, Ho Jung Kang, Jeong Hee Hahm The use of rubber gloves has increased in recent years. At the same time, there has been a progressive increase of incidence of occupational and nonoccupational sensitization to rubber components. Chromate sensitivity has been reported as a very common combination in the rubber allergic building workers.
We report a case of contact dermatitis to rubber glove and cement in a 69-year-old man who presented erythematous patches with severe itching on both hands, especially on the lateral sides of fingers. On patch tst, he showed positive reactions to thiuram mix, mercaptobenzothazole, potassium dichromate and rubber glove as is.
The patient was treated with topical and sysmetic corticosteroid and antihistamine with a good clinical responses.
Many patients disabled the knees by severe rheumatiod and degenerative arthritis have been treated with total knee replacement arthroplasty since 1970. Total knee arthroplasty(TKA) afforded much improvement in pain relief and function. We analyzed the result in 32 knees who were performed TKA at Department of Orthopaedic Surgery. Ewha Womans University Hospital from May 1987 to July 1992.
The results were as follows.
1) There were 25 females and 3 males, their mean age was 53 years old.
2) Preoperative etiology was degenerative arthritis in 20 cases, rheumatoid arthritis in 8 cases and osteonecrosis in 4 cases.
3) Knee joint function by Hospital for Special Surgery(HSS) knee rating score was increased from 55.3 points preoperatively to 87.0 points postoperatively.
4) The tibiofemoral angle was changed from 7.4 degree varus to 5.5 degree valgus.
5) The prosthesis type used were Press Fit Condylar(PFC) in 18 knees. Anatomic Modular Knee(AMK) in 6 knees, Miller-Galante(MG) in 4 knees and Porous Coated Anatomic(PCA) in 4 knees.
6) Complication was only one case of knee due to concomitant postoperative deep infection and skin necrosis.
, Chung Nam Kang, Jin Man Wang, Kwan Jae Roh, Woo Sup Youn Diseases or traumas involving the spine occasionally cause severe vertebral body collapse to result in either spinal instability or neural deficit, or both. In methods of treatment, conventional decompressive laminectomy results in neural improvement, but it can cause local instability of spine and lead progressive neural deficit. Vertebral stabilization by using bone cement(methylmethacrylate) provides immediate stabilization and avoids bulky external-fixation devices and external supports. We report two cases of thoracic spinal stabilization by using bone cement.
, Jin Man Wang, Chung Nam Kang, Ki Hong Choi Management of bed-ridden patients with polyarticular rheumatoid arthritis poses a considerable challenge to the orthopaedic surgeon. Current techniques of total joint replacement provide for the potential restoration of joint function in patients previously considered inoperable due to far-advanced joint destruction. Because many patients with far advanced polyarticular rheumatoid arthritis will predictably require more than one total joint replacement before an improved functional status will occur, the question of multiple joint replacement arises. We have had a bilateral total kneereplacement in the chronic polyarticular rheumatoid patient. Three years after the operation, the patient has slight pain and motion of full extension to 90'flexion. Bilateral total knee replacement improved mobility and reduced pain in this patient.
, Jeong Soo Suh, Chung Sik Rhee To investigate whether measurements of hepatic metastases before contrast administration are different from measuments after contrast administration. And to gain more effective follow up method by analyzing the difference of contrast between pre- and postcontrast scans.
Thirty patients with herpatic metastases were underwent conventional CT. Continuous 10mm thick slices were obtained from liver dome to pelvic inlet, then the patients received IV injection of contrast material, and same method as precontrast CT scan was performed. Additional 5mm thin slice scan was obtained in case of need. Three radiologists performed independent bidimensional measurements of the randomly selected lesion on both pre- and postcontrast images at the same level and analyzed the difference of the size and contrast.
The size of hepatic metastases were measured as smaller on postcontrast images ; average 41.4±43.5cm2 on precontrast scan & 35.2±37.5cm2 on postcontrast scan. There was significant difference by paired t-test(p<0.02). 24 of 30 cases(80%) showed better conspicuity on postcontrast images, 5(16.7%), on precontrast images and 1(3.3%) showed similiar conspicuity on both pre- and postcontrast images. The contrast of hepatic metastases was significantly higher on postcontrast scan by chi-square test(p<0.01).
Hepatic metastases are significantly smaller on postcontrast images. The contrast between metastatic lesion & liver parenchyme was better on postcontrast scan. Therefore, serial assessment of hepatic metastases size by CT should not be compared mixed pre- and postcontrast image. And postcontrast scan is more effective method than precontrast for follow up of hepatic metastasis.
, Choon Won Park This study was performed to find out obstetricians-gynecologists' view on taking hormone replacement therapy HRT to perimenopausal women in Korea.
Questionnaires were mailed to 300 Korean obstetricians-gynecologists in order to obtain their views on the use of hormone replacement therapy. A total of 136 gynecologists responded.
Most of obstetricians-gynecologists(88.2%) were prescrinbing HRT to the perimenopausal or postmenopausal women. The most common indication of HRT was the treatment of vasomotor symptoms(56.6%) in symptomatic postmenopausal women and the prevention of osteoporosis(46.6%) in asymptomatic postmenopausal women. The most common routes of HRT were the oral(66.3%) administration. About two third of respondents prescribed HRT by cyclic estrogen-progestogen combined therapy(47.4%), and 46.8% of respondents thought that HRT must be started within 5 years after menopause. The duration of HRT was variable and 23.5-36.9% of respondents thought that HRT should be continued through the life.
This survey suggests that the most of Korean obstetricians-gynecologists favors the use of HRT in postmenopausal women but the results may become generalisable to the wider population as information on the potential benefits of hormone replacement therapy is disseminated.
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