The congenital dislocation of the hip is one of the most common congenital disease in the field of the orthopedic surgery. For the normal development of the acetabulum and femoral head, the displaced femoral head shouid be replaced in the acetabular socket as early as possible. In most cases treated in proper time, closed reduction is successful. If not, operative correction will almost always be necessary due to abnormal changes of the acetabulum and femoral head. We experienced 33 cases in 32 patients of the congenital dislocation of the hip at the Department of Orthopedic Surgery of Hanyang University Hospital from May, 1972 to December, 1980. The results obtained were as follows: 1. The most common aged group at the first visit was ranged from 12 months to 24 months and the preponderance of girl to boy was 3.6:1. 2. The ratio of left to right side was 1.6:1. 3. In delivery history, there were 3 cases of breech presentation, 1 case of Cesarean section and 1 case of prematurity. The associated congenital anomaly was observed in a case of which combined internal tibial torsion and talipes metatarsus varus deformity. 4. In 33 cases in 32 patients, 22 cases were treated conservatively and 11 cases were treated surgically. The results of treatment were excellent in 21 cases, good in 11 cases and fair in 11 case. We experienced 4 cases of neglected congenital dislocation of the hip in the period of late childhood, 3 cases were treated with Chiari osteotomy and the other 1 case was treated with Colonna capsular arthroplasty. The overall results were excellent.
Acetabulum ; Arthroplasty ; Breech Presentation ; Cesarean Section ; Clinical Study ; Clubfoot ; Congenital Abnormalities ; Dislocations ; Female ; Head ; Hip ; Humans ; Male ; Metatarsus ; Orthopedics ; Osteotomy ; Pregnancy

BACKGROUND: In order to investigate the effects of intensive training on cardiorespiratory response to maximal exercise in soccer players, graded excercise stress tests were carried out before and after the training, and the results were compared. METHODS: Fourteen male soccer players of a university team with the mean age and career of 19.9 and 7.8 years, respectively, underwent intensive training for approximately 20 weeks, 6 days a week and 4 hours a day, which included running of 2 km daily during the last 8-9 weeks. The symptom-limited maximal exercise test was done by Bruce protocol. RESULTS: After the training. HR max showed no significant changes but Vo2 max, O2 pulse and AT were increased approximately 13%, 12% and 10%, respectively. At maximal exercise, the V(E)/M2 was also increased 18%, but VE/MVV was significantly decreased owing to a marked increase in MVV. However, the rest of various ventilatory parameters showed no significant changes. CONCLUSION: These data indicate that the intensive training of about 20 weeks duration can further improve the level of cardiorespiratory fitness in the soccer players who have been regularly trained and are already highly fit.
Exercise Test ; Humans ; Male ; Running ; Soccer*

PURPOSE: To determine the sonographic findings of degenerative change in femoral articular cartilage of the knee by comparative study of specimen sonography and pathology. MATERIALS AND METHODS: We obtained 40 specimens of cartilage of the femur (20 medial and 20 lateral condylar) from 20 patients with osteoarthritis of the knee who had undergone total knee replacement. The specimens were placed in a saline-filled container and sonography was performed using a 10MHz linear transducer. Sonographic abnormalities were evaluated at the cartilage surface, within the cartilage, and at the bone-cartilage interface, and were compared with the corresponding pathologic findings. In addition, cartilage thickness was measured at a representative portion of each femoral cartilage specimen and was compared with the thickness determined by sonography. RESULTS: 'Dot 'lesions, irregularity or loss of the hyperechoic line, were demonstrated by sonography at the saline-cartilage interface of 14 cartilages. Pathologic examination showed that these findings corresponded to cleft, detachment, erosion, and degeneration. Irregularities in the hyperechoic line at the bone-cartilage interface were revealed by sonography in eight cartilages and were related to irregularity or loss of tidemark, downward displacement of the cartilage, and subchondral callus formation. Dot lesions, corresponding to cleft and degeneration, were noted within one cartilage. Cartilage thickness measured on specimen and by sonography showed no significant difference (p=0.446). CONCLUSION: Specimen sonography suggested that articular cartilage underwent degenerative histopathological change. Cartilage thickness measured by sonography exactly reflected real thickness.
Arthroplasty, Replacement, Knee ; Bony Callus ; Cartilage ; Cartilage, Articular* ; Femur ; Humans ; Knee* ; Osteoarthritis ; Pathology* ; Transducers ; Ultrasonography

Background: As one of the most challenging fractures to orthopedic surgeons, acetabular fractures show a wide range of incidence among countries and regions with even more variance in the treatment modalities. In this study, we aimed to investigate the epidemiology of acetabular fractures, and to compare the rate of subsequent total hip arthroplasty (THA) between nonoperative and operative treatments in South Korea using a medical claims database. Methods: This was a retrospective study using the Korean Health Insurance Review and Assessment database. Patients admitted for acetabular fractures from January 2007 to December 2018 were identified using International Classification of Diseases-10 codes.Kaplan-Meier survival analysis was used to compare the cumulative incidence of THA between two groups. We also evaluated the survivorship of operative group according to the type of institutions. Results: The incidence rate of acetabular fractures increased by 28% between 2007 and 2018. Acetabular fractures were more common in men (62%) than women (38%), and most common in the patients older than 80 years. The number of acetabular fractures was estimated to increase 1.7-fold in 2030 compared to 2018. Operative treatment accounted for 16% of cases, and nonoperative treatment for 84%. The incidence of subsequent THA was higher in the operative treatment group than in the nonoperative group (P < 0.001).The higher rate in the operative treatment group is probably related with the severity of the fracture type. The rate of subsequent THA was higher in patients who initially treated in general hospitals compared with those who were initially treated in tertiary hospitals. Conclusion The incidence of acetabular fractures is increasing in South Korea, in line with global trends. Most acetabular fractures are treated conservatively, and those who receive surgery are more likely to require a subsequent THA. Patients who were operated in general hospitals had highest possibility of subsequent THA after acetabular fractures.

Limited data are available about the incidence of hypertension over the 5-yr in non-hypertensive subjects. The study subjects were 1,806 subjects enrolled in a rural area of Daegu, Korea for a cohort study from August to November 2003. Of them, 1,287 (71.3%) individuals had another examination 5 yr later. To estimate the incidence of hypertension, 730 non-hypertensive individuals (265 males; mean age = 56.6 +/- 11.1 yr-old) at baseline examination were analyzed in this study. Hypertension was defined as either a new diagnosis of hypertension or self-reports of newly initiated antihypertensive treatment; prehypertension was if the systolic blood pressure was 120-139 mmHg and/or diastolic blood pressure was 80-89 mmHg. During the 5-yr follow-up, 195 (26.7%) non-hypertensive individuals developed incident hypertension. The age-adjusted 5-yr incidence rates of hypertension were 22.9% (95% confidence interval [CI] = 19.9-29.0) in overall subjects, 22.2% (95% CI = 17.2-27.2) in men, and 24.3% (95% CI = 20.4-28.2) in women. The incidence rates of hypertension significantly increased with age. In the multivariate analysis, prehypertension (Odds ratio [OR] 2.25; P < 0.001) and older age (OR 2.26; P = 0.010) were independent predictors for incident hypertension. In this rapidly aging society, population-based preventive approach to decrease blood pressure, particularly in subjects with prehypertension, is needed to reduce hypertension.
Adult ; Age Factors ; Aged ; Antihypertensive Agents/administration & dosage/*therapeutic use ; *Blood Pressure ; Blood Pressure Determination ; Body Weights and Measures ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Hypertension/diagnosis/drug therapy/*epidemiology/physiopathology ; Incidence ; Male ; Middle Aged ; Questionnaires ; Republic of Korea/epidemiology ; Risk Factors

OBJECTIVE: To investigate the effect of intravenous infusion of peripheral blood mononuclear cells (mPBMC) mobilized by granulocyte-colony stimulating factor (G-CSF) on upper extremity function in children with cerebral palsy (CP). METHODS: Fifty-seven children with CP were enrolled. Ten patients were excluded due to follow-up loss. In total, 47 patients (30 males and 17 females) were analyzed. All patients' parents provided signed consent before the start of the study. After administration of G-CSF for 5 days, mPBMC was collected and cryopreserved. Patients were randomized into two groups 1 month later. Twenty-two patients were administered mPBMC and 25 patients received normal saline as placebo. Six months later, the two groups were switched, and administered mPBMC and placebo, respectively. Quality of Upper Extremity Skills Test (QUEST) and the Manual Ability Classification System (MACS) were used to evaluate upper motor function. RESULTS: All subdomain and total scores of QUEST were significantly improved after mPBMC and placebo infusion, without significant differences between mPBMC and placebo groups. A month after G-CSF, all subdomain and total scores of QUEST were improved. The level of MACS remained unchanged in both mPBMC and placebo groups. CONCLUSION: In this study, intravenously infused mPBMC showed no significant effect on upper extremity function in children with CP, as compared to placebo. The effect of mPBMC was likely masked by the effect of G-CSF, which was used in both groups and/or G-CSF itself might have other neurotrophic potentials in children with CP.
Cerebral Palsy* ; Child* ; Classification ; Follow-Up Studies ; Granulocyte Colony-Stimulating Factor ; Humans ; Infusions, Intravenous* ; Male ; Masks ; Parents ; Peripheral Blood Stem Cell Transplantation ; Upper Extremity*

BACKGROUND: Emergence and spread of antimicrobial resistant bacteria make it difficult to treat infections. A rapid increase in antimicrobial-resistant bacteria has become a serious problem in many countries including Korea, and it is important to perform a nationwide study of antimicrobial resistance to obtain some basic data that will help solve these problems. The aim of this study was to determine the nationwide prevalence of resistance among frequently isolated bacterial pathogens in 2005 and 2006 in Korea. METHODS: We collected routine susceptibility data for medically important bacterial pathogens from 12 university and general hospital laboratories in Korea from April to September in 2005 and from January to June in 2006. Collected data was analyzed by patient group. RESULTS: The proportions of methicillin-resistant Staphylococcus aureus (MRSA) were 65% in 2005 and 72% in 2006, respectively. The resistance rates of Enterococcus faecium to vancomycin were 29% in 2005 and 24% in 2006. The non-susceptible rates of Streptococcus pneumoniae to penicillin were 68% in 2005 and 74% in 2006. The resistant rates of Escherichia coli and Klebsiella pneumoniae to the 3rd generation cephalosporin were 10~12% and 25~39%, respectively, in 2005 and 11~15% and 30~34% in 2006. In Citrobacter freundii, Enterobacter cloacae and Serratia marcescens, the resistance rates to 3rd generation cephalosporin were 23~31%, 32~34%, and 17~27%, respectively, in 2005 and 21~37%, 37~43%, and 13~31% in 2006. The resistance rates to imipenem and meropenem were 21% and 18%, respectively, in Pseudomonas aeruginosa and 18% and 25% in Acinetobacter baumannii in 2005; 29% and 20% in P. aeruginosa and 18% and 23% in A. baumannii in 2006. Cotrimoxazole and levofloxacin resistance rates of Stenotrophomonas maltophilia were 5% and 13%, respectively, in 2005 and 3% and 7% in 2006. There were no isolates resistant to 3rd generation cephalosporin and fluoroquinolone among non-typhoidal Salmonella in 2005. CONCLUSION: Antimicrobial resistance of medically important bacteria is still a serious problem in Korea. To manage the problem, a continuous nationwide surveillance and diversified investigation and effort have become more important.
Acinetobacter baumannii ; Bacteria* ; Citrobacter freundii ; Enterobacter cloacae ; Enterococcus faecium ; Escherichia coli ; Hospitals, General ; Humans ; Imipenem ; Klebsiella pneumoniae ; Korea* ; Levofloxacin ; Methicillin-Resistant Staphylococcus aureus ; Penicillins ; Prevalence ; Pseudomonas aeruginosa ; Salmonella ; Serratia marcescens ; Stenotrophomonas maltophilia ; Streptococcus pneumoniae ; Trimethoprim, Sulfamethoxazole Drug Combination ; Vancomycin

BACKGROUND: Clinical isolates of Escherichia coli were evaluated to determine the prevalence and genotypes of Ambler class A extended-spectrum beta -lactamases (ESBLs). METHODS: Clinical isolates of E. coli were collected from 12 hospitals from February through July, 2004. Antimicrobial susceptibility was tested by disk diffusion and agar dilution methods, and ESBLproduction was determined by double-disk synergy test. TEM, SHV, CTX-M, PER-1, VEB, IBC, GES, and TLA type ESBL genes were detected by PCR amplifications, and the PCR products were subjected to direct sequencing. RESULTS: The double-disk synergy test was positive in 90.9% (149 in 164) of the ceftazidime- or cefotaxime-resistant E. coli isolates. The most prevalent types of Ambler class A ESBLs in E. coliisolates were CTX-M-15 (n=53). CTX-M-14 (n=24), CTX-M-3 (n=9), CTX-M-9 (n=3), CTX-M-12 (n=3), SHV-2a (n=1), SHV-12 (n=5) and TEM-52 (n=3) were also found. CTX-M-12 ESBL had never been reported before in Korea. CONCLUSIONS: CTX-M type ESBL-producing E. coli isolates are spreading and CTX-M-12 is emerging in Korea.
Agar ; beta-Lactamases* ; Diffusion ; Escherichia coli* ; Genotype ; Korea ; Polymerase Chain Reaction ; Prevalence

BACKGROUND: The aims of this study were to survey the nation-wide susceptibilities of Klebsiella pneumoniae isolates against ceftazidime and cefotaxime and to determine the prevalence of class A extended-spectrum beta-lactamases (ESBLs). METHODS: During the period of February to July 2004, K. pneumoniae isolates intermediate or resistant to ceftazidime and/or cefotaxime were collected from 12 hospitals in Korea. Antimicrobial susceptibilities were determined by the disk diffusion and the agar dilution methods and ESBL-production was by double-disk synergy test. Ceftazidime or cefotaxime-resistance determinants of the ESBLproducers were transfered to Escherichia coli J53 by transconjugation. Searches for class A ESBL genes were performed by PCR amplication. RESULTS: Among 212 clinical K. pneumoniae isolates, 172 (81%) isolates showed positive results in double-disk synergy test; the most prevalent ESBL was SHV-12 (n=104). Genes encoding ESBLs including SHV-2 (n=6), SHV-2a (n=17), CTX-M-3 (n=18), CTX-M-9 (n=6), CTX-M-12 (n=1), CTX-M- 14 (n=27), CTX-M-15 (n=3), and a novel CTX-M-type beta-lactamases were also detected. CONCLUSIONS: It is concluded that diversity of ESBLs in K. pneumoniae isolates are increasing in Korea. CTX-M-12 has never been reported in Asia, and a novel CTX-M-type ESBL has emerged.
Agar ; Asia ; beta-Lactamases ; Cefotaxime ; Ceftazidime ; Diffusion ; Escherichia coli ; Klebsiella pneumoniae* ; Klebsiella* ; Korea ; Pneumonia ; Polymerase Chain Reaction ; Prevalence

BACKGROUND: A rapid increase in antimicrobial-resistant bacteria has become a serious problem in Korea. Moreover, the antibiotic resistance problem has worsened noticeably during the past several years. The aim of this study was to determine the prevalence of resistance among frequently isolated gram-positive and -negative bacteria in Korea. METHODS: Routine susceptibility data for medically important bacteria isolated during 6 months of 2003 were collected from 12 university and general hospital laboratories in Korea. RESULTS: The proportion of methicillin-resistant Staphylococcus aureus (MRSA) was 66%; however, vancomycin-resistant strains were not detected. The rates of vancomycin-resistant Enterococcus faecium and penicillin-nonsusceptible Streptococcus pneumoniae (PNSP) were 22% and 73%, respectively. The resistance rates to 3rd generation cephalosporins and monobactam were: Escherichia coli 8-12%, Klebsiella pneumoniae 18-22%, Citrobacter freundii 22-32%, Enterobacter cloacae 34-37%, and Serratia marcescens 12-21%, respectively. Imipenem resistance rates of Acinetobacter baumannii and Pseudomonas aeruginosa were 23% and 25%, respectively. CONCLUSIONS: Antimicrobial resistant strains were already prevalent among the clinically important isolates, especially, MRSA, PNSP, and extended-spectrum cephalosporin resistant gram-negative bacilli in Korea. The imipenem-resistant rates of A. baumannii and P. aeruginosa increased, respectively, from 13% and 20% in 2002 to 23% and 25% in 2003. The results of this study will provide a basis for proper treatment of bacterial infections and prevention of spread of resistant bacteria. A continuous nationwide surveillance of antimicrobial resistance is very important and should be performed.
Acinetobacter baumannii ; Bacteria* ; Bacterial Infections ; Cephalosporins ; Citrobacter freundii ; Drug Resistance, Microbial ; Enterobacter cloacae ; Enterococcus faecium ; Escherichia coli ; Hospitals, General ; Imipenem ; Klebsiella pneumoniae ; Korea* ; Methicillin-Resistant Staphylococcus aureus ; Prevalence ; Pseudomonas aeruginosa ; Serratia marcescens ; Streptococcus pneumoniae