14.8 vs. 54.3+/-13.6 years, p<0.05). There was no difference in sex, type of membrane, primary renal disease, serum beta2MG, ESR, EPO dose, duration of dialysis and serum albumin level. The mean value of Kt/V was higher in Group II (1.39+/- 0.36 vs. 1.51+/-0.27, p<0.035). CONCLUSION: Pruritus was more common in older patients and low Kt/V, but other clinical characteristics and laboratory findings were not correlated with uremic pruritus.
Male ; Humans

We report one family with bilateral renal hypoplasia and ocular coloboma in two consecutive generations. Ophthalmological examination revealed optic disc coloboma and decreased visual acuity. Fragments spanning exon 1-12 of the PAX2 gene were amplified from genomic DNA using PCR primers. The PCR products were purified and directly sequenced. No definite mutation was detected in the PAX2 genes in these patients, but two coding region single nucleotide polymorphisms were identified. This result suggests that the optic disc coloboma with bilateral renal hypoplasia might be genetically heterogenous or other genes could be responsible.
Clinical Coding ; Coloboma ; DNA ; Exons ; Family Characteristics ; Humans ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; Visual Acuity

PURPOSE: To evaluate the incidence and clinical features of age-related macular degeneration (AMD) in Korea. METHODS: Web-based (www.armd-nova.or.kr) registration was conducted for AMD patients aged 50 or more who were newly diagnosed by retinal specialists in Korea from August 20, 2005 to August 20, 2006. Patient data including ophthalmologic examination, fundus photography, fluorescein angiogram and/or indocyanin green angiogram (ICG), past medical history, behavioral habit, combined systemic diseases were up-loaded. RESULTS: Among finally enrolled 1,141 newly diagnosed AMD patients, 690 patients (60.5%) were male and 451 patients (39.5%) were female. The average age of AMD patients was 69.7+/-8.0. Early AMD was observed in 190 patients and 951 patients had late AMD. Classic choroidal neovascular membrane (CNVM) was observed in 18.6% of exudative AMD patients and 63.4 % had occult CNVM. Subfoveal CNVM was observed in 80.4% of the patients with CNVM. Among the 580 exudative AMD eyes that performed indocyanin green angiography (ICG), 184 eyes (31.7%) had polypoidal choroidal vasculopathy (PCV) and 36 eyes (6.2%) showed retinal angiomatous proliferation (RAP). Age, male gender, smoking, diabetes and hypertension significantly increased the risk of the AMD among Koreans. CONCLUSIONS: Because of the low rate of participation by retinal specialists, definite incidence of AMD was not obtainable. However, the estimated 1-year AMD incidence in the Pusan area of Korea is at least 0.4%. In contrast to Western people, 31.7% of exudative AMD cases were revealed to be PCV and 6.2% were revealed to be RAP. This discrepancy between ethnic groups should be considered in the diagnosis and treatment modality selection of Korean AMD patients.
Aged ; Angiography ; Choroid ; Ethnic Groups ; Eye ; Female ; Fluorescein ; Humans ; Hypertension ; Incidence ; Korea ; Macular Degeneration ; Male ; Membranes ; Photography ; Retinaldehyde ; Smoke ; Smoking ; Specialization