OBJECTIVES: The main purpose of this study was aimed at examining the epidemiological and clinical data of firesetters in Konju forensic psychiatric hospital. METHOD: The thirty firesetters were admitted at Konju forensic psychiatric hospital from January. 1, 1998 to December. 1, 1995, They carefully investigated from January. 3, 1996 to July. 31, 1996 through the methods of psychiatric interview, chart review, the written judgement review and telephone interview. RESULTS: There are significant differences in education level and intelligence quotient among three groups. Prevalence of febrile convulsion, nail biting, and enuresis are highest among the firesettes. Alcohol-related family history is significantly high in firesetters. Most frequently reported motivation of firesetters were psychosis, and anger or revenge.
Anger ; Education ; Enuresis ; Hospitals, Psychiatric* ; Humans ; Intelligence ; Interviews as Topic ; Motivation ; Nail Biting ; Prevalence ; Psychotic Disorders ; Seizures, Febrile

One hundred and ninety-four consecutive patients with two hundred and one diaphyseal femur fractures were retrospectively reviewed to evaluate the frequencies, types and the results of treatments for the associated ipsilateral knee ligaments and menisci injuries from Oct. 1990 to Feb. 1997 at Eulji Medical Center. Fifteen patients had associated ipsilateral knee ligament injuries. There were eleven(73.3%) males and four(26.7%) females with an average age of 35.7(17-68) years. Thirteen(86.7%) patients were injured by traffic accident. Ten patients were followed for average of 38 months(12-73 months). There were five(33.4%) partial and two(13.3%) complete tears of anterior cruciate ligaments, three(20.0%) partial and four(26.7%) complete tears of posterior cruciate ligaments, one(6.7%) partial and four(26.7%) complete tears of medial collateral ligaments, one(6.7%) complete and three(20.0%) partial tears of lateral collateral ligaments, five(33.3%) tears of medial menisci and four(26.7%) tears of lateral menisci. There was no relationship between specific ligament damage and the cause of the injury or level of fracture. Better range of knee motion and HSS knee score was obtained when both the femur and ligament injuries were surgically managed. The invention of the MRI and the development of arthroscopic techniques have made it easy to diagnose and take care for ligament injuries. Early diagnosis and proper treatment on ruptured ligaments and tom meniscus combined with diaphyseal femur fractures seem to be important for good prognosis.
Accidents, Traffic ; Anterior Cruciate Ligament ; Collateral Ligaments ; Early Diagnosis ; Female ; Femoral Fractures* ; Femur ; Humans ; Inventions ; Knee* ; Lateral Ligament, Ankle ; Ligaments* ; Magnetic Resonance Imaging ; Male ; Menisci, Tibial ; Posterior Cruciate Ligament ; Prognosis ; Retrospective Studies

Particulate wear debris(polyethylene, polymethylmethacrylate and metal particles, or combination of these) can initiate aseptic loosening. To eliminate polyethylene debris and reduce the total amount of wear, metal on metal bearings(Metasul) which were made of a wrought Co-28Cr-6Mo-0.2C alloy, were introduced. From May 1994 total hip replacements using a Metasul metal on metal articulation were performed by the authors. 34 patients with 40 hips with minimum follow-ups during 24 months were analysed in this study. The mean follow up period was 31 months(ranging from 24 to 47 months). We used Armor cups and standard cups as acetabular comporients and SL stems, CLS stems and cone stems as femoral components. Preoperative average Harris hip score of 48 points became postoperatively 93(from minimum 81 to maximum 100). And there were slight and occasional thigh pains in 2 cases(5%). There were no revisions for the early aseptic loosening of femoral stems or stem failures. Radiologic evaluation which revealed mild calcar atrophy was developed in 33 cases(82.5%), revealing cortical hypertrophy in 10 cases(25%). Osteolysis was not noted around the prosthetic stem nor around the cup. Radiolucent lines were found in 9 cases of femoral components(22.5%) and in 1 case of acetabular component(2.5%) and subsidence of more than 3mm in 1 case of femoral components(2.5%) were also found. There was 1 case of definitive loosening of acetabular component(2.5%). These also showed that endosteal bone formation adjacent to femoral prosthesis was developed in 22 cases(55%) but no distal pedestal and stem shift occurred. The short-term but satisfactory results of the contemporary metal on metal articulation investigated in this study were encouraging and warrant continued study.
Acetabulum ; Alloys ; Arthroplasty* ; Arthroplasty, Replacement, Hip* ; Atrophy ; Follow-Up Studies ; Hip ; Humans ; Hypertrophy ; Osteogenesis ; Osteolysis ; Polyethylene ; Polymethyl Methacrylate ; Prostheses and Implants ; Thigh

Calcification of intervertebral discs of the cervical spine in a child is an uncommon disorder, and is often associated with clinical symptoms. The etiology is still unknown, but the natural history has been reported as having a self-limiting course with an excellent prognosis. Here we report two cases of symptomatic cervical disc calcification in a child and provide a literature review.
Child ; Humans ; Intervertebral Disc ; Natural History ; Prognosis ; Spine

Duodenal intramural hematoma is mostly caused by blunt abdominal trauma. It is also less commonly reported as a complication of anticoagulation therapy or as a blood dyscrasia, and as a complication of diagnostic/ therapeutic endoscopy. The presentation of these patients is abdominal pain, vomiting, fever and hematochezia, and this is rarely accompanied with intestinal obstruction, severe pancreatitis and acute peritonitis as its complications. The diagnosis is made clear by performing abdominal ultrasonography and abdominal computed tomography. We reported here on one case of intramural duodenal hematoma and hemoperitoneum after performing endoscopic hemostasis in a chronic renal failure patient who was on maintenance hemodialysis.
Abdominal Pain ; Diagnosis ; Duodenum ; Endoscopy* ; Fever ; Gastrointestinal Hemorrhage ; Hematoma* ; Hemoperitoneum* ; Hemostasis, Endoscopic ; Humans ; Intestinal Obstruction ; Kidney Failure, Chronic* ; Pancreatitis ; Peritonitis ; Renal Dialysis ; Ultrasonography ; Vomiting

STUDY DESIGN: A radiological analysis of the sagittal balance in younger and older aged volunteers. OBJECTIVES: To determine the normal range of the sagittal spinal alignment, and define significant spinopelvic compensations over the hip axis for the sagittal balance with aging. SUMMARY OF LITERATURE REVIEW: Normative data of the sagittal spinal alignment has wide variation and limited clinical usefulness. In addition, the extent to which the "normal"sagittal spinal contour changes with aging remains unknown. MATERIALS AND METHODS: Inclusion criteria were an age between 20 and 29 years (n=50), group A, and between 55 and 65 years (n=50), group B, for the asymptomatic subjects. Measurements made on the standing lateral radiographs included the following: thoracic kyphosis, lumbar lordosis and sagittal vertical axis. In addition, measurements of the sacropelvic translation, spinopelvic balance, pelvic incidence, pelvic tilting and sacral slope were made. RESULTS: The average thoracic kyphosis was 24 degrees, ranging from 3 to 42 degrees, in group A, and 33 degrees, ranging from 9 to 53 degrees, in group B (p<0.001). The average lumbar lordosis was -47 degrees, ranging from -65 to -23 degrees, and -51 degrees, ranging from -69 to -33 degrees, in groups A and B, respectively (p>0.05). The C7 plumb line, on average, fell 15.4 mm more anteriorly to the posterosuperior corner of S1 in group B than in group A (p<0.05). The anterior positioning of the C7 was also positively correlated with decreasing lordosis (p<0.001). The average sacropelvic translation was -41mm, ranging from -76 to 20 mm, and -48 mm, ranging from -76 to -17 mm, in groups A and B, respectively (p<0.05). The average spinopelvic balance was -57 mm, ranging from -104 to -4 mm, and -49 mm, ranging from -101 to -3 mm, in groups A and B, respectively. The C7 plumb line fell posterior to the hip axis in all cases. The average pelvic incidence was 46 degrees, ranging from 30 to 61 degrees, and 54 degrees, ranging from 28 to 76 degrees, in groups A and B, respectively (p<0.05). The average pelvic tilt was 14 degrees, ranging from 4 to 33 degrees, and 19 degrees, ranging from 3 to 37 degrees, in groups A and B, respectively (p<0.05). The average sacral slope was 32 degrees, ranging from 17 to 47 degrees, and 35 degrees, ranging from 25 to 50 degrees, in groups A and B, respectively (p<0.05). There was significant correlation between pelvic incidence and lumbar lordosis (p<0.001). CONCLUSIONS: The sagittal spinal balance is maintained by spinopelvic compensations over the hip axis with aging, and sacropelvic parameters over the hip axis are important for the evaluation of the sagittal spinal balance.
Aging ; Animals ; Axis, Cervical Vertebra ; Hip ; Incidence ; Kyphosis ; Lordosis ; Pelvis ; Reference Values ; Volunteers*

STUDY DESIGN: A radiological analysis of the sagittal balance in younger and older aged volunteers. OBJECTIVES: To determine the normal range of the sagittal spinal alignment, and define significant spinopelvic compensations over the hip axis for the sagittal balance with aging. SUMMARY OF LITERATURE REVIEW: Normative data of the sagittal spinal alignment has wide variation and limited clinical usefulness. In addition, the extent to which the "normal"sagittal spinal contour changes with aging remains unknown. MATERIALS AND METHODS: Inclusion criteria were an age between 20 and 29 years (n=50), group A, and between 55 and 65 years (n=50), group B, for the asymptomatic subjects. Measurements made on the standing lateral radiographs included the following: thoracic kyphosis, lumbar lordosis and sagittal vertical axis. In addition, measurements of the sacropelvic translation, spinopelvic balance, pelvic incidence, pelvic tilting and sacral slope were made. RESULTS: The average thoracic kyphosis was 24 degrees, ranging from 3 to 42 degrees, in group A, and 33 degrees, ranging from 9 to 53 degrees, in group B (p<0.001). The average lumbar lordosis was -47 degrees, ranging from -65 to -23 degrees, and -51 degrees, ranging from -69 to -33 degrees, in groups A and B, respectively (p>0.05). The C7 plumb line, on average, fell 15.4 mm more anteriorly to the posterosuperior corner of S1 in group B than in group A (p<0.05). The anterior positioning of the C7 was also positively correlated with decreasing lordosis (p<0.001). The average sacropelvic translation was -41mm, ranging from -76 to 20 mm, and -48 mm, ranging from -76 to -17 mm, in groups A and B, respectively (p<0.05). The average spinopelvic balance was -57 mm, ranging from -104 to -4 mm, and -49 mm, ranging from -101 to -3 mm, in groups A and B, respectively. The C7 plumb line fell posterior to the hip axis in all cases. The average pelvic incidence was 46 degrees, ranging from 30 to 61 degrees, and 54 degrees, ranging from 28 to 76 degrees, in groups A and B, respectively (p<0.05). The average pelvic tilt was 14 degrees, ranging from 4 to 33 degrees, and 19 degrees, ranging from 3 to 37 degrees, in groups A and B, respectively (p<0.05). The average sacral slope was 32 degrees, ranging from 17 to 47 degrees, and 35 degrees, ranging from 25 to 50 degrees, in groups A and B, respectively (p<0.05). There was significant correlation between pelvic incidence and lumbar lordosis (p<0.001). CONCLUSIONS: The sagittal spinal balance is maintained by spinopelvic compensations over the hip axis with aging, and sacropelvic parameters over the hip axis are important for the evaluation of the sagittal spinal balance.
Aging ; Animals ; Axis, Cervical Vertebra ; Hip ; Incidence ; Kyphosis ; Lordosis ; Pelvis ; Reference Values ; Volunteers*

STUDY DESIGN: A retrospective study. OBJECTIVES: To analyze the clinical and radiological results of different surgical methods in osteoporotic vertebral fracture patients, with neurologic deficits in the thoracolumbar junction. SUMMARY OF LITERATURE REVIEW: Various surgical methods have been reported for osteoporotic vertebral fractures, with neurologic deficits, in the thoracolumbar junction. These are: anterior decompression, anterior decompression and anterior or posterior reconstruction, and Egg shell procedure. However, it is controversial as to which method is better. MATERIALS AND METHODS: 13 patients that had undergone surgical treatment for osteoporotic vertebral fractures, with neurologic deficits, With a mean age of 68+/-8.4, ranging from 51 to 79 years. Six of the cases were male and seven were female. The mean follow up period was 18 months. The patients were divided into two groups. Group A (n=8): Anterior decompression, anterior interbody fusion, with cage or autologous strut iliac bone block, and instrumentation (anterior or posterior). Group B (n=5): Posterior decompression and posterior reconstruction (egg shell procedure). The kyphotic angles, neurologic improvements and complications in each group were analyzed preoperatively, postoperatively and at final follow up. RESULTS: In group A, the mean kyphotic angles were 29+/-5.9 degrees, 18+/-6.7 degrees and 23+/-7.7 degrees preoperatively, postoperatively and at the final follow up, respectively. In group B, the mean kyphotic angles were 31+/-1.1 degrees, 12+/-6.3 degrees and 18+/-5.5 degrees preoperatively, postoperatively and at the final follow up, respectively. In group A, 3 and 5 patients were graded as Frankel grades C and D, respectively. In group B, 1, 1 and 3 patients were graded as Frankel grades B, C and D, respectively. The neurological status improved in all the patients, by mean 1.1 grades in group A and 1.2 grades in group B. In group A, postoperative transient dyspnea and screw loosening occurred in one and two patients, respectively. In group B, postoperative paralytic ileus and screw loosening occurred in one two patients, respectively. CONCLUSIONS: Posterior decompression and posterior reconstruction (egg shell procedure) was an effective surgical method, equivalent to an anterior or anterior and posterior procedure, for osteoporotic vertebral fracture patients, with neurologic deficits.
Animals ; Decompression ; Dyspnea ; Egg Shell ; Female ; Follow-Up Studies ; Humans ; Intestinal Pseudo-Obstruction ; Male ; Neurologic Manifestations* ; Retrospective Studies

STUDY DESIGN: A retrospective study. OBJECTIVES: To analyze the clinical and radiological results of different surgical methods in osteoporotic vertebral fracture patients, with neurologic deficits in the thoracolumbar junction. SUMMARY OF LITERATURE REVIEW: Various surgical methods have been reported for osteoporotic vertebral fractures, with neurologic deficits, in the thoracolumbar junction. These are: anterior decompression, anterior decompression and anterior or posterior reconstruction, and Egg shell procedure. However, it is controversial as to which method is better. MATERIALS AND METHODS: 13 patients that had undergone surgical treatment for osteoporotic vertebral fractures, with neurologic deficits, With a mean age of 68+/-8.4, ranging from 51 to 79 years. Six of the cases were male and seven were female. The mean follow up period was 18 months. The patients were divided into two groups. Group A (n=8): Anterior decompression, anterior interbody fusion, with cage or autologous strut iliac bone block, and instrumentation (anterior or posterior). Group B (n=5): Posterior decompression and posterior reconstruction (egg shell procedure). The kyphotic angles, neurologic improvements and complications in each group were analyzed preoperatively, postoperatively and at final follow up. RESULTS: In group A, the mean kyphotic angles were 29+/-5.9 degrees, 18+/-6.7 degrees and 23+/-7.7 degrees preoperatively, postoperatively and at the final follow up, respectively. In group B, the mean kyphotic angles were 31+/-1.1 degrees, 12+/-6.3 degrees and 18+/-5.5 degrees preoperatively, postoperatively and at the final follow up, respectively. In group A, 3 and 5 patients were graded as Frankel grades C and D, respectively. In group B, 1, 1 and 3 patients were graded as Frankel grades B, C and D, respectively. The neurological status improved in all the patients, by mean 1.1 grades in group A and 1.2 grades in group B. In group A, postoperative transient dyspnea and screw loosening occurred in one and two patients, respectively. In group B, postoperative paralytic ileus and screw loosening occurred in one two patients, respectively. CONCLUSIONS: Posterior decompression and posterior reconstruction (egg shell procedure) was an effective surgical method, equivalent to an anterior or anterior and posterior procedure, for osteoporotic vertebral fracture patients, with neurologic deficits.
Animals ; Decompression ; Dyspnea ; Egg Shell ; Female ; Follow-Up Studies ; Humans ; Intestinal Pseudo-Obstruction ; Male ; Neurologic Manifestations* ; Retrospective Studies

PURPOSE: To compare the mineral density of periprosthetic bone around the two collarless stems, CLS and Alloclassic, which were same in composition and coating, but different in their shape and fit. It is known that the CLS stem is designed for metaphyseal fit and the Alloclassic stem is for upper diaphyseal fit. MATERIALS AND METHODS: In this matched cohort study, we performed DEXA scan using Hologic QDR-1000 on 20 patients, 9 of whom had CLS (Sulzer, Switzerland) femoral stem (group A), and 11 had Alloclassic (Sulzer, Switzerland) femoral stem (group B). BMD was obtained for seven zones of Gruen, and the difference was compared between the two groups. RESULTS: In group A, there was a significant decrease (P<0.05) of mean BMD in Gruen zones 1, 2 and 7 compared to normal side. In group B, there was a significant decrease (P<0.05) of mean BMD in Gruen zones 1, 2, 3, 4, 6 and 7 compared to normal side. Comparing the percent decreases of BMD, the only significant difference was observed in Gruen zone 1, in which group B showed more than 10% decrease than group A (P<0.05). CONCLUSION: Our findings suggest that the design of stem affects postoperative changes of BMD, and that the stem with more proximal fit would behave better in terms of stress shielding.
Absorptiometry, Photon ; Arthroplasty, Replacement, Hip* ; Bone Density* ; Cohort Studies ; Humans