Infection in primary total hip arthroplasty may cause catastrophic results and is the major reason for implant failure. The purpose of this study was to evaluate the utility of the hip joint fluid culture as a method of predicting the possibility of a hip joint infection by calculating the sensitivity, specificity and accuracy. We performed 628 primary total hip arthroplasty and aerobic and anaerobic bacterial cultures for hip joint fluid between January 1989 and June 1996. The hip joint fluid culture was routinely performed to evaluate the utility of the femoral head for bone banking. Thirty-two cases out of the 628 hips showed positive intraoperative culture and 596 cases showed negative intraoperative culture. The isolated organisms from 32 positive cultures were 11 for Staphylococcus aureus, eight for Staphylococcus coagulase negative, seven for Enterococcus, three for E.coli and one each for Enterobacter, Acinetobacter and Pseudomonas. Anaerobic culture was negative in all cases. In the positive intraoperative culture cases, none had delayed infection during the follow-up period. But in the negative intraoperative culture cases, one case had acute infection and two cases had delayed infection. In the case with acute infection, Staphylococcus aureus was isolated and on two cases with delayed infection, Enterococcus and Staphylococcus coagulase negative were isolated, respectively. All 32 positive culture cases were fa~lse positive and 595 negative culture cases were true negative and one negative culture case was fa~lse negative. The sensitivity of the hip joint culture was 0%, the specificity was 94.9% and the accuracy was 0%. The specificity of hip joint fluid culture in primary total hip arthroplasty was high, hut the sensitivity score was zero. Therefore, the hip joint fluid culture should not be used for a routine check of infection status in primary total hip arthroplasty. We recommend the hip joint fluid culture in revision arthroplasty or hips in which infection is clinically suspected.
Acinetobacter ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Bone Banks ; Coagulase ; Enterobacter ; Enterococcus ; Follow-Up Studies ; Head ; Hip Joint* ; Hip* ; Pseudomonas ; Sensitivity and Specificity ; Staphylococcus ; Staphylococcus aureus

OBJECTIVE: The purpose of this study was to examine the relationship between attachment and behavior problems in adolescents. METHOD: A sample of 792 high school students were examined. Revised Adult Attachment Scale, Self-report Attachment Style, Youth Self-Report Child Behavior Checklist (YSR) were used to measure the attachment quality, the attachment pattern and the behavior problems respectively. RESULTS: As to the attachment quality, high score in fear of rejection, low dependability and low intimacy were related to the development of adolescent's internalizing problems. As to the attachment pattern, preoccupied and fearful with attachment experience were linked to the internalizing behavior problems of higher level as well as 'Attention problems' and 'Aggressive behavior' sub-scales of externalizing ones on YSR. CONCLUSION: High fear of rejection, low dependability and low intimacy characterise the insecure attachment. So the insecure attachment might predict the development of all internalizing behavior problems, attention problems and aggressive behavior in adolescents. Also the result suggested that the adolescents classified as Dismissing attachment may have a positive view of the self and may minimize the self reported behavior problems.
Adolescent* ; Adult ; Checklist ; Child ; Child Behavior ; Humans ; Self Report

Objective: To investigate whether baseline olfactory dysfunction in Parkinson’s disease (PD) patients is associated with baseline and longitudinal motor and cognitive function. Methods: We recruited 228 drug-naïve PD patients who were followed for a mean of 6 years. Patients underwent the Cross-Cultural Smell Identification Test (CCSIT), a neuropsychological test, and N-(3-[18F]fluoropropyl)-2β-carbomethoxy-3β-(4-iodophenyl) nortropane positron emission tomography within 6 months of the baseline evaluation. Olfactory dysfunction was categorized as normosmia (CCSIT score ≥ 9), hyposmia (CCSIT score 5–8), and anosmia (CCSIT score ≤ 4). During the follow-up period, we investigated changes in the levodopa-equivalent dose (LED) and the occurrence of wearing-off, levodopa-induced dyskinesia, and dementia. Results: Among the PD patients, 80.7% were hyposmic at the time of diagnosis, and 26.1% were anosmic. Baseline olfactory dysfunction was not associated with either initial parkinsonian motor symptoms or with the longitudinal LED increment and motor complications. Meanwhile, the anosmic group had lower baseline scores on the Korea version of the Boston Naming Test and Stroop color reading test than the normosmic and hyposmic groups. The anosmic group exhibited a higher rate of conversion to dementia than the normosmic [adjusted hazard ratio (HR) 3.99, 95% confidence interval (CI) 1.08–14.72] and hyposmic (adjusted HR 2.48, 95% CI 1.15–5.32) PD groups, regardless of baseline motor deficits and cognitive status. Conclusion Baseline olfactory dysfunction was not associated with motor deficits and complications, but it was associated with cognitive dysfunction and prognosis, suggesting that severe olfactory impairment may reflect early cortical involvement, probably in the frontotemporal region, and rapid spreading of Lewy body pathology.

PURPOSE: B cell-activating factor (BAFF) is a tumor-necrosis factor (TNF) superfamily member best known for its role in the survival and maturation of B cells. BAFF activity is observed in naive cells as well as in effector/memory T cells. We aimed to explore whether BAFF in sputum is expressed at elevated levels in asthmatic airways and associated with eosinophilic inflammation, pulmonary function, and bronchial hyperresponsiveness in children. METHODS: One hundred and fifty-four asthmatic children and 98 healthy children were enrolled in the study. Sputum supernatants were collected and sputum BAFF and eosinophil cationic protein (ECP) levels were measured. We performed pulmonary function tests and methacholine challenge tests, while measuring total eosinophil count, total serum IgE, and serum ECP in all subjects. RESULTS: Asthmatic children had significantly higher levels of BAFF in induced sputum [26.50 (10.50-100.27) pg/mL] compared to healthy children [18.32 (7.68-44.63) pg/mL; P=0.011]. Sputum BAFF positively correlated with sputum eosinophils (gamma=0.406, P<0.001) and sputum ECP (gamma=0.789, P<0.001). Significant negative correlations were found between sputum BAFF and FEV1 (gamma=-0.291, P<0.001) or post-bronchodilator FEV1 (gamma=-0.334, P<0.001), whereas nonsignificant correlations were found between sputum BAFF and bronchial hyperresponsiveness, serum eosinophil count, and serum ECP. CONCLUSION: These findings suggest that BAFF may play a role in childhood asthma, and BAFF levels in sputum could be a supportive marker that represents airway inflammation, especially eosinophilic inflammation.
Asthma ; B-Lymphocytes ; Child ; Eosinophil Cationic Protein ; Eosinophils ; Humans ; Immunoglobulin E ; Inflammation ; Methacholine Chloride ; Pneumonia ; Respiratory Function Tests ; Sputum ; T-Lymphocytes

Dermatoglyphics (fingerprints, palmprints, and palm creases) are helpful in early diagnosis of numeral aberrations of chromosome, each of which has specific dermatoglyphic characteristics. In this study, for early diagnosis of numeral aberrations of chromosome in the Korean population, the dermatoglyphic characteristics of the Korean patients who had various numeral aberrations of chromosome were compared with those of the normal Korean people. The hands of 28 Korean patients, who were previously diagnosed to have numeral aberrations of chromosome (24 Down, 1 Turner, 2 Klinefelter, and 1 cri du chat syndromes) by karyotyping, were imprinted to the paper using watersoluble ink; their dermatoglyphic characteristics were analyzed, and compared with those of 3,216 normal Korean people. In fingerprints of the patients with Down syndrome, ulnar loop pattern was frequent whereas whorl pattern was infrequent, which was more prominent in Mongolian than in Caucasian. In palmprints of the patients with Down syndrome, distances not only between a and b but also between b and c were short; and D was frequently found to traverse the palm. In palm creases of the patients with Down syndrome, palm creases were frequently found to join together; and the total degree of transversality of the normal and simian creases was high whereas that of the Sydney crease was low. In fingerprints of the patients with Turner (XO) and Kinefelter (XXY) syndromes, the X chromosome count was inversely proportional to the total ridge count. These results showed that there is a close relationship between dermatoglyphics and numeral aberrations of chromosome in the Korean population. In order to use dermatoglyphics as a more helpful diagnostic tool, dermatoglyphics of the more patients with numeral aberrations of chromosome should be analyzed using various methods.
Dermatoglyphics* ; Down Syndrome ; Early Diagnosis ; Hand ; Humans ; Ink ; Karyotyping ; X Chromosome

OBJECTIVES: This research was performed in order to develop the social perception scale which could detect the deficits of the social perception, composed of visual perception and contextual perception, in the patients with schizophrenia and might have the desirable reliability and discriminating power between the patients with schizophrenia and the normal controls, and so as to be appropriate to the schizophrenics' cognitive rehabilitation strategy of Brenner, et al. METHODS: We selected 10 photographs among 30 photographs which could show the variable social situations according to the consensus of the staff members of the Integrated Psychological Therapy. Then we developed the questions, composed of visual perception subscale and contextual perception subscale, which we called preliminary social perception scale. We tested the above scale to the 20 patients with schizophrenia in the chronic mental hospital. Then we tested the above scale to both the 20 patients meeting DSM-IV criteria for schizophrenia in the closed ward of the university psychiatric hospital and the 20 normal controls. We developed the final social perception scale to exclude the items of inadequate reliability. We compared the item difficulties of social perception scale between the patients in the chronic mental hospital and those in the university psychiatric hospital. finally, we compared the scores of social perception scale between the patients with schizophrenia and the normal controls. RESULTS: The final 6 items were selected to become the social perception scale according to the values of the item-total correlation, test-retest reliability, and interrater reliability. The final social perception scale showed similar rank of item difficulties between two groups with schizophrenia. The patient group differed significantly fiom the normal control group on the scores of contextual perception subscale(t=-3.09, p<.01) and the total scores of social perception scale(t= -3.33, p<.01). CONCLUSION: This study suggests that the above social perception scale which has excellent internal consistency, test-retest reliability, interrater reliability and the discriminating power. This scale can be applied to both the cognitive rehabilitation strategy in the patients with schizophrenia and the evaluation of the effectiveness of the cognitive rehabilitation.
Consensus ; Diagnostic and Statistical Manual of Mental Disorders ; Hospitals, Psychiatric ; Humans ; Rehabilitation* ; Schizophrenia* ; Social Perception* ; Visual Perception

OBJECTIVES: Coexistence of depression is one of the important behavioral symptoms in patients with dementia of Alzheimer type. The study on the relationship between depression and cognitive abilities and/or functional abilities emerges as very important one. The aim of this study was to investigate whether depression is related to the impairment of daily activities and to certain areas of cognitive function in mild to moderate dementia of Alzheimer type. METHODS: In this study, 48 patients with dementia of Alzheimer type among elderly community-residents in Kwangju, Kyunggi province, aged 65 and older, were finally included. We examined their demographics and administered Korean Version of the Mini-Mental State Examination(MMSE-K), Korean Version of the Neurobehavioral Cognitive Status Examination(Korean version of NCSE), Korean Form of Geriatric Depression Scale(KGDS), Activities of Daily Living(ADL), and Instrumental Activities of Daily Living(IADL) to the subjects. We classified the subjects into two groups, dementia with and without depression on the basis of KGDS scores. The two groups were compared using X2 test and independent ttest. RESULTS: The results show that the two groups did not differ in sex, age, education, and scores of MMSE-K. The depressed dementia group showed significantly poorer performance in bathing, one item of ADL, than the nondepressed dementia group. The depressed dementia group showed significantly more impairment in total scores of IADL and each score of three items(shopping, housework, handling finances) than the non-depressed dementia group. However, the two groups showed no significant differences in five major cognitive ability areas of Korean version of NCSE. CONCLUSION: These results suggest that depression in patients with dementia of Alzheimer type is highly related to the functional impairments, instrumental activities of daily living and part of activities of daily living, beyond the effects of cognitive impairments.
Activities of Daily Living* ; Aged ; Baths ; Behavioral Symptoms ; Dementia ; Demography ; Depression* ; Education ; Gwangju ; Gyeonggi-do ; Housekeeping ; Humans

This article describes the normal range of orbital linear dimensions (eq. orbital breadths, orbital height, orbital depth, interorbital breadths and biorbital breadth) and orbital indicies. One hundred and eighty-seven Korean skulls from grown-up individuals are studied with analysis for the purpose of evaluating anthropometric characteristics of Korean orbits. The results are compared to previously published data for modern Korean skulls. The width of the orbit is larger on the right side than the left and sexual difference was also shown. On the other hand, the heights of both orbits are much the same. Consequently, there is a slight tendency that chamaeconch is met with more frequently on the right side, whilst hypsiconch on the left side. The orbital depth is larger on the right side, however, depth index did not show any side difference. There are sexual differences on the biorbital breadth and upper facial breadth but not on the interorbital breadth on the basis of dacryon. These results represent the asymmetry of Korean orbit and that measurement on both sides must be necessary for anthropological comparison.
Adult* ; Hand ; Humans ; Orbit* ; Reference Values ; Skull*

Foreign bodies in the gastrointestinal (GI) tract can be seen in all age groups and is not uncommon to see in the emergency department. Most are pediatric, edentulous, incarcerated and/or psychiatric patients. Since ingested objects are expected to pass spontaneously in 80% to 90% of patients with normal anatomy, direct foreign body removal using surgical intervention is rarely required. However, an ingested toothpick is of surgical interest as a cause of significant morbidity and even mortality. This is due to the difficulty in preoperative diagnosis resulting from a lack of history of ingestion of the toothpick and to the toothpick's radiolucent qualities. We report the case of a patient with peritonitis due to perforation of the sigmoid colon, a complication of accidental ingestion of a toothpick, that was diagnosed at the surgical field. Related literature is reviewed together.
Colon* ; Colon, Sigmoid ; Diagnosis ; Eating ; Emergency Service, Hospital ; Foreign Bodies ; Humans ; Mortality ; Peritonitis

OBJECTIVE: The objective of this study was to establish a clinically applicable culture system by investigating the use of autologous cord blood plasma (ACBP) instead of fetal bovine serum (FBS) for the ex vivo expansion of umbilical cord blood (UCB) T-lymphocytes. METHODS: Fresh UCB mononuclear cell (MNC) fractions were isolated by Ficoll-Hypaque density centrifugation. The nonadherent MNC fractions were then cultured with the anti-CD3 antibody 5 microgram/mL plus IL-2 175 U/mL in the presence of 10% FBS, 10% ACBP or homologous cord blood plasma (HCBP). On day 8, proliferation rate, cell surface markers, cytotoxic assay of UCB T-lymphocytes according to the medium supplemented with FBS, ACBP or HCBP were evaluated. RESULTS: Proliferation studies demonstrated a significant increase in the proliferative ability of UCB T-lymphocytes incubated in anti- CD3 and IL-2 irrespective of the medium supplemented with FBS or ACBP. In the FBS supplemented medium, expressions of the activated T-lymphocytes were increased significantly after culture: CD3+CD8+, CD3+CD25+, CD3+CD38+, and CD45RO+ (p<0.05). Also in the ACBP supplemented medium, expressions of the activated T-lymphocytes were increased significantly after culture: CD3+ CD8+, CD3+CD25+, and CD45RO+ (p<0.05). In the HCBP supplemented medium, expressions of the activated T-lymphocytes were increased significantly after culture as in the ACBP: CD3+CD8+, CD3+CD25+, and CD45RO+ (p<0.05). Of the activated T-lymphocytes, increase of cytotoxic CD3+CD8+ cells increased significantly in the ACBP and HCBP groups compared to FBS group (p<0.05). CONCLUSION: These findings support the feasibility of ex vivo expansion of umbilical cord blood T-lymphocytes in the medium supplemented with autologous cord blood plasma, instead of fetal bovine serum, for future adoptive cellular immunotherapy.
Centrifugation ; Fetal Blood* ; Immunotherapy, Adoptive ; Interleukin-2 ; Plasma* ; T-Lymphocytes* ; Umbilical Cord*