We analysed the results of total knee replacement arthroplasty without patellar resurfacing in 20 patients(28 knees) retrospectively. The patella was not resurfaced when it maintained relatively healthy cartilage in osteoarthritis or the patella was too thin to be replaced in rheumatoid arthritis. The diagnoses were osteoarthritis in 11 and rheumatoid arthritis in 17 cases. The follow up period was 30.3 months in average(12-70 months). A lateral retinacular release was performed in 22 knees(78.6%). The mean knee society score improved from 45.4 preoperatively to 84.1 postoperatively and the functional score improved from 21.4 preoperatively to 63.3 postoperatively. The modified Kujala score was 43.2 points in osteoarthritis and 43.6 points in rheumatoid arthritis. We conclude the total knee replacement arthroplasty without patellar resurfacing shows good results, without high risk of postoperative peripatellar complication.
Arthritis, Rheumatoid ; Arthroplasty* ; Arthroplasty, Replacement, Knee* ; Cartilage ; Diagnosis ; Follow-Up Studies ; Knee ; Osteoarthritis ; Patella ; Retrospective Studies

No abstract available.
Leydig Cell Tumor*

No abstract available.
Impetigo*

No abstract available.
Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use ; Crohn Disease/*complications/*drug therapy ; Female ; Humans ; Intestinal Obstruction/*etiology ; Male

Background & Objectives: Frontal executive dysfunction, which is hypothesized to reflect dorsolateral prefrontal function, predominates in Parkinson’s disease (PD). Visuospatial dysfunction and episodic memory deficit, which are associated with the posterior cortical area, are critical symptoms of mild cognitive impairment in PD (PD-MCI). The first aim of this study is to investigate whether dominant cognitive deficits are caused by posterior cortical dysfunction in drug naïve, de novo PD-MCI patients. The second aim is to analyze the relationship between parkinsonian motor symptoms and the cognitive domain in these patients. Methods: Newly diagnosed PD patients who had not received treatment were divided into two subgroups as follows: PD-MCI (n=39) and PD patients with normal cognition (PD-NC) (n=39). Various neuropsychological tests were performed in all of the patients. The parkinsonian motor subscores were divided into tremor, rigidity, axial impairment, bulbar dysfunction and bradykinesia by the UPDRS motor scores. Results: Verbal episodic memory (immediate recall; p = 0.0001, delayed recall; p = 0.0001, recognition; p = 0.003), visual episodic memory (immediate recall; p = 0.0001, delayed recall; p = 0.002) and visuospatial function (p = 0.046) were lower in the PD-MCI group than in the PD-NC group. In the analysis of the correlation of the motor components to the cognitive tests, impairment in visual episodic memory correlated with axial symptoms (immediate recall; r = -0.441, p = 0.021, delayed recall; r = -0.393, p = 0.042). The contrast program test correlated with bradykinesia (r = -0.479, p = 0.013) Conclusion: Episodic memory and visuospatial dysfunction, which reflect impairment of the posterior cortical area, are critical cognitive deficits, and memory impairment is correlated with the axial symptoms that are associated with non-dopaminergic pathways in newly diagnosed PD-MCI patients.

Behavioral and psychological symptoms of dementia are major components of Alzheimer’s disease. In this study, we aimed at investigating the prevalence and severity of behavioral and psychological symptoms of dementia in very mild to mild Alzheimer’s disease. Forty-four patients with Alzheimer’s disease who visited the neurology outpatient clinic of Seoul Medical Center were included. A trained neurologist or a supervised test technician administered the neuropsychological test, the Seoul Neuropsychological Screening Battery including Mini Mental State Examination and Clinical Dementia Rating. The instrument used for assessing behavioral and psychological symptoms of dementia was Neuropsychiatric Inventory-Questionnaire. In order of prevalence, apathy, depression, irritability, anxiety, and agitation were the most common symptoms occurring in very mild-to-mild Alzheimer’s disease group. The prevalence and severity of behavioral and psychological symptoms of dementia were found to be in positive correlation with the Clinical Dementia Rating scores. Behavioral and psychological symptoms of dementia are found even in the very early stage of Alzheimer’s disease, apathy and depression being the most common symptoms. Physicians should be aware of this when managing dementia patients.

The purpose of this study is to evaluate the results of primary repair and autogenous tendon augrnentation for acute rupture of anterior cruciate ligament. We primarily repaired 13 cases of acute ACL injury with autogenous tendon augmentation between Jul. 1988 and Jan. 1996. Among 13 cases, there were 2 isolated ACL injuries and 11 cases were combined with MCL injuries. All 13 cases were followed up over 1 year. An average follow up period was 4.1 years (1.1 - 8). All patients had open primary rnultiple suture repair and semitendinosus tendon (11 cases) or iliotibial band (2 cases) augmentation at average 3.6 days after the injury. In 11 cases, medial collateral ligarnent injuries were noted and these ruptured ligaments were supplemented with staple or vicryl suture. We evaluated the results with Lysholm Knee Score, KT-1000 arthrometer, postoperative ROM of knee, thigh muscle atrophy, extension lag, Lachman and pivot shift test. The clinical results were as follows 1. Lysholm Knee Score was mean 87.2 points; over 90 points: 5 cases, 80-8$ points: 5 cases, 70-79 points: 3 cases 2. Using the KT-1000 arthrometer, the average side to side difference wm 1.8nun in 201b (89N) and the compliance index was average 1.7mm. 3. Postoperative ROM of knee was nearly normal and there was no extensioe lag in any cases. But, we performed arthroscopic adhesiolysis in one case for limited motion of knee joint a ( postoperative 8 months. Thigh circumference was measured 0.95 cm difference than the healthy side at 10cm above upper pole of patella. 4. Lachman test was positive in 2 cases. 5. Pivot shift test was positive in 2 cases. Even if not many cases, we obtained relatively satisfactory results. So the pirimary repair with autogenous tendon auynentation was recornmandable procedure for acute rupture of ACL, especially combined with MCL injury.
Anterior Cruciate Ligament ; Compliance ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Ligaments ; Methods ; Muscular Atrophy ; Patella ; Polyglactin 910 ; Rupture ; Sutures ; Tendons* ; Thigh

The previous reports about Supracondylar-Condylar Fracture of the femur which extends to articular surfaces revealed poor results in general, regardless of the methods of treatment. But those results are thought to be much alleviated if they are treated according to the principles of ASIF. Fifteen cases of Supracondylar-condylar fractures of the femur from 13 patients were treated by open reduction and rigid internal fixation during last 3 years at Department of Orthopedic Surgery, Early mobilization of knee joint was permissible in most of the cases without loss of fixation or other complications during convalescence Subsequently, greatifying results were obtained as observed in varying period of follow up days.
Convalescence ; Early Ambulation ; Femur ; Follow-Up Studies ; Humans ; Knee Joint ; Orthopedics

36 consecutive cases of major limbs replantation and 81 consecutive cases of finger replantation performed at Kyung Hee University Medical Center from Oct. 1975 through Sept. 1979 were reviewed. In 19 cases, amputation had occurred in wirst or palm. In 11 cases, amputation had occurred between forearm and shoulder. In 4 cases, amputation had occurred in thigh and leg. In 26 cases, amputation had occurred in thumb, and in 47 cases in index. The youngest was 4, the oldest was 52 in limb amputation, but from 5 through 38 in finger amputation. All amputed parts were cooled while awaiting replantation. Ischemic period was from 4 hours and 30 minutes to 29 hours and 35 minutes in limb amputation. And circulation was reestablished from 4 hours and 30 minutes to 29 hours and 35 minutes in limb replantation, and from 4 hours and 40 minutes to 15 hours and 10 minutes in finger replantation. In all cases bone was shortened from 2 to 5 cm in limb replantation, and from 0.3 to 0.8 cm in finger replantation and stabillzed by means of skeletal fixation. Dicision regarding primany repair of nerves and tendons depended upon the level and extent of local injury, but most cases performed primary repair. The success rate were 80.6% (29/36) in limb replantation, and 88.9% (72/81) in finger replantation respectively. Main cases of failure were thrombosis at anastomosed vessel, tissue crushing at distal part, and too long ischemic period. Surgical technique, type and level of amputation, number of artery and vein anastomosis, and ischemic period had direct relationship to success rate. But degree of amputation, patients age, infection in amputed part, and systemic heparinization had no relationship to success rate. In limb replantation, 25 cases were achieved follow up study from 6 months to 43 months. All cases except two were satisfied wlth replanted Iimbs, and were fully independent carrying out activities of daily living. All cases show cold intolerance. In finger replantation, 59 cases were achieved follow up study from 6 months to 47 months. All cases were satisfied wlth replanted digits, and used their replanted digits for grip, pinch, and hook. 46 cases (80%) had return of two polnt discrimination of less than 10 mm and useful finger Joint motion. Early and aggressive rehabilitation can be achieved good functional result in replanted limb and digit.
Academic Medical Centers ; Activities of Daily Living ; Amputation ; Arteries ; Discrimination (Psychology) ; Extremities ; Finger Joint ; Fingers ; Follow-Up Studies ; Forearm ; Fracture Fixation ; Hand Strength ; Heparin ; Humans ; Leg ; Rehabilitation ; Replantation ; Shoulder ; Tendons ; Thigh ; Thrombosis ; Thumb ; Veins

The tuberculous infection of the skeletal system especially, tuberculous spondylitis is frequently encountered with orthopedic fields. Up to date, Various methods of the treatment are present but each method has problems. Recently, as a development of the microsurgical instrumentation and surgical technique, we had been tried to the two patients of tuberculous spondylitis by vascularized fibular bone graft and anterior fusion. The advantages were as follows; 1. Shortened the bony union times by this operative method. 2. Earlier returning to the social activities compared to the ordinary method. 3. The children involved tuberculous spondylitis with severe kyphosis, who can be corrected the severe kyphosis by this operative method. 4. We can be obtained the rigid graft bone fixation with adequate length of bone by this operative method.
Child ; Humans ; Kyphosis ; Methods ; Orthopedics ; Spondylitis ; Transplants