Most sacral fractures have generally been treated with a nonoperative method. However, the authors of this study treated, with an operative method, a transverse sacral fracture that was displaced forward into the pelvic cavity and the patient also had extensive neurologic injury and instability. Fracture site stabilization and decompression proved to be successful management and the patient experienced a remarkably good outcome. In selected cases, surgical treatment is a good option for the management of transverse sacral fracture.
Decompression ; Humans ; Sacrum

Colorectal cancer (CRC) is a major cause of cancer mortality worldwide, and this has led to an increased use of screening colonoscopy. This screening has resulted in long-term risk reduction in asymptomatic individuals. However, endoscopists may fail to detect advanced adenomas or colon cancer during screening. The reasons that adenomas or cancers are missed are thought to be associated with the location of the lesions or the skills of the endoscopist. To address the limitations of white light endoscopy (WLE) for adenoma detection, advanced endoscopic images have recently been used. Image-enhanced endoscopies (IEEs), including the use of topical dyes, optical filtering, and ultramagnification, allow for gastrointestinal lesion analysis. Many studies have compared the adenoma detection rate (ADR) obtained by using WLE and IEE, but with different results. IEE can be used to help the endoscopist to improve their ADR in screening colonoscopy. This review examines the possible roles of image-enhanced colonoscopy in CRC screening.
Adenoma ; Colonic Neoplasms* ; Colonoscopy ; Colorectal Neoplasms ; Coloring Agents ; Endoscopy* ; Image Enhancement ; Mass Screening* ; Mortality ; Risk Reduction Behavior

No abstract available.
Adolescent ; Capsule Endoscopy ; Endoscopy, Gastrointestinal ; Humans ; Male ; Meckel Diverticulum/*diagnosis/radionuclide imaging/surgery ; Radiography, Abdominal ; Radiopharmaceuticals/diagnostic use ; Sodium Pertechnetate Tc 99m/diagnostic use ; Surgical Instruments ; Tomography, X-Ray Computed

BACKGROUND: To characterize the recently issued femur shaft insufficiency fracture in terms of a patient's own epidemiological status. METHODS: Fourteen patients were treated for insufficiency fracture from July 2002 to June 2008, excluding cases including the risk factors of insufficiency fracture. All patients were female, and their mean age was 75.6 years (range, 65 to 89 years). The mean follow-up period was 50.6 months (range, 14 to 86 months). RESULTS: The mean body weight of the Koreans in the same age group was 58.1 +/- 9.7 kg, and the mean height was 155.5 +/- 8.8 cm. The mean body weight of our insufficiency fracture patients was 45.7 kg and it was statistically significantly lower than that of the Koreans in the same age group (p < 0.001). The mean height was 147.3 cm and it was significantly shorter than the mean height of the Koreans in the same age group (p = 0.002). In regard to menopausal time, the mean menopausal time of the Koreans was 48.0 +/- 4.2 years, it was 44 years in our study, as menopause occurred statistically significantly earlier (p = 0.017). The patients with insufficiency fracture showed statistically lower weight, shorter stature and an earlier menopausal period than that of the general population. CONCLUSIONS: In early menopausal, underweight, and short patients prescribed osteoporosis medication for an extended period of time, if predromal symptom is present, it is necessary to suspect insufficiency fracture of the femur.
Aged ; Aged, 80 and over ; Body Height ; Female ; Femoral Fractures/epidemiology/*pathology/surgery ; Femur ; Fractures, Stress/epidemiology/*pathology/surgery ; Humans ; Menopause ; Republic of Korea/epidemiology ; Risk Factors

Endoscopic submucosal dissection (ESD) procedure is composed of circumferential mucosal incision and submucosal dissection. A variety of endoscopic accessories are required to perform mucosal incision and submucosal dissection safely. As a result of the improvements in ESD devices and peripheral equipment and development of the ESD technique, ESD procedures have been performed extensively worldwide. Here I review the history of the development of accessories used in performing ESD procedures.

A total of 605 implant fixture prosthesis delivered by 3 clinics and 2 laboratories were examined in this study. The object of this study was to determine the proper length of screw head. The depth of access hole were measured and compared to the type of fixture, abutment, gold screw and prosthesis. The results were as follows: 1. The average number of fixtures per patient were 2.97. 2. The number of fixture installed in the lower posterior area are 327(55.56 %), the upper posterior area 171(28.25%). 3. The depth of access hole is 4.23 mm in shallow area, and 5.46 mm in deep area and the differences were 1.23 mm. 4. The average depth of the aceess hole of the UCLA abutment were 5.02 mm. 5. The number of 4-5 mm access hole depth were 60(22.39%)in abutment screw level and the number of 4-5 mm depth in fixture level were 101(29.19%). 6. In the shape of screw head, hexed type were 576(95.21%), slotted type were 29(4.79%).
Head ; Humans ; Prostheses and Implants

Although small bowel the mainly occupies the most part of the gastrointestinal tract, small intestine tumors are rare, insidious in clinical presentation, and frequently represent a diagnostic and management challenge. Small bowel tumors are generally classified as epithelial, mesenchymal, lymphoproliferative, or metastatic. Familial adenomatous polyposis and Peutz-Jeghers syndrome are the most common inherited intestinal polyposis syndromes. Until the advent of capsule endoscopy (CE) and device-assisted enteroscopy (DAE) coupled with the advances in radiology, physicians had limited diagnostic examination for small bowel examination. CE and new radiologic imaging techniques have made it easier to detect small bowel tumors. DAE allows more diagnosis and deeper reach in small intestine. CT enteroclysis/CT enterography (CTE) provides information about adjacent organs as well as pictures of the intestinal lumen side. Compared to CTE, Magnetic resonance enteroclysis/enterography provides the advantage of soft tissue contrast and multiplane imaging without radiation exposure. Treatment and prognosis are tailored to each histological subtype of tumors.
Adenomatous Polyposis Coli ; Capsule Endoscopy ; Diagnosis ; Gastrointestinal Tract ; Intestinal Polyposis ; Intestine, Small ; Peutz-Jeghers Syndrome ; Prognosis ; Radiation Exposure

No abstract available.
Peutz-Jeghers Syndrome*

BACKGROUND: The authors hypothesized that the continuous infusion of ramosetron 0.15 mg following a 0.15 mg bolus administration would maintain higher 5-hydroxytryptamine type 3 receptor occupancy levels and be more effective in preventing postoperative nausea and vomiting (PONV) than a 0.3 mg single bolus administration. We conducted a study to compare the efficacy of single bolus ramosetron administration with the combination of continuous infusion following intravenous bolus administration for PONV prophylaxis. METHODS: One hundred and fifty female patients undergoing thyroidectomy were allocated randomly to one of three groups to receive a placebo (Group 1, n = 49), 0.3 mg of IV ramosetron (Group 2, n = 53), or the continuous infusion of 0.15 mg ramosetron following a bolus administration of 0.15 mg of ramosetron (Group 3, n = 48). Anesthesia was maintained with sevoflurane and N2O. The incidence of PONV, nausea severity, and use of rescue antiemetics during the postoperative 24 hours were recorded. RESULTS: Group 1 showed higher incidences of PONV during the postoperative 24 hour than Group 2 (81% vs. 58%, P = 0.02) and Group 3 (81% vs. 48%, P < 0.01), but there was no difference between Groups 2 and 3 (P = 0.39). The use of rescue antiemetics was significantly lower in Groups 2 and 3 than Group 1 during the postoperative 6 to 24 hours. CONCLUSIONS: There were no significant differences of incidence and severity of PONV between ramosetron 0.3 mg single bolus administration and the combination of ramosetron infusion after 0.15 mg bolus administration.
Analgesia, Patient-Controlled ; Anesthesia ; Antiemetics* ; Female ; Humans ; Incidence ; Morphine ; Nausea ; Postoperative Nausea and Vomiting ; Serotonin ; Thyroidectomy

BACKGROUND: The single radius total knee prosthesis was introduced with the advantage of reduced patellar symptoms; however, there is no long-term follow-up study of the same. The purpose of this study was to determine the survival rate of single radius posterior-stabilized total knee arthroplasty and patellofemoral complication rates in a consecutive series. METHODS: Seventy-one patients (103 knees) who underwent arthroplasty without patellar resurfacing using a single radius posterior-stabilized total knee prosthesis were followed up for a minimum 10 years. Clinical evaluation using Knee Society knee and function scores and radiologic evaluation were performed at regular intervals. Anterior knee pain as well as patellofemoral complications were evaluated with a simple questionnaire. The Kaplan-Meier product-limit method was used to estimate survival. RESULTS: Seventeen patients (23 knees) were excluded due to death (12 knees) or lost to follow-up (11 knees). Of the 80 knees enrolled, all femoral components and 78 tibial components were well fixed without loosening at final follow-up. Two revisions were performed because of tibial component loosening and periprosthetic joint infection. One patient with tibial component loosening refused to have revision surgery. No obvious tibial insert polyethylene wear was observed. The survivorships at 132 months were 96.7% using revision or pending revision as end points. Anterior knee pain was present in 6 patients (6 knees, 7.5%) at the latest follow-up. No patellofemoral complication requiring revision was encountered. CONCLUSIONS: The single radius posterior-stabilized total knee prosthesis demonstrated an excellent minimum 10-year survivorship. The low rates of implant loosening and 7.5% of anterior knee pain as a patellofemoral complication are comparable with those reported for other modern total knee prosthesis.
Aged ; Arthralgia/*surgery ; Arthroplasty, Replacement, Knee/*instrumentation/*methods ; Cementation ; Female ; Follow-Up Studies ; Humans ; Knee Joint/*surgery ; Knee Prosthesis ; Male ; Middle Aged ; Patella/surgery ; Prosthesis Failure ; Retrospective Studies ; Treatment Outcome