No abstract available.
Inhalation* ; Lung Injury* ; Lung*

PURPOSE: We performed a clinical study and a matched-set radiographic analysis to determine the factors that contribute to dislocation after total hip arthroplasty. MATERIALS AND METHODS: We reviewed 346 total hip arthroplasties (46 were revision procedure) followed by more than 1 year from January, 1992 to June, 1998. A clinical study was performed for dislocated group (16 cases) and non-dislocated group as to disease and patient's factors and prosthesis type. A radiographic analysis was performed for dislocated group and matched control group (32 cases) to evaluate operative factors. RESULT: Dislocation occurred in sixteen cases (4.6%) of the 346 total hip arthroplasties. There was no statistical correlation between age, gender, preoperative diagnosis or prior hip surgery in disease and patient's factor and dislocation. The patients who had a history of alcoholism (more than 0.8 bottle of Soju a day) had the significant difference in dislocation rate in comparison with the patients who did not have such a history. Operative factors were studied by radiographic analysis for sixteen hips that had dislocated and thirty-two that had not. We detected no relationships between the angle of the anteversion and inclination of the cup, leg length difference or the rate of horizontal offset and the risk of dislocation. The prosthesis type and acetabular liner also had no relationships with the dislocation. CONCLUSION: Although the causative factors for dislocation after total hip arthroplasty were not related to operative factor and prosthesis type, alcoholism in patient related factors was important.
Acetabulum ; Alcoholism ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Diagnosis ; Dislocations* ; Hip ; Humans ; Leg ; Prostheses and Implants

Cysts of the adrenal glands are uncommon and present difficult problems in differential diagnosis. In autopsy studies, the incidence of adrenal cysts is ranges from 0.064% to 0.18%. Recently, we have experienced a 22-year-old female patient with spontaneous hemorrhagic pseudocyst of adrenal gland without known cause, presenting symptoms of nausea, epigastric discomfort and intermittent pain of right upper abdomen. In clinical presentation, abdominal ultrasonogram and computerized tomogram suggest cystic degeneration of malignant pheochromocytoma, but screening hormonal evaluation was normal. Selective adrenal venous sampling, adrenal scintigram and pathologic examination were not compatible with the functioning adrenal cortical or medullary adenoma/carcinoma, the mass results in spantaneous hemorrhagic necrosis and cystic degeneratio#n of adrenal gland. The authors reported a case of spontaneous hemorrhagic pseudocyst of adrenal gland, which was successfully resected by laparoscopic excision with reviews of the literatures.
Abdomen ; Adrenal Glands* ; Autopsy ; Diagnosis, Differential ; Female ; Humans ; Incidence ; Mass Screening ; Nausea ; Necrosis ; Pheochromocytoma* ; Ultrasonography ; Young Adult

An 8-years old boy with facial asymmetry and unilateral posterior crossbite on the left side received orthopedic and orthodontic treatment. During the first phase of treatment, the narrow maxillary arch was expanded using an acrylic plate. Then, the acrylic plate was used as a bite block with occlusal indentations from the construction bite that was obtained with the incisors in a coincident dental midline. After the position of the mandible was stabilized, the second phase of orthodontic treatment was initiated using fixed appliances for detailing of the occlusion. Skeletal symmetry, ideal occlusion, and coincident dental midlines were thus achieved. Functionally, occlusal force balance and masticatory muscle activity were improved, and the chewing patterns were normalized.
Bite Force ; Electromyography ; Facial Asymmetry* ; Humans ; Incisor ; Male ; Malocclusion* ; Mandible ; Mastication ; Masticatory Muscles ; Orthopedics* ; Palatal Expansion Technique

OBJECTIVES: The purpose of this study was to evaluate the condylar position in relation to the glenoid fossa before and after orthodontic-orthognathic surgical treatment and to investigate the relationship with skeletal relapse. MATERIALS AND METHODS: Lateral cephalograms and temporomandibular joint tomograms from 19 patients with mandibular prognathism who received orthodontic-orthognathic surgery were included in this study. Samples were divided into two groups based on skeletal change during the retention period. The relapse group consisted of 7 patients (3 females and 4 males; mean age, 21.9 years) whose pogonion or menton displaced more than 1 mm during the retention period and the stable group consisted of 12 patients (5 females and 7 males; mean age, 21.7 years). Anterior joint space, posterior joint space, superior joint space, and anteroposterior index were measured on tomograms at pretreatment and posttreatment timepoints. Condyle position and frequency of the positional change were compared between both groups. RESULTS: In the relapse group and stable group, 42.9% and 45.8% of the condyles, respectively, showed forward or backward displacement at posttreatment. However, the changes were small and the mean anterior, posterior, superior joint spaces and frequencies of the positional changes did not differ statistically between both groups. CONCLUSION: Our results suggest that small positional changes of the condyle, which may occur after orthodontic-orthognathic surgery treatment, may not be related to skeletal relapse after removal of the orthodontic appliances.
Female ; Humans ; Joints ; Male ; Malocclusion ; Mandibular Condyle ; Orthodontic Appliances ; Orthognathic Surgery ; Prognathism ; Recurrence* ; Temporomandibular Joint

The purpose of this postmortem retrieval study of the femoral stem was to measure, analyse and compare the femoral stem taken from the patient who died after hip arthroplasty morphologically and radiologically. In this case we analysed the femoral stem from a patient who underwent bipolar endoprosthesis 4 months previously, which had never been reported previously in Korea. From radiologic and stereomicroscopic studies, we found that the cement around the femoral stem was inserted uniformly, and the cement thickness was shown the same uniform pattern. A cross sectional study showed small voids and defects that was not seen on the radiographs. Postmortem retrieval of hip arthroplasties can help in studies of operation methods, voids, cement, stemcement interfaces, and cement-bone interfaces.
Arthroplasty ; Hip ; Humans ; Korea

PURPOSE: To report upon factors predicting complication after multiple pinning of femoral neck fractures, the authors performed a comparative study upon a success group and a failure group and reviewed the literature. MATERIALS AND METHODS: Among cases of multiple pinning from July 1990 to June 1998, we defined 63 cases as successful that had more than 2 years follow-up and had no complications, and 18 cases as unsuccessful that had complications like avascular necrosis, nonunion and required a secondary operation. We analyzed the two groups from the viewpoints of age, cause of injury, classification of fracture, degree of displacement, degree of osteoporosis, time interval to operation and accuracy of reduction. RESULTS: Statistically significant factors were the degree of displacement by Garden classification (p=0.007), the degree of displacement and anatomical position by AO classification (p=0.005), the time interval to operation after 7 days (p=0.012) and the postoperative accuracy of reduction (p=0.010). However, age, Singh index and the type of internal fixation device did not show statistical significance. CONCLUSION: Displaced subcapital fracture, time interval to operation after 7 days and reduction accuracy may be prediction of complications.
Classification ; Femoral Neck Fractures* ; Femur Neck* ; Follow-Up Studies ; Internal Fixators ; Necrosis ; Osteoporosis

Congenital Abnormalities ; Facial Asymmetry ; Humans ; Imaging, Three-Dimensional ; Lip ; Mouth ; Orthognathic Surgery ; Osteotomy

BACKGROUND: The cause of autoimmune thyroid diseases (AITD), including Graves disease and Hashimotos thyroiditis, is largely unknown. To identify the genes responsible, most attention has been focussed on the HLA regions in the early studies. However, these studies have repeatedly shown a weak association between AITD and the HLA-DR3 in Caucasians. To understand and find out the mechanisms underlying the development of AITD, a search for non-HLA linked susceptibility genes is important. A recent study from American population have indicated an association between a polymorphism of CILA-4 gene and Graves disease. To clarify the relationship of the CTLA-4 polymorphism and AITD, the allele frequency of CTLA-4 gene from the patients with Graves disease and with Hashimotos thyroiditis in Korean papulation were analysed. METHODS: The CTLA-4 exon 1 polymorphism (49, A/G) was analysed by PCR-based, RFLP (Restriction Fragment Length Polymorphism) from 92 women and 37 men with Graves disease and 50 women and 9 men with Hashimotos thyroiditis diagnosed. Also, 287 healthy controls including 155 women and 132 men with no clinical evidence or family history of thyroid disease were enrolled. RESULTS: 1) In the group of Graves disease, there was significantly more patients with alanine homozygote (GG) than in control group (P<0.0005, RR=1.40). However, there was not significant with threonine homozygote (AA) between two groups (P=0.052). In the group of Hashimotos thyroiditis, no significant differences were found between all homozygotes and heterozygote. 2) In the group of Graves disease, there were significantly more patients with alanine homozygote (GG) (P<0.0001, RR=1.85) and significantly fewer patients with threonine homozygote (AA) than in the group of Hashimoto's thyroiditis (P<0.005, RR 0.25). CONCLUSION: Regardless of sex difference, alanine homozygote (GG) at exon 1 (codon 17) of CTLA-4 is associated with Graves disease in Korean population, which suggests genetic susceptibility is some role in the pathogenesis of Graves disease.
Alanine ; Exons ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Graves Disease ; Heterozygote ; HLA-DR3 Antigen ; Homozygote ; Humans ; Lymphocytes* ; Male ; Polymorphism, Restriction Fragment Length ; Sex Characteristics ; Threonine ; Thyroid Diseases* ; Thyroid Gland* ; Thyroiditis

A statistical observation was made on 841 cases of urolithiasis among the l.004 cases which were seen during the 15 years period from January 1963 to December. 1977. 1. The incidence of the patients with urolithiasis was 1.85 % of total urological patients and 19.2 % of the inpatients. 2. The incidence of the patients with urolithiasis did not increase in spite of increasing annual incidence of inpatients. 3. They consisted of 266 patients with kidney stone (29 %) . 573 patients with ureter stone (61 %). 68 patients with bladder stone (7%) .and 26 patients with urethral stone (3%) The ratio of upper urinary tract stones to lower urinary tract stones was 9 to I. Among the 266 cases of the kidney stone, 21 cases were staghorn calculi. 4. The most favored predilection of ureter stones was lower 1/3 of ureter in 61% of these. 5. Seasonal variation of urolithiasis was not distinct, but the summer was the most favored season. 6. They were most commonly found between the ages of 20 to 50 (82 %). The causes were not found in all cases of childhood urolithiasis ( 8 cases) under the ages of 10. 7. The ratio of males to females was 2.7 to 1, however, the staghorn calculi were more commonly found in female. The ratio of males to females under age of 25 years was 1.8 to 1. 8. The upper urinary tract calculi occurred both in the right and left side with approximately equal frequency. 9. Multilocated stones were found in 10.7 % of all cases and bilateral stones were found in the 8.4% of the all cases. 10. The clinical symptoms of upper urinary tract calculi were flank pain in 85%, hematuria in 27.7 %, frequency in 17.8 %, nausea and vomiting in 10.4 %, and fever in 7.2%. The clinical symptoms of lower urinary tract calculi were painful urination in 78.7%, frequency in 48.8%, hematuria in 33%, and sudden stoppage in 33%. 11. The microscopic hematuria was found in 68.2% and pyuria in 47.7%. 12. Treatment consisted of surgical intervention in 70.3%, rnknown or expectant therpay in 14.4%, spontaneous expelling in 8.5%, and instrumental manipulation in 6.9%. 13. Definite histor of recurrent calculi was found in 27 cases (3.2%) and average duration of recurrence was 2.5 years.
Calculi ; Female ; Fever ; Flank Pain ; Hematuria ; Humans ; Incidence ; Inpatients ; Kidney Calculi ; Male ; Nausea ; Pyuria ; Recurrence ; Seasons ; Ureter ; Urinary Bladder Calculi ; Urinary Calculi ; Urinary Tract ; Urination ; Urolithiasis* ; Vomiting