There are many reports about the snapping syndrome in the hip, shoulder, ankle, but the snapping knee has rarely been reported. In general, the symptom of this disease was relatively tolerable for that seldom requires operative treatment. We experienced one case of snapping knee, for which the pain, easy fatigability and feeling of instability on both knee joint were main complaints. During an exploratory operation, we confirmed the gracilis and semitendinosus tendon passing over the medial tibial condyle. The clinical, radiologic and operative findings were reviewed.
Ankle ; Hip ; Knee Joint ; Knee ; Shoulder ; Tendons

Hand and wrist tuberculosis in adults are relatively rare disease. The purpose of treatment is to minimize the limitation of motion and to relieve the pain and swelling of involved joints. The treatments consist of curettage of bone, synovectomy and arthrodesis, which were combined with chemotherapeutic agents for tuberculosis. In the period from June 1989 to Oct. 1993, we performed operative treatment in twelve cases of hand and wrist tuberculosis(hand in 3, wrist in 9). We performed curettage and synovectomy in eight cases and arthrodesis in four. The length of follow up was over one year in all cases. Patients were evaluated by clinical examination, radiography and the Robins criteria for clinical results. The results were analysed, as follows, l. Eight patients who had tenosynovitis with moderate joint destruction were treated by curettage and synovectomy, and seven patients(87.5%) of them were evaluated "good" by Robins criteria. 2. Arthrodesis was performed in four patients who had severe joint destruction, and demonstrates "good" results in 75% of cases. 3. One patient who was treated by synovectomy, complaint intermittent pain after three years postoperatively, but no active lesion was visible on the bone scanning. 4. One patient who was performed wrist arthrodesis feels discomfort during lift up heavy products due to insufficient grip power. In conclusion, the synovectomy and curettage in early diagnosed and not so much advanced hand wrist tuberculsis is more preferable, but arthrodesis is inevitable in advanced cases with profound degree of bony destruction and nonviable cartilage in operative findings, for painless and powerful joint.
Adult ; Arthrodesis ; Cartilage ; Curettage ; Follow-Up Studies ; Hand Strength ; Hand ; Humans ; Joints ; Radiography ; Rare Diseases ; Songbirds ; Tenosynovitis ; Tuberculosis ; Wrist

We evaluated the results of twelve total elbow arthroplasties that had been performed from Feb. 1986 to Mar. 1993 in ten patients. The duration of follow-up averaged three years two months(range, one year to seven years one month). There were six females and four males. Two females had bilateral procedures. The average age at the time of the operation was 35.3 years(range, 22 to 53). Five patients had severe rheumatoid arthritis, four patients had fracture sequelae around elbows and one patient had sequele of tuberculous arthritis. Total elbow arthroplasty had been performed for improving the range of motion and relief of pain. Total elbow arthroplasties had been performed in six cases of total ankylotic elbows and in six cases who complained severe painful limitation of motion of the elbow joints. Preoperatively, ankylotic group were fixed by 30 degrees of flexion on an average. In painful elbow group, the average total range of motion was 68 degrees. The prosthesis which were used in total elbow arthroplasties were semiconstrained type in nine cases and noncostrained in three cases. Most of the patients had relief of pain. Postoperative complications were permanent ulnar nerve palsy in one case, superficial infection in one case and dislocation in one case. Total gain of range of motion(ROM) was 17 degrees in painful elbow group and 102 degrees in ankylotic elbows. Total elbow arthroplasty was effective method for improvement of range of motion in ankylotic elbows and relief of pain in elbows which had painful limitation of motion.
Ankylosis ; Arthritis ; Arthritis, Rheumatoid ; Arthroplasty ; Dislocations ; Elbow Joint ; Elbow ; Female ; Follow-Up Studies ; Humans ; Male ; Methods ; Postoperative Complications ; Prostheses and Implants ; Range of Motion, Articular ; Ulnar Neuropathies

Phenomenology has been developed by philosophers like Kant and Husserl since the late 18th century. Jaspers, a German psychiatrist, adopted it into psychopathology studies and accumulated data by closely observing and recording the patients' symptoms and signs. Among descriptions done even before the psychopathology or diagnostic criteria of disorders in the field of child psychiatry was established, we can find exact and valuable descriptions matching the autism spectrum disorder or attention deficit/ hyperactivity disorder. The diagnostic criteria of modern childhood psychiatric disorders were established based on these grounds. Phenomenological/descriptive methods in various psychiatric fields lead to medical study methods for social phenomenon such as oiettolie, hikikomori, and internet game addiction. Since Romanian orphans were adopted to the western world, descriptive studies along with neurobiological studies on the influence of stimulus deprivation on emotional and physical development are being conducted. While phenomenology, which was adopted by Jaspers to verify psychopathology, was developed mainly by observation and description, recent studies are explaining such descriptive phenomena even at the synapse level due to advances in neurobiology. Although phenomenological/descriptive psychiatry, describing precise and detailed experiences of patients, is less applied nowadays among modern study methods, we must remember that such descriptions may lead to biological studies and provide evidence to improve the accuracy of choosing and applying treatment methods.
Autistic Disorder ; Child ; Autism Spectrum Disorder ; Child Psychiatry* ; Child, Orphaned ; Humans ; Internet ; Neurobiology ; Psychiatry ; Psychopathology ; Romania ; Synapses ; Western World

In studying child and adolescent psychiatry (CAP), animal models are extremely useful to explore the pathogenesis of disorders or to experiment drugs as substitutes for the human body. Particularly in young children, the accuracy of their expression can be low and there are many restrictions in experiments directly upon the patients including difficulties in medication and tests. However, it is not easy to develop animal models because standards for diagnosis are phenomenological and based on behavioral descriptions. The biggest problem in research using animal models in CAP is that it is difficult to make representative models specific to each disorder. The present study reviewed articles about research with animal models in connection to disorders common in CAP such as autism , Tourette syndrome (TS), attention deficit/hyperactivity disorder (ADHD) and mental retardation (MR). Recent researches through animal models are mainly focused on anatomical studies on sites related to disorders and genetic studies. Although there have been many researches for autism, they still seem to be away from establishing representative models. For TS, it is not easy to make specific animal models because of the complexity of the syndrome, but animal models have been greatly helpful to find pathogenesis and develop remedies for TS. In ADHD, Spontaneously Hypertensive Rats (SHR) model is recognized as a fine model. With regard to MR, a majority of studies are gene researches related to known abnormal chromosomes. Throughout this review, authors recognized that only few articles have been published using animal models for CAP in Korea. We hope that research using animal models will be more activated in Korea.
Adolescent ; Adolescent Psychiatry* ; Adolescent* ; Animals* ; Autistic Disorder ; Child* ; Diagnosis ; Hope ; Human Body ; Humans ; Intellectual Disability ; Korea ; Models, Animal* ; Rats, Inbred SHR ; Tourette Syndrome

Along with language, socialization is a unique feature of the human being. There is a continuous debate regarding whether the development of socialization is innate, and conducted by the environment in the growing process, or the result of the interaction of both aspects. If socialization is the result of the interaction with the environment or is an acquired developmental process, the following question rises. "Is there a 'critical period' for the development of socialization?" Although there are a huge number of studies seeking for treatment and solutions for developmental delay or deficits of socialization, it is very complicated question to answer. Historical figures such as 'Hugh Blair' of Borgue in England, and 'the wild boy of Aveyron' in France, seem to have innate socialization deficits. Nowadays patients with non-verbal learning disorder, social communication disorder, or autism spectrum disorder seem to have genetic defects. On the other hand, Harry Harlow's monkey experiments, hikikomori of Japan, Romanian orphans and patients with reactive attachment disorder seem to display social deficits due to environmental factors. However, it is not easy to clearly draw a line between innate or acquired factors. Therefore, rather than subdividing the diseases for etiological and pathophysiological approach to heterogenous groups with the common denominator of social deficit, and for the research of pathophysiology and treatment development, the authors suggest a comprehensive concept of "social dysfunction spectrum."
Autistic Disorder ; Child ; Autism Spectrum Disorder ; Child, Orphaned ; Communication Disorders ; England ; France ; Hand ; Haplorhini ; Humans ; Japan ; Learning Disorders ; Male ; Reactive Attachment Disorder ; Socialization

Objective: The shortage of clinical data regarding adult patients with often results in adults with ADHD being stigmatized and being inadequately treated. In this paper, famous people who potentially have ADHD were analyzed to understand better, the life-long progression of ADHD. Methods: 131 people were analyzed as potential candidates for ADHD. A grading system for the candidates was developed: class 1, compatible with ADHD; class 2, likely; class 3, less likely; class 4, uncertain with a shortage of data; and class 5, not compatible. Initially, 39 subjects in class 4 and 12 in class 5 were excluded from the analysis. Finally, 80 subjects (30 in class 1, 33 in class 2, and 17 in class 3) were analyzed for sociodemographic data and psychiatric comorbidities. Results: 88.8% were men and 47.5% of the subjects were married once. In terms of occupation, 45.0% of the subjects were cultural professionals and 25.0% were chief executives. Narcissistic personality disorder was the most frequently noted comorbidity, followed by substance-related and addictive disorder. Conclusion Famous people with ADHD in this study revealed high skill levels in occupation, offering positive aspects of ADHD in adults.

OBJECTIVE: There is a rich literature confirming the default mode network found compatible with task-induced deactivation regions in normal subjects, but few investigations of alterations of the motor deactivation in patients with intracranial lesions. Therefore, we hypothesized that an intracranial lesion results in abnormal changes in a task-induced deactivation region compared with default mode network, and these changes are associated with specific attributes of allocated regions. METHODS: Blood oxygenation level dependent (BOLD) functional magnetic resonance imaging (fMRI) during a motor task were obtained from 27 intracranial lesion patients (mean age, 57.3 years; range 15-78 years) who had various kinds of brain tumors. The BOLD fMRI data for each patient were evaluated to obtain activation or deactivation regions. The distinctive deactivation regions from intracranial lesion patients were evaluated by comparing to the literature reports. RESULTS: There were additive deactivated regions according to intracranial lesions: fusiform gyrus in cavernous hemangioma; lateral occipital gyrus in meningioma; crus cerebri in hemangiopericytoma; globus pallidus, lateral occipital gyrus, caudate nucleus, fusiform gyrus, lingual gyrus, claustrum, substantia nigra, subthalamic nucleus in GBM; fusiform gyrus in metastatic brain tumors. CONCLUSION: There is increasing interest in human brain function using fMRI. The authors report the brain function migrations and changes that occur in patients with intracranial lesions.
Basal Ganglia ; Brain ; Brain Neoplasms ; Caudate Nucleus ; Globus Pallidus ; Hemangioma, Cavernous ; Hemangiopericytoma ; Humans ; Magnetic Resonance Imaging ; Meningioma ; Oxygen ; Substantia Nigra ; Subthalamic Nucleus

PURPOSE: Given the emerging evidence for differential responses to new targeted therapies and the identification of molecular differences between specific subtypes of non-small cell lung carcinoma (NSCLC), there is an increased need for greater accuracy in subtyping NSCLC. In a substantial proportion of cases, standard morphology cannot specifically subtype the tumor, resulting in a final diagnosis of NSCLC-not otherwise specified. In this study, we added newly proposed markers (napsin A, desmocollin-3) to conventional markers (p63, thyroid transcription factor-1 [TTF-1], cytokeratin 5/6 [CK5/6], high molecular weight cytokeratin [HMWCK], cytokeratin 7 [CK7]) and evaluated for the minimal panel of immunohistochemical markers required for subtyping poorly differentiated (PD) NSCLC. MATERIALS AND METHODS: Resection specimens of 110 adenocarcinomas (ADCs) and 171 squamous cell carcinomas (SCCs) were collected and tissue microarrays were constructed to simulate small biopsy conditions. All specimens were stained with TTF-1, napsin A, CK7, p63, CK5/6, HMWCK, desmocollin-3 and mucicarmine. RESULTS: For 32 PD ADC, a combination of TTF-1 and napsin A increased sensitivity (81%). With regard to the 29 PD SCC, a combination of desmocollin-3 and p63 did not substantially increase diagnostic performance. Logistic regression analysis identified napsin A, p63 and TTF-1 as the optimal panel to separate PD ADC and PD SCC. Mucin stains for PD NSCLC increased accuracy rate (88%) for diagnosis of PD ADC. CONCLUSION: We recommend a minimal panel of immunohistochemical and histochemical markers to include TTF-1, p63, napsin A and one of mucin stains for tumor subtyping of PD NSCLC in a small biopsy sample.
Adenocarcinoma ; Biopsy ; Carcinoma, Squamous Cell ; Coloring Agents ; Immunohistochemistry ; Keratin-7 ; Keratins ; Logistic Models ; Lung ; Lung Neoplasms ; Molecular Weight ; Mucins ; Thyroid Gland