Supracondylar fracture of femur is not well suited to internal fixation. A wide canal, thin cortex, comminution and compound wound make open reduction difficult. And the associated injuries, such as popliteal artery rupture are not infrequent. Some authors reported the favorable results with open reduction and rigid internal fixation. But still we have had failure cases with loosening or breakage of plate and screws, infection, post-operative joint stiffness and non-union etc. The present paper reports the result of surgically treated supracondylar fracture. From March 1982 to February 1989 25 patients who were treaed at Department of Orthopedic Surgery, St. Vincent Hospital were analysed. The results obtained as follows:l. Age distribution was between 29 and 74 years of age, and the ratio between males and females was 1.8:1. The most common of injury was traffic accident. 2. According to Neer's classification, there were 5 patients of type I, 7 patients of type II
Accidents, Traffic ; Age Distribution ; Amputation ; Classification ; Clinical Study ; Female ; Femur ; Fractures, Open ; Humans ; Joints ; Knee ; Leg ; Male ; Orthopedics ; Osteoarthritis ; Patella ; Popliteal Artery ; Rupture ; Tibia ; Wounds and Injuries

No abstract available.
Mongolian Spot* ; Nevus, Blue*

Objective: Since the impact of the coronavirus disease-2019 pandemic, the need for efficiency in medical services has become more urgent than ever. The digital treatment market is rapidly growing worldwide and digital therapeutics (DTx), a major part of the digital medical services, is also emerging as a new paradigm for treatment, with its industry growing rapidly as well. Increasing research is done on the effectiveness of mobile DTx in improving mental health conditions such as insomnia, panic, and depression. Methods: This review paper investigates 1) the functions and characteristics of mobile digital mental health care applications for the treatment of anxiety symptoms, 2) extracts common attributes of the applications, and 3) compares them with existing traditional treatment mechanisms. Results: Among the 20,000 mental health management applications that have been developed so far, 8 applications that are relatively widely used were selected and reviewed. Check-in, self-help tips, quick relief, journal, courses for practice are common features of the digital mental health care applications for anxiety and are also widely used feature in the cognitive behavioral therapy. Conclusion Based on this review, we have proposed the essential elements and directions for the development of a Korean digital mental health care applications for anxiety disorders.

OBJECTIVE: To examine the relationship between Osteoprotegerin gene polymorphisms, and bone mineral density (BMD). METHODS: Restriction fragment length polymorphisms at the Osteoprotegerin A163G (promoter), G1181C (exon 1) gene site, and BMD at the lumbar spine and proximal femur were analyzed in 229 postmenopausal Korean women (81 normal, 111 osteopenic and 37 osteoporotic patients). BMDs were measured by DEXA. RESULTS: The distribution of A163G and G1181C polymorphisms in all postmenopausal women was as follows: AA 54.6%, AG 37.1%, GG 8.3%; GG 52.4%, GC 38.0%, CC 9.6%, respectively. After adjusting for potential confounding factors such as age, BMI, and menopause duration, A163G polymorphism was significantly associated with BMD at the lumbar spine and G1181C polymorphism BMD at the trochanter in all postmenopausal women. A163G polymorphism was significantly associated with BMD at the lumbar spine in normal and osteoporotic patients, and BMD at the femur neck and wards triangle in normal patients. G1181C polymorphism was significantly associated with BMD at the femur neck in osteopenic and osteoporotic patients, and BMD at the wards triangle and trochanter in osteoporotic patients. CONCLUSION: These findings suggest that osteoprotegerin gene polymorphisms may be an important contributor to the variation of BMD among postmenopausal Korean women.
Bone Density ; Female ; Femur ; Femur Neck ; Humans ; Menopause ; Osteoprotegerin* ; Polymorphism, Restriction Fragment Length ; Spine

BACKGROUND: Transient elastography (FibroScan®) is a non-invasive and rapid method for assessing liver fibrosis. While the feasibility and usefulness of FibroScan® have been proven in adults, few studies have focused on pediatric populations. We aimed to determine the feasibility and usefulness of FibroScan® in Korean children. METHODS: FibroScan® examinations were performed in 106 children (age, 5–15 years) who visited the Konyang University Hospital between June and September 2018. Liver steatosis was measured in terms of the controlled attenuation parameter (CAP), while hepatic fibrosis was evaluated in terms of the liver stiffness measurement (LSM). Children were stratified into obese and non-obese controls, according to body mass index (≥ or < 95th percentile, respectively). RESULTS: The obese group was characterized by significantly higher levels of aspartate aminotransferase (AST, 57.00 ± 48.47 vs. 26.40 ± 11.80 IU/L; P < 0.001) and alanine aminotransferase (ALT, 91.27 ± 97.67 vs. 16.28 ± 9.78 IU/L; P < 0.001), frequency of hypertension and abdominal obesity (abdominal circumference > 95% percentile) (P < 0.001), CAP (244.4–340.98 dB/m), and LSM (3.85–7.77 kPa) (P < 0.001). On FibroScan®, 30 of 59 obese children had fibrosis (LSM > 5.5 kPa), whereas the remaining 29 did not (LSM < 5.5 kPa). Obese children with fibrosis had higher levels of AST (73.57 ± 56.00 vs. 39.86 ± 31.93 IU/L; P = 0.009), ALT (132.47 ± 113.88 vs. 48.66 ± 51.29 IU/L; P = 0.001), and gamma-glutamyl transferase (106.67 ± 69.31 vs. 28.80 ± 24.26 IU/L; P = 0.042) compared to obese children without fibrosis. LSM had high and significant correlation (P < 0.05) with AST, ALT, homeostasis model assessment for insulin resistance, and AST-to-platelet ratio index. CONCLUSION: FibroScan® is clinically feasible and facilitates non-invasive, rapid, reproducible, and reliable detection of hepatic steatosis and liver fibrosis in the Korean pediatric population.
Adult ; Alanine Transaminase ; Aspartate Aminotransferases ; Body Mass Index ; Child ; Diagnosis ; Elasticity Imaging Techniques ; Fatty Liver ; Fibrosis ; Homeostasis ; Humans ; Hypertension ; Insulin Resistance ; Liver Cirrhosis ; Liver ; Methods ; Non-alcoholic Fatty Liver Disease ; Obesity, Abdominal ; Transferases

Resistance to thyroid hormone (RTH) is a condition caused by a mutation in the thyroid hormone receptor gene. It is rarely reported in individuals with no family history of RTH or in premature infants, and its clinical presentation varies. In our case, a premature infant with no family history of thyroid diseases had a thyroid stimulating hormone level of 85.0 µIU/mL and free thyroxine level of 1.64 ng/dL on a thyroid function test. The patient also presented with clinical signs of hypothyroidism, including difficulties in feeding and weight gain. The patient was treated with levothyroxine; however, only free thyroxine and triiodothyronine levels increased without a decrease in thyroid-stimulating hormone levels. Taken together with thyroid gland hypertrophy observed on a previous ultrasound examination, RTH was suspected and the diagnosis was eventually made based on a genetic test. A de novo mutation in the thyroid hormone receptor β gene in the infant was found that has not been previously reported. Other symptoms included tachycardia and pulmonary hypertension, but gradual improvement in the symptoms was observed after liothyronine administration. This report describes a case involving a premature infant with RTH and a de novo mutation, with no family history of thyroid disease.
Diagnosis ; Goiter ; Humans ; Hypertension, Pulmonary ; Hypertrophy ; Hypothyroidism ; Infant ; Infant, Newborn ; Infant, Premature ; Receptors, Thyroid Hormone ; Tachycardia ; Thyroid Diseases ; Thyroid Function Tests ; Thyroid Gland ; Thyroid Hormone Receptors beta ; Thyroid Hormone Resistance Syndrome ; Thyrotropin ; Thyroxine ; Triiodothyronine ; Ultrasonography ; Weight Gain

OBJECTIVE: Treating patients with bipolar disorder has many problems such as recurrent various episodes, breakthroughs, treatment resistance, switching and worsening of its course. In addition to these obstacles, recent developments of psychiatric medications make it difficult to choose the appropriate pharmacological options. This study was performed to survey the expert opinion of medication treatment for bipolar disorder. METHODS: The survey questionnaire used in 'The Expert Consensus Guideline Series-Medication Treatment of Bipolar Disorder 2000' was translated in Korean and amended by executive committee according to Korean situations. Forty eight of 50 (96%) members of review committee completed the survey. RESULTS: In acute manic episode lithium or divalproex is a first-line drug as a monotherapy, and combination treatment is considered in partial or non-responder. Carbamazepine is also a first-line drug in dysphoric and mixed episodes. For moderate and more severe depression, an antidepressant is added with a mood stabilizer. For psychotic bipolar disorder, mania or depression, both atypical antipsychotics and high potency typical antipsychotics are preferred, but the latter is less likely to be recommended. A mood stabilizer should be used in rapid cycling bipolar illness. For manic episode in rapid cycler a mood stabilizer and an atypical antipsychotic drug are recommended in combination as an initial treatment. CONCLUSION: Most experts present strong consensus for many options concerning to initial strategies and first-line medications, although there are some non-consensus and gaps between research data and clinical usage in some steps. Nevertheless these data might be a cornerstone for producing the Korean medication algorithm for bipolar disorder.
Advisory Committees ; Antipsychotic Agents ; Bipolar Disorder ; Carbamazepine ; Consensus ; Depression ; Expert Testimony ; Humans ; Lithium ; Questionnaires ; Valproic Acid

OBJECTIVE: This study examined the differences in psychiatric comorbidities and behavioral aspects in accordance with the severity of Internet addiction in male adolescents. METHODS: One hundred and twenty-five adolescents from four middle and high schools in Seoul were enrolled in this study. The subjects were divided into non-addict, abuse, and dependence groups according to a diagnostic interview by psychiatrists. The psychiatric comorbidities and behavioral aspects of subjects were evaluated through psychiatric clinical interviews based on the Diagnostic and Statistical Manual of Mental Disorders (4th edition), the Children's Depression Inventory, the State-Trait Anxiety Inventory, the Internet Addiction Test, and a self-reported questionnaire about behavioral aspects. RESULTS: The psychiatric comorbidity distributions were significantly different in the abuse and dependence groups, particularly in terms of attention-deficit hyperactivity disorder and mood disorder items. The Children's Depression Inventory, the State-Trait Anxiety Inventory, and the Internet Addiction Test scores were also significantly different among the three groups. There were significant differences in 10 of the 20 items of the Internet Addiction Test between the non-addict, abuse, and dependence groups. There were significant differences in seven items between the non-addict and abuse groups, but no differences between subjects in the abuse and dependence groups. Significant differences were observed in three items between the abuse and dependence groups, but there were no significant differences between the non-addict and abuse groups. In terms of behavioral aspects, scores for abusive, sexual, and decreased social interest behaviors were highest in the dependence group, and lowest in the non-addict group. However, the behavioral aspects of decreased interpersonal relationships did not show this difference between groups. CONCLUSION: This study suggests that there are differences in psychiatric comorbidities and behavioral aspects between adolescent males with characteristics of Internet abuse and Internet dependence.
Adolescent* ; Anxiety ; Comorbidity* ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Internet* ; Male ; Mood Disorders ; Psychiatry ; Surveys and Questionnaires ; Seoul

PURPOSE: To evaluate the clinical usefulness of KCL 990(R) for the treatment of dry eye with meibomian gland dysfunction (MGD). METHODS: Patients (n = 54 eyes, 27 subjects) diagnosed with dry eye with MGD were recruited for a prospective, one-month clinical trial. Patients received a twice-a-day 15-minute treatment using the KCL 990(R). Effectiveness parameters included patient symptom scores using the Ocular Surface Disease Index (OSDI) questionnaires, tear osmolarity measured with TearLab(R) (TearLab Corporation, San Diego, CA, USA), classical tear break-up time (TBUT), and objective TBUT value using an Optical Quality Analysis System (OQAS(R), Visiometrics, Castelldefels, Spain). Data are presented for pre-treatment (baseline) and at 1 week and 1 month post-treatment. An objective TBUT value was estimated in each eye when the optical scattering index (OSI) started to increase consistently, and data were obtained at pretreatment (baseline) and at 1 month post-treatment. RESULTS: The symptom scores on OSDI questionnaires, tear osmolarity, and tear break-up time improved significantly from baseline to one week (p < 0.05). This improvement was maintained with no significant regression at 1 month (p < 0.05). The objective TBUT value decreased significantly at 1 month (p < 0.05). CONCLUSIONS: KCL 990(R) contributed to improve not only signs and symptoms of dry eye with MGD, but also the function of the tear film and ocular surface.
Dry Eye Syndromes ; Eye ; Humans ; Meibomian Glands ; Osmolar Concentration ; Prospective Studies ; Surveys and Questionnaires ; Tears

Malignant glioma is the most frequent type in brain tumors. The prognosis of this tumor has not been significantly improved for the past decades and the average survival of patients is less than one year. Thus, an effective novel therapy is urgently needed. TNF-related apoptosis inducing ligand (TRAIL), known to have tumor cell-specific killing activity, has been investigated as a novel therapeutic for cancers. We have developed Ad-stTRAIL, an adenovirus delivering secretable trimeric TRAIL for gene therapy and demonstrated the potential to treat malignant gliomas. Currently, this Ad-stTRAIL gene therapy is under phase I clinical trial for malignant gliomas. Here, we report preclinical studies for Ad-stTRAIL carried out using rats. We delivered Ad-stTRAIL intracranially and determined its pharmacokinetics and biodistribution. Most Ad-stTRAIL remained in the delivered site and the relatively low number of viral genomes was detected in the opposite site of brain and cerebrospinal fluid. Similarly, only small portion of the viral particles injected was found in the blood plasma and major organs and tissues, probably due to the brain-blood barrier. Multiple administrations did not lead to accumulation of Ad-stTRAIL at the injection site and organs. Repeated delivery of Ad-stTRAIL did not show any serious side effects. Our data indicate that intracranially delivered Ad-stTRAIL is a safe approach, demonstrating the potential as a novel therapy for treating gliomas.
Adenoviridae/genetics ; Animals ; Blood-Brain Barrier ; Brain/drug effects/*metabolism/pathology ; Brain Neoplasms/genetics/metabolism/pathology/*therapy ; Clinical Trials, Phase I as Topic ; DNA, Viral/metabolism ; Disease Models, Animal ; Drug Delivery Systems ; Drug Evaluation, Preclinical ; *Gene Therapy ; Glioma/genetics/metabolism/pathology/*therapy ; Humans ; Liver/drug effects/metabolism/pathology ; Protein Multimerization/genetics ; Rats ; Spleen/drug effects/metabolism/pathology ; TNF-Related Apoptosis-Inducing Ligand/genetics/*pharmacokinetics