[Objective] To determine the long term survivorship and establish the idea I correction angle in proximal tibial osteotomy for primary osteoarthritis. [Method] Seventy-nine patients suffering from primary osteoarthritis (111 knees) were performed with proximal tibial valgus osteotomy from 1985 to 1997, among which 74 women (106 knees) and 5 men (5 knees). The age ranged from 37 to 70 years (mean, 55 years). Postoperatively, hospital for Special Surgery knee score (HSS) was used for clinical assessment. The femorotibial angle (FTA) was measured to classifiy patients to group Ⅰ of 61 knees with less than 7 of valgus; group Ⅱ of 23 knees with 7～9 of valgus; group Ⅲ of 27 knees with over 10 of valgus. Closed wedge osteotomy was performed in all cases. HSS was assessed pre-and post-operatively. [Result] The average follow-up period was 9 years and 6 months (2 years and 4 months to 14 years and 1 month). The HSS knee score averaged 60 points preoperatively, 94 after 1 year and 87 at the last follow-up. Falure I was the need for conversion of a proximal tibial osteotomy to a total knee arthrop lasty, and Failure Ⅱ was the need for conversion of HSS knee score of less than 60 points. The 4 and 14 years survival rates were 99% and 85% using the first definition of failure, and 96. 4% and 75.1% using the second. [Conclusion] Proximal tibial osteotomy is reliable for treating unicompartmental osteoarthritis, providing that the postoperative femorotibial angle is corrected to more than 7° of valgus and falls in the range of 10°～15°.

PURPOSE: The admission rates for pediatric asthma are increasing annually and are partially responsible for the increased rates of readmission. Selections of children with a high-risk of readmission and aggressive treatments of them may improve treatment outcome and cost- effectiveness. The purpose of this study is to evaluate the risk factors affecting readmission in cases of bronchial asthma in children. METHODS: We reviewed the medical records of 95 cases under 14 years of age who were admitted to the Department of Pediatrics, Kyung-Hee University, from March 1996 to February 1997 and divided them into readmission and first admission group. RESULTS: Readmission cases were 52 (55%). Age, sex, duration of admission, duration of oxygen therapy, serum IgE concentration, duration of symptoms prior to admission and severity of asthma were not statistically significant compared with those of the control group (t-test) (P>0.05). Use of prophylactic agents, family history of allergic diseases and past history of bronchiolitis were significant (P<0.05), but age under 4 years and sex were not significant (X2-test). Age under 4 years, history of bronchiolitis, and history of previous hospital admission for asthma were significant (P<0.05), but sex, severity of asthma, history of frequent upper respiratory tract infection, family history, and the use of prophylactic agents were not statistically significant (P>0.05) as independent risk factors. CONCLUSION: Age under 4 years, past history of bronchiolitis, and history of previous hospital admission for asthma were significant risk factors for hospital readmission. Further study needs to be done to decrease the readmission rates.
Asthma* ; Bronchiolitis ; Child ; Humans ; Immunoglobulin E ; Medical Records ; Oxygen ; Patient Readmission ; Pediatrics ; Respiratory Tract Infections ; Risk Factors* ; Treatment Outcome

In the abstract, case description and figure 2, the nomenclature of two mutations was misprinted because of misreading the cDNA nucleotide sequences.

Since the introduction in 1996 of the novel antipsychotic risperidone in Korea, clinical experiences with this agent for the treatment of schizophrenia have been accumulated. This article attempts to review the published literature on clinical effects of risperidone in Korean patients with schizophrenic disorder. All available clinical articles by Korean authors or involving Korean patients were searched through electronic databases (KISEP and KMBASE) or manually. Retrieved articles were primarily written in Korean and were of several types (original article, case report, review and tutorial), and addressed various issues:efficacy, safety and tolerance, quality of life and subjective well-being, pharmacoeconomics, optimal dose and titration rate, etc. The main results are as follows. Many clinical trials to date have shown that risperidone is an effective antipsychotic agent in the treatment of positive and negative symptoms, with a milder side effect profile, in particular much less EPS than haloperidol. The effects were favorable even in chronic or treatment-resistent patients. It appears to have additional effects on quality of life and subjective well-being. Preliminary evidence suggested that risperidone may improve some types of cognitive function. Weight gain was a major problem although the weight increase was less severe than that seen with clozapine and olanzapine. Some experimental studies demonstrated prolactin elevation in patients treated with risperidone;however, clinical significance of hyperprolactinemia was unclear. Various specific cases of adverse events were reported during risperidone therapy, including new onset of manic symptoms, neuroleptic malignant syndrome, stuttering, premature ventricular contraction and hepatotoxicity;however, the numbers of cases were very few, the causal relationship was not clear in some cases, and there were no fatalities or life threatening events. At present the medication costs for risperidone are much greater than those for conventional drugs. However, risperidone therapy may be associated with substantial cost benefits, when total health service costs and quality of life were taken together into account. The target dose found to be effective was lower than the originally proposed target dose of 6 mg/day. A slower titration was also found to be preferable. Taken together, in spite of lacking in randomized controlled clinical trials and long term studies, Korean literature on risperidone use for schizophrenia provides valuable information to clinicans regarding the effective use of risperidone. Risperidone should be a first line drug for the treatment of Korean patients with schizophrenic disorder.
Clozapine ; Cost-Benefit Analysis ; Economics, Pharmaceutical ; Haloperidol ; Health Services ; Humans ; Hyperprolactinemia ; Korea ; Neuroleptic Malignant Syndrome ; Prolactin ; Quality of Life ; Risperidone* ; Schizophrenia* ; Stuttering ; Ventricular Premature Complexes ; Weight Gain

BACKGROUND: Although a number of indices of diastolic function based on transmitral flow have been proposed, no single factor seems to be adequate for seperating patients with normal from with abnormal diastolic functions. Pulsed Doppler echocardiography of pulmonary venous flow(PVF) is another non-invasive method to evaluate left ventricular diastolic performance. The purpose of this study is to evaluate the normal PVF pattern by TEE. METHOD: We performed pulsed-wave Doppler studies of the PVF and of the mitral flow by transesophageal-(TEE) and transthoracic echocardiography(TTE) in a healthy young adults. RESULTS: In TEE, all sublects showed four phases of the PVE pattern ; two antewgrade systolic phase(early and late : SE and SL), one antewgrade diastolic phase(D) and one retrograde diastolic phase(A). In TTE, there were three phases of the PVF pattern ; two antewgrade phase(systolic, diastolic) and one retrograde diastolic phase but we couldn't find out early systolic phase flow. Peak velocity of each phase of PVF was as follows:SE was 48.9+/-14.1cm/sec, SL was 56.3+/-16.1cm/sec, D was 52.6+/-14.9cm/sec. The timing of SL flow was correlated significantly with that of peak aortic flow(r=0.42, p=<0.01), while the timing of D flow and that of A flow were correlated significntly with timing of mitral E peak and A peak, respectively(r=0.84, p<0.01 ; r=0.80, p<0.01). CONCLUSIONS: In the young normal subject, PVF showed four phase of flow pattern and could be easily obtained by TEE. Furthermore it may be used for evaluation of left ventricular function.
Echocardiography, Doppler, Pulsed ; Echocardiography, Transesophageal* ; Humans ; Ventricular Function, Left ; Young Adult*

It has been believed that the increased release of free oxygen radicals(O2-, H2O2 and OH-) might be one of important factors in the pathogenesis of periodontal diseases. Polymorphonuclear leukocytes(PMNs) constitute the primary host resistance factor against infection. They are prominent cells in both the gingival tissue and gingival sulcus in most forms of periodontal disease. In response to invading microorganisms, the activated PMNs and macrophages generate free oxygen radicals, which play an important role in bacterial killing. The normal production of these free oxygen radicals is vital for the successful resistance of individuals to bacterial infection. However, the enhanced production of reactive oxygen species by accumulating PMNs may be detrimental to the host in certain disease states. This study was performed to evaluate the effect of Tetracycline-HCl(Tc-HCl) on generation of superoxide anion by PMNs. For the present study, 60ml of peripheral venous blood were obtained from systemically healthy subjects by venipuncture in median cubital vein and PMNs were separated by a one-step Ficoll-Hypaque gradient centrifugation method. PMNs were incubated with 1microgram/ml P.gingivalis strain A7436 LPS, 5% serum and Tc-HCl(5, 10, 50 and 100microgram/ml). The superoxide anion analysis was carried out by superoxide dismutase-inhibitable cytochrome C reduction method using Microplate autoreader(BIO-TEK(TM) Instrument Inc.). The difference of superoxide anion generation between control group and Tc-HCl group was statistically analyzed by paired t-test. The superoxide anion generation in the course of time after treatment with Tc-HCl was analyzed by ANOVA, and the superoxide anion generation in the course of time after treatment with various concentrations of Tc-HCl was analyzed by Repeated Measurement test. The results were as follows: 1. Superoxide anion generation by PMNs was significantly decreased by Tc-HCl(p<0.05). 2. There was no statistical significance in the inhibition of superoxide anion generation in the course of time after treatment with various concentrations of Tc-HCl(p>0.05). 3. Superoxide anion generation by PMNs was significantly decreased in the course of incubation time after treatment with Tc-HCl(p<0.05). The results demonstrate that the Tc-HCl inhibit superoxide anion generation by PMNs and the inhibitory effects depend on the exposure time rather than the concentration of Tc-HCl.

BACKGROUND: Epidural morphine has side effects, especially pruritus, nausea, and vomiting. Butorphanol has been added in studies to reduce these side effects in post cesarean patients. The purpose of this study was to evaluate the side effects and analgesic efficacy when a combination of epidural morphine and butorphanol was administered in patients having combined local anesthetic and opioid epidural infusion. METHODS: Sixty patients having epidural anesthesia for cesarean section were randomly divided into two groups. Group M (n=30) received a bolus of 0.25% bupivacaine 4 ml, morphine 2 mg, and saline 0.75 ml, whereas group B (n=30) received a bolus of 0.25% bupivacaine 4 ml, morphine 2 mg, and butorphanol 1.5 mg (0.75 ml). Continuous epidural infusion was done by Two-day Infusor containing either 0.25% bupivacaine 75 ml, morphine 5 mg, and saline 20 ml in group M or 0.25% bupivacaine 75 ml, morphine 5 mg, butorphanol 4 mg (2 ml), and saline 18 ml in group B. We compared the side effect and analgesic effect of group M to those of group B for 2 days. RESULTS: The incidence of pruritus and vomiting were reduced significantly in group B (p<0.05). There were no significant differences between both groups in the incidence of nausea or other side effects as well as no differences in analgesic effect. CONCLUSIONS: We conclude that the addition of butorphanol to morphine in combined local anesthetic and opioid epidural infusion for postoperative analgesia decreases the occurrence of pruritus and vomiting without significant increase of other side effects and adverse effect on analgesia.
Analgesia ; Anesthesia, Epidural ; Bupivacaine ; Butorphanol* ; Cesarean Section* ; Female ; Humans ; Incidence ; Infusion Pumps ; Morphine* ; Nausea ; Pregnancy ; Pruritus ; Vomiting

Aortopulmonary septal defect is a rare congenital cardiac anomaly. A 15 year old boy was admitted to Department of Internal Medicine of Seoul National University Hospital because of exertional dyspnea. Aortopulmonary septal defect was confirmed by cardiac catheterization demonstrating severe pulmonary hypertension and patent foramen ovale, and retrograde aortogram showing contrast material passing from the ascending aorta just above the aortic valve into the pulmonary trunk. We present a case of aortopulmonary septal defect with a review of literatures.
Adolescent ; Aorta ; Aortic Valve ; Aortopulmonary Septal Defect* ; Cardiac Catheterization ; Cardiac Catheters ; Dyspnea ; Foramen Ovale, Patent ; Humans ; Hypertension, Pulmonary ; Internal Medicine ; Male ; Seoul

BACKGROUND: The objective of this study is to evaluate the relationship between chewing ability and health status in order to provide basic information for the development of program which may lead to an improvement of a the elderly health status in urban areas. MATERIALS AND METHODS: The subjects of this study were 128 elderly urban female over the age of 65 who reside at house. The data were collected from May 21 to August 20, 2001, through questionnaires about nutrient intake status, direct measurement of anthropometrics, and oral examinations. RESULTS: In terms of remaining teeth, there was significant negative relationship between age and number of remained teeth. The average number of remained teeth our subjects was 13.1 10.6. About sixty five percent of the subjects were denture users (partial or full dentures) and there was positive relationship between age and the percentage of denture user. There was a significant negative correlation between age and chewing ability. The group that was able to chew had more remained teeth than the other group. CONCLUSION: This study suggests that there is strong positive relationship between chewing ability (remaining teeth) and elderly health status in urban areas, and the importance of preserving original teeth to improve the elderly health status in the public health program.
Aged* ; Dentures ; Diagnosis, Oral ; Female ; Humans ; Mastication* ; Public Health ; Surveys and Questionnaires ; Tooth

No abstract available.
HIV-1* ; Humans* ; Tumor Necrosis Factor-alpha*