Cemented total hip replacement is one of the established methods of treatment in various hip joint disorder in adults in spite of the high incidence of the complications. The authors report a clinical experience of 39 patients(47 hips) among the 111 patients (126 hips) who were treated with cemented total hip replacement from May 1973 to August 1985 at the Department of Orthopaedic Surgery of National Medical Center. The follow-up period ranged from 3 years to 11 years and 6 months with an average of 6 years and 9 months. The results are follows : 1. The functional results were good or excellent in 73% using Harris Hip Score. 2. The rate of mechanical loosening was 34.8% in femoral components, and 28.3% in acetabular components, and 19.6% in both components. 3. Average rate of socket wear was 0.243mm/yr in Charnley type prosthesis and 0.32mm/yr in Miieller type prosthesis. 4. Age, types of prosthesis, follow-up period showed stastical correlation with functional results(p<0.05). 5. Follow-up periods affected the incidence of radiographic loosening(p<0.05). 6. The relationship between follow-up periods and wear was stastically significant(p<0.05). 7. Septic loosening occurred in one case, who was eventually given Girdle-stone operation. 8. The rate of trochanteric non-union was 16.6% and ectopic bone formation occurred in 23.4%.
Acetabulum ; Adult ; Arthroplasty, Replacement, Hip ; Femur ; Follow-Up Studies ; Hip ; Hip Joint ; Humans ; Incidence ; Osteogenesis ; Prostheses and Implants

PURPOSE: This study was performed to evaluate the results of surgical treatment of Nirschl procedure for intractable lateral epicondylitis of the elbow. MATERIALS AND METHODS: We retrospectively reviewed the functional records of surgically treated 21 cases from the 196 cases of lateral epicondylitis, which had been followed up at least 12 months from March 2000 to May 2003. Surgery was generally considered to be indicated if six months of conservative treatments since the first diagnosis had led to no improvement of the symptoms. The patients were evaluated by assessing of Pain Analog Scales (PAS) score. The objective outcomes of all patient after surgery were investigated according to the criteria by Roles and Maudsley. RESULTS: The mean PAS score followed up for 12 months postoperatively, had indicated significant improvements (p<0.001): 0.31 points (range, 0-2) at rest, 1.22 points (range, 0-3) at daily activities, and 2.25 points (range, 0-5) at sports and occupational activities. According to the Roles and Maudsley scores, there were 12 excellent, 7 good, 2 fair from the total of 21 cases; therefore, 19 (90%) cases showed the satisfactory results. CONCLUSION: The surgical treatment using the Nirschl procedure for intractable lateral epicondylitis of the elbow is considered as one of recommendable methods for the cases of no response at the conservative treatment.
Diagnosis ; Elbow ; Humans ; Retrospective Studies ; Sports ; Weights and Measures

IgA nephropathy is the most common form of glomerulonephritis characterized by deposit of IgA on mesangium. We experienced an elderly patient who was admitted for generalized edema, and diagnosed IgA nephropathy and early gastric cancer concomittantly. It has been reported that the incidence of nephrotic syndrome combined with malignancy increases with aging. Moreover, close relationship between IgA nephropathy and malignancy has been reported especially in the elderly patient. So, active investigations for possible malignancy are required in case of elderly patient with IgA nephropathy. In this case, we found improved proteinuria and hematuria of the patient after tumor resection during following up. This case suggest causal association between early gastric cancer and IgA nephropathy clinically.
Aged* ; Aging ; Delirium ; Depression ; Edema ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Incidence ; Nephrotic Syndrome ; Proteinuria ; Stomach Neoplasms*

Serum aspartate aminotransferase (AST) is a common enzyme for the evaluation of the hepatic, muscular and cardiac diseases and is produced also at kidney, brain, pancreas, lung, leukocytes, erythrocytes, etc. The elevation of its activity is usually caused by the necrosis of hepatocytes when there are not muscular injuries or myopathies. Recently, it is found that AST can exist as a macroenzyme by forming a complex with an immunoglobulin and this complex is erroneously considered to indicate the presence of liver disease as a result of elevation of AST activity on routine blood chemistry analysis. We experienced the patient with isolated AST elevation due to the formation of AST-mmunoglobulin complex confirmed by AST isoenzyme electrophoresis (EP).
Aspartate Aminotransferases ; Brain ; Chemistry ; Electrophoresis ; Erythrocytes ; Heart Diseases ; Hepatocytes ; Humans ; Immunoglobulins ; Kidney ; Leukocytes ; Liver Diseases ; Lung ; Muscular Diseases ; Necrosis ; Pancreas

PURPOSE: Raman spectroscopy is a vibrational spectroscopic technique, which is capable of providing details on the chemical composition, molecular structure and molecular interactions in cells and tissues. The primary objective of this study was to explore Raman spectroscopy for the detection of spectral changes between normal and cancer tissue in the stomach. METHODS: Tissue specimens were obtained from the resected stomach of advanced gastric cancer patients. The normal gastric and cancer tissues were harvested from the middle, lower portion of the stomach and from the tumor mass, respectively. 19 sets (antrum, body and cancer) of spectral data, with clearly defined histopathological findings, were selected in this study. FT-Raman spectroscopy (Bruker Inc., Karsruhe, Germany) was used for tissue Raman studies, with excitation at 1, 064 nm. The Raman spectra from the gastric tissue specimens were obtained with a 20 minute signal acquisition time. RESULTS: In the range 700~1, 900 cm-1, the Raman spectra of gastric antral tissue were dominated by a number of vibrational modes of biomolecules, such as proteins, lipids and nucleic acids. The Raman spectrum pattern of gastric body tissue was similar to that of the antrum, suggesting the structure and composition between the gastric antrum and body are much the same. The Raman spectra differed significantly between the normal and malignant cancer tissues, with cancers showing higher percentage signals for protein, lipid and nucleic acid compared to normal tissue (P<0.05). Difference were observed in the shapes of the Raman spectra between the normal and cancer tissues, particularly in the spectral ranges 1, 250~1, 255, 1, 330~1, 340 and 1, 440~1, 450 cm-1, which contain signals relating to protein and lipid conformations and CH2 bending mode of nucleic acids. CONCLUSION: This study demonstrates the ability of Raman spectroscopy to detect biochemical changes in malignant gastric tissue, and may become a useful adjunct to pathological diagnosis allowing guided biopsies and assessment of adequacy of resection margins.
Biopsy ; Diagnosis ; Humans ; Molecular Structure ; Nucleic Acids ; Pyloric Antrum ; Spectrum Analysis ; Spectrum Analysis, Raman* ; Stomach Neoplasms ; Stomach*

Background: Antineutrophil cytoplasmic antibodies (ANCA)-associated glomerulonephritis (AAGN) is a common cause of rapidly progressive glomerulonephritis and requires prompt and proper immunosuppressive therapy to improve renal prognosis. This study aimed to evaluate the predictive value of two different classifications for renal outcomes in Korean AAGN patients. Methods: Ninety-two patients who were diagnosed with AAGN at two tertiary hospitals between 2004 and 2018 were retrospectively analyzed retrospectively. The histopathologic classification according to glomerular pathology and the clinicopathologic classification according to normal glomeruli ratio, degree of interstitial fibrosis/tubular atrophy, and baseline renal function were evaluated using the Cox proportional hazards model. Results: Forty-five patients (48.9%) progressed to end-stage kidney disease (ESKD) during the observation period. The mean age was 61.0 ± 15.3 years, and most patients had myeloperoxidase-ANCA (93.5%). In the histopathologic classification, the best renal survival occurred in the focal class, whereas the sclerotic class had the worst renal survival (sclerotic class vs. focal class; adjusted hazard ratio [aHR], 5.05; 95% confidence interval [CI], 1.32–19.31; p = 0.018). The mixed class had intermediate renal outcomes (mixed class vs. focal class; aHR, 4.23; 95% CI, 1.23–14.58; p = 0.022). In the clinicopathologic classification, the high-risk group had poor renal outcomes compared with the low-risk group (aHR, 6.56; 95% CI, 1.25–34.26; p = 0.026), but renal outcomes did not differ between the low- and medium-risk groups. Conclusion In Korean AAGN patients, histopathologic and clinicopathologic classifications had predictive value for renal outcomes, especially in the sclerotic class or the high-risk group with higher risk of progression to ESRD despite treatment.

Background: Antineutrophil cytoplasmic antibodies (ANCA)-associated glomerulonephritis (AAGN) is a common cause of rapidly progressive glomerulonephritis and requires prompt and proper immunosuppressive therapy to improve renal prognosis. This study aimed to evaluate the predictive value of two different classifications for renal outcomes in Korean AAGN patients. Methods: Ninety-two patients who were diagnosed with AAGN at two tertiary hospitals between 2004 and 2018 were retrospectively analyzed retrospectively. The histopathologic classification according to glomerular pathology and the clinicopathologic classification according to normal glomeruli ratio, degree of interstitial fibrosis/tubular atrophy, and baseline renal function were evaluated using the Cox proportional hazards model. Results: Forty-five patients (48.9%) progressed to end-stage kidney disease (ESKD) during the observation period. The mean age was 61.0 ± 15.3 years, and most patients had myeloperoxidase-ANCA (93.5%). In the histopathologic classification, the best renal survival occurred in the focal class, whereas the sclerotic class had the worst renal survival (sclerotic class vs. focal class; adjusted hazard ratio [aHR], 5.05; 95% confidence interval [CI], 1.32–19.31; p = 0.018). The mixed class had intermediate renal outcomes (mixed class vs. focal class; aHR, 4.23; 95% CI, 1.23–14.58; p = 0.022). In the clinicopathologic classification, the high-risk group had poor renal outcomes compared with the low-risk group (aHR, 6.56; 95% CI, 1.25–34.26; p = 0.026), but renal outcomes did not differ between the low- and medium-risk groups. Conclusion In Korean AAGN patients, histopathologic and clinicopathologic classifications had predictive value for renal outcomes, especially in the sclerotic class or the high-risk group with higher risk of progression to ESRD despite treatment.

BACKGROUND: Arsenic is a carcinogenic heavy metal that has a species-dependent health effects and abandoned metal mines are a source of significant arsenic exposure. Therefore, the aims of this study were to analyze urinary arsenic species and their concentration in residents living near abandoned metal mines and to monitor the environmental health effects of abandoned metal mines in Korea. METHODS: This study was performed in 2014 to assess urinary arsenic excretion patterns of residents living near abandoned metal mines in South Korea. Demographic data such as gender, age, mine working history, period of residency, dietary patterns, smoking and alcohol use, and type of potable water consumed were obtaining using a questionnaire. Informed consent was also obtained from all study subjects (n = 119). Urinary arsenic species were quantified using high performance liquid chromatography (HPLC) and inductively coupled plasma mass spectrometry (ICP/MS). RESULTS: The geometric mean of urinary arsenic (sum of dimethylarsinic acid, monomethylarsonic acid, As3+, and As5+) concentration was determined to be 131.98 μg/L (geometric mean; 95% CI, 116.72–149.23) while urinary inorganic arsenic (As3+ and As5+) concentration was 0.81 μg/L (95% CI, 0.53–1.23). 66.3% (n = 79) and 21.8% (n = 26) of these samples exceeded ATSDR reference values for urinary arsenic (>100 μg/L) and inorganic arsenic (>10 μg/L), respectively. Mean urinary arsenic concentrations (geometric mean, GM) were higher in women then in men, and increased with age. Of the five regions evaluated, while four regions had inorganic arsenic concentrations less than 0.40 μg/L, one region showed a significantly higher concentration (GM 15.48 μg/L; 95% CI, 7.51–31.91) which investigates further studies to identify etiological factors. CONCLUSION: We propose that the observed elevation in urinary arsenic concentration in residents living near abandoned metal mines may be due to environmental contamination from the abandoned metal mine. TRIAL REGISTRATION: Not Applicable (We do not have health care intervention on human participants).
Arsenic* ; Cacodylic Acid ; Chromatography, Liquid ; Delivery of Health Care ; Drinking Water ; Environmental Health ; Female ; Humans ; Informed Consent ; Internship and Residency ; Korea* ; Male ; Mass Spectrometry ; Plasma ; Reference Values ; Smoke ; Smoking

Cancer metastases to the thyroid or adrenal gland are uncommon. Furthermore, cases showing long-term survival after surgical resection of those metastatic tumors are rare. We report a case of pulmonary artery intimal sarcoma with metastases to the thyroid and adrenal glands sequentially that was successfully treated with sequential metastasectomies. A 62-year-old woman presented with a 4-week history of dyspnea on exertion and facial edema in November 1999. Echocardiography and chest computed tomography (CT) revealed an embolism-like mass in the pulmonary trunk. Pulmonary artery endarterectomy with pulmonary valve replacement was performed, and histopathology revealed pulmonary artery intimal sarcoma. A thyroid nodule was found by chest CT in November 2001 (2 years after initial surgery). During follow-up, this lesion showed no change, but we decided to obtain fine needle aspiration cytology (FNAC) in August 2004 (4.7 years after initial surgery). FNAC revealed atypical spindle cells suggestive of metastatic intimal sarcoma. She underwent total thyroidectomy. During follow-up, a right adrenal gland mass was detected by chest CT in March 2006 (6.3 years after initial surgery), and adrenalectomy was done, which also revealed metastatic sarcoma. She has been followed up without any evidence of recurrent disease until May 2012 (12.5 years after initial surgery).
Adrenal Glands ; Adrenalectomy ; Biopsy, Fine-Needle ; Dyspnea ; Echocardiography ; Edema ; Endarterectomy ; Female ; Follow-Up Studies ; Humans ; Metastasectomy ; Neoplasm Metastasis ; Pulmonary Artery ; Pulmonary Valve ; Sarcoma ; Thorax ; Thyroid Gland ; Thyroid Nodule ; Thyroidectomy

BACKGROUND: A allele, A(var), characterized by a 784G>A polymorphism (Asp262Asn) has been identified only in Korean A(weak)B donors. This study evaluated the serological and genetic characteristics of thirteen samples with newly identified A(var) allele. METHODS: This study examined 10 samples with the A(var) allele including 4 members from a family, who were randomly obtained from blood donors recruited at Gwangju-Chonnam Red Cross Blood Center, and patients at the Chonnam National University Hospital. Routine ABO serologic tests, ABO genotyping using an allele specific polymerase chain reaction (AS-PCR), and the sequencing of exon 6 and 7 of ABO gene were performed on all samples. In addition, sequencing of exon 1~5 of the ABO gene was carried out on two randomly selected samples. RESULTS: The A(var) allele was identified in nine A(weak)B and one O (II-1 of the family study) sample. Eight of these nine individuals showed 1+ agglutination with the monoclonal anti-A reagents on forward typing but one sample showed no agglutination. Weak anti-A was detected in all sera. From the family study, the A(var) allele, which was transmitted from the propositus through her descendant (II-1, II-3 and III-1), produced either the weak A phenotype when inherited with a B allele or the O phenotype when inherited with an O allele. CONCLUSION: A(var) erythrocytes showed different agglutination patterns to anti-A. Different expressions (possible allelic enhancement) were observed depending on the co-inherited ABO alleles from samples with the A(var) allele.
Agglutination ; Alleles* ; Blood Donors ; Erythrocytes ; Exons ; Humans ; Indicators and Reagents ; Jeollanam-do ; Phenotype ; Polymerase Chain Reaction ; Red Cross ; Serologic Tests ; Tissue Donors