The purpose of this study is to evaluate the short-term results of the reconstruction of acetabular bone defect radiographically. Twenty three reconstruction with bone graft and non-cemented porous hemispherical cup and one reconstruction with bone graft and cemented polyethylene cup that had been performed in 24 patients from 1991 at Wonkwang University Hospital and had followed more than one year were included in this study. Osseous union, resorption of the graft, the amount of the migration and angle change of the acetabular components and radiolucency were checked on plain X-ray. 9 morselized grafts for contained defect showed 100% union within 6 months, without severe resorption and loosening. Of the 15 structural grafts, 11 minor column or shelf grafts showed 100% union and remodeling, and one case of radiolucency around the cup. There were two collapses of the structural graft and one migration of the cup which suggest the failure among the 4 major column grafts. For the above 3 failed cases, non-cemented porous hemispherical cups were used. In conclusion, bone graft for reconstruction of the deficient acetabular bone stock seems to be suc- cessful, but the use of cement and the delay of weight bearing should be considered for the major column graft.
Acetabulum* ; Arthroplasty, Replacement, Hip ; Humans ; Polyethylene ; Transplants* ; Weight-Bearing

No abstract available.
Tibia*

Epinephrine ; Pulmonary Edema

There were 21 cases of tibial pilon fractures in total: type I-2 cases, type II-14 cases, type III-5 cases according to Rued's classification. In type I and II, ring fixators were applied to tibia and foot and closed reduction was performed monitoring the quality of the reduction with an image intensifier. When the quality of the reduction was questionable, we rechecked it using arthroscopy and if neces- sary, the reduction was readjusted. Instead of using plate and screws, we used olive stop wires to achieve stable fixation. In type III, a limited open reduction was performed in the place of arthroscopy. Approximately at the eighth week after operation, we removed the fixation of calcaneus, metatarsal and foot mounting. Between 16 and 28 weeks, we removed the foot mounting after achieving bony union in all cases except one case(20 cases). In the follow-up cases of 2 years and more, we obtained the fine functional results of 15 good, 4 fair and 2 poor cases. Fewer major complications were observed except 8 cases of pin tract infection(grade 1) and 1 case of reduction loss. Using ring fixators and arthroscopy, we had fewer surgical complications.
Arthroscopy ; Calcaneus ; Classification ; Follow-Up Studies ; Foot ; Metatarsal Bones ; Olea ; Tibia

PURPOSE: To compare the functional results of posterior cruciate-retaining (PCR) and posterior sub- stituting (PS) replacement in patients undergoing primary total knee arthroplasty (TKA) for osteoarthritis. MATERIALS AND METHODS: A randomized controlled study was carried out to compare the clinical and radiological outcomes of PCR and PS primary P.F.C.(R) TKA. One hundred and sixty eight patients (188 cases), who had a primary diagnosis of osteoarthritis, and an intact functioning posterior cruciate ligament, were enrolled in this study. The patients were randomized regardless of the level of posterior cruciate ligament preservation. One hundred and eighty eight cases had a minimum 6-year follow-up, which included 96 and 92 cases in the PCR and PS groups, respectively. RESULTS: The Knee Society Score, the Hospital for Special Surgery (HSS) knee rating scores, average flexion contracture and radiologic alignment improved significantly, but there were no significant difference between the two groups. On the other hand, the mean postoperative flexion angles in the PCR and PS knees increased from 114.7degrees to 121.2degrees and 119.3degrees to 131.3degrees, respectively (p<0.05). CONCLUSION: There were no significant differences between PCR and PS TKA in the follow-up knee scores. However, the level of postoperative improvement in further flexion was better in the PS group.
Arthroplasty ; Contracture ; Follow-Up Studies ; Hand ; Humans ; Knee ; Osteoarthritis ; Polymerase Chain Reaction ; Posterior Cruciate Ligament

INTRODUCTION: Radial nerve palsy is a fairly common complication of fracture of the humerus. We know that if axonal continuity is not restored within a reasonable period of time, motor end plates and muscle atrophy, distal segments constrict, and sensory reception is substantially less than it was before the injury. So in cases of humeral shaft nonunion associated with complete, old radial nerve palsy, the nerve should be explored with surgical treatment becoming necessary. PURPOSE: The purpose of this study is to compare the results of primary and secondary radial nerve palsy and to investigate the influence of age, delay in nerve surgery, and length of nerve defect on the results of nerve surgery in humeral shaft nonunion associated with complete, old radial nerve palsy. MATERIALS AND METHODS: From March 1985 to March 1996, 32 cases who had complete radial nerve palsy associated with humeral shaft nonunion were treated by various surgical treatments, such as neurolysis or nerve graft for the injured nerve. The ages of the patients studied ranged from 12 to 66 years (average 38.3 years). The interval between operation or trauma that caused radial nerve palsy and nerve surgery ranged from 6 to 23 months (average 10.8 months). The cause of radial nerve palsy were initial trauma in 18 cases and operations for fracture in 14 cases. The practical cause of radial nerve palsy were found by surgical exploration: 13 cases were severe atrophy and adhesion of nerve by surrounding scar tissue, 15 cases were cross section of nerve and 4 cases were entrapment between the site of fracture or by DCP plate. RESULTS: The overall recovery rate of radial nerve palsy was 56.3%. CONCLUSIONS: In the author's experience, the amount of nerve tissue lost and delayed time of surgery causes a more unfavorable prognosis. Early surgery is recommended for radial nerve palsy associated with humeral shaft nonunion.
Atrophy ; Axons ; Cicatrix ; Humans ; Humerus ; Muscular Atrophy ; Nerve Tissue ; Paralysis* ; Prognosis ; Radial Nerve* ; Transplants

BACKGROUND: Though many adolescents are suffering from depression in Korea, there have been few studies about the prevalence of it and depressive adolescents are not managed appropriately yet because of ignorance of the society and family. This study was intended to find out college freshmen's prevalence of depression, and the relationship between family function and depression. METHODS: The subjects were college freshmen of one university both in Seoul and Suwon and the study period was from January to February on 1999. Family APGAR was used as a family function index and Beck's Depression Inventory (BDI) was used to measure the degree of depression. Chi square tests and logistic regression were done for analysis using SPSS 8.0/PC program. RESULTS: The prevalence of depression among college freshmen was 1.5%(37 out of 2465) as of BDI score 21 or more. Depression was more common in the families with low Family APGAR score and those in Suwon campus. No significant differences were found in gender, age, blood pressure, blood type, BMI, present illness, number of families, marital status of parents or siblings. Relative risks of depression were 4.5 times for family dysfunction group and 2.6 times for Suwon campus group. CONCLUSION: Depression is not a rare disease among college freshmen. Therefore, family physician as a primary care physician should consider the possibility of depression among adolescence and screen depression using BDI for adolescents in dyfunctional family particularly.
Adolescent ; Apgar Score ; Blood Pressure ; Depression* ; Gyeonggi-do ; Humans ; Korea ; Logistic Models ; Marital Status ; Parents ; Physicians, Family ; Physicians, Primary Care ; Prevalence ; Rare Diseases ; Seoul ; Siblings

OBJECTIVES: This study was conducted to compare the mothers' rearing attitude of ADHD children and that of children with depressive disorder. METHODS: The participant consisted of 58 school-aged children diagnosed as ADHD, 14 children diagnosed as depressive disorder based on DSM-IV criteria. Normal control group consisted of 34 school-aged children who are free of any diagnosis of psychiatric disorders. Parental Acceptance-Rejection Questionnaire, Parenting Style Questionnaire, Children's Depression Inventory, Marital Satisfaction Scale, Beck's Depression Inventory were administered to all children and their mothers. RESULTS: The parents of ADHD children showed more aggressive/hostile, neglecting/indifferent and less warm/affectionate parenting styles to their children than those of the depression and control groups. The depressive group perceived their parents as more rejecting than the control groups. CONCLUSION: The externalizing symptoms of ADHD might provoke parental distress and make it difficult for the parents to show positive rearing attitude toward their children. The depressive children might be more sensitive and perceptive to the negative sign of their parents' rearing attitude.
Child ; Depression ; Depressive Disorder ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Parenting ; Parents ; Surveys and Questionnaires

PURPOSE: To analyze the clinical and radiographic results after revision total knee arthroplasty (TKA) using Nexgen(R) LCCK (Legacy(R) knee constrained condylar knee, Zimmer, Warsaw, IN) with allograft. MATERIALS AND METHODS: Twenty patients (21 knees) taken revision TKA were analyzed. The average age of the patients was 69.2 years old and the average of follow-up duration was for 2 year to 8 years 2 months (average 3 years 5 months). The clinical result and radiographic measurements were assessed using the Hospital for Special Surgery (HSS) knee rating score and the roentgenographic method of the American Knee Society. RESULTS: The mean interval from TKA to revision surgery was 6 years 4 months. In all cases, allograft was used. The average range of motion was increased from 93degrees to 107degrees, HSS score was increased from an average of 45 to 87 points. Postoperative femorotibial alignment was averaged 5.7degrees valgus. In all cases, radiolucency was below 4 scores and there was no loosening of implant. But, three radiopaque lines around a stem. There were wound dehiscence in 1 case and superficial infection in 2 cases. CONCLUSION: Satisfactory results were obtained in revision TKA using a NexGen(R) LCCK with allograft. But, this study is favorable for the long term follow-up.
Arthroplasty ; Follow-Up Studies ; Humans ; Knee ; Range of Motion, Articular ; Transplantation, Homologous

Pseudohypoparathyroidism(PHP) is a genetic disorder characterized by target cell resistance to the effect of parathyroid hormone(PTH). The disorder is classified into type I a, I b, I c and II depending on the phenotype and biochemical findings. In type I a, urinary cyclic AMP and urinary phosphate excretion are not increased after PTH stimulation because of deficient G unit activity in target cells. Deficiency of the G unit is a generalized cellular defect and accounts for the association of other endocrine disorders with type I a PHP. Type I b PHP shows resistance to PTH but not to other hormones and normal phenotypic appearance. In type I c PHP affected children have defect in catalytic unit of adenylate cyclase and in addition to resistance to PTH, resistance to the metabolic effects of TSH, gonadotropins, and glucagon may be detected. Typical appearance of Albright's hereditary osteodystrophy is common in PHP type Ia and Ic. In type II PHP, urinary cyclic AMP response is generated but this does not lead to phosphaturia. We experienced two patients with PHP. One is a 11-year-old girl diagnosed type I a PHP and the other is a 11-year-old boy suspected type I b PHP. They visited emergency room because of tetanic movement. Both patients had no previous history of tetany and showed low serum calcium level, high phosphorus level and high PTH level. The girl had typical features of Albright's hereditary osteodystrophy such as round face, short neck, obese feature, brachydactyly and mental retardation but didn't have basal ganglia calcification on brain CT. The boy showed normal appearance and no mental retardation.
Adenylyl Cyclases ; Basal Ganglia ; Brachydactyly ; Brain ; Calcium ; Child ; Cyclic AMP ; Emergency Service, Hospital ; Female ; Glucagon ; Gonadotropins ; Humans ; Hypophosphatemia, Familial ; Intellectual Disability ; Male ; Neck ; Phenotype ; Phosphorus ; Pseudohypoparathyroidism* ; Tetany