A case of severe osteoarthritic patient of both hip treated with McKee-Farrar total endoprosthesis on one hip is reported. The introduction, indication, procedure of the surgery and the use of the self curing acrylic cement were reviewed briefly. The hip following the surgery, even though the follow-up duration is short, showed exceIlent result.
Follow-Up Studies ; Hip ; Humans

The most common cause of blurred vision after extracapsular cataract extraction is known to be an opacification of the posterior lens capsule. The pathogenesis of posterior lens capsule opacification is primarily caused by residual lens epithelial cells. For the prevention of posterior capsular opacification, several kinds of anti-mitotic drugs is being actively investigated. But the antimitotic drugs are not clinically used due to toxicity towards the intraocular tissues. The objectives of this study is to evaluate the effect of mitomycin C and tirilazad mesylate(FREEDOX(TM)) respectively for inhibiting the proliferation of rabbit lens epithelial cells when it is administered in a short period. Lens epithelial cells from white rabbits were harvested andcultured for 4 passages. Mitomycin C was applied for 3 minutes with 0.025mg/ml and 0.05mg/ml in concentration respectively. The proliferation assay was performed by [(3)H]-thymidine uptake test. Significant decrease of lens epithelial cell proliferation appeared in both drugs.When Mitomycin-C was applied with 0.025mg/ml for 3 minutes, cell proliferation was reduced to 31.5% compared with control and in 0.05mg/ml concentration, to 12.5%. When tirilazad mesylate was applied 0.15mg/ml for 3 minutes, cell proliferation was reduced to 46.5% compared with control and in 1.5mg/ml concentration, to 7.5%. If futher investigation would show the effectives and safety of these drugs, these agents could be applied into the lens capsular bad at the time of surgery to prevent the posterior capsular opacification after cataract surgery.
Antimetabolites* ; Antimitotic Agents ; Capsule Opacification ; Cataract ; Cataract Extraction ; Cell Proliferation ; Epithelial Cells* ; Mesylates ; Mitomycin ; Rabbits

The presence of functioning semicircular canal is regarded as a prerequisite for the development of benign paroxysmal positional vertigo (BPPV) since BPPV is irritative vestibulopathy. However, authors experienced a case of horizontal semicircular canal BPPV in which bithermal caloric test and ice water test were compatible with complete canal paralysis. Forty eight year-old man visited ER for sudden onset of vertigo and right hearing loss developed 3 hours and 4 hours ago, respectively. Vertigo was vaguely complained and was floating in nature, which was aggravated with head position change. Initial audiometry showed 110 dB on pure tone averages. Positional test showed horizontal geotropic direction changing positional nystagmus and it was compatible with canalolithias of right horizontal semicircular canal. The results of initial and follow up bithermal caloric tests and ice water test on supine and prone position were compatible with right side complete canal paralysis. This case implies that caloric dead labyrinth may not represent complete absence of the lateral semicircular canal function and also BPPV can be developed even in a condition with minimal functional remaining.
Audiometry ; Caloric Tests ; Ear, Inner* ; Follow-Up Studies ; Head ; Hearing Loss ; Ice ; Nystagmus, Physiologic ; Paralysis ; Prone Position ; Semicircular Canals ; Vertigo* ; Water

The presence of functioning semicircular canal is regarded as a prerequisite for the development of benign paroxysmal positional vertigo (BPPV) since BPPV is irritative vestibulopathy. However, authors experienced a case of horizontal semicircular canal BPPV in which bithermal caloric test and ice water test were compatible with complete canal paralysis. Forty eight year-old man visited ER for sudden onset of vertigo and right hearing loss developed 3 hours and 4 hours ago, respectively. Vertigo was vaguely complained and was floating in nature, which was aggravated with head position change. Initial audiometry showed 110 dB on pure tone averages. Positional test showed horizontal geotropic direction changing positional nystagmus and it was compatible with canalolithias of right horizontal semicircular canal. The results of initial and follow up bithermal caloric tests and ice water test on supine and prone position were compatible with right side complete canal paralysis. This case implies that caloric dead labyrinth may not represent complete absence of the lateral semicircular canal function and also BPPV can be developed even in a condition with minimal functional remaining.
Audiometry ; Caloric Tests ; Ear, Inner* ; Follow-Up Studies ; Head ; Hearing Loss ; Ice ; Nystagmus, Physiologic ; Paralysis ; Prone Position ; Semicircular Canals ; Vertigo* ; Water

Lead aVR ST segment elevation in patients with clinically suspected acute coronary syndrome strongly suggests the possibility of occlusion of the left main coronary artery (LMCA), and stenosis or occlusion in this area can cause severe life-threatening left ventricular dysfunction or malignant arrhythmias. Thus, it could be a sign suggestive of a poor prognosis for patients. In this study, we report on the case of a 67-year-old male who presented to the emergency department with total occlusion of LMCA with ST-segment elevation in only lead aVR, and without ST-segment elevation in other leads.
Acute Coronary Syndrome ; Aged ; Arrhythmias, Cardiac ; Constriction, Pathologic ; Coronary Vessels ; Electrocardiography ; Emergency Service, Hospital ; Humans ; Male ; Myocardial Infarction* ; Prognosis ; Ventricular Dysfunction, Left

The purpose of this study was to demonstrate corticospinal tract compression that was due to a hematoma by using diffusion tensor tractography (DTT) and functional MRI (fMRI) in a patient with an intracerebral hemorrhage (ICH). A 23-year-old right-handed woman presented with severe paralysis of her right extremities at the onset of a spontaneous ICH. Over the first three days from onset, the motor function of the affected upper and lower extremities rapidly recovered to the extent that she was able to overcome applied resistance to the affected limbs, and her limbs regained normal function 3 weeks after onset. The tract of the right hemisphere originated from the primary sensori-motor cortex (SM1) and it passed through the known corticospinal tract pathway. However, the tract of the left hemisphere was similar to that of the right hemisphere except that it was displaced to the antero-medial side by the hematoma at the cerebral peduncle. Only the contralateral SM1 area centered on the precentral knob was activated during affected (right) or unaffected (left) hand movements, respectively. In conclusion, fMRI and DTT demonstrated a corticospinal tract compression due to hematoma in this patient. We conclude that the combined use of these two modalities appears to improve the accuracy of investigating the state of the corticospinal tract.
Spinal Cord Compression/complications/*diagnosis/pathology ; Pyramidal Tracts/*pathology ; *Magnetic Resonance Imaging ; Humans ; Hematoma/complications/*diagnosis/pathology ; Female ; Diffusion Magnetic Resonance Imaging/*methods ; Cerebral Hemorrhage/complications/*diagnosis/pathology ; Adult

BACKGROUND AND OBJECTIVES: Client Oriented Scale of Improvement (COSI) has been designed to identify client needs, changes in listening ability, and final listening ability in situations important to each client. The aim of this study was to translate COSI into Korean with subsequent linguistic validation and to determine the reliability of the Korean version of the COSI (K-COSI). SUBJECTS AND METHOD: An expert panel translated the original version of COSI into the Korean language. A bilingual translator back-translated the translated version into English, which was subsequently compared with the original English version. K-COSI was administered at 14 referral hospitals, to 128 patients with hearing disability after cognitive debriefing. Reliability was assessed using correlation study. RESULTS: K-COSI showed an excellent test-retest correlation and high reliability in degree of change (Spearman correlation=0.89, interclass correlation coefficient=0.922). It also showed a fair test-retest correlation and high reliability in final hearing ability (Spearman correlation=0.49, interclass correlation coefficient=0.353) CONCLUSION: K-COSI proved to be highly reliable. The results suggest that the adapted Korean version of COSI is a reliable and valid measure for Korean-speaking patients with hearing loss.
Hearing ; Hearing Aids ; Hearing Loss ; Humans ; Linguistics ; Methods ; Referral and Consultation ; Statistics as Topic

Purpose: Internal hernia after gastrectomy is a rare but potentially life-threatening condition without surgical intervention. Clinical risk factors of internal hernia should, hence, be reviewed after gastrectomy.From 2008 to 2018, patients who underwent gastrectomy for gastric cancer were investigated. Methods: Abdominal computed tomography (CT) was used to screen for internal hernia, and surgical exploration was performed to confirm the diagnosis. Using retrospective statistical analysis, the incidence, characteristics, and risk factors were identified, and the characteristics of the internal hernia group were reviewed. Results: The overall incidence of internal hernia was 0.9%. From statistical analysis, it was found that laparoscopic surgery was almost five times riskier than open gastrectomy (odds ratio [OR], 4.947; 95% confidence interval [CI], 1.308–18.710; p = 0.019). Body mass index < 25 kg/m2 (OR, 4.596; 95% CI, 1.056– 20.004; p = 0.042) and proximal gastrectomy (OR, 4.238; 95% CI, 1.072–16.751; p = 0.039) were also associated with internal hernia. Among 20 patients with internal hernia, 12 underwent laparotomy, and five had their bowels removed due to ischemia. All patients with bowel resected had suffered from short bowel syndrome. Conclusion Suspecting an internal hernia should be an important step when a patient with a history of laparoscopic gastrectomy visits for medical care. When suspected, emergent screening through CT scan and surgical intervention should be considered as soon as possible to prevent lifetime complications accordingly.

PURPOSE: We undertook this study to evaluate the pertinence of yearly CPR training for three years in hospital. METHODS: We evaluated 106 participants (79 registered nurses, 17 assistant nurses, 10 medical technicians who were not emergency medical technicians). We performed the education once a year for three years. We used color slides and videos for the lecture. We used a CPR training manikin for training in the CPR skills. For the evaluation, we used a list involving 10 items about understanding the CPR scheme and the CPR training program. We divided the 106 participants based on frequency of training, occupation and career. RESULTS: The mean number of points for understanding the CPR scheme was 17.5 points out of 28. The mean number of points for check for breathing, rescue breathing, pulse check, and chest compression were 2.5, 2.3, 1.7, and 1.7, respectively out of 4 points. In CPR skills, appropriate rescue breathing was 37+/-31%, and appropriate chest compression was 62+/-39%. There were no significant statistical differences based on frequency of CPR training or career. There were significant statistical differences based on occupation. CONCLUSION: Our yearly CPR training in the hospital was not pertinent in improving the ability to perform CPR. Different CPR training methods are needed for different occupation. We think that further study are needed to develope effective CPR training methods and to identify the appropriate re-training interval.
Cardiopulmonary Resuscitation* ; Education ; Emergencies ; Manikins ; Nursing* ; Occupations ; Respiration ; Thorax

Tricuspid regurgitation after blunt chest trauma is rarely seen in the emergency department. A 19-year-old patient visited our emergency department with chest discomfort after collision with his brother while skiing. Recently, Skiing as a winter sports has become popular with the Korean people, so there is an increasing tendency for patients with diverse traumas associated with ski accidents to visit the emergency department. From simple abrasions or contusions to deadly injuries with unstable vital signs, we are seeing many kind of injuries in the emergency department. We present the case report of a patient with tricuspid regurgitation after a blunt chest trauma during the skiing.
Contusions ; Emergency Service, Hospital ; Humans ; Siblings ; Skiing ; Sports ; Thorax* ; Tricuspid Valve Insufficiency* ; Vital Signs ; Young Adult