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 effects and the appropriateness of CPR training for elementary school children. METHODS: The Kangwon National University developed a "Human Body Explorer Program", where local fifth and sixth grade students would learn about the human body. The 72 students who participated in this program were used in this study. The subjects were evaluated by comparing CPR data collected from nurses working at Kangwon National University Hospital. The education sessions consisted of a 30 minute video tape and slides; then, under the supervision of their teacher, the subjects were asked to practice what they had seen. Ten criteria were used to evaluate the subject's CPR proficiency. The CPR skill sessions used Laerdal's HeartSim(R) 4000, and the data stored from the HeartSim(R) 4000 were collected for further analysis. A statistical analysis was done using the SPSS statistical software package. A pvalue< 0.05 was considered to statistically significant. RESULTS: A total of 72 subjects were evaluated. Their average age was 13.2+/-0.5 years. The subjects had very little experience with CPR education(0.17) prior to this study. The data gathered were compared to the evaluation table and yielded an average score of 20.53. The criteria used in the study had the following results: The assessing responsiveness(2.0/2.0), activating the EMS (calling for help) (1.99/2.0), checking for breathing(3.47/4.0), and compression to ventilation ratio of 15:2(1.6/2.0) showed to be at the 80 percentile. However the follow criteria showed a less than 80 percentile: opening the airway(1.54/2.0), mouth-to-mouth breathing(2.04/4.0), checking the carotid pulse(2.0/4.0), chest compression(1.88/4.0), chest compression velocity(1.02/4.0), and reassessment(1.44/2.0). The data from the manikin was extrapolated, and upon examination, we found the following: Correct ventilation was 25+/-31%, insufficient ventilation was 67+/-38% and excessive ventilation was 3+/-10%. Correct chest compression was 9+/-23% and insufficient compression was 91+/-23%, and excessive compression was absent. We compared these scores to the score from nurses of Kangwon University Hospital and found that elementary school children scored higher in all variables except in rate of chest compression. The scores were statistically significant (p<0.05) in total score, check for breathing, and reassessment. The skills evaluation showed that the adults scored higher than the elementary school children. All variables were significant (p<0.05). CONCLUSION: We found that elementary school children were superior to adult counterparts in understanding the CPR scheme. An expansion of CPR training to elementary school children is needed.
Adult ; Cardiopulmonary Resuscitation* ; Child* ; Education ; Gangwon-do ; Human Body ; Humans ; Manikins ; Organization and Administration ; Respiration ; Thorax ; Ventilation

PURPOSE: We address investigative or analytical methods to report death in drawing up a death certificate. METHOD: This study was based on the death certificates completed at the emergency department, Kangwon University hospital, from September 2003 to August 2005. The data were collected through notices about drawing up death certificates and included the death certificate and the medical records in the emergency department. RESULTS: The research subjects were 29,059 patients who came to the emergency room during the period of study. Death certificates or medical certificates of death were issued to 793 of these. As to the place of death, 537 (72.5%) deaths occurred at home, 1 (0.1%) in medical institutions, 12 (1.6%) in public institutions, 48 (6.5%) patients was dead on arrival, 2 (0.3%) at industrial factories, 20 (2.7%) on road, 120 (16.2%) at other places and 1 (0.13%) was not defined. As to the types of death, death from disease was the highest (445, 60.1%), and death from external causes was next (168, 22.7%), followed by death from other or unknown causes (128, 17.3%). For death from external causes, traffic accident was 24 (14.1%), poisoning was 13 (7.6%), accidental fall was 18 (10.6%), accidental drowning was 27, 15.9%), suicide was (64, 37.6%), murder was 1 (0.6%), and other was 23 (13.5%). The study on the cause of death, 92 (16.4%) of 562 patients was found to have been helped in diagnosing the cause of death. However, in the case of death from external causes, except for death from disease, 109 patients were surveyed, the study helped to identify the cause of death in only 46 (42.2%). Likewise, in 14 (60.7%) of 23 patients the study helped to identify the cause of death as sudden death. CONCLUSION: Simple X-rays and laboratory examinations were used to determine the cause of death when drawing up a death certificate, and these helped more in identifying the causes of death from external causes than in identifying the causes of death from diseases. Especially, these worked much better for sudden death.
Accidental Falls ; Accidents, Traffic ; Cause of Death* ; Death Certificates* ; Death, Sudden ; Diagnosis ; Drowning ; Emergency Service, Hospital ; Gangwon-do ; Homicide ; Humans ; Medical Records ; Poisoning ; Research Subjects ; Suicide