Erratum agreed to by all authors, editor in chief, publisher, and scientific society.

Vertical and marginal fractures of the patella are uncommon injuries compared with other types of patellar fracture. It's possible that they are more common than supposed, but often remain undiagnosed as acute injuries. Vertical and marginal fractures often results in less acute disability than stellate or transverse fracture and the routine radiographs are often unhelpful. Failure to diagnose acute vertical and marginal fractures of the patella, especially when the fragments are displaced, may result in prolonged disability of the knee and possible development of degenarative changes in the patello-femoral joint later. Twelve patients of the vertical and the marginal patellar fractures treated at St. Mary's Hospital from Feb. 1982 to Dec. 1987 were analyzed in clinical and radiological aspect. The results obtained from this study were as followings. 1. Vertical and marginal fractures had 15.4% of injury rate in all patellar fractures. 2. The fracture and its displacement were always present on the tangential view of the patella. 3. The mechanism of the fracture was s direct blow to the patella in which the affected knee was flexed. 4. The location of the fracture line was related to the degree of the flexed knee at the time of fracture. 5. Large separated fragments of the patella should be accurately reduced with rigid fixation in the rationale of the intraarticular fracture.
Clinical Study ; Humans ; Intra-Articular Fractures ; Joints ; Knee ; Patella

No abstract available.
De Lange Syndrome*

In 1941, Jaffe and coworkers studied a lesion with histologic appearance of fibrous stroma, pigmented deposition and histiocytic infiltration as well as giant cell, for which they named pigmented villonodullar synovitis, bursitis and tenosynovitis. Thereafter many authors have disscussed etiology, clinical and radiological features, pathology and treatment regarding the disease. Recently we experienced a case of pigmented villonodular synovitis involving an hip joint which was treated by synovectomy and total hip replacement with good result.
Arthroplasty, Replacement, Hip ; Bursitis ; Giant Cells ; Hip Joint ; Hip ; Pathology ; Synovitis ; Synovitis, Pigmented Villonodular ; Tenosynovitis

No accepted standard currently exists to classify asphyxia and define its subtypes. Sauvageau and Boghossian proposed an asphyxia classification system in 2010 that divided asphyxia into suffocation, strangulation, mechanical asphyxia, and drowning. Here, we present a modification of this classification system. We propose to classify asphyxia into four main categories: suffocation, strangulation, mechanical asphyxia, and complicated asphyxia. Suffocation includes smothering and choking as well as confined spaces, entrapment, and vitiated atmosphere. Strangulation is subdivided into hanging, ligature strangulation, manual strangulation, and other unspecified strangulation. Mechanical asphyxia includes positional and traumatic asphyxia. Finally, complicated asphyxia is defined as cases with two or more identifiable mechanisms of asphyxia. In this study, we review autopsy cases from 2012 diagnosed as asphyxia and classify them according to our proposed asphyxia classification system. In 24.7% of cases, the age range was 40-49 years, and 51.9% were men. The most common method of asphyxia was hanging (245 cases, 55.1%), followed by ligature or manual strangulation (53 cases, 11.9%). Most hangings were suicides; smothering, ligature, and manual strangulation were usually homicides. Eighteen cases were complicated asphyxia. This classification provides a simplified, unified, and useful tool to classify and understand deaths due to asphyxia.
Airway Obstruction ; Asphyxia* ; Atmosphere ; Autopsy* ; Classification* ; Confined Spaces ; Drowning ; Homicide ; Humans ; Korea* ; Ligation ; Male ; Suicide

This statistical analysis of 4,709 legal autopsies performed in Korea in 2012 was conducted to obtain primary data about and related variables. The analysis revealed the following: 1. Of the total number of deaths, men accounted for and women, 26.8%. Evidently, the number of deaths among men was more than twice that among women. 2. With respect to mode of death, 54.8% were recorded as unnatural deaths, 39.2% were natural deaths, and 6.0% had unknown causes. Of the 2,581 unnatural deaths, 44.8% were accidental deaths; 27.2%, suicidal; 17.5%, homicidal; and 10.3%, undetermined. 3. Of the total number of unnatural deaths, 43.0% were trauma-related deaths, for which falling down was the leading cause, accounting for 33.5% cases. Asphyxiation was accounted for 17.2%, among which the predominant cause was hanging (55.3%). Moreover, 12.5% of deaths were due to drowning; 11.5%, poisoning; 11.2%, thermal injuries; 2.7%, complications in medical procedures; and 0.3%, electrocution, starvation, or neglect. 4. Among 1,847 natural deaths, heart diseases accounted for 50.2% and vascular diseases accounted for 16.7%. 5. There were 207 cases of deaths among children under the age of 10, of which 94 were unnatural and 49 were homicidal deaths. Of all cases, 9.2% had an unknown cause of death, and of these 67.6%, were putrefied or skeletonized bodies.
Autopsy* ; Cause of Death ; Child ; Drowning ; Female ; Heart Diseases ; Humans ; Korea* ; Male ; Poisoning ; Skeleton ; Starvation ; Vascular Diseases

This study was made to evaluate the effect of oral atenolol, a cardioselective beta-adrenergic blocking agent without intrinsic sympathomimetic activity, on left ventricular function in patient with essential hypertension. Atenolol, 100mg/day, was given to 11 hypertensive patients for 4 weeks, and its effects on arterial pressure, pulse rate, left ventricular dimensions and ejection phase indices of myocardial performance were examined by echocardiography. Echocardiographic studies were performed before treatment and after 4 weeks of atenolol therapy. Arterial pressure fell form 145/90 mmHg to 138/84mmHg after 4 weeks. Pulse rate fell significantly from 69/min to 58/min(p<0.05). Left ventricular end-diastolic and end-systolic dimensions and mean rate of circumferential fiber shortening(mVcf) did not change significantly. Ejection fraction increased significantly from 0.66 to 0.72(p=0.01). This results indicate that atenolol in the resting state has no depressant effect on left ventricular function in patients with essential hypertension.
Arterial Pressure ; Atenolol* ; Echocardiography ; Heart Rate ; Humans ; Hypertension* ; Ventricular Function, Left*

OBJECTIVES: The differentiation of tuberculous effusion from the other causes of exudative pleural effusion remained difficult even with aids of biochemical analyses and pleural biopsy. As the pathophysiology of tuberculous pleural effusion is an enhanced cell mediated immunity, Adenosine deaminase(ADA) and various cytokines including Inteferon-γ, tumor necrosis factor alpha(TNF-α) are considered as useful diagnostic tools in differentiating exudative pleural effusion The author would like to demonstrate the diagnostic usefulness of TNF-α in the differentiation of exudative pleural effusion, and compared the discriminating ability of TNF-α with ADA. METHODS: Pleural fluids obtained from 80 patients (tuberculous : 39, malignant : 31, parapneumonic : 10) with exudate pleural effusions were processed for cell counts and biochemical analysis including ADA and TNF-α RESULTS: Tuberculous pleural fluid showed higher levee of ADA and TNF-α, 48.7α 32.7U/L and 184.1±214.2pg/mL than that of non-tuberculous effusion 26.0α41.3U/L and 44.1α114.2pg/mL, respectively (ADA, TNF-α : p<0.05, p<0.01). Receiver operating characteristics(ROC) curves were generated for ADA and TNF-α, and the best cut-off value for adenosine deaminase and TNF-α were considered as 30U/L and 15pg/ml, respectively. Comparing the area under the ROC curves, there was no significant difference between ADA and TNF-α CONCLUSION: For the differential diagnosis of tuberculous pleural effusion from the other causes of exudative pleural effusions, TNF-α as well as ADA was considered as useful diagnostic method. However adding TNF-α to ADA has no further diagnotic benefit than ADA alone.
Adenosine ; Adenosine Deaminase ; Biopsy ; Cell Count ; Cytokines ; Diagnosis, Differential ; Exudates and Transudates ; Humans ; Immunity, Cellular ; Pleural Effusion* ; ROC Curve ; Tuberculosis ; Tumor Necrosis Factor-alpha*

BACKGROUND/AIMS: The aim of this study was to evaluate the clinical features and course of Crohn disease (CD) in children. METHODS: The medical records of 30 patients diagnosed with CD between January 1996 and December 2005 were reviewed retrospectively. RESULTS: The actual number of newly diagnosed patients with CD has increased during the 8-year period. The male/female ratio was 2:1 and the mean age at diagnosis was 10.6+/-4.3 years. The major symptoms of CD at diagnosis were abdominal pain (79.2%), weight loss (54.2%), perianal lesion (54.2%), diarrhea (45.8%), hematochezia (41.7%), anemia (29.2%), and fever (23.3%). The disease location of CD was the small bowel in 33.3%, the large bowel in 12.5% and both the small and large bowel in 54.2%. Granuloma was found in 54.2% of patients. The relapse rate of CD in the group with a higher pediatric Crohn disease activity index (PCDAI) at diagnosis (> or =30) was higher than in the group with a lower PCDAI (<30). The cumulative relapse rates of the patients with granuloma were 30.2% within 1 year and 53.8% within 5 years after the diagnosis. CONCLUSIONS: The incidence of CD in children appears to be increasing. Granuloma formation and a higher score of the PCDAI are associated with a more severe disease course. Pediatric CD may have a somewhat different clinical presentation from older-onset CD.
Abdominal Pain ; Anemia ; Child* ; Crohn Disease* ; Diagnosis ; Diarrhea ; Fever ; Gastrointestinal Hemorrhage ; Granuloma ; Humans ; Incidence ; Medical Records ; Recurrence ; Retrospective Studies ; Weight Loss

This study was performed to assess the effect of one year's of meal service for home-staying urban elderly with low incole on their nutritional status. One hundred and eighty three subjects, who had already completed the first nutritional survey, were assigned to two group : meal served(served) and non-meal served(non-served). A meal containing approximately on half of the RDA for energy, protein, calcium and iron was served as lunch everyday to served group. After on year of meal service, follow-up-nutritional survey was done and changes of parameters were analyzed with paired t-test. Served female showed signficantly increased intake of riboflavin and calcium, while non-served female showed significantly decreased intake of calcium. Serum total protein, serum albumin and serum cholesterol were significantly increased in female regardless of meal service. Served remale was observed with significantly elevated LDL-cholesterol, whereas non-served female showed singnificantly lowered HDL-cholesterol. Significantly decreased serum iron, serum transferrin saturaion and significantly increased TIBC were observed for female regardless of meal service. But the proportion of anemic elderly according to Hb or serum iron was decreased more in served group. Female showed significantly increased serum zinc and copper regardless of meal service, whereas only served male showed significantly increased serum copper.
Aged* ; Calcium ; Cholesterol ; Copper ; Female ; Humans ; Iron ; Lunch ; Male ; Meals* ; Nutrition Surveys ; Nutritional Status ; Riboflavin ; Serum Albumin ; Transferrin ; Zinc