Purpose: We wanted to evaluate the clinical and radiologic results of acetabular revision using the acetabular reinforcement ring and also the allograft impaction in the acetabulum having deficient bone stock. Material and Methods: Nineteen hips revision arthroplasty were performed in 18 patients (9 males and 9 females) with using an acetabular reinforcement ring and allograft between July 1993 and December 2003. The patients were followed for an average of 64 months (range: 24-153). The mean age at the time of arthroplasty was 59 years old (range: 34-76). The causes of revision were aseptic loosening of the acetabular component in 16 cases, severe progressive osteolysis around the acetabular component in 2 cases and Girdlestone state after infected total hip arthroplasty in one case. The acetabular deficiency was type II in 5 hips, type III in 13 hips, and type IV in one hip according to the AAOS classification. The clinical results were evaluated using the modified Harris hip score, and the radiologic results were evaluated by assessing the preoperative and serial follow-up radiographs. Results: The mean preoperative Harris hip score of 47 was improved to 86 points at the latest follow-up. Periacetabular osteolysis was found in 2 cases, which did not progress at follow-up. The anatomic hip center was restored after revision arthroplasty (p<0.05). Complications were dislocation in 2 cases, breakage of the hook of the Ganz ring in one case, heterotopic ossification in one case and femoral artery injury in one case. All cases showed stable fixation of the acetabular component and good remodelling of the impacted allograft. There was neither recurrence of dislocation nor progression of the acetabular component loosening on the radiographs. Conclusion: Acetabular revision with acetabular reinforcement ring and allograft impaction showed satisfactory clinical and radiologic results with restoration of the hip center and consolidation of the allograft.
Acetabulum* ; Allografts* ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Classification ; Dislocations ; Femoral Artery ; Follow-Up Studies ; Hip ; Humans ; Male ; Ossification, Heterotopic ; Osteolysis ; Recurrence

OBJECTIVES: The Personality Belief Questionnaire-Short Form (PBQ-SF) is a self-report instrument for assessment of dysfunctional beliefs based on Beck's cognitive formulations of personality disorders. The aims of this study was to examine the reliability and validity of the Korean version of PBQ-SF in clinical samples. METHODS: The Korean version of PBQ-SF was examined in 115 participants (50 patients with personality disorder and 65 patients without personality disorder). All participants were assessed for personality disorder using the semi-structured clinical interview of the Personality Assessment Schedule. The construction validity was examined by correlation with Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory, and Neuroticism-Extraversion-Openness Five-Factor Inventory neuroticism scales. Twenty four randomly sampled patients were examined for the test-retest reliability. RESULTS: The Korean version of PBQ-SF showed good internal consistency [Cronbach's alpha=0.73 (schizoid)-0.92 (paranoid)] and test-retest reliability [r=0.74 (narcissistic)-0.92 (paranoid)]. The PBQ-SF was correlated with depression, anxiety, and neuroticism. The overall subscales of PBQ-SF were correlated with Diagnostic and Statistical Manual of Mental Disorders based diagnosis of personality disorders. CONCLUSION: Consistent with previous findings using the Korean full version of PBQ as well as the English version of PBQ-SF, our results support that the Korean version of PBQ-SF is a reliable and valid instrument for assessment of dysfunctional beliefs associated with personality pathology.
Anxiety ; Appointments and Schedules ; Depression ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Pathology ; Personality Assessment ; Personality Disorders ; Reproducibility of Results ; Weights and Measures

OBJECTIVES: The aims of this study were to evaluate acceptability and usefulness of the Korean version of Self-report Standardized Assessment of Personality-Abbreviated Scale (SAPAS-SR) as an instrument for screening patients with a personality disorder. METHODS: The Korean version of the SAPAS-SR was administered to a non-random sample of 186 psychiatric patients (155 patients with a personality disorder and 31 patients with no personality disorder). The International Classification of Diseases 10th version Personality Assessment Schedule was used as a gold standard in diagnosis of personality disorder. Receiver-operant-characteristics and validity indicators were determined. In addition, the SAPAS-SR was administered to 22 healthy men to examine the test-retest reliability. RESULTS: The area under the curve for the SAPAS-SR was 0.69 (95% confidence interval 0.59-0.79). The SAPAS-SR score of 4 or more correctly classified 67.2% of patients with a personality disorder. Sensitivity (0.67) and specificity (0.68) were slightly lower compared with the original English version. CONCLUSION: This study provides preliminary evidence of the usefulness of the Korean version of the SAPAS-SR as a self-administered instrument for screening personality disorders in the clinical population.
Appointments and Schedules ; Diagnosis ; Humans ; International Classification of Diseases ; Male ; Mass Screening* ; Personality Assessment ; Personality Disorders* ; Sensitivity and Specificity

PURPOSE: To compare clinical outcomes of infective and non-infective groups in revision total knee arthroplasty. MATERIAL AND METHODS: From December 1993 to December 2001, 29 cases of revision total knee arthroplasty were performed in 27 patients. The mean age at the time of surgery was 64.2 years (48~74). The average follow-up was 45.4 months (24~90). All cases were divided into two groups (fourteen noninfective and fifteen infective groups). The clinical results were evaluated according to range of motion, Hospital of Special Surgery score, Knee Society score and tibiofemoral angle. The causes of revision in noninfective group were aseptic loosening in eleven, instability in two, and femoral periprosthetic fracture in one. RESULTS: There was a significant improvement of range of motion, Hospital for Special Surgery Knee score and Knee Society score at the final follow-up compared with the pre-operative status. The above three evaluation criteria showed no significant difference between the two groups except higher further flexion in non-infective than infective group. Preoperative average tibiofemoral angle was varus 1.4degrees in non-infective group and valgus 2.6degrees in infective group (P<0.05). Postoperatively, the angles changed to be valgus 6.7degrees in non-infective group and valgus 6.8degrees in infective group(P>0.05). There were three complications in infective group, which were two reinfections, and one avulsion of osteotomized tibial tubercle. CONCLUSION: Preoperative planning, choice of proper implants, meticulous management of bony defect and soft tissue enabled successful results in infective group as well as non-infective group except less further flexion in infective group.
Arthroplasty* ; Follow-Up Studies ; Humans ; Knee* ; Periprosthetic Fractures ; Range of Motion, Articular

BACKGROUND: During the Pringle maneuver (PM), the increase of systemic vascular resistance (SVR) and the active constriction of the intrahepatic capacitance vessels could minimize arterial blood pressure change. Pressor reactivity to sympathetic agonists is impaired and blood volume buffering capability is less efficient in a cirrhotic liver. Accordingly, we evaluated the relations between hemodynamics during PM and preoperative liver function test (LFT) by serum aminotransferase and Indocyanine Green (ICG) clearance. METHODS: Twenty-seven patients undergoing hepatectomy with PM were classified into two groups according to the liver function state assigned by serum aminotransferases and ICG clearance test. Sequential changes of hemodynamics were measured with Doppler flowmeter during PM. Hemodynamic data were analyzed by using ANOVA for repeated measurement. Correlation between LFTs were sought using Pearson correlation and logistic regression. RESULTS: During the PM, cardiac output decreased significantly compared to the preclamping period in the abnormal LFT group. There were no significant changes in any other hemodynamic variables in the normal LFT group. When comparing the two groups during PM, mean arterial blood pressures and cardiac output were significantly lower in the abnormal LFT groups compared to the normal LFT groups (P< 0.05). CONCLUSIONS: These differences may suggest that cardiovascular responsiveness to reflex autonomic stimulation during the PM is significantly impaired in patients with abnormal LFT compared with normal LFT subjects.
Arterial Pressure ; Blood Volume ; Cardiac Output ; Constriction ; Flowmeters ; Hemodynamics* ; Hepatectomy ; Humans ; Indocyanine Green ; Liver Function Tests ; Liver* ; Logistic Models ; Reflex ; Transaminases ; Vascular Resistance

OBJECTIVES: The aims of this study were to examine validity and reliability of the Korean version of the Social Function Questionnaire (SFQ) and evaluated social function with SFQ in patients with personality disorder. METHODS: The SFQ was administered to 186 psychiatric patients (155 patients with personality disorder and 31 patients without personality disorder), and 22 healthy men were recruited to examine the test-retest reliability of SFQ. The severity of personality disorders was determined using the proposed the International Classification of Diseases (ICD)-11th revision (ICD-11) personality disorders. All participants completed the NEO-Five Factor Inventory, Beck Depression Inventory, and Spielberger State and Trait Anxiety Inventory to examine the convergent validity of SFQ. RESULTS: The Korean version of the SFQ showed good internal consistency (Cronbach's alpha=0.811) and test-retest reliability (r=0.746). Patients with personality disorder had more social dysfunction than those without personality disorder. A graded increase in social dysfunction was observed with increasing severity of personality disorder. Social dysfunction showed a strong linear relationship with the 5 factor model. CONCLUSION: The Korean version of the SFQ has good psychometric properties. The results of our study support the severity classification of personality disorder integrated to upcoming ICD-11.
Anxiety ; Classification ; Depression ; Humans ; International Classification of Diseases ; Male ; Personality Disorders* ; Psychometrics ; Reproducibility of Results

PURPOSE: Vitamin D deficiency is a public health problem in many countries. There has been a reappearance of rickets from vitamin D deficiency in recent decades as a result of multiple factors. One of the factors is breast feeding. The purpose of this study was to describe the clinical presentation of rickets in breastfed infants. METHODS: Retrospective review of patients presenting to Ajou University hospital between 2003 and 2008 with rickets caused by vitamin D deficiency during breast feeding. RESULTS: Seventeen patients (10 boys and 7 girls) were diagnosed with vitamin D deficiency. There were six in the asymptomatic and eleven in the symptomatic patients. The mean age of the patients was 8.5+/-0.5 months. The mean 25-hydroxycholecalciferol was 3.55+/-1.88 ng/mL. 25-hydroxycholecalciferol levels were below 5 ng/mL in 13 patients. The mean serum alkaline phosphatase was 765.53+/-563.9 IU/L, the mean intact parathyroid hormone was 231.6+/-225.7 pg/mL. All except 3 patients were showed cupping and fraying of metaphysis. CONCLUSION: Breast feeding is associated with increased risk of rickets. We recommend vitamin D supplementation of all breastfed infants to prevent rickets. Supplementation should begin within the first 2 months of life. Also, we hope to initiate further research and debate about guideline of vitamin D supplementation
Alkaline Phosphatase ; Breast Feeding ; Calcifediol ; Humans ; Infant ; Parathyroid Hormone ; Public Health ; Retrospective Studies ; Rickets ; Vitamin D ; Vitamin D Deficiency ; Vitamins

Introduction: The treatment of proximal humeral fracture is traditionally determined by Neer's classification system. The severely displaced three-part or four-part fracture is an indication for primary hemiarthroplasty. The current authors report the clinical results of 10 patients who received hemiarthroplasty for proximal comminuted fractures. The minimum follow-up period was 12 months. Materials and Methods: The current authors studied 10 patients who, between July 1999 and March 2005, each received hemiarthroplasty for a proximal humeral fracture of one shoulder. According to Neer's classification system, 5 of the patients had three-part fractures, and 5 of the patients had 4-part fractures. The mean interval between trauma and hemiarthroplasty was 6.1 days. The mean age of the 6 female and 4 male patients was 67.4 years (range: 56 to 76). Shoulder function was evaluated using the Constant score, the Simple Shoulder Test, and the modified UCLA score. Results: The mean Constant score was 51.4(range: 34 to 60). The mean modified SST score was 7.8 out of 12 tasks. Excluding the one patient who had also sustained an axillary artery rupture and a brachial plexus injury after the initial trauma, the mean Constant score for the remaining 9 patients was 53.5(range: 44 to 60), and the mean SST score was 7.2 tasks. The modified UCLA score averages for pain, function, and active forward flexion and strength were, respectively, 8.2(6~10), 6.6(2~8), and 6.9(4~8). The total UCLA score was an average of 21.7(12~26). Patients' the modified UCLA ratings were as follows: Excellent: 3, Good: 6, and Poor: 1. The patient with the poor outcome was the one who had also sustained the neurovascular injury. Patient's subjective satisfaction rating were as follows: Excellent: 2, Good: 7, and Poor: 1. Conclusion: Based on short term follow-up results, this study indicates that hemiarthroplasty is the treatment of choice for proximal humeral fractures on which it would be difficult to perform open reduction and internal fixation. Hemiarthroplasty is a useful treatment modality to prevent shoulder stiffness and to allow daily living tasks in elderly patients. However, restoration of muscle power and range of joint motion were not recovered satisfactorily.
Aged ; Axillary Artery ; Brachial Plexus ; Classification ; Female ; Follow-Up Studies* ; Fractures, Comminuted ; Hemiarthroplasty* ; Humans ; Joints ; Male ; Rupture ; Shoulder ; Shoulder Fractures*

PURPOSE: Past studies have reported that S-allylcysteine (SAC) inhibits the migration and invasion of cancer cells through the restoration of E-cadherin, the reduction of matrix metalloproteinase (MMP) and Slug protein expression, and inhibition of the production of reactive oxygen species (ROS). Furthermore, evidence is emerging that shows that ROS induced by radiation could increase Met activation. Following on these reports of SAC and Met, we investigated whether SAC could suppress Met activation. MATERIALS AND METHODS: Wound healing, invasion, 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium (MTT), soft agar colony forming, western blotting, and gelatin zymography assays were performed in the human nasopharyngeal cancer cell lines HNE1 and HONE1 treated with SAC (0, 10, 20, or 40 mM) and hepatocyte growth factor (HGF). RESULTS: This study showed that SAC could suppress the migration and invasion of HNE1 and HONE1 cell lines by inhibiting p-Met. An increase of migration and invasion induced by HGF and its decrease in a dose dependent manner by SAC in wound healing and invasion assays was observed. The reduction of p-Met by SAC was positively correlated with p-focal adhesion kinase (p-FAK) and p-extracellular related kinase (p-ERK in both cell lines). SAC reduced Slug, MMP2, and MMP9 involved in migration and invasion with the inhibition of Met-FAK signaling. CONCLUSION: These results suggest that SAC inhibited not only Met activation but also the downstream FAK, Slug, and MMP expression. Finally, SAC may be a potent anticancer compound for nasopharyngeal cancer treated with radiotherapy.
Agar ; Blotting, Western ; Cadherins ; Cell Line ; Emigration and Immigration ; Gastropoda ; Gelatin ; Hepatocyte Growth Factor* ; Hepatocytes* ; Humans ; Nasopharyngeal Neoplasms* ; Phosphotransferases ; Radiotherapy ; Reactive Oxygen Species ; Wound Healing

PURPOSE: To evaluate the necessity of lateral translation and the primary stability of the fixation devices in a closed wedge high tibial osteotomy. MATERIALS AND METHODS: The authors studied four pairs of high tibial osteotomy: Pair I, lateral translation with blade plate fixation; Pair II, lateral translation with staple fixation; Pair III, no translation with blade plate fixation; Pair IV, no translation with staple fixation. Four models of bovine tibia were taken and analyzed for stress distribution at the osteotomy site under axial loading. After axial loading, information recorded in pressure sensitive film was transformed to image file. After, by using image analysis software, the mean stress value and maximum stress value was calculated. RESULTS: The mean stress calculated at each osteotomy site is as follows; 3.89 MPa in the first pair; 4.55 MPa in the second pair; 4.62 MPa in the third pair; and 4.67 MPa in the fourth pair. In Group I, stress value was distributed evenly. But in group II, III, IV, the stress was concentrated at posteromedial area of the osteotomy site. CONCLUSION: The primary in the high tibial osteotomy was dependent more on the rigid fixation than on the continuity of the medial cortex. The pairs on which blade plate fixation was used more stable than the pairs on which staple fixation was used regardless of lateral translation.
Osteotomy* ; Tibia