OBJECTIVE: To evaluate the effect of Mcdonald's cerclage and postoperative care on perinatal outcome in patient with incompetent cervix and bulging fetal membranes. METHODS: In the descriptive study, the charts of 78 patients admitted from 1993 to 1997 with a diagnosis of incompetent cervix and cervical dilatation (3cm) were reviewed, Mcdonald's cerclage rate, predisposing factor, fetal salvage by time, factors of falled operation, delivery type were analyzed. RESULTS: The results of the study were as follows; The incidence of II OC was 0.4% of 18702 case, the mean age was 31.9 years old, the average number of gravida was 2.9, the fetal salvage rate was 83.3%, the predisposing factor was previous history of midtrimester termination(56.4%), dilation and curettage(19.2%), unknown(14.1%) etc, the fetal salvage by time was the highest success rate(88.9%) revealed with period from 14th to 16th weeks of gestation, the factors of falled operation were preterm labor(76.9%), PROM(15.4%), infection(7.7%), and delivery type was vaginal delivery in 36 case(55.4%), cesarean section in 29 case(44.6%). CONCLUSION: We concluded that fetal salvage rate was greatly increased when Mcdonald operation was done from 14th to 16th week of gestation if midtrimester abortion and dilatation and curettage were experienced, Even though we have not compared experimental group with control group, upper part of Mcdonald cerclage, no exposure of suture material, benzol conium dressing, bed rest were increased to fetal salvage rate.
Bandages ; Bed Rest ; Benzene ; Causality ; Cervix Uteri* ; Cesarean Section ; Conium ; Diagnosis ; Dilatation and Curettage ; Extraembryonic Membranes ; Female ; Humans ; Incidence ; Labor Stage, First ; Postoperative Care ; Pregnancy ; Pregnancy Trimester, Second ; Sutures ; Uterine Cervical Incompetence

No abstract available.
Breast Neoplasms* ; Breast*

The roentgenograms following arthroscopic ACL reconstruction show the enlargement of bone tunnels. Many authors hypothesized the cause of the tunnel enlargement, either mechanical or biological causes. The purpose of this study was to find the factors which affected the enlargement of the tibial tunnel following arthroscopic ACL reconstruction with bone-patellar tendon-bone or hamstring tendon. Sixty patients were reviewed retrospectively for radiographic measurement of tibial tunnel at post-operative one year (27 patients received bone-patellar tendon-bone autograft, 12 patients received bone-patellar tendon-bone autograft and Kennedy LAD-ligament augmentation device, 21 patients received Semitendinosus and Gracilis tendons with Endobutton). Roentgenographic anteroposterior and lateral films were checked and the tunnel was measured by two independent observers using a digital caliper. Statistical analysis was performed using a one-way analysis of variance (ANOVA) and t-test. The tibial tunnel enlargement was only related to the position of the fixation of the tibial tunnel. We concluded that tibial tunnel enlargement following arthroscopic ACL reconstruction is attributed to the mechanical effect rather than the properties of grafts and the clinical results.
Autografts ; Humans ; Retrospective Studies ; Tendons ; Transplants

In anterior cruciate ligament (ACL) deficient knee, several treatment methods were recommended. Recently, arthroscopic reconstruction is widely used as the best treatment method. As the graft materials, bone-patellar tendon-bone (BPB) unit is a gold standard material. Whereas, it has many problems. The purpose of this study was to introduce the new arthroscopic ACL reconstruction technique with quadrupled semitendinosus tendon and Endobutton and to evaluate its results. Twenty one patients were prospectively reviewed after ACL reconstruction with quadrupled semitendinosus tendon and Endobutton at one year post-operation. The surgery was performed in the series of graft tendon harvest, graft preparation, tunnel drilling and Endobutton fixation. The outcomes showed improved knee functions. Endobutton technique with quadrupled semitendinosus tendon is useful method for the arthroscopic ACL reconstruction. Stability and functional outcomes were similar to those with patellar tendon but it showed less donor site morbidity, less pitfall of fixation and simple procedure.
Anterior Cruciate Ligament ; Humans ; Knee ; Patellar Ligament ; Prospective Studies ; Tendons* ; Tissue Donors ; Transplants

Controversies about the posterior cruciate ligament continue with regards to total knee arthroplasty. There has been a long debate regarding PLC and its importance seems to be overrated in total knee arthroplasty. Twenty four patients had twenty six total knee replacements with insertion of the PCL substituting Press Fit Condylar modular total knee system with cement, and they were enrolled in a prospective study to assess the clinicoradiological results and measure the femoral roll-back postoperatively. Follow-up ranged from twenty four months to fifty months with an average of thirty two months. The mean HSS score was 92.1 points and the mean range of motion was 122.7 degrees. Twenty five cases(96.1%) showed excellent and good clinical results. The radiologic evaluation based on Knee Society roentgenographic system revealed proper alignment of all components and one significant radiolucent area. The mean femoral roll-back was 2.3mm posteriorly. In the present series, total knee arthroplasties with the Press Fit Condylar modular knee system resulted in excellent relief of pain, excellent range of motion and restoration of function.
Arthroplasty* ; Arthroplasty, Replacement, Knee* ; Follow-Up Studies ; Humans ; Knee ; Posterior Cruciate Ligament ; Prospective Studies ; Range of Motion, Articular

OBJECTIVE: Recently, the incidence of elderly primipara is increasing. Thus, impact of old age on pregnancy outcomes became important. Our purpose was to assess the effect of maternal age on pregnancy outcomes. METHODS: 73 cases of the elderly primipara over 35 years at the department of obstetrics and gynecology, Chon-ju presbyterian medical center, from Jan. 1, 1995 to Dec. 31, 1998, were compared with 73 cases randomly chosen young primiparas during same period. RESULTS: Elderly primipara had higher rate of infertility and spontaneous abortion history, antenatal complications, cesarean section, poorer neonatal outcome than young primipara. CONCLUSION: The pregnancy outcome of elderly primipara is considered to be less favorable than those of young primipara. Careful antenatal and intrapartal care should be performed for the elderly primipara. We think that many clinical study of congenital anomaly in elderly primipara will be necessary.
Abortion, Spontaneous ; Aged* ; Cesarean Section ; Female ; Gynecology ; Humans ; Incidence ; Infertility ; Jeollabuk-do ; Maternal Age ; Obstetrics ; Pregnancy Outcome ; Pregnancy* ; Protestantism ; Statistics as Topic*

BACKGROUND: To evaluate the usefulness of the modified lateral pillar classification as a prognostic factor in Legg-Calve-Perthes disease (LCPD). METHODS: Thirty nine patients diagnosed with lateral pillar C in LCPD from May, 1977, to October, 2001 were reviewed, and their skeletal maturity was followed. The mean follow up duration was 12 years and 7 months (4 years, 6 months to 24 years, 9 months). Lateral pillar C classification was divided into C1 (50-75% collapse of the lateral pillar) and C2 (> 75%). All radiological and clinical prognostic factors were evaluated. The final results were evaluated according to the Stulberg classification. RESULTS: Twenty one and 18 of the affected hips were in groups C1 and C2, respectively. According to the Stulberg classification, the final results of group C1 were better than those of C2 (p = 0.002). Patients with more head-at-risk signs had significantly poorer outcomes. CONCLUSIONS: The modified lateral pillar classification has significant value for predicting the prognosis of LCPD.
Adolescent ; Adult ; Chi-Square Distribution ; Child ; Child, Preschool ; Female ; Femur Head/*pathology/radiography ; Follow-Up Studies ; Hip Joint/*pathology/radiography ; Humans ; Legg-Perthes Disease/*classification/*pathology/radiography/therapy ; Male ; Predictive Value of Tests ; Prognosis ; Treatment Outcome ; Young Adult

PURPOSE: The first web space of the foot has a similar thickness and skin texture of the pulp of the fingers. Moreover, it has a reliable blood vessel and sensory nerve. The purpose of this study was to evaluate the clinical results of the first web space free flap to reconstruct the pulp of fingers. MATERIALS AND METHODS: Authors have performed 23 cases of first web space free flap to reconstruct the pulp defect of the fingers between June 2004 and May 2009. The age of the patients ranged from 20 years old to 55 years old. The size of the flap ranged from 1x1.5 cm to 8.5x2.5 cm. The mean flap area was 5.4 cm2. In 4 cases, we elevated the flap including lateral aspect of the big toe and medial aspect of the second toe. And then we made an artificial syndactyly to reconstruct the pulps on two fingers at the same time. In all cases, we performed 1 digital artery and 1 dorsal vein anastomosis. Every donor site that had a small defect healed spontaneously without any additional operations to cover it. RESULTS: Of this type of surgery 21 flaps (91.3%) survived, 2 flaps (8.7%) failed. There was no severe complication in the donor sites. There was no walking disturbance due to the skin defect of the donor site. The static 2 point discrimination in 11 cases that we could check ranged from 3 mm to 15 mm. CONCLUSION: The authors believe that the first web space free flap of the foot is a good option for the reconstruction of the pulp of the fingers and it has a minimal donor site morbidity.
Arteries ; Blood Vessels ; Discrimination (Psychology) ; Fingers ; Foot ; Free Tissue Flaps ; Glycosaminoglycans ; Humans ; Skin ; Syndactyly ; Tissue Donors ; Toes ; Veins ; Walking

OBJECTIVES: This study was conducted to investigate knowledge, attitude, and experience regarding suicidal behavior among mental health workers in Gangwon province of Korea to use as a basis for development of suicide prevention and education programs. METHODS: Questionnaires consisted of 31 questions including general knowledge regarding suicide statistics and suicide related legislation, attitude toward suicide, awareness of suicide, and individual experiences of suicidal behaviors. Chi-square and binary logistic regression analyses were used to determine differences and association among attitude toward suicide, individual experience of suicide, and sociodemographic characteristics. RESULTS: Taboo attitude toward suicide showed association with age and male. Males thought that social responsibility for suicide is necessary. Religiously non-affiliated group and people who had previous suicidal ideation and attempts showed a more permissive attitude toward suicide. CONCLUSION: The findings of this study suggest that demographic characteristics and previous individual experience of suicidal behaviors might influence attitude toward suicide. These personal characteristics should be considered in development of suicide prevention programs for mental health workers.
Education ; Gangwon-do ; Humans ; Korea* ; Logistic Models ; Male ; Mental Health* ; Social Responsibility ; Suicidal Ideation ; Suicide ; Taboo

OBJECTIVES: This study was conducted to investigate knowledge, attitude, and experience regarding suicidal behavior among mental health workers in Gangwon province of Korea to use as a basis for development of suicide prevention and education programs. METHODS: Questionnaires consisted of 31 questions including general knowledge regarding suicide statistics and suicide related legislation, attitude toward suicide, awareness of suicide, and individual experiences of suicidal behaviors. Chi-square and binary logistic regression analyses were used to determine differences and association among attitude toward suicide, individual experience of suicide, and sociodemographic characteristics. RESULTS: Taboo attitude toward suicide showed association with age and male. Males thought that social responsibility for suicide is necessary. Religiously non-affiliated group and people who had previous suicidal ideation and attempts showed a more permissive attitude toward suicide. CONCLUSION: The findings of this study suggest that demographic characteristics and previous individual experience of suicidal behaviors might influence attitude toward suicide. These personal characteristics should be considered in development of suicide prevention programs for mental health workers.
Education ; Gangwon-do ; Humans ; Korea* ; Logistic Models ; Male ; Mental Health* ; Social Responsibility ; Suicidal Ideation ; Suicide ; Taboo