OBJECTIVES: The purpose of this study was to estimate the number of serious and persistent mentally ill patients in Korea. METHODS: Study populations were recruited from medical insurance data of two district areas one rural and the other urban areas. Subjects were all mentally ill who had ever visited any hospital in 1993 and were diagnosed as having psychosis, personality disorder and drug abuse. We conducted a home visiting survey applying semi-structured diagnostic interview, assessing the level of social adjustment with Strauss-Carpenter Scale, and past psychiatric history by the trained researchers, in October and November, 1994. RESULTS: According to diagnostic assessment, schizophrenic patients constituted the major portion(61.1%) of study subjects. The distribution of occupational functions and social contacts was variable according to diagnosis. Most schizophrenic patients were unemployed or worked less than 6 months in the previous year(67.2%), and showed poor social contact(72.3%). But affective disorder patients were relatively independent in job maintenance and social relationship. Alcoholic patients lay between those of schizophrenic and affective disorder groups. It was estimated that about 87,000 adult Koreans were suffering from chronic mental disorders which seriously interfere with their daily life. CONCLUSIONS: Serious and persistent mentally ill patients were common in Korea. Community support program should be provided for them.
Adult ; Alcoholics ; Community Psychiatry ; Surveys and Questionnaires* ; Diagnosis ; Epidemiology ; House Calls ; Humans ; Insurance ; Korea* ; Mental Disorders ; Mentally Ill Persons* ; Mood Disorders ; Personality Disorders ; Psychotic Disorders ; Schizophrenia ; Social Adjustment ; Substance-Related Disorders

BACKGROUND AND OBJECTIVES: Bone resorption of adjacent structures in aural cholesteatoma is mostly responsible for serious complication of the disease. Recent researches have been aimed at preventing bone resorption with tools of non-surgical therapy. The effect of pam-idronate disodium on systemic bone resorption is mainly attributed by its function against osteoclast recruitment and activation. In this study, we investigated the effect of systemic pam-idronate disodium on localized osteoclastic bone resorption in experimental cholesteatoma. MATERIAL AND METHODS: Experimental cholesteatomas were induced in 40 mongolian gerbils. pam-idronate disodium (Aredia(R), Ciba-Geigy Limited)were injected subcutaneously once a week in 20 gerbils (treated group)and none were injected in the other 20 gerbils (untreated group). pam-idronate disodium were injected with a dose of 2 mg/kg in 10 of the treated group (low dose group) and with a dose of 4 mg/kg in the remainder (high dose group). Gerbils were sacrificed at 12 weeks (3 month group) or 17 weeks (4 month group) after the injection. Harvested temporal bones were examined by light microscope and transmission electron microscope. RESULTS: The clinical stage of cholesteatoma tended to be more advanced in the untreated group than in the treated group although it was not statistically significant. Scores of osteoclast number per total bone length in millimeter were lower in the treated group than in the untreated, although the percentage of surface occupied by osteoclasts per total bone surface were not different between the groups. CONCLUSION: These results will provide fundamental data for further studies on the prevention and treatment of osteoclastic bone resorption in aural cholesteatoma.
Bone Resorption ; Cholesteatoma* ; Cholesteatoma, Middle Ear ; Gerbillinae ; Osteoclasts ; Temporal Bone

212 cases of hypertensive intracerebral hematoma were treated and followed for more than 3 months. The outcome was analysed in point of comparison between conservative treatment and operative treatment. The precipitating factors on prognosis depend on size and site of hematoma, level of mental deterioration, and blood pressure on admisson. Operative treatment showed better outcome than conservative treatment in cases of severly mentally deteriorated patients, large hematoma, and pontine hematoma.
Blood Pressure ; Hematoma* ; Humans ; Precipitating Factors ; Prognosis

A prospective analysis of 106 patients with head injury whose initial Glasgow Coma Scale was 3 to 10, who were managed in a uniform way was analyzed to relate out come to initial Glasgow Coma Scale, combined injuries and secondary systemic insults characterized by serum electrolytes imbalance, arterial gas study, blood pressure, and hemoglobin and hematocrit. The good recovery or moderate disability were achieved by 37% of the patients. The remaining 63% resulted in severe disability, vegetable and death. The poor out come group in comparing with the good outcome group showed lower initial Glasgow Coma Scale and more combined injuries. The five week follow up of secondary systemic insults mean flow showed higher serum Na flow and lower arterial PaO2 flow in poor outcome group.
Blood Pressure ; Craniocerebral Trauma ; Electrolytes ; Follow-Up Studies ; Glasgow Coma Scale* ; Glasgow Outcome Scale ; Head* ; Hematocrit ; Humans ; Prospective Studies ; Vegetables

PURPOSE: The purpose of this study is to evaluate the clinical and radiological result in patients who got salvage re-fixation for the failed fixation of pertrochanteric fracture retrospectively. MATERIALS AND METHODS: Between 1992 and 2009, 21 patients who could be followed-up for more than 1 year after salvage re-fixation for the failed fixation of pertrochanteric fracture were enrolled in this study. There were 16 men and 5 women. The mean age was 53 years (19-84 years) at the index surgery and the mean follow-up was 6.4 years. We evaluated the clinical and radiographic results and postoperative complications. RESULTS: Walking ability and pain were improved in all cases and the mean leg length discrepancy was improved from 2.5 cm (0-10 cm) preoperatively to 1 cm (0-4 cm) at the latest follow-up. Nineteen patients (90.5%) out of 21 patients achieved bony union at the final evaluation and the mean union time was 4 months (3-7 months). There were 2 cases of non-union who had not received bone graft as a complication. CONCLUSION: The clinical and radiological results of the salvage re-fixation for the failed fixation of pertrchanteric fracture were satisfactory in our study. Secure component fixation for the mechanical stability and proper bone graft for the improvement of bone biology are mandatory to improve the result.
Biology ; Female ; Femur ; Follow-Up Studies ; Humans ; Leg ; Male ; Transplants ; Walking

PURPOSE: We wanted to report on the outcomes of using a strut allograft and extensively porous-coated femoral stems in revision total hip arthroplasty that was performed due to extensive femoral bone loss. MATERIALS AND METHODS: Between 1998 and 2005, we performed 167 consecutive revision total hip arthroplasties. Among them, twelve cementless femoral revision surgeries with a strut allograft and extensively porous-coated stems were retrospectively reviewed. The average follow up was 4.6 years. The average age at the time of the index revision was 55.9 years. The reasons for the revisions were periprosthetic fracture due to extensive osteolysis in 5 hips and aseptic loosening in 7 hips. RESULTS: The Harris hip score improved from a mean of 40.8 points before revision surgery to a mean of 85.1 points at the latest follow up. Radiographic evidence of bony stable stems were present in 11 hips and a fibrous stable stem was present in 1 hip. Moderate stress-shielding was noticed in one hip. Nonunion of the allograft was observed in 1 hip due to deep infection. To date, no significant wear or osteolysis has been observed. CONCLUSION: Revision total hip arthroplasty with a strut allograft and an extensively porous-coated femoral stem for treating cases of extensive femoral bone loss seems to be a reasonable choice. However, the concerns related to stress shielding, the difficulties in re-revisions and the complications associated with an allograft will require longer term follow up.
Arthroplasty ; Follow-Up Studies ; Hip ; Osteolysis ; Periprosthetic Fractures ; Retrospective Studies ; Transplantation, Homologous

Background: Pilomatrixoma is a benign tumor that originates from the hair follicle matrix. It usually presents as a hard, slow growing, solitary mass that can be easily misdiagnosed as other skin masses. The aim of this study was to clinically analyze a case series of pilomatrixoma in pediatric patients from Korea. Methods: A total of 165 pediatric patients from 2011 to 2018 with a histological diagnosis of pilomatrixoma were included. A retrospective review was performed using the electronic medical records, including patient demographics, number and location of the mass, clinical and imaging presentation, and postoperative outcomes. Results: There were 61 male and 104 female patients with 152 solitary and 13 multiple pilomatrixomas. Among solitary pilomatrixomas, the lesion commonly occurred in the head and neck (84.2%), followed by upper limbs (11.2%), lower limbs (3.3%), and trunk (1.3%). The pilomatrixoma lesion presented as the following types based on our clinical classification: mass (56.02%), pigmentation (25.31%), mixed (12.65%), ulceration (4.82%), and keloid-like (1.2%). Ultrasonography showed a high positive predictive value (95.56%). There were no specific complications observed except for two cases of recurrence. Conclusion Pilomatrixoma has various clinical feature presentations and commonly occurs in the head and neck. Ultrasonography is a helpful diagnostic tool. Surgical removal of the lesion is the main treatment method with a low recurrence rate.

Adenomyosis is a nonneoplastic hyperplastic lesion, characterized by invagination of proliferating endometrial glands into myometrium. In dogs, uterine adenomyosis is relatively rare and it is important in Toxicologic Pathology to differentiate other non-neoplastic and neoplastic lesions in uterus. In the present study, we report two cases of adenomyosis in the female beagle dogs used for a chemical toxicity test. Clinically, one out of the two female beagle dogs, 15 months of age, had vaginal bleeding for 2 weeks and the other one, 11 months of age, showed swelling of vulva for a week. At necropsy, the weight of uterus was markedly increased to 27.9 g and 15.8 g, compared with the mean value (4.01+/-2.37, n=6) of that of other normal dogs, respectively. The parameters of hematology and serum chemistry were ranged normal in both of the dogs with enlarged uterus. For differentiation of connective tissue with muscle fibers, Van Gieson stain was also performed in the serial tissue sections. Histopathologically, the lesions of the enlarged uteruses were characterized by proliferating endometrial glands into myometrium, surrounded by connective tissue. The endometrial glands were proliferating downward to myometrium or embedded in multiple clustered glands in deeper myometrium without compressing the adjacent muscle fibers. The gland epithelial cells are uniformly cuboidal shape with a dense and bottom-located nucleus. These gross and histological findings were consistent with adenomyosis.
Adenomyosis ; Animals ; Connective Tissue ; Dogs ; Endometrial Hyperplasia ; Epithelial Cells ; Female ; Hematology ; Humans ; Mice ; Muscles ; Myometrium ; Toxicity Tests ; Uterine Hemorrhage ; Uterus ; Vulva

PURPOSE: To assess the usefulness of diffusion-weighted imaging(DWI) in evaluating serial parenchymal changesin renal infarction induced by renal artery ligation, by comparing this with the conventional spin echo techniqueand correlating the results with the histopathological findings. MATERIALS AND METHODS: In 22 rabbits, renalinfarction was induced by ligation of the renal artery. Spin-echo T1-weighted imaging(T1WI), turbo spin-echo(TSE)T2-weighted imaging(T2WI), and DWI were performed, using a 1.5-T superconductive unit, at 30 minutes, 1 hour, 2,3, 6, 12 and 24 hours, and 2, 3, 7 and 20 days after left renal artery ligation. Changes in signal intensity onT1WI, T2WI, and DWI were correlated with histopathologic findings. RESULTS: On MR images obtained 30 minutesafter ligation, the signal intensity of affected kidney was not significantly different from that of contralateralkidney, as seen on T1WI and T2WI, but was noticeably higher on DWI. On T2WI, the signal intensity ratio(SIR) wasslightly higher over time from 30 minutes to 2 days after ligation, and then decreased slightly. The SIR on DWIincreased abruptly at 30 minutes, remained high until 12 hours, and then fell, returning to close to the normalrange at between 2 and 3 days. It fell further, below the normal range, until 20 days after ligation. The mainhistopathologic findings after ligation were congestion and swelling of renal tubules (1-6 hours after ligation),degeneration and necrosis of renal tubules (12 hours - 2 days), coagulation necrosis of renal tubules(3 days),collection of cellular debris between renal tubules (7 days), and proliferation of fibroblast between renaltubules (20 days). CONCLUSION: Diffusion-weighted imaging is useful for the detection of hyperacute renalinfarction, and the apparent diffusion coefficient may provide additional information concerning its evolution.
Animals ; Diffusion ; Estrogens, Conjugated (USP) ; Fibroblasts ; Infarction* ; Kidney ; Ligation* ; Magnetic Resonance Imaging* ; Necrosis ; Rabbits* ; Reference Values ; Renal Artery*

Calcific amyloidoma of the soft tissue is quite rare and it is difficult to make a differential diagnosis from other lesions such as osteomyelitis or bone tumor. We encountered a case of a calcified amyloidoma found in the anterior tibial muscle that occurred more than 20 years after a proximal tibial fracture adjacent to the origin of the muscle. The features of the lesion resembled osteomyelitis. Satisfactory result was obtained by a thorough mass excision. We report this case with review of the relevant literature.
Diagnosis, Differential ; Muscle, Skeletal ; Muscles ; Osteomyelitis ; Tibial Fractures