PURPOSE: To assess the indication and effect of screw fixation in the transverse patellar fractures. MATERIALS AND METHODS: We analysed the results of 14 transverse patellar fractures fixed with screws from January 1991 to May 2005. Mean follow-up period was 47 months (range, 12~143 months). We analysed the radiologic union, operation time, ROM and postoperative Lysholm score. RESULTS: All fractures healed uneventfully. The mean displacement was decreased from 2.2 mm preoperatively to 0.3 mm postoperatively (p=0.001, Wilcoxon signed rank test). The mean operation time was 34 minutes (range, 20 to 60 minutes). Normal range of motion was achieved in 13 knees (92.9%). Average Lysholm score was 95.9 at final follow-up. CONCLUSION: Screw fixation seemed to be useful for treatment of transverse patellar fracture even in comminuted fractures with large fragments. The advantage of this technique was the preservation of extensor mechanism, simplicity, short operation time and good cosmesis.
Follow-Up Studies ; Fractures, Comminuted ; Knee ; Patella ; Reference Values

PURPOSE: To compare the accuracy of tibial cutting between in dangling position and standing position of the lower limb for Oxford unicompartmental knee arthroplasty. MATERIALS AND METHODS: From September 2001 to September 2003, While performing Oxford unicompartmental knee arthroplasty, we cut tibial plateau with lower extremity in dangling position and standing position alternately. Group 1 consisted of 12 cases underwent tibial cutting in dangling position. Group 2 consisted of 12 cases underwent tibial cutting in standing position. Clinical assessments consisted of radiologic evaluation and HSS knee score. RESULTS: There were no significant differences in limb alignments and HSS knee scores between group 1 and group 2 at one year postoperatively. In anteroposterior radiographs, the mean alignment of tibial component of group 1 was measured 4.07+/-5.7 degrees varus to the tibial axis and that of group 2 was measured 2.34+/-2.4 degrees varus to the tibial axis(P=0.35). CONCLUSION: In Oxford unicompartmental knee arthroplasty, tibial cutting in standing position showed a tendency to cut tibia more perpendicular to the tibial axis. But it was statistically not significant.
Arthroplasty* ; Axis, Cervical Vertebra ; Extremities ; Knee* ; Lower Extremity* ; Tibia

Background: The goal of this study was to confirm the relationship between subjective body shape perception and the depression screening tool Patient Health Questionnaire-9 (PHQ-9) in the geriatric population. Methods: A total of 1,251 subjects were analyzed among adults aged 65 or older who performed the 2020 Korean National Health and Nutrition Examination Survey. The subjective body shape perception was divided into three groups (thin, normal, and obese). Depression screening tool PHQ-9 10 points were employed as a cut-off value. The association between subjective body shape perception and the risk of depression based on the PHQ-9 was first verified by achi-square test, and then logistic regression analysis was performed along with items expected to influence the relationship. Results: There was a considerable difference between the depression risk and the normal groups in subjective body shape perception, which was classified as thin, normal, and obese. In the final model, the group who thought they were thin had an increased risk of depression compared with the normal group. Dyslipidemia, being female, and not owning a home have all been demonstrated to greatly raise the risk of depression. Conclusion We verified that subjective body shape was related to the risk of depression through the PHQ-9.

Background: Preterm birth is associated with increased infant mortality. However, it is not clear whether prematurity is associated with mortality after 1 year of age. There is a lack of research on mortality rate and causes of death after infancy in preterm babies in Korea. We aimed to analyze the mortality rates and causes of deaths up to 5 years of age in Korea. Methods: Using the Microdata Integrated Service of Statistics Korea database, this retrospective cohort study screened infants born between 2010 and 2012. After applying the exclusion criteria, 1,422,913 live births were classified into the following groups by gestational age: those born at < 32 weeks' gestation (n = 10,411), those born between 32 and 36 weeks' gestation (n = 75,657), and those born at ≥ 37 weeks' gestation (n = 1,336,845). The association of gestational age with mortality in infancy (< 1 year of age) and childhood (1–5 years of age) was analyzed, with and without covariates. The major causes of death in infancy and childhood were analyzed by gestational age. Results: Overall, 4,930 (0.3%) children died between birth and 5 years of age, with 19.1% of these deaths occurring after infancy. Adjusted hazard ratios (HRs) for infant death were 78.79 (95% confidence interval [CI], 71.33–87.04) and 4.62 (95% CI, 4.07–5.24) for the < 32 and 32–36 weeks groups, respectively, compared to the full-term group; the adjusted HRs for deaths occurring at ages 1–5 years were 9.25 (95% CI, 6.85–12.50) and 2.42 (95% CI, 1.95–3.01), respectively. In infancy, conditions originating in the perinatal period were the most common cause of deaths in the < 32 and 32–36 weeks groups (88.7% and 41.9%, respectively). Contrarily, in the ≥ 37 weeks group, conditions originating in the perinatal period explained 22.7% of infant deaths, with congenital malformations primarily accounting for 29.6% of these deaths. The most common cause of death in children (after infancy) in the < 32 weeks group was perinatal causes (25.0%); in the 32–36 weeks group, congenital malformation and nervous system disease were the common causes (21.7% and 19.1%, respectively). In the ≥ 37 weeks group, injury, poisoning, and other consequences of external causes explained 26.6% of childhood deaths, followed by neoplasms and nervous system disease (15.7% and 14.7%, respectively). Conclusion Low gestational age is associated with not only infant mortality but also child mortality. The major causes of death differed by gestational age in infancy and childhood.For the care of preterm infants, especially those born at < 32 weeks' gestation, particular attention and continuous monitoring are needed in consideration of the major causes of deaths until 5 years of age.

BACKGROUND: Abdominoperineal resection (APR) combined with autonomic nerve preservation (ANP) is proven to reduce sexual dysfunction. However, Sexual dysfunction after APR combined ANP occurs as many as 59% of case. PURPOSE: The aims of this study were to assess prog nostic value of various postoperative factors affective sexual function after APR combined with ANP and to suggest a clinical relevant factors for the improvement of sexual function. METHODS: This was a cross sectional descriptive study. Data were collected using individual-based interviews from 63 patients who underwent APR during the period of Feb. 2001 and April. 2001. The tool for this study was developed by the researcher through modification of the QLQ-CR38 (European Organization for Research and Treatment of Cancer, 1999). RESULTS: The severity of sexual function showed significant differences according to occupation, intervals after operation, colostomy irrigation. Intervals of longer than 18 month after operation was associated with better sexual function. In multiple regression analysis, colostomy related problems, colostomy irrigation, colostomy complications, intervals after operation, recurrence affected sexual function significantly. CONCLUSIONS: Colostomy related problems, colostomy irrigation, colostomy complications, intervals after operation and recurrence appear to be associated with sexual function after APR.
Atrial Natriuretic Factor ; Autonomic Pathways ; Colostomy ; Humans ; Occupations ; Rectal Neoplasms* ; Recurrence

Esophageal granular cell tumor (GCT) is a rare neoplasm originating from the Schwann cells of the submucosal neuronal plexus. Histology is the gold standard for its diagnosis. Endoscopic resection or surgical excision should be considered, depending on the potential for malignancy. Here, we report a case of an esophageal GCT in an adolescent. A 12-year-old boy presented with a 1-year history of dysphagia and vomiting. Upper gastrointestinal endoscopic examination and esophagography showed narrowing of the midesophagus, and computed tomography angiography of the thoracic aorta revealed an esophageal or periesophageal mass posterior to the paratracheal segment of the esophagus. The tumor was surgically excised, and based on the pathological findings, esophageal GCT was diagnosed.
Adolescent* ; Angiography ; Aorta, Thoracic ; Child ; Deglutition Disorders ; Diagnosis ; Esophageal Neoplasms ; Esophagus* ; Granular Cell Tumor* ; Humans ; Male ; Neurons ; Pediatrics ; Schwann Cells ; Vomiting

Degenerative disc disease of the lumbar spine caused leg pain with associated calf weakness and atrophy. However, an unusual case of leg pain and calf atrophy due to neural compression is reported. We reported a rare case of a Baker's cyst causing common peroneal nerve and tibial nerve entrapment neuropathy. Initially, after arthroscopic menisectomy and cyst decompression, Baker's cyst was recurred and then open excision was done. Until 1 year after surgery, the cyst was not recurred, increased muscle bulk was noted and EMG showed improved findings. But she continued to complain of lower leg weakness and sole paresthesia owing to delayed diagnosis and cyst decompression.
Atrophy ; Decompression ; Delayed Diagnosis ; Leg ; Paresthesia ; Peroneal Nerve* ; Popliteal Cyst* ; Spine ; Tibial Nerve*

The type III histone deacetylase silent information regulator 1 (SIRT1) is an enzyme that is critical for the modulation of immune and inflammatory responses. However, the data on its role in rheumatoid arthritis (RA) are limited and controversial. To better understand how SIRT1 regulates adaptive immune responses in RA, we evaluated collagen-induced arthritis (CIA) in myeloid cell-specific SIRT1 knockout (mSIRT1 KO) and wild-type (WT) mice. Arthritis severity was gauged on the basis of clinical, radiographic and pathologic scores. Compared with their WT counterparts, the mSIRT1 KO mice exhibited less severe arthritis, which was less destructive to the joints. The expression levels of inflammatory cytokines, matrix metalloproteinases and ROR-γT were also reduced in the mSIRT1 KO mice compared with the WT mice and were paralleled by reductions in the numbers of Th1 and Th17 cells and CD80- or CD86-positive dendritic cells (DCs). In addition, impaired DC maturation and decreases in the Th1/Th17 immune response were observed in the mSIRT1 KO mice. T-cell proliferation was also investigated in co-cultures with antigen-pulsed DCs. In the co-cultures, the DCs from the mSIRT1 KO mice showed decreases in T-cell proliferation and the Th1/Th17 immune response. In this study, myeloid cell-specific deletion of SIRT1 appeared to suppress CIA by modulating DC maturation. Thus, a careful investigation of DC-specific SIRT1 downregulation is needed to gauge the therapeutic utility of agents targeting SIRT1 in RA.
Animals ; Arthritis ; Arthritis, Experimental* ; Arthritis, Rheumatoid ; Coculture Techniques ; Cytokines ; Dendritic Cells* ; Down-Regulation ; Histone Deacetylases ; Joints ; Matrix Metalloproteinases ; Mice* ; T-Lymphocytes ; Th17 Cells

OBJECTIVES: To assess the effects of hormone replacement therapy on bone mineral density (BMD), biochemical markers of bone turnover, and lipid profiles in postmenopausal women. METHODS: We retrospectively reviewed the medical records of 199 postmenopausal women who had received care at the Department of Obstetrics and Gynecology of Catholic University Seoul St. Mary's Hospital between January 1994 and December 2008. The patients were divided into the following three groups: group 1 received combined estrogen and progesterone therapy (n = 91); group 2 received estrogen only (n = 65); and group 3 received tibolone (n = 43). We compared the changes in biochemical markers of bone turnover, lipid profiles, and BMD during therapy. RESULTS: The BMD of the lumbar spine increased in groups 1 and 3 by 2.0% and 1.2%, respectively, and the BMD of the total femur increased in groups 1 and 2 by 2.3% and 0.5% from the initial values after 3 years, respectively. However, the BMD of the femoral neck and total femur decreased significantly in group 3 by 4.8% and 1.9%, respectively, 3 years after treatment initiation (P < 0.05). Serum osteocalcin and urinary deoxypyridinoline decreased in all groups 1 year after treatment. In groups 1 and 3, the total cholesterol level decreased and the triglycerides level increased. However, there were no definite changes in the total cholesterol and triglycerides levels in group 2. The high density lipoprotein cholesterol (HDL)-cholesterol level increased in groups 1 and 2, but decreased in group 3. As a result, the BMD of the lumbar spine increased and the total cholesterol level decreased in the combined therapy and tibolone groups. Tibolone had no beneficial effect on the BMD of the femoral neck. CONCLUSION: Our results suggest that each therapy has different effects on BMD, biochemical markers of bone metabolism, and lipid profiles. A prospective study involving a larger group, and considering multiple factors, will be required to obtain more clinically meaningful conclusions.
Amino Acids ; Biomarkers ; Bone Density ; Cholesterol ; Cholesterol, HDL ; Estrogens ; Female ; Femur ; Femur Neck ; Gynecology ; Hormone Replacement Therapy ; Humans ; Lipoproteins ; Medical Records ; Norpregnenes ; Obstetrics ; Osteocalcin ; Progesterone ; Retrospective Studies ; Spine ; Triglycerides

OBJECTIVES: To assess the effects of hormone replacement therapy on bone mineral density (BMD), biochemical markers of bone turnover, and lipid profiles in postmenopausal women. METHODS: We retrospectively reviewed the medical records of 199 postmenopausal women who had received care at the Department of Obstetrics and Gynecology of Catholic University Seoul St. Mary's Hospital between January 1994 and December 2008. The patients were divided into the following three groups: group 1 received combined estrogen and progesterone therapy (n = 91); group 2 received estrogen only (n = 65); and group 3 received tibolone (n = 43). We compared the changes in biochemical markers of bone turnover, lipid profiles, and BMD during therapy. RESULTS: The BMD of the lumbar spine increased in groups 1 and 3 by 2.0% and 1.2%, respectively, and the BMD of the total femur increased in groups 1 and 2 by 2.3% and 0.5% from the initial values after 3 years, respectively. However, the BMD of the femoral neck and total femur decreased significantly in group 3 by 4.8% and 1.9%, respectively, 3 years after treatment initiation (P < 0.05). Serum osteocalcin and urinary deoxypyridinoline decreased in all groups 1 year after treatment. In groups 1 and 3, the total cholesterol level decreased and the triglycerides level increased. However, there were no definite changes in the total cholesterol and triglycerides levels in group 2. The high density lipoprotein cholesterol (HDL)-cholesterol level increased in groups 1 and 2, but decreased in group 3. As a result, the BMD of the lumbar spine increased and the total cholesterol level decreased in the combined therapy and tibolone groups. Tibolone had no beneficial effect on the BMD of the femoral neck. CONCLUSION: Our results suggest that each therapy has different effects on BMD, biochemical markers of bone metabolism, and lipid profiles. A prospective study involving a larger group, and considering multiple factors, will be required to obtain more clinically meaningful conclusions.
Amino Acids ; Biomarkers ; Bone Density ; Cholesterol ; Cholesterol, HDL ; Estrogens ; Female ; Femur ; Femur Neck ; Gynecology ; Hormone Replacement Therapy ; Humans ; Lipoproteins ; Medical Records ; Norpregnenes ; Obstetrics ; Osteocalcin ; Progesterone ; Retrospective Studies ; Spine ; Triglycerides