Methods of management of Legg-Calve-Perthes Disease (LCPD) are at present controversial. Some practical prognostic indices were imperative for proper management of the disease. .We followed up on twenty LCPD patients-14 who underwent varization osteotomy of proximal femur and 6 who underwent pelvic innominate osteotomy or shelf procedure-for more than 3 years and analyzed the results using the Stulberg classification. There were three requirements for the hip to be included in this study: follow-up until residual stage occurred, Catterall group III or IV and complete clinical and radiological data. The purpose of this study-was to determine the validity of radiological and clinical factors in predicting prognosis in surgical treatments. Results of the evaluation were as follows; 1.Age was found to be an important prognostic index. Older children aged > 9 years tended to do worse than younger children (P<0.05). Other prognostic indices were not found to be statistically significant. 2. When Stulberg classification IV atients were considered, there were common factors in the children who were more than 9 years old, were of Catterall group IV, and late fragmentation stage disease with more than 1.5 of the lateral subluxation index, regardless of treatment. 3. Although Catterall's classification had been widely accepted, Catterall group III or IV seemed to be difficult to be distinguished. Many cases that had been regarded as Catterall group IV were proved to have intact posteromedial portion of femoral head later in residual stage. 4. Even though well-known prognostic indices were important in anticipating the results, we considered additional unknown biomechanical factors. In some cases continuous deformation of femoral head would not be prevented even though necrotic portion of femoral head was well contained by surgical treatment.
Child ; Classification ; Femur ; Follow-Up Studies ; Head ; Hip ; Humans ; Legg-Calve-Perthes Disease* ; Osteotomy ; Prognosis

STATEMENT OF PROBLEM: The most commonly reported problem associated with dental implant restoration is the loosening of the screws. PURPOSE: This study compared the efficacy of an implant system incorporating an anti-rotational locking sleeve(Anti-Rotating Inner Post Screw System(ARIPS-system)) with other, traditional implant systems as a means of minimizing vibration loosening. MATERIALS AND METHODS: Three implant systems were examined; the conventional external hex type, the ARIPS-system, and the internal taper type implant system. 30 specimens(10 samples per group)were fabricated and each abutment screw was secured to the implant fixture with 32Ncm of torque force and loosening torque was measured using a Torque Gauge. The procedure was repeated 3 times, recording initial loosening torque each time. The re-tightened abutment screw was subjected to a cyclic load having a maximum force of 200N and minimum of 20N at 2Hz over a period of 12,600 cycles, after which the loosening torque was measured. Measured values were calaulated for statistical analysis. Analysis of measured value was performed by 3 methods: (i) as a percentage average of the initial 3 loosening-torque values(initial loosening value) to the tightening torque of 32Ncm, (ii) as a percentage of the loosening torque value after a load of 200N(experimental value) to the initial loosening value, and (iii) as a percentage of the experimental value to the 32Ncm of tightening torque. The analyses shows the amount of initial loosening at the screw, loosening by repetitive load and the the final loosening value. RESULTS: The results of this study were as follows. (1) Percentage of initial loosening value to tightening-torque was increased in order of external hex, ARIPS-system and internal taper and all values between each groups showed statistical significance (p<0.05). (2) Percentage of experimental value to initial loosening value was increased in order of external hex, ARIPS-system and internal taper. Value of internal taper showed significant difference with those of external hex and ARIPS-system (p <0.05). (3) Percentage of experimental value to tightening torque was increased in order of external hex, ARIPS-system and internal taper and all values between each groups showed statistical significance (p <0.05). CONCLUSION: The results of the analysis of the final loosening level value, which are closely correlated to clinical use, show that the ARIPS-system can be a useful means of minimizing abutment screw loosening when compared to the external hex type system. Although further clinical studies need to be made, the ARIPS-system should be considered to maximize the long-term success of the implant prosthesis.
Dental Implants ; Prostheses and Implants ; Torque ; Vibration

Turnip yellow mosaic virus (TYMV) is a spherical plant virus that has a single 6.3 kb positive strand RNA as a genome. Previously, we have made the recombinant TYMV construct containing a 0.7 kb eGFP gene or a 1.8 kb GUS gene. The genomic RNAs from these constructs were efficiently encapsidated. To examine in more detail whether size constraint exists for replication and packaging of TYMV, we have inserted into the TY-GUS an extra sequence derived from either eGFP or GUS. We also made a recombinant containing RNA1 sequence of Flock house virus. These TYMV recombinants were introduced into Nicotiana benthamiana leaves by agroinfiltration. Northern blot analysis of the viral RNAs in the agroinfiltrated leaves showed that the genomic RNA band from the recombinant TYMV became weaker as longer sequence was inserted. The result also showed that the efficiency of genomic RNA encapsidation decreased sharply when an extra sequence of 2.2 kb or more was inserted. In contrast, the recombinant subgenomic RNA containing an extra sequence of up to 3.2 kb was efficiently encapsidated. Overall, these results show that size constraint exists for replication and encapsidation of TYMV RNA.
Blotting, Northern ; Genome ; Genome Size* ; Plant Viruses ; Product Packaging* ; RNA ; RNA, Viral ; Tobacco ; Tymovirus*

PURPOSE: The aim of this study was to verify the effects of daily 2% chlorhexidine gluconate (CHG) bathing on the acquisition of multidrug-resistant organisms (MDRO) and healthcare-associated infection (HAI) in a medical intensive care unit (MICU). METHODS: The study was a randomized controlled group posttest only design, involving 91 patients in MICU at a tertiary hospital (47 patients in the experimental group and 44 patients in the control group). The 2% CHG bathing was performed daily according to bathing protocol to the patients in the experimental group, and traditional bath was performed every three days to those in the control group. Fisher's exact test and χ² test were used to analyze the data. RESULTS: MDRO were found in 6 patients of the experimental group and in 15 patients of the control group. The difference was statistically significant (p=.016). HAI occurred in 2 patients of the experimental group and in 7 patients of the control group. The difference was not statistically significant (p=.084). CONCLUSION: The results confirmed that daily bathing with CHG was effective in reducing the incidence of MDRO acquisition. Therefore, it is expected that daily bathing with CHG will be used as an effective nursing intervention to reduce the incidence of MDRO acquisition.
Baths ; Chlorhexidine ; Critical Care ; Cross Infection ; Drug Resistance, Microbial ; Humans ; Incidence ; Intensive Care Units ; Nursing ; Tertiary Care Centers

Purpose: To evaluate the clinical characteristics and courses of Best disease in Korean patients. Methods: We retrospectively reviewed the medical records of patients with Best disease followed-up for more than 12 months after diagnosis. The disease stage and best-corrected visual acuity (BCVA) at diagnosis, and stage progression during follow-up, were evaluated. The BCVA at diagnosis was compared to that at the final follow-up. The BCVA changes were compared between those evidencing stage progression and not. Results: A total of 16 patients (32 eyes) were enrolled. The mean follow-up period was 52.1 ± 31.8 months. At diagnosis, three eyes had stage 1, nine stage 2, seven stage 3, 11 stage 4, and two stage 5 disease. During follow-up, stage progression was observed in nine eyes (28.1%). The mean logarithm of the minimal angle of resolution (logMAR) BCVA significantly worsened from 0.19 ± 0.19 at baseline to 0.30 ± 0.27 at the final follow-up (p = 0.004). In six eyes (18.8%), a deterioration of logMAR 0.2 or greater was noted. The extent of deterioration was greater in the nine eyes (0.25 ± 0.26) exhibiting stage progression than in the 24 eyes (0.05 ± 0.08) lacking such progression (p = 0.001). Conclusions The visual acuity of Best disease patients was relatively good at diagnosis. However, stage progression and visual deterioration were noted in some patients. Stage progression was associated with a poor visual prognosis.

Purpose: To evaluate the clinical characteristics and courses of Best disease in Korean patients. Methods: We retrospectively reviewed the medical records of patients with Best disease followed-up for more than 12 months after diagnosis. The disease stage and best-corrected visual acuity (BCVA) at diagnosis, and stage progression during follow-up, were evaluated. The BCVA at diagnosis was compared to that at the final follow-up. The BCVA changes were compared between those evidencing stage progression and not. Results: A total of 16 patients (32 eyes) were enrolled. The mean follow-up period was 52.1 ± 31.8 months. At diagnosis, three eyes had stage 1, nine stage 2, seven stage 3, 11 stage 4, and two stage 5 disease. During follow-up, stage progression was observed in nine eyes (28.1%). The mean logarithm of the minimal angle of resolution (logMAR) BCVA significantly worsened from 0.19 ± 0.19 at baseline to 0.30 ± 0.27 at the final follow-up (p = 0.004). In six eyes (18.8%), a deterioration of logMAR 0.2 or greater was noted. The extent of deterioration was greater in the nine eyes (0.25 ± 0.26) exhibiting stage progression than in the 24 eyes (0.05 ± 0.08) lacking such progression (p = 0.001). Conclusions The visual acuity of Best disease patients was relatively good at diagnosis. However, stage progression and visual deterioration were noted in some patients. Stage progression was associated with a poor visual prognosis.

Purpose: To evaluate the clinical characteristics of Korean patients diagnosed with retinitis pigmentosa. Methods: We retrospectively reviewed the medical records of patients diagnosed with retinitis pigmentosa from January 2014 to December 2019. We evaluated age, gender, the chief complaints, posterior subcapsular cataract status, abnormalities on optical coherence tomography, visual field test results, and electrooculograms. Results: A total of 492 eyes of 246 patients were included. The mean patient age was 48.0 ± 16.0 years and the chief complaints were decreased vision and night blindness. The mean logarithm of the minimal angle of resolution (logMAR) best‐corrected visual acuity (BCVA) was 0.31 ± 0.50. The BCVA was 0.5 or better in 368 eyes (74.8%). A total of 328 (71.0%) of 462 eyes that underwent visual field testing exhibited visual field defects within 10º. The mean Arden ratio was 1.28 ± 0.28 for the 242 eyes that underwent electro‐oculography. Optical coherence tomography revealed vitreomacular traction/an epiretinal membrane, cystoid macular edema, and retinal thinning in 135 (27.4%), 48 (9.8%), and 112 (22.8%) eyes, respectively. The ellipsoid zone was intact in 222 eyes (45.1%), disrupted in 220 (44.7%), and absent in 50 (10.2%). Conclusions Most patients with retinitis pigmentosa exhibited visual acuity of 0.5 or better, but also had central visual field defects. Various abnormalities were noted on optical coherence tomography of most patients.

OBJECTIVE: The purpose of this study was to evaluate the efficacy of implant removal of percutaneous short segment fixation after vertebral fracture consolidation in terms of motion preservation. METHODS: Between May 2007 and January 2011, 44 patients underwent percutaneous short segment screw fixation due to a thoracolumbar burst fracture. Sixteen of these patients, who underwent implant removal 12 months after screw fixation, were enrolled in this study. Motor power was intact in all patients, despite significant vertebral height loss and canal compromise. The patients were divided into two groups by degree of osteoporosis : Group A (n=8), the non-osteoporotic group, and Group B (n=8), the osteoporotic group. Imaging and clinical findings including vertebral height loss, kyphotic angle, range of motion (ROM), and complications were analyzed. RESULTS: Significant pain relief was achieved in both groups at final follow-up versus preoperative values. In terms of vertebral height loss, both groups showed significant improvement at 12 months after screw fixation and restored vertebral height was maintained to final follow-up in spite of some correction loss. ROM (measured using Cobb's method) in flexion and extension in Group A was 10.5degrees (19.5/9.0degrees) at last follow-up, and in Group B was 10.2degrees (18.8/8.6degrees) at last follow-up. Both groups showed marked improvement in ROM as compared with the screw fixation state, which was considered motionless. CONCLUSION: Removal of percutaneous implants after vertebral fracture consolidation can be an effective treatment to preserve motion regardless of osteoporosis for thoracolumbar burst fractures.
Follow-Up Studies ; Humans ; Methods ; Osteoporosis ; Range of Motion, Articular

Objective: Medication beliefs are a significant determinant of medication adherence in chronic illness. This study aimed to identify demographic, clinical, and medication-related factors associated with medication beliefs in patients with Parkinson’s disease (PD). Methods: We used a descriptive cross-sectional design with a convenience sample of 173 PD patients who had been taking antiparkinson drugs for more than one year. Results: The subjects who believed PD medication was more necessary had more severe illness, younger age of onset, longer illness duration, and longer duration of levodopa therapy. They had higher levels of non-motor symptoms and depression, number of medication uses, number of drugs, and levodopa equivalent dose, and they reported fluctuation of motor symptoms and dyskinesia. The subjects who used catechol-O-methyltransferase (COMT) inhibitors, dopamine agonists, amantadine, and monoamine oxidase-B (MAO-B) inhibitors had significantly higher necessity scores than those who did not use them. The subjects who had higher concerns about PD medications had higher levels of non-motor symptoms and depression. The subjects using amantadine and anticholinergics had significantly higher concern scores than those who did not use them. Positive necessity-concerns differentials were associated with severe illness, the presence of motor fluctuation and dyskinesia, and the use of COMT inhibitors. Based on stepwise multiple regression, the most significant factors influencing necessity beliefs were severe illness, followed by depression and motor fluctuation. Conclusion Severe illness, higher levels of depression, and motor fluctuation are independent factors influencing patients’ beliefs regarding medication necessity. Therefore, these characteristics should be considered in medication belief assessment and interventions for PD patients.

Objective: Medication beliefs are a significant determinant of medication adherence in chronic illness. This study aimed to identify demographic, clinical, and medication-related factors associated with medication beliefs in patients with Parkinson’s disease (PD). Methods: We used a descriptive cross-sectional design with a convenience sample of 173 PD patients who had been taking antiparkinson drugs for more than one year. Results: The subjects who believed PD medication was more necessary had more severe illness, younger age of onset, longer illness duration, and longer duration of levodopa therapy. They had higher levels of non-motor symptoms and depression, number of medication uses, number of drugs, and levodopa equivalent dose, and they reported fluctuation of motor symptoms and dyskinesia. The subjects who used catechol-O-methyltransferase (COMT) inhibitors, dopamine agonists, amantadine, and monoamine oxidase-B (MAO-B) inhibitors had significantly higher necessity scores than those who did not use them. The subjects who had higher concerns about PD medications had higher levels of non-motor symptoms and depression. The subjects using amantadine and anticholinergics had significantly higher concern scores than those who did not use them. Positive necessity-concerns differentials were associated with severe illness, the presence of motor fluctuation and dyskinesia, and the use of COMT inhibitors. Based on stepwise multiple regression, the most significant factors influencing necessity beliefs were severe illness, followed by depression and motor fluctuation. Conclusion Severe illness, higher levels of depression, and motor fluctuation are independent factors influencing patients’ beliefs regarding medication necessity. Therefore, these characteristics should be considered in medication belief assessment and interventions for PD patients.