In case of the large bone defect due to severe varus or valgus deformity in total knee replacement, there are many different methods for reconstruction of the bone defect for insertion of the tibial component after resection of the proximal tibia. Total knee replacement using the autogenous bone graft were performed in 27 knees (18 patients) with tibial bone defect. Authors report the methods and results with an average 23 months follow-up. We used the bone removed from distal femur and calculated the size of the proximal tibia. We used the screws, if necessary, for rigid fixation of the grafted bone. l. According to the type of bone defect, central defect type were 3 knees, peripheral defect type were 13 knees and combined type were 11 knees. 2. In A-P view of x-ray, the size of bone defect of the tibial plateau ranged 5mm to 25mm (average 11.1mm) in height. 3. Screws were used for fixation of grafted bone in 14 knees and the average size of the screws was 27.8mm. 4. Bony union of the grafted bone achieved from 3 months to 12 months (average 5.7months). 5. Average knee ROM was 105 degrees and improved post-operatively 121 degrees, and average flexion contracture was 22.4 degrees and improved post-operatively 7.5 degrees. 6. Post-operative tibiofemoral angle was average 7.5 degrees valgus. 7. Average knee rating score was 54.5 and improved post-operatively 89.2. 8. The comlication of bone graft was partial resorption in 1 case and the loosening or displacement due to screw were abscent.
Arthroplasty, Replacement, Knee ; Congenital Abnormalities ; Contracture ; Femur ; Follow-Up Studies ; Knee ; Tibia ; Transplants

Shaken baby syndrome refers to the group of nonaccidental injuries occuring in infants and children as a consequence of violent shaking. The characteristic injuries include subdural and subarachnoid hemorrhages, retinal hemorrhages, traction-typed metaphyseal fracture of long bone and fractures of the ribs. General physical findings may include bruising and burns, but sometimes no extracranial injuries are detected. Affected children are nearly always under 2 years of age or younger. Common symptoms include lethargy, irritability, seizures, increased or decreased muscle tone, poor feeding, impaired consciousness, vomiting and apnea. We experienced a case of shaken baby syndrome in a 3-month-old girl. Although the history of trauma(shaking) is little known, our findings of clinical and radiographic features corresponded to shaken baby syndrome. (J Korean Pediatr Soc 2000;43:851-855)
Apnea ; Burns ; Child ; Consciousness ; Female ; Humans ; Infant ; Lethargy ; Muscle Hypotonia ; Retinal Hemorrhage ; Ribs ; Seizures ; Shaken Baby Syndrome* ; Subarachnoid Hemorrhage ; Vomiting

No abstract available.
Ankle* ; Arthroplasty*

No abstract available.
Arthroplasty* ; Knee*

BACKGROUND: To find out characteristics and classification of toxic agents by clinical analysis of pediatric poisoning and to determine the clinical availability of grading by using MSPC score. METHOD: Subjects were patients under 15 years exposed to toxic agents, who visited Ajou university hospital emergency center from June, 1994 to October, 1997. The study was performed retrospectively. RESULTS: The subjects were 126 cases and male to female sex ratio was 1.2:1. Mean age was 29+/-30 months old. The most common route of exposure was ingestion, following contact, inhalation and bite. The most common reason was mistake by the patient, following mistake by caregiver, suicide attempt and accident. The MSPC score distribution of symptomatic patient was as follows; 1 point: 26 cases(63.4%), 2 point: 12 cases(29.2%), 3 point: 1 case(2.4%), 4 point: 2 cases(4.8%). The classification of exposed poison was as follows; therapeutic drugs: 29 cases(23.0%), non-therapeutic drugs: 97 cases(73.0%). The most common exposed poison was household products: 23 patients(18.3%) were admitted to hospital. CONCLUSION: There was statistically significant difference in the classification of poison, MSPC score, treatment modality at hospital, first follow up period after discharge between admitted group and non-admitted group. There was statistically significant difference in the reason of exposure, route of exposure, MSPC score, admission period according to patient's age. severity grading according to MSPC score is regarded as an available method to determine the modality of management.
Caregivers ; Classification ; Eating ; Emergencies ; Female ; Follow-Up Studies ; Household Products ; Humans ; Inhalation ; Male ; Poisoning* ; Retrospective Studies ; Sex Ratio ; Suicide

Background: The prevalence of sleep disorders increases as pregnancy progresses, which affects the health of pregnant women, fetal health, and the outcomes of pregnancy. The aim of this study is to evaluate the quality of sleep and life in pregnant women in Korea. Methods: This study is a prospective cross-sectional, case-control study of pregnant women and age-matched controls. From July to September 2019, all participants completed Korean-language versions of the sleep questionnaires including Pittsburgh sleep quality index (K-PSQI), Insomnia severity index, Epworth sleepiness scale, Back’s depression inventory-2(K-BDI), STOP (Snoring, Tiredness, Observed apneas, and high blood Pressure), and short-form 36 (K-SF-36). Results: A total of 422 participants consisted of 385 pregnant women and 137 controls. Second and third trimester were 200 and 185, respectively. K-PSQI scores were higher in pregnant women compared with the controls (7.87±3.49 and 8.50±3.55 vs. 5.79±2.76, p<0.001). Total score of K-SF-36 was lowest in third trimester (62.07±17.72) and highest in the control group(79.41±13.36). There was no statistical difference between groups in K-BDI. Conclusions This study demonstrated worsening of sleep quality as well as life quality during pregnancy. More attention to sleep of pregnant women is needed.

BACKGROUND: Primary hepatocellular carcinoma(HCC) is the second cause of cancer death in our country. Hepatitis B virus(HBV) and hepatitis C virus(HCV) are important risk factors for hepatocellular carcinoma. The mechanism of HCC development and the epidemiology in HCV infected individuals are still unclear. In this study, we investigated the epidemiolgical and clinical features of HCC in relation to viral infection. METHODS: We reviewed the medical records of 160 HCC patients retrspectively who had been admitted to one University Hospital located in Seoul between January 1991 and December 1995. Among these patients, 113 patients were positive for HBsAg(B group), 24 for anti-HCV(C group). We compared epidemiological and clinical data between B group and C guoup. RESULTS: Anti-HCV positivity was significantly higher in HBsAg negative patients than in HBsAg positive patients(53.3:1.7%, p<0.01). The mean age of patients in B group was significantly lower than that in C group(52:62yr, p<0.01). In C group, the proportion of Child-Pugh class B and C was significantly larger than that of B group(35.4: 75.0%, p<0.01). In C group, the proportion of transfusion history was significantly larger than that in B group(4.4: 16.7%, p<0.05), and the proportion of drug abuse hestory was significantly larger than that in B group (31.0:62.5%, p<0.01). In C group, the albumin, cholesterol, Gamma-glutamyl transferase leves were significantly lower than those in B group. In B group, the proportion of metastasis was significantly larger than that in C group(31.9:4.2%, p<0.01). Alpha fetoprotein levels greater than 400ng/ml are much more prevalent in group B significantly(67:39.1%, p<0.05). No significant differences in cumulative survival rate(1yr, 2yr) and median survival time were observed between the two groups. CONCLUSIONS: We ascertain that the HBV and HCV are inportant factors in HCC. In epidemiology and clinical features of HCC, there were some difference between the HBsAg and anti HCV positive group. Therefore, on primary health care settings, it is necessary to test for hepatitis C as well as hepatitis B in order to prevent and manage HCC and chronic liver desease.
alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Cholesterol ; Epidemiology* ; Hepatitis B ; Hepatitis B Surface Antigens* ; Hepatitis C ; Humans ; Liver ; Medical Records ; Neoplasm Metastasis ; Primary Health Care ; Risk Factors ; Seoul ; Substance-Related Disorders ; Transferases

No abstract available.
Atrioventricular Block* ; Myocarditis* ; Pancreatitis* ; Typhoid Fever*

We evaluated median value and lower confidence limit of total serum IgE level in each age group of 1,493 pure atopic dermatitis patient without respiratory atopic diseases. The results were as follows . 1. The median value of total serum IgE level of each age group in patients with atopic dermatitis distributed from 56.5 IU/@Ll to 660It.J/C. The distributions of the median value of total serum IgE levels of total patients with atopic dermatitis, total male patients with atopic dermatitis, and total female patients with atopic dermatitis were 185 IU/C, 220 IUj'@C, and 165 IUj'C. There was no statistical significance of median value of total serum IgE level between mole patients and female patients. 2. The 95% and 99% lower confidence limit(one-sided) of total serum IgE level of ea.ch age group in patients with atopic dermatitis distributed from 32.6 IU /n4 to 287IU/v4 and from 31 IU/m0 to 202 IU4. The 95% lower confidence limit (one-sided) of total serum IgE level of total patients with atopic dermatitis, tatal male patients with atopic dermatitis, and. total female patients with atopic dermatitis were 170 II.J/m0, 185 IU,m/l, and 133 IUm/l. The 99% lower confidence limit.(one-sided) of total serum IgE level of total patient with atopic dermatitis, total male patient with atopic dermatitis, and total female patients with atopic dermatitis were 165 IU/ml, 180 IU/ml, and 125 IU/ml.
Dermatitis, Atopic* ; Female ; Humans ; Immunoglobulin E* ; Male

No abstract available.
Thyroid Gland*