PURPOSE: The distal chevron osteotomy has gained popularity for the mild to moderate hallux valgus, but necessity of fixation is controversy. No fixation of distal chevron osteotomy cause instability, but fixation has problem which has pin site infection and irritability, extension of operation time, discomfort of rehabilitation. So, the author was going to analyse and compare with and without in the fixation of distal chevron osteotomy. MATERIALS AND METHODS: Between 2004 and 2005, a total 18 patients (20 feet) following with and without in fixation of distal chevron osteotomies. The fixation group (A) was performed for the treatment of 10 patients (10 feet) and no fixation group (B) was done to 8 patients (10 feet). RESULTS: On group A, the mean first MTP (metatarsophalangeal) angle corrected 17 degrees pre-operatively to average 29 degrees (range; 20-37 degrees) and the mean first IM (intermetatarsal) angle corrected 10 degrees pre-operatively to average 15 degrees (range; 9-18 degrees). On Group B, the mean first MTP angle corrected 16 degrees pre-operatively to average 29 degrees (range; 18-33 degrees) and the mean first IM angle corrected 7 degrees pre-operatively to average 13 degrees (range; 9-16 degrees) (P>0.05). Clinical results, based on AOFAS score showed an improvement in the overall results. CONCLUSIONS: Comparing the clinical and radiographic results of the distal chevron osteotomies no difference in with and without fixation of distal chevron osteotomies.
Hallux Valgus* ; Hallux* ; Humans ; Osteotomy* ; Rehabilitation

Thymomas are associated with different paraneoplastic syndromes, with the most clinically important association being with myasthenia gravis, hypogammaglobulinemia, and pure red cell aplasia (PRCA). The optimal therapy for PRCA that complicates a thymoma is unknown, given the rarity of the clinical situation. It has been suggested that remission following surgery alone is uncommon and most patients will require some other form of therapy. We report a case of PRCA with a thymoma in a 59-year-old man who remained in complete remission of the PRCA after surgical resection of the thymoma.
Agammaglobulinemia ; Humans ; Middle Aged ; Myasthenia Gravis ; Paraneoplastic Syndromes ; Red-Cell Aplasia, Pure* ; Thymoma*

Mycoplasma pneumoniae (M. pneumoniae) is the leading cause of pneumonia in older children and young adults. Normally, it does not progress to a condition requiring hospitalization but improves spontaneously or has a mild clinical course. We report two cases of M. pneumoniae pneumonia with different clinical manifestations from the normal course. The patients were young healthy individuals. The diagnoses were made by serology. However, it could not be determined beforehand that they had M. pneumoniae pneumonia. Based on the empirical treatment strategy of severe community acquired pneumonia, the patients were treated with broad-spectrum antibiotics including cephalosporin, quinolone and macrolide. After administering the antibiotics, they showed a gradually favorable clinical course and recovered without residual complications. A M. pneumoniae infection should be considered as a cause of severe community acquired pneumonia, and empirical treatment targeting this organism might be helpful in treating patients with the severe manifestation.
Anti-Bacterial Agents ; Child ; Diagnosis ; Hospitalization ; Humans ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma* ; Young Adult

Mycoplasma pneumoniae (M. pneumoniae) is the leading cause of pneumonia in older children and young adults. Normally, it does not progress to a condition requiring hospitalization but improves spontaneously or has a mild clinical course. We report two cases of M. pneumoniae pneumonia with different clinical manifestations from the normal course. The patients were young healthy individuals. The diagnoses were made by serology. However, it could not be determined beforehand that they had M. pneumoniae pneumonia. Based on the empirical treatment strategy of severe community acquired pneumonia, the patients were treated with broad-spectrum antibiotics including cephalosporin, quinolone and macrolide. After administering the antibiotics, they showed a gradually favorable clinical course and recovered without residual complications. A M. pneumoniae infection should be considered as a cause of severe community acquired pneumonia, and empirical treatment targeting this organism might be helpful in treating patients with the severe manifestation.
Anti-Bacterial Agents ; Child ; Diagnosis ; Hospitalization ; Humans ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma* ; Young Adult

BACKGROUND: Malignancies are a common and important causes of exudative pleural effusions. Several tumor markers have been studied because the pleural fluid cytology and pleural biopsy specimens do not provide a diagnosis in a high percentage of malignant effusions. In an attempt to overcome this limitation, procalcitonin and C-reactive protein (CRP) in pleural effusions and serum, which are known to be inflammation markers, were measured to determine if they can differentiate an exudate from trasndate as well as the diverse causes of exudative pleural effusion. METHODS: 178 consecutive patients with pleural effusion (malignant 57, tuberculous 51, parapneumonic 31, empyema 5, miscellaneous benign 7, transudative 27)were studied prospectively. The standard parameters of pleural effusion and measured serum and pleural procalcitonin were examined using in immunoluminometric assay. The level of CRP in serum and pleural fluid was determined by turbidimetric immunoassay. RESULTS: The pleural procalcitonin levels in the exudate were significantly higher than those in the transudate, 0.81+/-3.09 ng/mL and 0.12+/-0.12 ng/mL, respectively (p=0.007). The pleural CRP levels were significantly higher in the exudate than the transudate, 2.83+/-3.31 mg/dL and 0.74+/-0.67 mg/dL, respectively (p<0.001). The pleural procalcitonin levels in the benign effusion were significantly higher than those in the malignant effusion, 1.15+/-3.82 ng/mL and 0.25+/-0.92 ng/mL, respectively (p=0.032). The pleural CRP levels were significantly higher in the benign effusion than in the malignant effusion, 3.68+/-3.78 mg/dL and 1.42+/-1.54 mg/dL, respectively (p<0.001). The pleural procalcitonin levels in the non-tuberculous effusion were significantly higher than those in the tuberculous effusion, 1.16+/-3.75 ng/mL and 0.13+/-0.37 ng/mL, respectively (p=0.008). CONCLUSION: Measuring the level of procalcitonin and CRP in the pleural fluid is helpful for differentiating between transudates and exudates. In addition, it is useful for differentiating between benign and malignant pleural effusions.
Biopsy ; C-Reactive Protein* ; Diagnosis ; Empyema ; Exudates and Transudates ; Humans ; Immunoassay ; Inflammation ; Pleural Effusion* ; Pleural Effusion, Malignant ; Prospective Studies ; Biomarkers, Tumor