Total knee arthroplaty has been used to treat the elderly patient who has severe arthritis but the early designs were associated with many problems, which frequently led to early failure. In 1974, the total knee arthroplasty was introduced and the reported results of this operation have improved consistantly with time. Recently the good results has been shown to treat rheumatoid patients and osteoarthritis patients less than 45 years old patients. At the department of orthopaedic surgery of Kosin Medical College, between 1984 and 1988, total knee arthroplasty was performed in 17 patients (22 kness) who had rhematioid arthritis (7 patients) and osteoarthritis (11 patients), and had followed for an average of 1 year and 8 months. The results were as follows 1. The knee that had rheumatoid arthritis had better knee scores than that of osteoarthritis. 2. The knee that remained the post cruciate lig. had better range of motion than that sacrificed. 3. The knees that had not used cement had better knee scores than that had used the cement. 4. The knees that had patella resulrfacing had better scores for pain than that had not.
Aged ; Arthritis ; Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Humans ; Knee ; Osteoarthritis ; Patella ; Range of Motion, Articular

Recently elevated plasma homocysteine concentration is considered an independent risk factor for atherosclerosis and thrombosis with coronary artery disease. Folate and vitamin B12 are cofactors and closely related with metabolism of homocysteine. The purpose of this study is to evaluate the correlation between homocysteine and folate and vitamin B12 in patients with ischemic heart disease. Twenty-six patients, in whom coronary angiographic finding revealed more than 50% of stenosis at least in one coronary vessel were enrolled as the patient group, and thirty subjects, in whom angiographic finding revealed in not significant stenosis, but complained of chest pain, were selected as the control group. Fasting venous blood was obtained and measured the concentration of plasma total homocysteine, folate and vitamin B12 by high performance liquid chromatography and fluorescence detection method. We examined the correlation between homocysteine and folate and/or vitamin B12 in the control group and the patient group, respectively. Compared with the control group, the patient group had relatively higher plasma total homocysteine concentration (10.7 +/- 4.2 vs 9.6 +/- 3.5 umol/L), but showed no significant difference. Folate and vitamin B12 concentration are low in the patient group, but showed no significant difference between patient and control group. Plasma total homocysteine concentration showed negative correlation with folate and vitamin B12 in both the control group and the patient group, and showed significantly negative correlation in patient group {r = -0.550 (p<0.01) vs r = -0.609 (p<0.01)}. We knew that the plasma total homocysteine concentration were relatively elevated in patient group compared with the control group. Because plasma total homocysteine concentrations are closely negative correlated with folate and vitamin B12 in the patient group, folate and vitamin B12 supplement can lower the mortality and morbidity of ischemic heart disease.
Atherosclerosis ; Chest Pain ; Chromatography, Liquid ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Stenosis* ; Coronary Vessels ; Fasting ; Fluorescence ; Folic Acid* ; Homocysteine* ; Humans ; Metabolism ; Mortality ; Myocardial Ischemia ; Plasma* ; Risk Factors ; Thrombosis ; Vitamin B 12* ; Vitamins*

BACKGROUND: Depression and anxiety are common psychiatric symptoms in patients with epilepsy, exerting a profound negative effect on health-related quality of life. Several issues, however, pertaining to their association with psychosocial, seizure-related and medication factors, remain controversial. In the present study we have investigated the association of depression and anxiety with various demographic and seizure-related variables in patients with newly-diagnosed and chronic epilepsy. METHODS: We investigated 80 patients with epilepsy (46.3% males, mean age 36.1+/-11.4 years, range 18~64; mean disease duration, 13.4+/-12.2 years). Depression and anxiety were assessed in the interictal state with the Beck Depression Inventory, 21-item version (BDI-21) and the state and trait subscales of the State-Trait Anxiety Inventory (STAI-S and STAI-T), respectively. The association of depression and anxiety with various variables was investigated using univariate analyses and multiple linear regression analyses. RESULTS: Duration of epilepsy, the number of side effects and the number of GABAergic anti-epileptic drugs were correlated with depression, together accounting for 25.1% of the variation of the BDI-21. The STAI-S index was significantly associated with occupation status and the number of GABAergic anti-epileptic drugs accounting for 27.4% of the variation of the STAI-S. Finally, the number of side effects was correlated with trait anxiety. CONCLUSIONS: Our study shows that the duration of epilepsy, occupation status, GABAergic anti-epileptic drugs and the number of side effects are risk factors for the development of depression and/or anxiety.
Accounting ; Anxiety ; Depression ; Epilepsy ; Humans ; Linear Models ; Male ; Occupations ; Quality of Life ; Risk Factors

OBJECTIVES: This study determined the work schedules of public project workers who work an irregular shift and assessed the effect of these schedules on depression. METHODS: Study subjects were 2934 laborers who are members of seven labor unions. Each was given a questionnaire requesting basic personal information, habits, socioeconomic status, and work schedules. Information gathered on work schedules included daytime, nighttime, and weekend work hours. Depression was evaluated using the Beck Depression Inventory (BDI), with Laborers who checked "not depressed" and "slightly depressive" categorized to a low-risk group, whereas laborers who checked "depressed" and "severely depressed" were categorized to a high-risk group. We used the Chi-square test and multivariate logistic regression to examine associations between work schedules and depression. RESULTS: Laborers on an irregular work schedule averaged 47.8 hours/week and laborers who working over 48 hours/week comprised over half (54.5%) of the total population. Laborers performing night work, Sunday work, and Saturday work more than once in a month made up 25.7%, 30.8% and 33.5% of the examined population, respectively. A high-risk for depression was identified in 10.4% of laborers. Using logistic regression, depression was statistically associated with working : over 10 hours a day (OR=1.63, 95% CI 1.10~2.43), night work (OR=2.20, 95% CI 1.46~3.32), Sunday work (OR=1.81, 95% CI 1.15~2.85) and Saturday work (OR=1.82 95% CI 1.18~2.82). CONCLUSION: A significant number of laborers with irregular working shifts work long hours and on weekends. Depression was significantly associated with this type of work schedule.
Appointments and Schedules ; Depression ; Humans ; Labor Unions ; Logistic Models ; Public Sector ; Questionnaires ; Social Class

For the patients who visit outpatient clinics due to asymptomatic microscopic hematuria, cystoscopy has been looked upon as rather invasive compared to other diagnostic methods. We tried to elucidate the actual diagnostic value of cystoscopy in the initial evaluation of asymptomatic microscopic hematuria. We reviewed the results of cystoscopic examinations in 213 patients who visited our hospital due to asymptomatic microscopic hematuria. No definite lesion that could explain the microscopic hematuria was detected by means of IVP, urine cytology, and other nephrologic evaluations for all the patients. Among the abnormal cystoscopic findings in 55 patients, the lesions suspected to be directly related to microscopic hematuria were classified as 'significant lesions' (31 patients, 17.6%) which include entities such as bladder cancer (1.31%). 27 of 31 patients with significant lesions (85.2%) were over 50 yr old, and furthermore, 3 patients who were diagnosed as bladder tumor by cystoscopy were over 60 yr. Cystoscopy should be utilized as initial diagnostic modality in lder patients with asymptomatic microscopic hematuria to rule out any possibility of bladder cancer occurrence. Further studies are needed to justify implementation of cystoscopy as an initial diagnostic modality in younger patients with asymptomatic microscopic hematuria.
Cystoscopy/*methods ; Female ; Hematuria/*diagnosis/physiopathology ; Human ; Male ; Middle Age ; Retrospective Studies

The elevation of plasma total homocysteine(tHcy) is now established as a risk factro for cardiovascular disease. It is also well known that plasma levels of folate and vitamin B/sub 12/ influences homocysteine metabolism as cofactors. Recently, the effects of health-related lifestyle factors, such as smoking, alcohol drinking coffee consumption, regular exercise, and etc, on plasma tHcy have been determined. The Hordalane Homocysteine Study revealed that smoking and coffee consumption are major deter minants of plasma tHcy as well as folate levels; however, the influence of alcohol intake is still controversial. In Koreans, the effects of lifestyle factors of plasma tHcy have not yet been determined. Thus, we investigated the relationships of various lifestyle determinants with plasma tHcy, folate, and vitamin B/sub 12/ levels and the erythrocyte folate concentrations in Korean adults (99 males and 96 fermales). Plasma tHcy levels were significantly hight in male subjects. On the contrary, plasma levels of folate and vitamin B/sub 12/ and erythrocyte folate concentration of the females were significantly higher than those of the males. Among the five lifestyle factors determined in the study, regular exercise significantly affects plasma tHcy levels only in the females, Contrary to the expectation, there were on significant differences in plasma tHcy levels between alcohol drinkers and non-alcohol drinkers as well as smokers and non-smokers. And also, plasma tHcy leverls were not different between coffee consumers and non-coffee consumer and between green tea consumers and non-green tea consumers. Although alcohol intake did not influence plasma tHcy levels, the duration, frequency, and amount of alcohol drinking showed significant negative relationships with plasma folate levers. These results indicate the regular exercise and alcohol intake might influence plasma levels of tHcy and folate in Koreans, although the results were not reveled in both sexes.
Adult* ; Alcohol Drinking ; Cardiovascular Diseases ; Coffee ; Erythrocytes ; Female ; Folic Acid* ; Homocysteine* ; Humans ; Life Style* ; Male ; Metabolism ; Plasma ; Smoke ; Smoking ; Tea ; Vitamin B 12 ; Vitamins*

Bone defect of the long bone continues to challenge orthopedic surgeons. It is usually very difficult to obtain union. Ilizarov ext. fixation has recently gained popularity as a multifactorial approach to the management of tibial bone defect because nonunion, bone defects, limb shortening, and deformity can all be addressed simultaneously with the Ilizarov apparatus. From February 1992 to May 1993 at the department of orthopedic surgery, Inje University Pusan Paik Hospital, 9 patients aged from 8 to 37 years were treated for tibial bone defect. The causes were open comminuted fractures with initial bone loss and bone defect after removal of infected necrotic bone. Bony defect size was ranged from 2cm to 14cm, averaging 7.2cm. Bony defects were gradually closed by the Ilizarov's internal bone transport technique, and final equalization of leg length discrepancy was achieved by means of external lengthening technique. Soft tissue defects were treated with secondary closure, split thickness skin graft, and muscle flap. The average healing index was 42.8 days/cm. According to Paley's classification the complications were developed as follows; The problem included pin tract infection(9), knee flexion contracture(4), and intractable pain(1), the obstacles included delayed union(3) and premature consolidation(1), the complication included nonunion(9) and equinus ankle(1). At an average 1 years follow up, according to Paley and Catagnl's classification, body and functional results were either excellent or good in 7 cases. So, we recommend that Ilizarov technique is very useful treatment for open fracture with bone loss, bone defect after removal of infected necrotic bone and limb shortening.
Busan ; Classification ; Congenital Abnormalities ; Extremities ; Follow-Up Studies ; Fractures, Comminuted ; Fractures, Open ; Humans ; Ilizarov Technique ; Knee ; Leg ; Orthopedics ; Skin ; Surgeons ; Tibia ; Transplants

Purpose: This study aimed to examine the effect of person-environment fit on positive psychological capital, career commitment, and turnover intention among nurses working in university hospitals. Methods: A survey was administered to 277 nurses working in a university hospital with more than 800 beds in J city. SPSS 25.0 and AMOS 18.0 were used for analysis. Results: Factors that directly explain turnover intention, person-environment fit, career commitment, and psychological capital exhibited a negative effect. However, while person-job fit did not directly affect turnover intention, it exhibited an indirect effect and total effect via positive psychological capital and career commitment. Conclusion Various programs should be developed to enhance nurses’ person-environment fit and person-job fit. Forming a positive attitude and strengthening nurses’ attachment and commitment toward nursing contribute to a lower turnover intention.

We examined the associations between thigh muscle area (TMA) and insulin resistance (IR) according to body mass index (BMI) in middle-aged Korean general population.

BACKGROUND/AIMS: Serum HBV DNA levels are correlated with hepatic histologic activity in chronic HBV infection based on HBeAg. Liver injury may persist, even though HBV DNA are not detected by hybridization assay. This study was to investigate whether serum HBV DNA levels determined by more sensitive quantitative method are correlated with histologic activities in chronic HBV infections. METHODS: This study included 66 chronic HBV infected patients. HBV DNA level was quantified by Cobas Amplicor HBV Monitor(TM). RESULTS: Serum HBV DNA levels in HBeAg-positive patients were significantly higher than HBeAg-negative patients. In HBeAg-positive patients, serum HBV DNA levels showed a significant negative correlation with portal-periportal activity and fibrosis (r=-0.451, -0.446 respectively). AST levels were correlated with lobular, portal-periportal activity and fibrosis (r=0.432, 0.365, 0.301 respectively), whereas ALT levels were related to lobular activity (r=0.294). Elevated AST levels predicted lobular activity, portal-periportal activity, and fibrosis with moderate to severe degree (OR 1.733, 95% CI 1.083-2.775; OR 1.518, 95% 1.028-2.243, p=0.336; OR 17.897, 95% CI 1.517-211.208, p=0.022, respectively). CONCLUSIONS: In HBeAg-positive patients, serum HBV DNA level correlates inversely with histologic activity. On the other hands AST level correlates with histologic activity and the stage of moderate or severe degree.
Adolescent ; Adult ; Child ; Child, Preschool ; DNA, Viral/*blood ; Female ; Hepatitis B e Antigens/analysis ; Hepatitis B virus/genetics/*isolation & purification ; Hepatitis B, Chronic/pathology/*virology ; Humans ; Liver/*pathology ; Male ; Middle Aged