Change of Cognitive Functions in Switching of Risperidone for Chronic Schizophrenic Patients / 대한정신약물학회지

OBJECTIVE: The aim of this study is to evaluate the effect of risperidone on cognitive functions in chronic schizophrenic patients after 8 weeks of treatments and determine whether any improvement on cognitive function relates to improvement in psychopathology. METHODS: The subjects were 20 chronic schizophrenic outpatients, who participated in eight-week crossover study from conventional antipsychotics to risperidone. Clinical symptoms were assessed by Positive and Negative Syndrome Scale, Clinical Global Impression and Extrapyramidal Symptom Rating Scale, while they were receiving conventional antipsychotic treatment. Cognitive functions were assessed by K-WAIS digit span and digit symbol substitution test, and vigilance, continuous attention, reaction unit, corsi-block-tapping test. Patients were then reassessed after changing to a new treatment of risperidone. RESULTS: After crossover from conventional antipsychotics to risperidone, positive and negative symptoms and the general psychopathology were significantly improved. The only item of Vienna tests significantly improved after risperidone treatment was corsi-block-tapping test. However, this improvement was not related to the improvement in psychopathology. Backward digit span score, digit span total score, digit symbol substitution score were significantly improved after risperidone treatment. But this improvement was not related to the improvement in psychopathology, except digit span total score. Digit span total score was related to the improvement in negative symptom score and PANNS total score. CONCLUSION: Treatment with risperidone appeared to exert a favorable effect on visuospatial memory and working memory, but long-term and larger sample replication study is necessary.

The Objective Personality Characteristic of the Dry Eye Syndrome Patients

To investigate personality characteristic of dry eye patient, an investigation on objective personality characteristics of 41 dry eye syndrome patients was performed with MMPI (Minnesota Multiphasic Personality Inventory). Of 41 patients tested, 14 (34.1%)patients had at least one MMPI clinical scale more than 70 point of T-score, abnormality greater than 70 point of T-score occurred most frequently in the scales for ypochondriasis, psychasthe-nia, depression, hysteria, social introversion.In the group profile study, mean T-scores on each clinical scale were within normal range, and the highest scales in rank order were hypochondriasis, depression, psychasthenia. In the relation between results of TBUT and Schirmer test and T-scores of each clinical scale, correlation coefficient is insignificantly low (r0.4). Therefore we recommend comprehension of their emotional condition and an additional psycholgical management with classical treatment as dry eye syndrome management.

The clinical study for geriatric patients with hip fracture treated with knowles pin / 대한정형외과학회잡지

No abstract available.

Clinical analysis of Acromioclavicular and Coracoclavicular Ligament Injury / 대한정형외과학회잡지

The acromioclavicular and coracoclavicular ligament are usually injured by traffic accident or during sports. So, various methods of treatment has been introduced. Fourty four cases of acromioclaviclar and coracoclavicular ligament injuries were admitted and treated at Koryo General Hospital from March 1985 to February 1989. 26 cases were treated by operative method, 18 cases by conservative method in Grade 1, 2 and 3 injuries. The following results were obtained. 1. These injuries were more prevalent in male and more in left side. 2. The most common cause of injuries was traffic accident. 3. Among 44 cases, 13 cases were Grade 1, 9 cases Grade 2 and 22 cases Grade 3 by Allman's classification. 4. 18 cases were treated conservatively and 26 cases operatively. Conservatively treated 18 cases include 15 cases by Kenny-Howard sling and 3 cases by skillful neglect. And operatively treated 25 cases include 12 cases by modified Phemister method(46.2%), 2 cases by modified Bosworth method(7.7%), 2 cases by acromioclavicular plate method(7.7%), 2 cases by Stewart method(7.7%) and one case by Mumford method(3.8%). 5. There were good functional results with the K-wire fixation method after the acurate diagnosis by operative method in the Grade 2 injury. And in the Grade 3 injury we could get the functional results with the modified Phemister method.

The Clinical Study of the Supracondylar Fracture of the Femur / 대한정형외과학회잡지

The various methods of treatment of the supracondylar fractures of the femur were adapted by many authors according to degree of the involvement of the articular surface, displacement of fragments, degree of comminution and external forces. Authors experienced the supracondylar fracture of the femur in 31 cases who were treated at Koryo General Hospital from March 1984 until March 1988 and among them, 14 cases were treated by operative methods and 17 cases by conservative methods. The results were as follows:1. The male was more common, and the 3rd & 4th decades were most. 2. The most common cause of injuries was traffic accident. 3. The most common fracture type was type I by Neer's classification. 4. The type I was treated mostly by conservative methods and the type II & III by operative methods. 5. In the operative treatments, after anatomical reduction and rigid fixation, the duration of the rehabilitation was shortened by using the C.P.M. exerciser. 6. The complications were partial ankylosis of the knee, chronic osteomyelitis, nonunion and delayed union.

Morphologic Analysis and the Clinical Significance of the Patella in Sagittal Plane / 대한정형외과학회잡지

In 1941 Wiberg discribed morphologic classification of patella in axial plane and the correlationship between its shape and dysfunction. Here the authors reviewed 120 cases and divided them into four groups. Group I is the one with no knee joint pain or patella dysfunction, group II is the patients with meniscus injury, gruop III is the patients with chondromalacia of patella and group IV is the patients with osteoarthritis of knee joint. We analysed them according to the ratio between the length of the patella and the articular surface in lateral X-ray films of patella. The results were as follows:1. The ratio between the length of the patella and the articular surface is 1.45±0.13(mean±SD) in group I, 1.47±0.18 in group II, 1.56±0.12 in group lll and 1.57±0.15 in group IV. 2. Statistically(P<0.05), no significant difference between group I and group II, but group III and group IV is significantly different from the group I. 3. The ratio between the length of the patella and the articular surface is thought to be helpful for diagnosing the patient with vague knee joint pain.

The Clinical Study of the Lateral Collateral Ligament of the Ankle / 대한정형외과학회잡지

The ankle is one of the most common site of ligamentous injury. The incidence of the injury is increasing in these days, probably due to prevailing leisure and sports. Lateral collateral ligament is more susceptible to injury than medial because of anatomical and biomechanical difference. There was a tendency to treat the ankle ligamentous injury with conservative method, but because of the problem of chronic and recurrent ankle instability and injury, operative method is necessary in certain patients. We have experienced of 14 cases of surgical treatment of the lateral ligaments, excluding the associated fracture, from March 1983 to February 1986, in Koryo General Hospital. Among 14 cases, the acute injury, which were treated with primary repair, were 9 cases and the chronic cases, which with modified Watson-Jones method, were 5. The average follow up period was 1 year and 2 months. The results are as follows : 1. The male and female ratio, was 9 to 5 and peak incidence was 3rd and 4th decade. 2. The cause of injury was mainly slip down (9 cases) and sports injury(4 cases). 3. There was no correlation between the degree of the ligament rupture and talar tilt. 4. When the talar tilt is above 10, it may cause ankle instability. 5. The clinical results are both satisfactory in acute and chronic cases, but in chronic cases, some degenerative changes began to appear in 2 cases. 6. C.P.M.(Continuous Passive Motion) and Air Cast have much advantages in postoperative care.

A Clinical Study on the Treatment of Tibial Shaft Fracture in Adult / 대한정형외과학회잡지

Sixty four cases of tibial shaft fracture in adult were treated by various methods at Department of Orthopedic Surgery, Koryo General Haspital during 3 years from March 1983 to Feb. 1986. The resuIts of 'treatment of these cases were analysed according to method of treatment, type and level of fracture, and degree of injury, in attempt to seek the most suitable method of treatment. The following results were observed 1. Of 64 cases of tibial shaft fracture, 24 cases were treated by cast immobilization, 16 cases by 0/ R and plate, screw fixation, 17 cases by Ender I-M nailing, 7 cases by Hoffmans ext. fixator. 2. The most common site of fracture was middle 1/3 of the shaft (62.5%). 3. On the union time of fracture, I-M nailing by use of Ender nail was more rapid than other methods of treatment. (average: 16.2 Wks. POD) 4. On the time of weight bearing, earlier weight bearing was possible by Ender I-M nailing than other method of treatment. 5. On the complications of fracture, fewer complications were developed after Ender I-M nailing than other method of treatment. 6. According to Modified Ellis classification, more rapid union was obtained by C/R and cast imm-obilization in the case of Minor degree, no significant difference among each group in the case of Moderate degree.

The Methods of Treatment in Estabilished Non-union of Femur Shaft / 대한정형외과학회잡지

The incidence of non-union in the shaft of femur is increasing gradually in spite of considerably improved methods of femoral fracture care. It is necessary that orthopaedic surgeon must draw attention to improve the method of treatment and to prevent the occurance of non-union. This paper presents the follow-up result of 27 cases among 30 established femoral shaft non-union cases, that were treated at the orthopaedic dept. of the National Medical Center from March 1971 to March 1980 by various methods. The study of this series shows the following. l. Amount 27 cases, male was predominant (82%), peak age group was 3rd & 4th decades (52%). 2. The causes of injury were auto-accident (56%), falling down accident (22%), direct blow (11%) & slipping down accident (11%). 3. The most common location was around the mid-shaft of femur (44.4%). 4. The probable causes of non-union were loosening of the implants & metal failure due to improper internal fixation (10 cases), incomplete reduction (7 cases), infection (5 cases) & inadenaute external immobilization (5 cases). 5. Excellent results were obtained by combined method of compression plate, screws & intramedullary nailing with additional autogenous bone graft.