The cement-free hip prosthesis coated with hydroxyapatite was developed to obtain primary firm fixation by an enhanced anatomic design and secondary biologic stable fixation by hydroxyapatite which is bioactive and has the same chemical and structural components with those of human bone tissue in total hip arthroplasty. Between January 1992 and June 1994, we used ABG cement free hip prosthesis (Anatomique Benoist Giraud, Howmedica Europe, Staines, England) in 28 hips (avascular necrosis of femoral head; 17, osteoarthritis; 6, posttraumatic arthritis; 3, rheumatoid arthritis; 2) of 25 patients in Pusan National University Hospital. Those cases had a minimum of two years and maximum of four years and five months (average three years and six months) of follow up, including analysis of the clinical and radiological data. The results were obtained as follows: 1. The average Modified Harris Hip Score increased from 51 points preoperatively to 96 points at last follow up. Almost all cases (97%) were excellent or good results in Modified Harris Hip Score. 2. In radiologic results, no migration of the cup, no change in the inclination of the cup, ar.d no oste-olysis around the cup and the stem were observed. Endosteal bone apposition around the cup was found in 54% of the cases and subcortical cancellous densification around the stem was found in 89%. This results indicate that we obtained direct and biologic firm fixation without fibrous tissue interposition between bone and metallic component by inducing on-growth of bone. 3. In the radiologic follow up according to the initial bone quality, it was demonstrated that the incidences of cortical hypertrophy, calcar resorption, and radiolucent line in type B and type C were higher than those in type A. The early clinical and radiological results of the cement-free hip prosthesis coated with hydroxyapatite are encouraging, although a longer follow up period is necessary.
Arthritis ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Hip* ; Bone and Bones ; Busan ; Durapatite* ; Europe ; Follow-Up Studies ; Head ; Hip ; Hip Prosthesis ; Humans ; Hypertrophy ; Incidence ; Necrosis ; Osteoarthritis

Total 40 cases of serial bone scans with Tc99-m-MDP performed on less than 24 hour, 2nd day, 3rd day, 5th day, 1 week, 4 week, 12 week and 1 year respectively after fractures in tibia were analysed. All 5 cases of bone scans performed within 24 hour after injury showed increase in generalized tracer uptake and 3 cases of them(60%) showed localized increase in tracer uptake at the fracture sites. The earliest bone sean performed 9 hour after injury showed generally and locally increased uptake at the fracture sites. All 5 cases of bone scan performed 1 year after injury sinowed localized increased uptake at the fracture sites and 2 cases of them (40%) showed generalized increase in tracer uptake. Bone scans performed 12 week after injury showed the most outstanding increase in generalized and localized tracer uptake. Bone scans performed 1 year after injury showed decreased amount of generalized increase in tracer uptake (but more increased uptake than normal) but the localized increase in traccer uptake at the fracture sites was observed persistently. More study should be needed to clarify the corelationship between the presence of cold spots during the fracture healing and the union of the fractures. It is difficult to differentiate the old fractures to fresh fractures with the bone scans performed within 1 year because of persistent increase in tracer uptake to 1 year after fracture.
Fracture Healing ; Tibia ; Tibial Fractures

PURPOSE: We intended to investigate the clinical features and the predictors of febrile seizure plus(FS+), not suspected of generalized epilepsy with febrile seizure plus (GEFS+). METHODS: We selected 24 patients, aged more than 6 years old, who were admitted to Myongji Hospital of Kwandong University from January, 2001 to March, 2005 due to febrile seizures. All of those had neither a family history of febrile seizures or epilepsy nor abnormalities in the EEG or MRI. We examined sex, age of seizure onset, type of seizure, duration of seizure, the time until seizure after fever and frequency of febrile seizure. We investigated also the statistical significances of these clinical features by comparing with patients of simple febrile seizure(FS) as a control group. RESULTS: The male to female of the FS+ group was 2:1, which had no statistical significance compared with the FS. The age of seizure onsets in the FS+(39.4+/-5.0 months) was significantly older than FS the group(24.1+/-2.1 months)(P<0.05). In the types of seizures, non-generalized tonic clonic seizures occurred significantly more often in the FS+ group(20.9%) than the FS(8.4%)(P<0.05). The frequency of febrile seizures also was high in the FS+ group(n=3.2+/-0.8) than the FS group(n=1.1+/-0.1)(P<0.05). The duration of seizures and the time until seizure after fever did not have statistical significance. CONCLUSION: We suggest that FS+ can be characterized by late onsets of initial seizures, more frequent non-generalized tonic clonic seizures and recurrent febrile seizures. Therefore, FS+ should be suspected for patients more than 4 years old with non-generalized tonic clonic seizures or recurrent febrile seizures of more than 4 times.
Child ; Child, Preschool ; Electroencephalography ; Epilepsy ; Epilepsy, Generalized ; Female ; Fever ; Humans ; Magnetic Resonance Imaging ; Male ; Seizures ; Seizures, Febrile*

OBJECTIVE: During the follow-up period of extrahepatic malignancy, one may encounter a solitary hepatic metastasis on CT scan which may be difficult to differentiate from hepatic abscess in an ambiguous clinical setting. It was our intention to copmare the radiological similarities and differences between two disease entities from which differentiation can be attempted. MATERIALS AND METHODS: Thirty-six cases of solitary heaptic meastesis and 23 cases of liver abscess were included in this study. Two radiologists interpreted the CT without knowledge of the clinical informations. CT pattern was categorized and the frequency of various findings were compared between the two groups. CT findings of the mass were analysed in misinterpreted cases. RESULTS: Without the clinical informations, the diagnostic accuracy of the mass was 72-76% without pattern analysis. Homogeneous masses were seen in both groups, but all masses larger than 4cm were metastases. In heterogeneous masses, metatases more frequently accompanied high attenuation in central or peripheral portion of the mass and showed thick intermediate zone, Irregular trabecular pattern or septations were more frequently observed in abscesses. Biliary dilatation or stone, pleural effusion, air in mass or biliary tree were more frequently seen in abscesses. The false diagnosis was encountered most frequently when the mass possessed any of the followings; homogeneous attenuation, mosaic pattern in the mass with inhomogeneous attenuation and thin intermediate attenuation area. CONCLUSION: Pattern analysis of the various CT character will be helpful to differentiate hepatic abscess and solitary hepatic metastasis in the equivocal clinical settings. However, similar pattern can be seen in both entities ;in this cases, corrdination of CT pattern and secondary findings is needed for better differentiation.
Abscess ; Biliary Tract ; Diagnosis ; Dilatation ; Follow-Up Studies ; Intention ; Liver Abscess* ; Neoplasm Metastasis ; Pleural Effusion ; Tomography, X-Ray Computed

Adult intussusception is rare involving of only 1% of the causes of bowel obstruction. We report a case of a 39-year-old female with intussusceptions due to inverted Meckel's diverticulum. She visited our hospital for diffuse abdominal pain during 1 week and aggravated abdominal pain for 2 days. Vital signs were stable, and there was periumbilical tenderness. She had no history of abdominal operation. CT scan showed a 3.7x2.1 cm of fatty mass with focal intussusception in the distal ileum. When the emergency operation was performed, the patient was found to be suffering from ileocolic intussusception. A manual reduction of intussusception showed inverted Meckel's deverticulum at 65 cm proximal to the ileocecal valve, and the segmental resection of small bowel including a Meckel's diverticulum was performed. Pathologic examination revealed a Meckel's diverticulum containing a 0.6x0.6 cm sized aberrant pancreas.
Abdominal Pain ; Adult ; Emergencies ; Female ; Humans ; Ileocecal Valve ; Ileum ; Intussusception ; Meckel Diverticulum ; Pancreas ; Stress, Psychological ; Vital Signs

Lipoma Arborescens is rarely encountered in hip joint. This term was first used by Mueller in 1838, to describe a fatty trmor of the knee which presented branched villous-like projection. The etiology is unknown, Suggests its probable reationship to tuberculosis, rheumatoid arthitis, trauma, chronic inflammation, diabetes mellitus and degenerative arthritis. It frequently involves knee joint, hand, wrist, foot, ankle, tendon sheath and hip joint. It usually presents bilaterally. Their nonspecific symptoms and signs are mild pain, joint swelling with minimum effusion, festriction of joint motion, redness, local heating and crepitus. We experienced a case of lipoma arborescens of hip joint, which was treated by synovectomy with excision of lesion.
Ankle ; Arthralgia ; Diabetes Mellitus ; Foot ; Hand ; Heating ; Hip Joint ; Hip ; Hot Temperature ; Inflammation ; Joints ; Knee ; Knee Joint ; Lipoma ; Osteoarthritis ; Tendons ; Tuberculosis ; Wrist

Neurologic complications of Epstein-Barr virus (EBV) infection are diverse including a number of neurologic diseases such as encephalitis, encephalomyelitis, Guillain-Barre syndrome, optic neuritis, acute disseminated encephalomyelitis, cerebellitis, and Alice-In-Wonderland syndrome. In general encephalitis caused by EBV in children has been considered a self-limited disease with few or no sequelae. Occasionally it leaves a severe neurologic sequela and complications. Therefore administration of high dose acyclovir and steroid in early stages of EBV encephalitis is recommended currently. In this case, the patient of a 8-year-old boy was admitted because of generalized tonic seizure of 2 times. He showed 16% of atypical lymphocytosis in peripheral blood smear and positive findings in VCA-IgM and EA-IgM tests. EBV DNA Antibody, and virus PCR in CSF was not evaluated. He also showed hepatosplenomegaly in abdominal sonography. Brain MRI revealed a bilateral increased signal intensity at lenticular nucleus and caudate nucleus, multiple high signal intensity at cortical layer of both gyrus reti, both frontal, inferior parietal, and dorsal aspect of the right paracentral lobue. As mentioned in serologic and imaging study, he was diagnosed as the EBV- associated encephalitis. Although we administered high dose acyclovir and corticosteroids, he showed clinical deterioration with confusion, delirium, and ataxia. Therefore, we administered additional high dose intravenous immunoglobulin, and finally he was recovered. We report the case of improvement of EBV-associated encephalitis after high-dose Intravenous immunoglobulin therapy.
Acyclovir ; Adrenal Cortex Hormones ; Ataxia ; Brain ; Caudate Nucleus ; Child ; Corpus Striatum ; Delirium ; DNA ; Encephalitis* ; Encephalomyelitis ; Encephalomyelitis, Acute Disseminated ; Guillain-Barre Syndrome ; Herpesvirus 4, Human* ; Humans ; Immunization, Passive* ; Immunoglobulins* ; Lymphocytosis ; Magnetic Resonance Imaging ; Male ; Optic Neuritis ; Polymerase Chain Reaction ; Rabeprazole ; Seizures

Neurologic complications of Epstein-Barr virus (EBV) infection are diverse including a number of neurologic diseases such as encephalitis, encephalomyelitis, Guillain-Barre syndrome, optic neuritis, acute disseminated encephalomyelitis, cerebellitis, and Alice-In-Wonderland syndrome. In general encephalitis caused by EBV in children has been considered a self-limited disease with few or no sequelae. Occasionally it leaves a severe neurologic sequela and complications. Therefore administration of high dose acyclovir and steroid in early stages of EBV encephalitis is recommended currently. In this case, the patient of a 8-year-old boy was admitted because of generalized tonic seizure of 2 times. He showed 16% of atypical lymphocytosis in peripheral blood smear and positive findings in VCA-IgM and EA-IgM tests. EBV DNA Antibody, and virus PCR in CSF was not evaluated. He also showed hepatosplenomegaly in abdominal sonography. Brain MRI revealed a bilateral increased signal intensity at lenticular nucleus and caudate nucleus, multiple high signal intensity at cortical layer of both gyrus reti, both frontal, inferior parietal, and dorsal aspect of the right paracentral lobue. As mentioned in serologic and imaging study, he was diagnosed as the EBV- associated encephalitis. Although we administered high dose acyclovir and corticosteroids, he showed clinical deterioration with confusion, delirium, and ataxia. Therefore, we administered additional high dose intravenous immunoglobulin, and finally he was recovered. We report the case of improvement of EBV-associated encephalitis after high-dose Intravenous immunoglobulin therapy.
Acyclovir ; Adrenal Cortex Hormones ; Ataxia ; Brain ; Caudate Nucleus ; Child ; Corpus Striatum ; Delirium ; DNA ; Encephalitis* ; Encephalomyelitis ; Encephalomyelitis, Acute Disseminated ; Guillain-Barre Syndrome ; Herpesvirus 4, Human* ; Humans ; Immunization, Passive* ; Immunoglobulins* ; Lymphocytosis ; Magnetic Resonance Imaging ; Male ; Optic Neuritis ; Polymerase Chain Reaction ; Rabeprazole ; Seizures

Baker's cyst is a distension of the gastrocnemius-semimembranosus bursa of the knee, which communicates with the posterior portion of the joint capsule. Baker's cyst is commonly located in the inferomedial or superficial layers of the knee joint and rarely extends laterally or proximally. Complications of Baker's cysts are dissection, rupture, pseudothrombophlebitis, leg ischemia, nerve entrapment, and compartment syndrome. However, hematomas in the Baker's cyst have not been reported in Korea. We report a rare case of hematoma in the Baker's cyst with subfascial extension into the calf. The hematoma was demonstrated by magnetic resonance imaging and removed by mass excision.
Compartment Syndromes ; Hematoma ; Ischemia ; Joint Capsule ; Knee ; Knee Joint ; Korea ; Leg ; Magnetic Resonance Imaging ; Nerve Compression Syndromes ; Popliteal Cyst ; Rupture

Y-STR haplotyping is a powerful forensic and anthropological tool for identifying male lineages. We used high-resolution Y-STR haplotyping to evaluate the possibility of an ancestral relationship between two individuals with the different surname. Of the 17 Y-STRs genotyped, 16 had identical alleles in two individuals, except for an unambiguously sporadic mutation (one-step mutation) at DYS385 locus. The common allele 11.1 (U3Ains) at DYS439 locus was also observed in these two individuals. Sequencing analysis of these alleles of two samples demonstrated an A insertion at base 3 upstream from the repeat region's first GATA motif. These findings suggested that two individuals were paternally related, even if male individuals live with different surname.
Alleles ; Haplotypes ; Humans ; Male