No abstract available.

No abstract available.
Child* ; Humans ; Humerus*

Objectives: This study aims to examine the effect of adolescent suicide survivors’ experience on suicide death risk, and the effect of referral to mental health services (hereafter referral) in this regard. Methods: This study used the data of 878 suicide-deceased and suicide-attempted adolescents aged 8–19 years, managed by the Suicide and School Mental Health Institute from 2016 to 2018. Results: Regression analysis for main effects showed that although suicide experience had no direct effect on suicide death, non-referral status was associated with a greater risk of death by suicide. While the “non-suicide survivor with non-referral” and “suicide survivor with non-referral” groups showed 1.87 [adjusted odds ratio=1.87, 95% confidence interval (CI)=1.21–2.89] and 4.59 (adjusted odds ratio= 4.59, 95% CI=2.02–10.42) times higher odds of suicide death, respectively, the “suicide survivor with referral” group showed no difference compared to the “non-suicide survivor with referral” group. Conclusion From these findings, there is a need to strengthen referral to mental health services and apply complicated grief treatment to improve the mental health of adolescent suicide survivors.

PURPOSE: To analyze the effectiveness of inserting beads made of calcium sulfate cement that were also impregnated with Vancomycin after debridement of an acute-immediate stage infected hip arthroplasty. MATERIALS AND METHODS: Between 2002 and 2008, the cases of 13 patients with documented acute-immediate stage infections of hip arthroplasty were reviewed and followed for at least two years postoperatively (average 4.3 years). The preoperative and postoperative clinical and radiologic findings and blood laboratory work of the cases were checked. All cases were performed through retention of the implant and massive debridement and saline irrigation. Next, vancomycin-impregnated calcium sulfate cement beads were inserted. RESULTS: After the first operation, the average interval to wait before performing a second operation was 27.7 days (17~37 days). During the second operation, the erythrocyte sediment rate and C-reactive protein were 150.97 mm/hr (34.6~339.7 mm/hr) and 76.4 mg/L (41~132 mg/L), respectively. Infectious organisms were cultured and isolated. There were 5 cases of Methicillin-resistant Staphylococcus aureus (MRSA). In addition, the results of an antibiotics sensitivity test revealed 8 cases of Vancomycin and 5 cases of 3rd generation Cephalosporin. Radiologic results showed 10 cases with a stable fixation on the last follow-up (femoral stem), and 1 case of hip joint space narrowing, called acetabular erosion. CONCLUSION: Inserting beads made of calcium sulfate cement that were also impregnated with Vancomycin proved to be a useful treatment for an acute immediate infection of hip arthroplasty.
Anti-Bacterial Agents ; Arthroplasty ; C-Reactive Protein ; Calcium ; Calcium Sulfate ; Debridement ; Erythrocytes ; Follow-Up Studies ; Hip ; Hip Joint ; Humans ; Methicillin-Resistant Staphylococcus aureus ; Retention (Psychology) ; Vancomycin

PURPOSE: To analyze the clinical and radiological results of hip arthroplasty following the failed internal fixation of intertrochanteric fractures of the femur. MATERIALS AND METHODS: We analyzed the reasons for failure in 29 cases of hip arthroplasty from January 1997 through December 2008 in which the hip arthroplasty was necessary due to failed internal fixation of an intertrochanteric fracture of the femur. Furthermore, we tried to find pitfalls encountered when performing the operations. We assessed those patients and drew both clinical (Harris hip score, HHS) and radiological results. The follow-up period was 34.2 months(12-96 months), on average. RESULTS: The average operating time was 174 min.(115-205 min.) and the mean amount of perioperative bleeding was 1,335 ml(759-2,450 ml). The amount of packed RBC transfusion was 2.8 units(0-10 units) on average. We could see prolonged operation time and a large amount of blood loss as we performed both the removal of the previously fixed implant and reduction of the displaced bone fragment simultaneously. The mean Harris hip score of the patients was improved from the preoperative score of 43 to the postoperative score of 85.7. No cases showed any radiological signs of loosening of acetabular cups or femoral stems, although an articular dislocation and a postoperative joint infection occurred. CONCLUSION: Although hip arthroplasties performed because of a failure in internal fixation could provide relatively satisfactory outcomes, as they result in extended surgery time and greater blood loss, a requirement for higher-level surgical skills, and greater consideration required for the systemic conditions of patients before performing surgery.
Arthroplasty ; Dislocations ; Femur ; Follow-Up Studies ; Hemorrhage ; Hip ; Hip Fractures ; Humans ; Joints

PURPOSE: This study was aimed to evaluate the effect of the deproteinated bovine bone powder (DBBP) coated with calcium phosphate (Ca-P) on osseous regeneration in the calvarial bone defect of rat. MATERIALS AND METHODS: The DBBP (Control group, n=6) and the Ca-P coated DBBP (Experimental group, n=6) were grafted in the critical sized calvarial bone defect (8 mm) of rat weighing 250 g. The animals were sacrificed at 1, 4 week. The biopsy specimens were decalcified with 5% formaldehyde and embedded in paraffin. The rats were sacrificed at 8 week received tetracycline (1 week), calcein blue (4 week), and alizarin red (7 week), and the biopsy specimens were taken. The specimens were embedded in methylmethacrylate and ground to 10 micrometer thin sections were made. All of the specimens were stained with H & E and Masson's trichrome and examined under light microscope. The specimens at 8 week were examined under fluorescent microscope. RESULTS: In the Control group, the grafted DBBP was surrounded with connective tissue, and osteoblasts were observed partially around the grafted particles at 1 week. At 4 week, some osteoid was observed and, new bone formation was observed at the periphery of grafted materials at 8 week, In the Experimental group, some osteoid was seen at the periphery of the grafted Ca-P coated DBBP at 1 week, and osteoblast and newly formed bone were observed around the grafted materials. At 8 week, newly formed bone was observed at the periphery of the grafted materials. CONCLUSION: These results suggest that Ca-P coated DBBP group was more and faster than DBBP group in new bone formation and Ca-P could contribute to enhance bone formation in the critical sized calvarial bone defect of rat.
Animals ; Biopsy ; Calcium ; Connective Tissue ; Formaldehyde ; Methylmethacrylate ; Osteoblasts ; Osteogenesis ; Paraffin ; Rats* ; Regeneration* ; Tetracycline ; Transplants

BACKGROUND: The purpose of this study was to evaluate the usefulness and safety of the anterosuperior deltoid splitting approach for fixation of displaced proximal humeral fractures by analyzing the surgical outcomes. METHODS: Twenty-three patients who could be followed-up for at least 8 months after the treatment of displaced proximal humeral fractures through the anterosuperior deltoid splitting approach were enrolled. We evaluated the reduction of the fractures and surgery-related complications at the last follow-up using X-ray results and clinical outcomes comprising the University of California at Los Angeles (UCLA) scoring system and the Korean Shoulder Society (KSS) score. RESULTS: At the last follow-up of patients treated using the anterosuperior deltoid splitting approach for internal fixation of proximal humeral fractures, we found 22 cases (95.6%) of bone union, a mean UCLA score of 28.3 (range, 15 to 34) and a mean KSS score of 82.1 (range, 67 to 95). Various surgery-related complications were noted; a case of varus malunion after fracture displacement, a case of nonunion, a case of delayed union, two cases of impingement, and a case of partial axillary nerve injury, which recovered completely through the follow-up. CONCLUSIONS: Plate fixation using the anterosuperior deltoid splitting approach could be another reliable option for treating displaced proximal humeral fractures.
California ; Follow-Up Studies ; Humans ; Humerus ; Shoulder ; Shoulder Fractures*

No abstract available.

This article reviews clinical characteristics, neurobiological aspects and treatment strategies in female patient with obsessive-compulsive disorder (OCD) compared to male. Female with OCD had a later age of onset and different patterns of OCD symptomatology and comorbidity. Female with OCD showed more favorable course and also reported more frequently stressful event in preceding OCD onset. The onset or worsening of OCD was related to female reproductive cycle events, especially at menarche and postpartum. There is a paucity of investigation regarding gender difference in treatment response in OCD. It has been suggested that gender may contribute to the clinical and biological heterogeneity of OCD and also sexually dimorphic pattern of genetic susceptibility to OCD may be present.
Age of Onset ; Comorbidity ; Female* ; Genetic Predisposition to Disease ; Humans ; Life Change Events ; Male ; Menarche ; Obsessive-Compulsive Disorder* ; Population Characteristics ; Postpartum Period

Psychopharmacotherapy is one of the effective treatments for the children and adolescents with attention-deficit hyperactivity disorder (ADHD). If there were a marginal improvement or significant adverse effects after having the first line medication such as psychostimulants and atomoxetine, the youth with ADHD can take alternative medications. If they have comorbidities such as disruptive behavior disorder, bipolar disorder, mental retardation and tic disorder, they need to have more medications. Recently, prescriptions of atypical antipsychotics were increasing among them. The efficacy, safety, and tolerability of atypical antipsychotics in the youth should be considered.
Adolescent ; Antipsychotic Agents ; Attention Deficit and Disruptive Behavior Disorders ; Bipolar Disorder ; Child ; Comorbidity ; Humans ; Intellectual Disability ; Prescriptions ; Propylamines ; Tic Disorders ; Atomoxetine Hydrochloride