Survivorship analysis is a useful way of expressing the long term results of joint replacement. With the increase of follow up period in total knee replacement, it has became possible to predict the survival rate of implants in total knee replacement. The survivorship of total knee replacement in 145 consecutive patients(209 knees) between 1982 and 1988 with follow-up period of up to 10 years was estimated by Dobbs' method(1980), and we analyzed, clinically and radiologically, 116 patients(177 knees) which were followed up more than 2 years(from 2 years to 10 years, average 6 years and 4 months). Also, we evaluated the knee function according to the functional knee scores of Hospital for Special Surgery. 1. The average age at operation was 55.6 years(from 19 years to 75 years). Male was 12 patients and female was 104 patients. 2. There were osteoarthritis in 83 knees(46.5%), rheumatoid arthritis in 71 knees(40.0%), secondary osteoarthritis in 18 knees(10.0%), tuberculous arthritis in 3 knees (2.0%), and Charcot joint in 2 knees(1.5%). 3. The Hospital for Special Surgery functional knee and pain scores was improved from average 43 points preoperatively to average 84 points postoperatively. The results were satisfactory in 162 knees(91.4%, excellent in 64.0% and good in 27.4%). 4. Revision surgery was performed in 15 knees of the 209 knees(7.2%), due to aseptic loosening in 9 knees(4.3%) and septic loosening in 6 knees(2.9%). 5. Survival rate of total knee replacement with reliability was 87.7%, 8 years after operation for 145 patients, 209 knees. In summary, total knee replacement is a relatively satisfying and predictable procedure which can obtain the relief of pain, restoration of function, and long term survivorship.
Arthritis ; Arthritis, Rheumatoid ; Arthropathy, Neurogenic ; Arthroplasty, Replacement, Knee ; Female ; Follow-Up Studies ; Humans ; Joints ; Knee ; Male ; Osteoarthritis ; Survival Rate

PURPOSE: This study was conducted to develop and test a hypothetical stage model of workplace self-protective behaviors with respect to blood transmitted infections and musculoskeletal injuries for Korean nurses. METHODS: A nonexperimental, cross-sectional study designwas adopted. The study participants were 320 nurses at two Korean university hospitals. Perceived sensitivity, severity, barriers, benefits, self-efficacy, social support, and safety climate were assessed. RESULTS: Overall, fit indicators showed a good fit for the hypothetical model of self-protective behaviors against blood transmitted infections and musculoskeletal injuries. The significant factors of self-protective behaviors against blood transmitted infections were perceived barriers and social support. The significant factors of self-protective behaviors against musculoskeletal injuries were perceived benefits, barriers, and self-efficacy. CONCLUSION: Our findings suggest that the significant psychosocial constructs of stages of self-protective behavior are dependent on health problem type. Accordingly, we advise that characteristics of behavior and types of disease and health problem should be given priority when developing intervention programs for particular self-protective health behaviors.
Adult ; *Blood-Borne Pathogens ; Cross-Sectional Studies ; *Health Behavior ; Humans ; Infection Control/*methods ; *Models, Theoretical ; Musculoskeletal System/*injuries ; Nurses/*psychology ; Questionnaires ; Republic of Korea ; Workplace ; Young Adult

OVJECTIVES: As the attention devoted to children's mental health increases, medical costs and burdens mount as well. In the present study, we evaluated the association between socioeconomic status (SES) and major child psychiatric symptoms. METHODS: The subjects of this study were children of recruited from a mental health screening program in the Seoul Sungbuk mental health center over the course of 3 months. To establish the SES of each child, we collected data about each child's medical insurance, years of parental education, household income, family structure and housing. 149 children& parents completed questionnaires including the Childhood Depression Inventory (CDI) and the Korean Attention Deficit Hyperactivity Disorder Rating Scale (K-ARS). RESULTS: The mean K-ARS-P score was 12.1+/-11.1 and the suspected prevalence of ADHD was 20.8% (n=31). The mean CDI score was 12.9+/-7.9, and the prevalence of suspected depression was 16.8% (25). Depressive symptoms and ADHD symptoms were both more severe than those observed in a previous epidemiologic study in Korea. Depressive symptoms were more closely associated with family SES status. CONCLUSION: SES status is one of the most important risk factors in the development of major child psychiatric symptoms. In our study we found that depressive symptoms in particular were most tightly associated with psychosocial factors. Evaluation of the risk factors, early screening and intervention for low SES children would be valuable mental health management tactics to implement in a community mental health system.
Attention Deficit Disorder with Hyperactivity ; Child ; Depression ; Epidemiologic Studies ; Family Characteristics ; Housing ; Humans ; Insurance ; Korea ; Mass Screening ; Mental Health ; Parents ; Prevalence ; Risk Factors ; Social Class ; Surveys and Questionnaires

Background and Objectives: Cochlear implants (CIs) are well known to improve audibility and speech recognition in individuals with hearing loss, but some individuals still struggle with many aspects in communication, such as prosody. This study explores how prosodic elements are perceived by those with normal hearing (NH) and CIs. Subjects and Methods: Thirteen individuals with NH and thirteen CI users participated in this study and completed speech perception, speech prosody perception, speech prosody production, pitch difference discrimination, and melodic contour perception testing. Results: NH listeners performed significantly better than CI users on speech perception, speech prosody perception (except for words with neutral meaning and a negative prosody change and when words were repeated twice), pitch difference discrimination, and melodic contour perception testing. No statistical significance was observed for speech prosody production for both groups. Conclusions Compared to NH listeners, CI users had limited ability to recognize prosodic elements. The study findings highlight the necessity of an assessment tool and signal processing algorithm for CIs, specifically targeting prosodic elements in clinical settings.

Background and Objectives: Cochlear implants (CIs) are well known to improve audibility and speech recognition in individuals with hearing loss, but some individuals still struggle with many aspects in communication, such as prosody. This study explores how prosodic elements are perceived by those with normal hearing (NH) and CIs. Subjects and Methods: Thirteen individuals with NH and thirteen CI users participated in this study and completed speech perception, speech prosody perception, speech prosody production, pitch difference discrimination, and melodic contour perception testing. Results: NH listeners performed significantly better than CI users on speech perception, speech prosody perception (except for words with neutral meaning and a negative prosody change and when words were repeated twice), pitch difference discrimination, and melodic contour perception testing. No statistical significance was observed for speech prosody production for both groups. Conclusions Compared to NH listeners, CI users had limited ability to recognize prosodic elements. The study findings highlight the necessity of an assessment tool and signal processing algorithm for CIs, specifically targeting prosodic elements in clinical settings.

Background and Objectives: Cochlear implants (CIs) are well known to improve audibility and speech recognition in individuals with hearing loss, but some individuals still struggle with many aspects in communication, such as prosody. This study explores how prosodic elements are perceived by those with normal hearing (NH) and CIs. Subjects and Methods: Thirteen individuals with NH and thirteen CI users participated in this study and completed speech perception, speech prosody perception, speech prosody production, pitch difference discrimination, and melodic contour perception testing. Results: NH listeners performed significantly better than CI users on speech perception, speech prosody perception (except for words with neutral meaning and a negative prosody change and when words were repeated twice), pitch difference discrimination, and melodic contour perception testing. No statistical significance was observed for speech prosody production for both groups. Conclusions Compared to NH listeners, CI users had limited ability to recognize prosodic elements. The study findings highlight the necessity of an assessment tool and signal processing algorithm for CIs, specifically targeting prosodic elements in clinical settings.

OBJECTIVES: The purpose of this study was to evaluate the psychometric properties of the Korean version of the Readiness to Change Questionnaire-Treatment version (RCQTV-K). METHODS: The participants were 92 patients who were seeking treatment of alcoholism in two hospitals for alcoholism. A confirmatory factor analysis was performed to test whether the factor structure of the RCQTV-K was consistent with the English version. Convergent validity was assessed by correlating the scores on the RCQTV-K with those on other scales (Alcohol Abstinence Self-Efficacy Scale, Beck Depression Inventory, Korean Version of Alcohol Use Disorders Identification Test). RESULTS: The factor structure of the RCQTV-K was consistent with the three-factor structure established for the original RCQTV. Cronbach's alpha was high, indicating that the reliability of the items for each subscale was satisfactory. Allocated stage of change showed significant differences among the scores on the other scales. CONCLUSION: The results of the present study indicate that the RCQTV-K is an effective and valid scale for evaluating the stage of readiness to change in patients seeking treatment for alcoholism. The findings suggest that the RCQTV-K is a promising assessment tool for use in the treatment and study of alcoholism.
Alcoholism ; Depression ; Humans ; Psychometrics ; Surveys and Questionnaires ; Reproducibility of Results ; Weights and Measures

PURPOSE: The human fetus is primarily dependent on the placenta for its nutrition. However, as the fetus matures, it swallows increasing amounts of amniotic fluid, which contributes to the growth of fetus. Accordingly fetuses with congenital obstruction of the gut at high level have a reduced capacity for intestinal absorption of amniotic fluid. We undertook a study to investigate the effect of congenital gut obstruction on fetal growth. METHOD: A retrospective review of the records of all patients presenting congenital gut obstruction over 6-year period (from 1992 to 1997) in Chung-ang Gil hospital was performed. Patients with a complete proximal obstruction were included in group A; patients with incomplete or lower obstruction were included in group B. RESULT: 1) The ratio of male to female was 1.5:1. The mean birth weight and gestational age were 2.89+/-0.60kg and 38.7+/-0.20weeks. The mean birth weight and gestational age in group A were 2.68+/-0.69kg and 37.8+/-0.25weeks. The mean birth weight and gesnal age in group B were 2.980.54kg and 39.1+0.17weeks. There was significant difference between group A and B (P<0.01). 2) Significant differences were found between group A and B in prematurity and growth retardation rate (P<0.01). No significant difference was found between group A and B in associated anomaly rate (P>0.05). 3) In group A, 3 (42.8%) of 7 patients with associated anomalies had IUGR, whereas 8 (40.0%) of 20 patients without associated anomalies had IUGR (P>0.05). The corresponding figures for group B were 23.0% and 14.8%, respectively (P>0.05). CONCLUSION: Congenital gut obstruction causes IUGR by reducing intestinal absorption of amniotic fluid and the effect of IUGR is more pronounced as the obstruction is proximal to jejunum rather than distal to it.
Amniotic Fluid ; Birth Weight ; Female ; Fetal Development* ; Fetal Growth Retardation ; Fetus ; Gestational Age ; Humans ; Intestinal Absorption ; Jejunum ; Male ; Placenta ; Retrospective Studies ; Swallows

BACKGROUND: Preoxygenation is a standard anesthetic technique using 100% oxygen for the prevention of hypoxia during the induction of anesthesia. Measuring end-tidal oxygen is the most useful indicator for determining the end-point of preoxygenation. We studied the effects of preoxygenation between pregnant and non-pregnant patients during 5 min of tidal volume breathing. METHODS: Non-pregnant women who were scheduled for general surgery (Group I, n = 25) and pregnant women who were scheduled for elective cesarean section (Group II, n = 20) were explained the technique of preoxygenation, which was conducted with 100% oxygen during 5 min of tidal volume breathing. End-tidal oxygen concentration was measured at 10 sec intervals for 5 min, simultaneously. RESULTS: Group II showed significantly higher end-tidal oxygen concentration than Group I from 30 sec to 170 sec during preoxygenation (P < 0.05). The mean time required for end-tidal oxygen concentration > or =90% was 110.0 +/- 31.7 sec for Group II and 152.8 +/- 34.5 sec for Group I. Therefore, Group II showed a significantly shorter time than Group I (P < 0.05). CONCLUSIONS: We concluded that the time for complete preoxygenation was shorter in pregnant patients compared to non-pregnant patients.
Anesthesia ; Anoxia ; Cesarean Section ; Female ; Humans ; Oxygen ; Pregnancy ; Pregnant Women ; Respiration ; Tidal Volume

BACKGROUND: Takotsubo cardiomyopathy is characterized by clinical features similar to those of acute myocardial ischemia, but without angiographic evidence of obstructive coronary artery disease. We present a patient with takotsubo cardiomyopathy following acute infarction involving the left insular cortex. CASE REPORT: A 52-year-old man was admitted with acute infarction of the left middle cerebral artery territory and acute chest pain. Acute myocardial infarction was suspected because of elevated serum troponin levels and hypokinesia of the left ventricle on echocardiography. However, a subsequent coronary angiography revealed no stenosis within the coronary arteries or ballooning of the apical left ventricle. CONCLUSIONS: We postulated that catecholamine imbalance due to the insular lesion could be responsible for these interesting features.
Cerebral Infarction ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Echocardiography ; Heart Ventricles ; Humans ; Hypokinesia ; Infarction ; Middle Aged ; Middle Cerebral Artery ; Myocardial Infarction ; Myocardial Ischemia ; Takotsubo Cardiomyopathy ; Troponin