This review-article is aimed at shedding a light upon the nature of age-associated changes in the human skeletal system. When the anatomical, physiological and biochemical consequences of bone aging are considered together with the hardening, drying and the diminished repair capabilities of the elderly, it can be seen that fractures assume greater importance as a clinical problem in the geriatric population. Older people start out with a deficit of cortical bone, making them more fracture prone and once fractures occur, the necessary treatments (immobilization, use of casts, etc.) accelerate the rate of bone loss. In addition, aged individuals stand a higher risk for complications of the hospital and enforced bed rest that may ensue. The problems resulting from bone loss in the elderly may be partially alleviated by providing adequate health service support which should include consideration of the following points : 1. Age, sex and general health status ; 2. Habits and inclinations towards physical activities ; 3. Nutritional and endocrine background ; 4. Presence of any specific bone diseases, including osteoporosis, osteoarthritis, osteomalacia and ankylosis ; 5. Psychosocial adaptability and other behavioral elements.
Aged ; Aging ; Ankylosis ; Bed Rest ; Biology* ; Bone Diseases ; Health Services ; Humans* ; Motor Activity ; Osteoarthritis ; Osteomalacia ; Osteoporosis

No abstract available.
Hematuria ; Hydronephrosis* ; Kidney* ; Lupus Erythematosus, Systemic* ; Ureter*

BACKGROUND: Diet and weight concerns are commonplace and almost accepted features of life for girls during adolescence. Until recently, younger age groups haue largely been ignored, as these concerns were thought to be a product of pubertal development and sexual maturity. Girls under the age of fifteen therefore, have been assumed to be free of the pressures experienced by adult women. However, this belief is now hard to sustain. The object of the present study was to investigate the self-perception and body shape satisfaction in different weight categories of boys and girls aged 12-years old in Korea. METHODS: In May, 1995, one hundred and sixty seven boys and one hundred and twenty girls from two schools in Seoul completed assessments of body-esteem, self-esteem, body shape preference. The children's body weight and height were also measured. RESULTS: The heaviest children expressed the most discontent, having a low body-esteem, a desire for thinness. By the age of 12, girls boys already differ in their body shape satisfaction and differ in their body shape aspirations. There was a significant effect of weight category on the children's body esteem(boys(P =.005), girls(P=.0001). Children in both extreme categories, under-and over-weight, had lower body-esteem scores than those in other weight categories. However, it was the overweight children who had the lowest. reported body-esteem. Body esteem was highest among girls in the 'slightly underweight' category and highest among boys on the 'average weight' category. There was no effects of either weight category or gender on the childrens appraisal of self-esteem. A comparison of the points chosen on the silhouette scales to reflect current and preferred body shapes revealed clear gender differences. Of the girls, 63% placed their preferred body shape at a point thinner than their currently perceived shape, while only 15% chose a broader figure. In contrast,, 41% of the boys rated their preferred figure as broader than their current perception, and 37% as thinner than their current perception. CONCLUSIONS: This study has noted a relationship between body weight and self-perception in 12-year old children. The heaviest children expressed low body-esteem, a desire for thinness. This pattern was more characteristic of girls than boys. Even at this age, well before they have completed physical maturation, girls are aspiring to a body shape which is thinner than their average. This discontent experienced by the heaviest children on this sample was apparent in their lower body-esteem and the distance between their current and preferred body shapes. The girls preference was for thinness, while in the boys it was for a body shape which was broader than their current shape. From their responses, it would appear that the boys' desire was not for fatness, but for a more athletic and muscular build.
Adolescent ; Adult ; Aspirations (Psychology) ; Body Weight ; Child* ; Diet ; Female ; Humans ; Korea ; Overweight ; Self Concept ; Seoul ; Sports ; Thinness ; Weights and Measures

BACKGROUND: The known etiologies of atrial fibrillation(AF) were valvular heart disease, coronary artery disease, hypertension(left ventricular hypertrophy), hypertrophic cardiomyopathy, dilated cardiomyopathy, and congenital heart disease and so on. Mitral stenosis, mitral regurgitation, and tricuspid regurgitation account for more than 2/3 of AF related to valvular heart disease. We evaluated the effect of mitral stenosis and mitral regurgitation on development of AF respectively, and the relation between mitral valve disease and that. METHOD: The medical records of patients who was performed transthoracic echocardiography at Dongsan medical center between January 1997 and July 1998 were reviewed retrospectively. Among them, we analyzed the 222 patients who had isolated mitral valve disease without any other cardiac disease. We divided them to 4 group according to left atrial size (group 1: <4.0cm, group 2: >4.0cm and (5.0cm, group 3: (3) 5.0cm and <6.0cm, group 4: (3)6.0cm), then evaluated the effects of disease entity. RESULTS: 1) 94 out of 222(42.3%) patients had atrial fibrillation. The mean age was 51.8+/-15.1 years old. The number of men was 55. 2) The mean left atrial size in the group of AF and sinus rhythm were 5.14+/-0.93cm and 4. 44+/-0.66cm respectively. The mean age in the groups were 57.0+/-11.9 and 48.1+/-16.1 respecitvely. The differences between them were statistically significant(p<0.05). 3) The prevalences of AF in each groups were 12.5%(group 1), 35.6%(group 2), 60.8%(group 3), 86.7%(group 4). More increased the left atrial size, the prevalance of AF was increased significantly(p<0.05). 4) The prevalence of AF was not related to the severity of mitral regurgitation. However, the relation between the severity of mitral stenosis and the prevalence of AF was statistically significally(p<0.01). 5) Increasing the age, the prevalence of AF was increased significantly(p<0.01). 6) The effect of mitral stenosis and regurgitation on the development of AF did not differ significantly in group 1, 2, 3. But in group 4, the AF was present in 100% of patients who had mitral stenosis and 60% of mitral regurgitation. The difference was significant. CONCLUSION: In patients with mitral valve disease, the development of AF was related to age and the size of left atrium. The relation between the severity of mitral regurgiation and the development of AF was not evident, but in mitral stenosis, the relation was significant. If the size of left atrium is similar, the effect of mitral stenosis and regurgitation itself seem to be not related to the development of atrial fibrillation.
Atrial Fibrillation* ; Cardiomyopathy, Dilated ; Cardiomyopathy, Hypertrophic ; Coronary Artery Disease ; Echocardiography ; Heart Atria ; Heart Defects, Congenital ; Heart Diseases ; Heart Valve Diseases ; Humans ; Male ; Medical Records ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Mitral Valve* ; Prevalence ; Retrospective Studies ; Tricuspid Valve Insufficiency

OBJECTIVES: Radiofrequency(RF) ablation is an effective and low risk curative treatment for supraventricular arrhythmias. Catheter ablation produced cardiac lesions primarily through formation of coagulation necrosis. We evaluated the degree of myocardial injury after RF catheter ablation by means of serial measurement of myocardial enzyme. METHODS: Fifty-one patients with symptomatic supraventricular tachycardia were included. There were 32 men and 19 women(mean age. 39.5+/-15.4 years)All patients underwent electrophysiologic study to detect accessary pathway and ablation with radiofreguency current. A mean of 18.3+/-14.2 radiofrequency pulses were delivered. The pulses were at a power of 50 to 60 Volts for a duration of 20 to 30 seconds. Unipolar method and a 6F or 7F catheter with a 4 mm tip electrode was used. LDH, CPK and Ck-MB as a kind of cardiac enzyme were measured before and after ablation. RESULTS: 1) The concentration of LDH and CPK were elecated at 8 hours and 16 hours after ablation (p<0.05). 2) The concentration of CK-MB was elevated at 8 hours, 16 hours, 24 hours and 72 hours after ablation(p<0.05). 3) There was no correlation between the number of applications and amounts of radiofrequency current and rise in LDH, CPK, CK-MB concentration. CONCLUSION: The concentration of LDH, CPK and CK-MB were elevated after ablation but they were within normal limits. RF catheter ablation produced myocardial damage inevitably but were within normal limits. RF catheter ablation produced myocardial damage inevitably but minimally, then RF ablation is an effective and safe therapeutic modality for patients with symptomatic tachyarrhythmias.
Arrhythmias, Cardiac ; Catheter Ablation* ; Catheters ; Electrodes ; Humans ; Male ; Necrosis ; Tachycardia ; Tachycardia, Supraventricular*

We applied arthroscopy in the diagnosis of thirty four patients with internal derangement of the knee from March to August, 1982. Its results were compared with clinical diagnosis and arthrographic findings. We also performed arthrofomy in twenty nine patients and the final diagnosis enabled us to evaluate the diagnostic accuracy of each method. The accuracy of clinical diagnosis was 63.4%. Arthrographic findings were correct in 77.8%. The diagnostic accuracy of arthroscopy was 92.3% with one false negative case. Unnecessary operations were avoided in five patients with the assistance of negative findings of arthroscopy. Arthrography and arthroscopy were complementary in the diagnosis of internal derangement of the knee.
Arthrography ; Arthroscopy ; Diagnosis ; Humans ; Knee ; Methods

No abstract available in English.
Arthroscopy ; Knee Joint ; Knee

Orientia tsutsugamushi is obligate intracellular bacterium that grows within the cytoplasm of the eukaryotic host cells. Therefore capability of the attachment, entry into the host cell and intracellular survival should be critical process for oriential infection. In this study we investigated the cellular invasion mechanism of Orientia tsutsugamushi and the role of transmembrane heparan sulfate proteoglycan, which binds diverse components at the cellular microenvironment and is implicated as host cell receptors for a variety of microbial pathogens. First of all Orientia tsutsugamushi can invade a wide range of nonprofessional phagocytic cells including fibroblast, epithelial cells a#nd endothelial cells of various host species, including B and T lymphocytes. Thus, it was postulated that the attachment of O. tsutsugamushi requires the recognition of ubiquitous surface structures of many kinds of host cells. Treatments with heparan sulfate and heparin inhibited the infection of Orientia tsutsugamushi in dose-dependent manner for L cell, mouse fibroblast, whereas other glycosaminoglycans such as chondroitin sulfate had no effect. Collectively, these findings provide strong evidence that initial interaction with heparan sulfate proteoglycan is required for the oriential invasion into host cells.
Animals ; Cellular Microenvironment ; Chondroitin Sulfates ; Cytoplasm ; Endothelial Cells ; Epithelial Cells ; Eukaryotic Cells* ; Fibroblasts ; Glycosaminoglycans ; Heparan Sulfate Proteoglycans ; Heparin ; Heparitin Sulfate ; Mice ; Orientia tsutsugamushi* ; Phagocytes ; T-Lymphocytes

No abstract available.

PURPOSE: Authors investigated the associated findings and their value in the diagnosis of anterior cruciate ligament(ACL) injury in MR image. MATERIAL AND METHODS: The knee MR images of 47 patients with ACL injury(complete; 24, partial; 23) and 61 patients with normal ACL confirmed by the knee arthroscopy or operation were reviewed retrospectively. The degree of anterior translocation of tibia and the degree of posterior cruciate ligament(PCL) buckling were evaluated. The prevalence and pattern of associated adjacent bone, ligament and meniscus injuries were studied. RESULTS: The means( +/- 2standard errors) of anterior translocation were different significantly in statistical analysis(p<0.001, student t-test) between injury group(7.51 +/- 1.16mm) and normal group(-0.56 +/- 0.92mm). In the level of 5mm of anterior translocation for the criteria of ACL injury, the sensitivity, specificity, accuracy were 78.7%, 89.5%, 84.3% for each. The means of PCL buckling ratio were also different statistically b. etween injury group(0.23 +/- 0.02) and normal group(0.17 +/- 0.01)(p<0.001). In the level of 0.20 for diagnostic criteria of ACL injury, the sensitivity, specificity, accuracy were 71.4%, 83.6%, 78.4% for each. Thirty one medial meniscus tear(66%), thirteen lateral meniscus tear(28%), ten medial collateral ligament injury(28%), one PCL injury (2%) were associated with ACL injury. The twenty nine bone marrow changes were found in twenty patients {43%) which included acutely injured seven patients. In acute cases, the bone marrow changes were depicted as diffuse or focal high signal intensity lesions in lateral femoral or tibial condyles in contrast to the changes in chronic cases depicted as focal low signal intensity lesions in variable location. Lateral femoral condylar notch depression were found in nine patients(19%) and avulsion fractures of anterior tibial spine in four patients(9%). CONCLUSION: The associated findings with ACL injury (anterior translocation, buckling of PCL, associated bone, ligament and meniscus injuries) are considered to be helpful in the diagnosis of ACL injury on Knee MR images, when the findings of anterior cruciate ligament itself are not confirmative.
Anterior Cruciate Ligament* ; Arthroscopy ; Bone Marrow ; Collateral Ligaments ; Depression ; Diagnosis ; Humans ; Knee ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Prevalence ; Retrospective Studies ; Sensitivity and Specificity ; Spine ; Tibia