The conventional therapy for supracondylar fracture of the femur is open reduction and internal fixation with plate and screws. But, wide dissection of the thigh with the following devascularization of the distal femur caused a high incidence of complications like joint stiffness, delayed union, nonunion, infection and loosening or breakage of plate and screws. On the contrary, interlocking intramedullary nailing does not need the exposure of the fracture so that soft tissue dissection and devascularization can be minimized. Undoubtedly, rapid healing by abundant formation of callus is promoted, irrespective of the degree of comminution. We reviewed 9 cases of interlocking intramedullary nailing for supracondylar and intercondylar frtures of the distal part of the femur at Pusan National University Hospital from November 1993 to December 1995. The mean time to union was 14 weeks (range, 11-23weeks). According to Rating System of Neer et al., excellent was 7 cases, satisfactory in 1 case and unsatisfactory in 1 case. Interlocking intramedullary nailing was applied to Type A, C1 and C2 of the AO classification but considered difficult to apply to Type B and C3. For the firm fixation and the prevention of nail breakage, the nail should be inserted deepest in order to place two distal screws as distally as possible from the fracture site. If necessary the distal tip of nail was cut off for use. Interlocking intramedullary nailing does not need the exposure of fracture site. Satisfactory result could be obtained by reducing complications such as joint stiffness, delayed union, nonunion, infection and breakage of implants caused by wide dissection of the thigh with the following devascularization of the distal femur for the open reduction and internal fixation with plate and screws. It also could be obtained by performing early ROM exercise with firm, fixation.
Bony Callus ; Busan ; Classification ; Femur* ; Fracture Fixation, Intramedullary* ; Incidence ; Joints ; Thigh

No abstract available.
Child ; Femoral Fractures ; Humans

OBJECTIVES: The purpose of this study was to examine the diagnostic availability of CPT in children with ADHD, and, what factors are affected to CPT results in the diagnosis of ADHD. METHODS: CPT, ADHD scales (ADDES-HV), K-ABC were administered to 68 ADHD patients and 30 normal elementary school students as the control group. Also, ages and sex are controlled between two groups. RESULTS: In the differences of the results of CPT between ADHD patients and normal subjects, attentiveness and risk taking are significantly different (p<0.05). In the differences of the results of CPT between ages in ADHD patients, usually as more aged children are better performances in CPT. Also, in the differences of the results of CPT between intelligence in ADHD patients, usually as higher intelligent children are better performances in CPT. There are no differences of the results of CPT between types of ADHD in ADHD patients. In the differences of the results of CPT between sex in ADHD patients, commission error, hit reaction time standard error, variability of standard error, and attentiveness are significantly different between male and female patients (p<0.05). The correlations between ADHD scales and the results of CPT show that inattention subscale is significantly related to hit, omission error, hit reaction time standard error, and variability of standard error. In the discriminant ability between ADHD patients and normal children by the results of CPT, accuracy rates are more than 50% in all results of CPT. Especially, the accuracy rate of hit reaction time standard error, and the accuracy rate of variability of standard error, and also, the accuracy rate of attentiveness are more than 60%. CONCLUSION: In this point of view, this study suggest that CPT is relatively valuable method in the diagnosis of ADHD. For instances, CPT is more likely to screen the ADHD from normal children, or to use as assisted method of diagnosis of ADHD in clinical settings.
Attention Deficit Disorder with Hyperactivity* ; Child* ; Diagnosis ; Female ; Humans ; Intelligence ; Male ; Reaction Time ; Risk-Taking ; Weights and Measures

PURPOSE: To report two cases of tractional retinal detachment after intravitreal bevacizumab injection. CASE SUMMARY: (Case 1) A 48-year-old female with insulin-dependent diabetes mellitus and a high HbA1c level came to our clinic for fundus evaluation. The best corrected visual acuity (BCVA) was 1.0 in the right eye and funduscopic examination of the right eye revealed proliferative diabetic retinopathy with preretinal hemorrhage and a mild fibrovascular proliferative membrane around the optic disc. Intravitreal bevacizumab injection (1.25 mg) was performed before starting panretinal photocoagulation (PRP) to prevent macular edema after PRP. Three days after the injection, visual acuity decreased to 0.3 and funduscopic findings showed tractional retinal detachment. Vitrectomy was performed and visual acuity recovered to 1.0 four months after operation. CONCLUSIONS: Intravitreal bevacizumab injection may cause tractional retinal detachment in poorly controlled insulin-dependent diabetes mellitus patients with fibrovascular proliferative membranes.
Antibodies, Monoclonal, Humanized ; Diabetes Mellitus, Type 1 ; Diabetic Retinopathy ; Eye ; Female ; Hemorrhage ; Humans ; Light Coagulation ; Macular Edema ; Membranes ; Middle Aged ; Porphyrins ; Retinal Detachment ; Retinaldehyde ; Traction ; Visual Acuity ; Vitrectomy ; Bevacizumab

Right atrial metastasis occurs in 1 to 4% of patients with hepatoma. and the extention to intracavitary or metastasis of tumor as a large mass rare. However, the high risk of progressive heart failure and sudden death from the tricuspid valve obstruction necessitates prompt diagnosis of intracavitary extension, and adequate intervention is needed to prolong a patient's life. A 49 year-old female was referred to our hospital for further evaluation of a liver mass, which was identified at a local clinic. The liver mass was confirmed as hepatocellular carcinoma with CT and celiac angiographic finding. She was treated with transarterial chemoembolization. Thirty-four months after discharge, a low density right atrial mass was noted incidentally with chest computed tomography while investigating massive right pleural effusion for possible pulmonary metastasis. Echocardiography showed a huge inhomogenous echogenic mass at the right atrium. The present report describes a case of primary hepatocellular carcinoma with a intracavitary cardiac mass detected with two dimensional echocardiography.
Carcinoma, Hepatocellular* ; Death, Sudden ; Diagnosis ; Echocardiography ; Female ; Heart Atria ; Heart Failure ; Humans ; Liver ; Middle Aged ; Neoplasm Metastasis ; Pleural Effusion ; Thorax ; Tricuspid Valve

Coloring Agents ; Cytomegalovirus ; Endothelial Cells ; Humans ; Intranuclear Inclusion Bodies ; Male ; Methenamine ; Mouth ; Oral Manifestations ; Stomatitis ; Tongue ; Ulcer

OBJECTIVE: This study was performed to investigate the prognostic value of multi-sensory evoked potentials (MSEPs) in neonatal period for the early diagnosis of delayed motor development, especially cerebral palsy. METHOD: The MSEPs studies composed of auditory brainstem evoked potentials (AEPs), visual evoked potentials (VEPs) and somatosensory evoked potentials were taken on 237 neonates, 136 boys and 101 girls, using Viking IV machine. Follow up MSEPs were repeated in every 4 or more weeks for those who showed abnormal responses in any of the MSEPs. Each neonate was also evaluated for motor development as an outpatient or by telephone interview. RESULTS: Among 237 neonates, 6.4% showed delayed development, and 4.6% were cerebral palsy: 3.8%, spastic type; 0.8%, athetoid type, and the others revealed normal motor development. AEP was useful method to predict motor development when this was done at 39.7 0.4 weeks of postmenstrual age (PMA). VEPs failed to show the validity, but there was the typical waveform change in accordance with increase of the postmenstrual age. Median nerve SEPs were valuable for prediction of motor development which were taken at PMA 40.7 0.6 weeks. After 45.3 1.5 weeks of PMA, median nerve SEPs did not reflect motor development outcome significantly. However, posterior tibial SEPs significantly reflect motor outcome regardless of the time of examination. CONCLUSION: Median and posterior tibial SEPs done before 40weeks of PMA are useful tool to predict motor development outcome. When any of these tests showed abnormal findings, follow up study is recommended and posterior tibial SEP study is thought to be the most useful for its predictability. It is necessary to correlate the AEPs and VEPs with hearing and vision whenever abnormal findings are found.
Brain Stem ; Cerebral Palsy ; Early Diagnosis ; Evoked Potentials* ; Evoked Potentials, Auditory ; Evoked Potentials, Somatosensory ; Evoked Potentials, Visual ; Female ; Follow-Up Studies ; Hearing ; Humans ; Infant, Newborn* ; Interviews as Topic ; Median Nerve ; Muscle Spasticity ; Outpatients

OBJECTIVES: The study is to test reliability and validity of the Korean version of spiritual well being scale which is devised by Paloutzian and Ellison. METHODS: The spiritual well being scale was translated into Korean by two psychiatrist and 131 Christians rated the Korean version of spiritual well being scale. For test-retest reliability, 80 telephone counsellor trainee rated it again after one week interval and statistical analysis was done with the collected data. RESULT: Correlation coefficients were regarded to have good test-retest reliability. Cronbach alpha value of total score, and religious well being subscale and existential well being subscale were significantly high. Among demographic factors, health(healthier) factors, is related with significantly high score of spiritual well-being scale(SWS). Period(over 30year) of christianity showed significant discriminative score of SWS. Factor analysis for validity showed 5 subgroups which were correlated with religious well-being scale(RWS) and existential well-being scale(EWS). 1st subgroup of RWS is related with educational factor, 2nd subgroup of RWS is related with health foactor, 3rd subgroup of RWS is related with personal relationship with God especially, 4th subgroup of EWS is related with health factor and 5th subgroup of EWS is related with reality oriented view. CONCLULSION: The Korean version of SWS which is consisted of RWS and EWS was proved to be a reliable and valid instrument of assessment of spirituality.
Christianity ; Demography ; Humans ; Psychiatry ; Reproducibility of Results* ; Spirituality ; Telephone

Visual evoked potentials(VEPs) are the cerebral electrical activities recorded from the occipital scalp following a flash or pattern stimulation and can detect the lesions of sensory visual pathways. Although the VEPs change with the maturation of CNS in children, a few studies have documented the maturational changes in premature infants. Using the light- emitting diode goggles, VEPs were studied in 131 neurologically intact infants of 28~41 weeks gestational age or 34~59 weeks postmenstrual age. The VEPs were analysed by three waveforms; normal, abnormal, and flat, and four patterns; N300, P200-N300, P100-N155-P200-N300, and P100 pattern. Normal waveforms were 63 of 131 VEPs(48.1%). Of the normal waveforms, N300 patterns were 38.1%, P200-N300 36.5%, P100-N155-P200-N300 19.0%, and P100 6.4%. Each pattern correlated with the postmenstrual age. These findings support the hypothesis of VEP pattern changes according to the maturation of the visual system with age.
Child ; Evoked Potentials, Visual* ; Eye Protective Devices ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Scalp ; Visual Pathways

The changes of the microorganism composition after therapeutic radiation for oral cancer patients are not well known and the long-term follow-up data are not reported. To obtain basic data for understanding of pathogenesis and prevention and treatment of dental caries and mucositis occuring after radiation therapy, 7 of the oral cancer patients presented at the Seoul National University Oral & Maxillofacial Department between 1997 and 1998 whose treatment plan included radiation therapy were recruited to investigate the changes in bacterial composition(total aerobic count, candida, Staphylococci, lactobacilli, S. mutans, and S. salivarius (mitis, sanguis)) of the saliva before, during, and after radiation therapy. The basic data obtained from this study on identification and composition change of the bacteria in saliva of patients treated with radiation therapy can be used (1) as a reference for deciding on the ideal anti-microbial spectrum of the oral rinsing agent to be used in patients treated with radiation therapy for malignant tumor of the head and neck region. (2) to enhance the understanding of increase of opportunistic infection after immunochemical changes of the saliva and its relation to specific bacterial infection. (3) as a reference in prescribing prophylactic antibiotics in immunodepressed patients after radiation therapy.
Anti-Bacterial Agents ; Bacteria ; Bacterial Infections ; Candida ; Dental Caries ; Follow-Up Studies ; Head ; Humans ; Mouth Neoplasms* ; Mucositis ; Neck ; Opportunistic Infections ; Saliva ; Seoul