The Primary objectives of total hip replacement arthroplasty are not only to relieve pain, but to improve motion and function. The range of motion following total hip replacement arthroplasty depends on several factors, especially the position of acetabular cup and femoral stem. Also the oriental need more flexion and abduction in hip motion for squarting position as compared with the European who have different living activity. We studied in vitro biomechanical evaluation of proper position of acetabular cup and femoral stem for T.H.R.A. The following results were obtained: l. Effect of component orientation on R.O.M. 2. Acceptable position of prosthesis was as follows: Acetabular cup: inclination 40–50 degree, anteversion 20–30 degree, Femoral stem: anteversion 0–10 degree. 3. The sum of ideal anteversion of the two components was 30–35 degree 4. Oriental sitting position was performed normally in the ideal position of the prosthesis 5. Acetabular cup is likely insert in the position as far as post sup rim of acetabulum mightbe feasible to be full recovered.
Acetabulum ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Hip ; In Vitro Techniques ; Prostheses and Implants ; Range of Motion, Articular

Segmental Spinal Instrumentation is effective operative procedure in unstable fracture and fracture-dislocation of the thoracolumbar spine, providing rigid spinal stability and reduces needs of external support and complications. Fifty nine patients with unstable fracture and fracture-dislocation of thoracolumbar spine were treated with Harrington rod instrumentation and sublaminar wiring(31 patients) and Luque rod instrumentation with sublaminar wiring(28 patients) in Hyun Dai Hae Seong Hospital, Ulsan, Paik Hospital, Pusan from Dec. 1983 to April 1986. We have analyzed the results of treatment about two type of S.S.I. and obtained following conclusions; l. In 59 patients, T12 level injury was 17 cases, Ll level was 25 cases and so T12 and Ll involvement were 71%. 2. By Francis Denis classification, 28 cases were burst type fracture, 20 cases were fracture-dislocation type, 6 cases were seat belt type and 5 cases were wedge compression type. 3. In Harrington rod with S.S.I., initial kyphotic angle was 22.4° and postoperative angle was 7.4° and correction rate was 66.9%; in Luque rod with S.S.I., preoperative kyphotic angle was 21.7° and postoperative angle was 6.5° and correction rate 69.6%. So there was no difference of correction rate in two type of S.S.I. 4. In Harrington rod with S.S.I., the loss of reduction was 1.2° and the loss was 7%; in Luque rod with S.S.I., the loss of reduction was 7.2° and the loss rate was 48%. So the loss of reduction of Luque rod with S.S.I. was greater than that of Harrington rod with S.S.I. 5. After removal of implants, Luque rod with S.S.I. patients have better range of motion than Harrington rod with S.S.I. patients clinically, but it needs more follow-up because of a few cases(18 cases).
Busan ; Classification ; Follow-Up Studies ; Humans ; Range of Motion, Articular ; Seat Belts ; Spine ; Surgical Procedures, Operative ; Ulsan

We have exprierienced 10 cases of pelvic bone fractures that were treated by Hoffmann's external fixation devices from June, 1979 to June, 1982. As a result, following advantages were noted; 1. Rapid recuction of pain, prevention of serious early complication, and easiness of nursing care were possible. 2. Late complications such as lumbosacral pain and gait disturbance could be preventable in majority of the patients, as well as shortening the duration of the hospitalization.
External Fixators ; Fracture Fixation ; Gait ; Hospitalization ; Humans ; Nursing Care ; Pelvic Bones

Segmental Spinal Instrumentation(S.S.I.) is more effective means of managing unstable thoraco-lumbar spine fractures than traditional Harrington Rod Instrumentation as an operative procedure which afforded rigid internal fixation with stability and needed minimal external immobilization. Early return to normal activity and successful rehabilitation are facilitated by efficient stabilization with S.S.I. Fifty-nine patients with fractures and fracture-dislocations of thoraco-lumbar spine were treated by Harrington Rod Instrumentation (29 patients) and S.S.I. (30 patients) at this hospital from June 1979 to July 1984. We have analysed the results of these treatment and obtained following conclusions: 1. S.S.I. is more rigid internal fixation than Harrington Rod Instrumentation. a) no or minimal external immobilization b) early ambulation and rehabilitation c) lowered complications 2. There was no significant difference in correction rate, loss of correction, and neurologic recovery between Harrington Rod Instrumentation and S.S.I.
Early Ambulation ; Humans ; Immobilization ; Rehabilitation ; Spine ; Surgical Procedures, Operative

Primary cutaneous large cell lymphomas of the T-cell phenotype are relatively uncommon. Previous studies have revealed the following prognostic variables: the distribution of skin lesions, a history of pre-existing mycosis fungoides, CD30(Ki-1) antigen positivity and anaplastic morphology. CD30 antigen positivity has been associated with an indolent clinical course, in contrast to CD30-negative cases. However, a recent study revealed that multicentric skin lesions confer a worse prognosis on this subgroup of patients rather than the absence of CD30 antigen. p53 immunoreactivity also has been reported to be associated with high grade non-Hodgkin's lymphoma, although it is relatively uncommon. Herein, we report a case of a patient with EBV-related, CD30-negative primary cutaneous large cell lymphoma of the T-cell phenotype showing p53 and mdm-2 expression. She was initially diagnosed as having a benign-looking deep folliculitis or furunculosis, but treated successfully with radiation therapy without recurrence up to now.
Antigens, CD30 ; Folliculitis ; Furunculosis ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin ; Lymphoma, T-Cell* ; Mycosis Fungoides ; Phenotype ; Prognosis ; Recurrence ; Skin ; T-Lymphocytes*

Intravenous immunoglobulin therapy has been used to treat various immune-mediated diseases. Its utility in dermatology continues to expand, including treatment for autoimmune blistering disease, graft-versus-host disease, and dermatomyositis. It is generally considered safe, and serious adverse effects such as anaphylaxis, renal tubular necrosis or aseptic meningitis rarely occur. Furthermore, adverse skin reactions very rarely occur, but can include urticaria, pruritus, eczema, alopecia, lichenoid dermatitis or pompholyx. We describe a case of a 48-year-old man who developed vesicular eczema on his palms and soles after administration of intravenous immunoglobulin therapy for encephalomyelopathy.
Alopecia ; Anaphylaxis ; Blister ; Dermatitis ; Dermatology ; Dermatomyositis ; Eczema ; Eczema, Dyshidrotic* ; Graft vs Host Disease ; Humans ; Immunization, Passive* ; Immunoglobulins* ; Meningitis, Aseptic ; Middle Aged ; Necrosis ; Pruritus ; Skin ; Urticaria

In recent years, cellular phones have become one of lifes necessities. In proportion to the number of cellular phones in use, the number of reported cellular phone dermatitis cases has increased. Chromate and nickel sulfate are thought to be the allergen of cellular phone dermatitis, but direct qualitative analysis of cellular phones has not yet been carried out. We report 2 cases of cellular phone dermatitis which were suspected to be caused by a contact allergy to nickel. Patch tests were performed and showed a positive reaction to cobalt chloride and nickel sulfate. Direct qualitative analysis by a scanning electron microscope-energy dispersive X-ray analyzer of the cellular phones of the patients showed peaks for nickel and chrome.
Cellular Phone* ; Cobalt ; Dermatitis* ; Dermatitis, Allergic Contact ; Humans ; Hypersensitivity ; Nickel ; Patch Tests

BACKGROUND: Major hepatic surgery often requires temporary occlusion of the portal triad in order to minimize intraoperative bleeding. The Occlusion of portal triad may induce hepatic ischemia-reperfusion injury. Hepatic hypothermia is intended to suppress hepatic metabolism by lowering the liver temperature, to reduce oxygen consumption, and to minimize ischemic damage to the liver. This study was undertaken to evaluate the effects of topical cooling following ischemia on the liver. METHODS: Twenty-four New Zealand white rabbits were divided into three groups; group A (n=8) received no clamping, group B (n=8) received only clamping, and group C(n=8) received topical cooling using ice slush during clamping. In group B and C, duration of ischemia was 30 miniutes and duration of reperfusion was 60 minutes. Serum alanine aminotransferase(ALT) and purine nucleoside phophorylase(PNP) were measured immediately before clamping, after 30-minute clamping, and after 60-minute reperfusion. Hepatic tissue adenosine triphosphate(ATP), xanthine oxidase, and malondialdehyde( MDA) plus 4-hydroxyalcenals(4HA) were measured after reperfusion. RESULTS: Group C was topically cooled and reached the lowest level of 23.3 degrees C after 20 minutes of cooling. The results showed that ALT levels were significantly lower in group C than in group B(p<0.01), but PNP levels showed no significant differences between them. ATP levels showed no significant differences among the three groups. Xanthine oxidase and MDA plus 4HA levels were significantly lower in group C than in group B(P<0.01). CONCLUSION: These results suggest that topical cooling has a protective effect on parenchymal cells by reduction of oxygen free radicals produced by xanthine oxidase.
Adenosine ; Adenosine Triphosphate ; Alanine ; Constriction ; Free Radicals ; Hemorrhage ; Hypothermia ; Ice ; Ischemia ; Liver* ; Metabolism ; Oxygen ; Oxygen Consumption ; Rabbits ; Reperfusion ; Reperfusion Injury* ; Xanthine Oxidase

PURPOSE: A recent study demonstrated that exertional desaturation is a predictor of rapid decline in lung function in patients with chronic obstructive pulmonary disease (COPD); however, the study was limited by its method used to detect exertional desaturation. The main purpose of this study was to explore whether exertional desaturation assessed using nadir oxygen saturation (SpO2) during the 6-minute walk test (6MWT) can predict rapid lung function decline in patients with COPD. MATERIALS AND METHODS: A retrospective analysis was performed on 57 patients with moderate to very severe COPD who underwent the 6MWT. Exertional desaturation was defined as a nadir SpO2 of <90% during the 6MWT. Rapid decline was defined as an annual rate of decline in forced expiratory volume in 1 second (FEV1) > or =50 mL. Patients were divided into rapid decliner (n=26) and non-rapid decliner (n=31) groups. RESULTS: A statistically significant difference in exertional desaturation was observed between rapid decliners and non-rapid decliners (17 vs. 8, p=0.003). No differences were found between the groups for age, smoking status, BODE index, and FEV1. Multivariate analysis showed that exertional desaturation was a significant independent predictor of rapid decline in patients with COPD (relative risk, 6.8; 95% CI, 1.8 to 25.4; p=0.004). CONCLUSION: This study supports that exertional desaturation is a predictor of rapid lung function decline in male patients with COPD.
Aged ; Anoxia/diagnosis/etiology ; Exercise/*physiology ; Female ; Forced Expiratory Volume/physiology ; Humans ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive/*physiopathology ; Respiratory Function Tests ; Retrospective Studies

BACKGROUND: To characterize the clinical features and determine the prognostic factors of severe community-acquired pneumonia. This study is the first of its kind in Korea. METHODS: Recruited were 40 patients diagnosed as severe community-acquired pneumonia in Hallym University Hospital from January 1, 1989 through July 31, 1996. Patients were analysed retrospectively for age, sex, underlying disease, respiration rate, hypoxemia, requirement of mechanical ventilation, involvement on chest radiograph, shock, and the serum concentration of BUN and albumin. All parameters were compared between survived and dead group. RESULTS: Male to female ratio was 2.07 : 1. The mean age was 63.1+/-l7.5years(range 25-90years) with 65% of patients aged equal to or more than 60. The major underlying diseases were old pulmonary tuberculosis(12.5%), chronic obstructive pulmonary disease(7.5%), bronchial asthma(5%), bronchiectasis(2.5%), and diabetes mellitus(22.5%). Microbiologic diagnosis was made in 26 out of 40 patients(65%). The most common causative organism was S. Pneumoniae(17.5%, 7/40) followed by S. aureus(15.0%, 6/40), K. Pncumoniac(12.5%, 5/40), M. tubercut osis(7.5%, 3/40), H. influenzae(2.5%, 1/40), coagulase negative staphylococcus(2.5%, 1/40), P aeruginosa(2.5%, 1/40), E. cloaceae(2.5%, 1/40), and E. coli(2.5%, 1/40). M. Pneumoniae was detected in no patient. The most frequent drugs administered in single or combination therapy were aminoglycosides(75%, 30/40), second- and third-generation cephalosporin(40%, 16/40 and 27.5%, 11/40), macro]ides(27.5%, 11/40), and amoxicillin/clavulanic acid(22.5%, 9/40). Of the 40 patients, 14 died of severe community-acquired pneumonia(37.S%). Among them, seven patients (50%) expired within 72h of hospital arrival. According to multivariate analysis, mortality was significantly associated with requirement of mechanical ventilation, bilateral pulmonary involvement, and serum albumin < or = 3.0g/dl. CONCLUSION: An understanding of the clinical charateristics and prognostic factors in severe community-acquired pneumonia identified in this study will optimize therapeutic approach in this disease and help decreasing its notorious mortality rate.
Anoxia ; Coagulase ; Diagnosis ; Female ; Humans ; Korea ; Male ; Mortality ; Multivariate Analysis ; Pneumonia* ; Prognosis ; Radiography, Thoracic ; Respiration, Artificial ; Respiratory Rate ; Retrospective Studies ; Serum Albumin ; Shock