No abstract available.
Hand*

No abstract available.
Fingers* ; Replantation* ; Transplants*

No abstract available.
Fingers* ; Replantation* ; Transplants*

No abstract available.
Fractures, Comminuted* ; Radius*

OBJECTIVE: To evaluate the relationship between postoperative increase in intervertebral disc space height (IVH) and posterior axial neck in cases of degenerative cervical disease treated with anterior cervical discectomy and fusion (ACDF). METHODS: A total of 155 patients who underwent ACDF with more than 1 year follow up were included. Radiologically, IVH and interfacet distance (IFD) of the operated segment were measured preoperatively and postoperatively. We clinically evaluated neck and arm pains according to visual analogue scale (VAS) scores and assessed neck disability index (NDI) scores preoperatively, postoperatively, at 3 months, 6 months, and 1 year postoperatively. The relationship between radiological parameters, and clinical scores were analyzed using a regression analysis. RESULTS: The mean increase in IVH was 2.62 mm, and the mean increase in IFD was 0.67 mm. The VAS scores for neck pain preoperatively, postoperatively, and at 3 months, 6 months, 1 year postoperatively were 4.46, 2.11, 2.07, 1.95, and 1.29; those for arm pain were 5.89, 3.24, 3.20, 3.03, and 2.18. The NDI scores were improved from 18.52 to 7.47. No significant relationship was observed between the radiological evaluation results regarding the increase in intervertebral height or interfacet distance and clinical changes in VAS or NDI scores. CONCLUSION: The increase in intervertebral space or interfacet distance by the insertion of a large graft material while performing ACDF for the treatment of degenerative cervical disease was not related with the change in VAS scores for neck and arm pains and NDI scores postoperatively and during the follow-up period.
Arm ; Diskectomy ; Follow-Up Studies ; Humans ; Intervertebral Disc* ; Neck ; Neck Pain* ; Transplants

No abstract available.
Spine* ; United Nations*

Pedicled bone flap raised from the volar aspect of lower end of the radius, pedicled by the pronator quadratus has been used for the treatment of scaphoid nonunion and Kienbock's disease. From July 1991 to Jan. 1992, authors performed this procedures for 3 cases of Kienbock's disease. Patients were 2 cases in the left hand, l case in the right hand. There was no critial trauma history. Age at operation were 25, 37 and 57 years. All patients were in Stage I in 2 cases and stage II-A in 1 case of Lichtman's radiologic classification. Preoperative grip powers were 11%, 38%, 63% and pinch powers were 20%, 41%, 61% of that of normal opposite hand. Follow up periods were 28, 31 and 33 months. At last follow up roentgenographic finding shows no progression of necrosis of lunate, new bone formation, decreased sclerosis, and joint space were preserved in all cases. The fuctional results at the last follow up were as follows. Pain during motion was markedly diminished in all patients. Grip power were 57%, 89% and 96% and pinch powers were 68%, 83% and 100% of that of normal opposite hand with use of calibrated Jamar dynamometer which showes significant increase than preoperative state. The ranges of motion of wrist were as follows. Volar flexion were 40, 45 and 80 degree. Dorsiflexion were 10, 20 and 45 degree. Ulnar deviation were 10, 20 and 30 degree. Radial deviation were 10, 25 and 30 degree. This viable bone graft with blood supply gives very satisfactory clinical results.
Classification ; Follow-Up Studies ; Hand ; Hand Strength ; Humans ; Joints ; Necrosis ; Osteogenesis ; Osteonecrosis ; Radius ; Sclerosis ; Transplants ; Wrist

OBJECTIVE: To evaluate the effects of piroxicam patch(Trast) in rheumatoid arthritis patients with knee joint pain and swelling and to determine the concentration of plasma and synovial fluid following patch application. METHODS: Twenty-two patients with rheumatoid arthritis participated in a double-blind, placebo-controlled study. The patients were instructed to apply piroxicam or placebo patch at one knee and re-apply it every other day for 2 weeks. They had washout period for 2 weeks and then applied the other patch for 2 weeks at the same joint. The patients recorded knee joint pain using visual analog scale. Knee joint swelling and tenderness were assessed before and after application of piroxicam and placebo patch. Complete blood count, AST, ALT, BUN, creatinine, joint fluid analysis were also done. Piroxicam concentration in plasma and synovial fluid were measured by high performance liquid chromatography(HPLC) after 2 weeks of piroxicam patch application. RESULTS: Knee joint pain improved significantly after the application of piroxicam patch for 2 weeks(visual analog scale, 56. 2+5. 9m vs 48. 2+5. 7mm, p=0. 03 by Wilcoxon signed rank test). There was no significant change in white cell count of synovial fluid, peripheral blood cell count, chemistry, C-reactive protein and erythrocyte sedimentation rate. In terms of adverse effects, mild gastrointesti nal disturbance(8/21 cases, 38%) and local side effects such as pruritus and ery thema(3/21 cases, 14%) were developed, which were insignificant compared with control groups(30%, 15% respectively). Piroxicam concentrations in plasma and synovial fluid after the application of piroxicam patch were 0. 129+0. 04ug/ ml (mean+SE) and 0. 644+0. 202ug/ml respectively. CONCLUSIONS: Piroxicam patch is a safe and effective therapeutic modality for knee joint pain in patients with rheumatoid arthritis. Mild adverse effects such as gastrointestinal disturbance and local side effects were noted. Piroxicam concentration was higher in synovial fluid than in plasma following the application of piroxicam patch.
Arthritis, Rheumatoid* ; Blood Cell Count ; Blood Sedimentation ; C-Reactive Protein ; Cell Count ; Chemistry ; Creatinine ; Humans ; Joints ; Knee ; Knee Joint ; Piroxicam ; Plasma ; Pruritus ; Synovial Fluid ; Visual Analog Scale

OBJECTIVES: To analyze the treatment results of combined treatment with percutaneous vertebroplasty and adhesiolysis in the patients who happened the osteoporotic compression fractures during the conservative treatment of pre-existing degenerative spinal stenosis. MATERIALS AND METHODS: A retrospective review was carried out on 38 patients who happened the osteoporotic compression fractures during the conservative treatment of pre-existing degenerative spinal stenosis. We performed percutaneous vertebroplasty for osteoporotic compression fractures and adhesiolysis for degenerative spinal stenosis after 4 weeks after vertebroplasty. Radiologic results were evaluated by progression of compression rate, fractures in adjacent segment and change of the BMD. Clinical results were evaluated with Denis pain scale for osteoporotic compression fractures and Katz satisfaction scale for degenerative spinal stenosis. RESULTS: The compression rate was 30.2% preoperatively, 21.4% postoperatively, and 24.6% at 12 months postoperatively. There was no fracture in adjacent segment. Clinically, the Denis score were P3 in 13 and P4 in 25, preoperatively, P1 in 11 and P2 in 26, P3 in 1, postoperatively (P=0.03). In regard to degenerative diseases, the Kats scale were 38 to 5, 86.8% in low back pain (P=0.017) and 38 to 4, 89.4% in claudication (P=0.006). The overall Katz satisfaction scale was 81.5% at 12 months postoperatively. The BMD changes in patients who treated neuroplasty was not significant (P=0.175). CONCLUSIONS: The combined treatment with percutaneous vertebroplasty and adhesiolysis may be an effective treatment strategy for the osteoporotic compression fracture and spinal stenosis without surgical intervention in old age patients.
Fractures, Compression ; Humans ; Low Back Pain ; Retrospective Studies ; Spinal Stenosis ; Vertebroplasty

OBJECTIVE: This study was conducted to elucidate the associations of HLA with systemic sclerosis (SSc) in Koreans. METHODS: HLA associations with SSc according to SSc-specific autoantibody status and clinical subsets (diffuse and limited) were investigated. HLA-A, B, and C antigens were typed by the serological method using microlymphocytotoxicity test, and HLA-DR by DNA typing method using PCR-reverse hybridization and PCR-SSCP in 56 Korean patients with SSc and 226 healthy controls. For SSc patients, anti-Scl-70 and anicentromere antibodies were tested by double immunodiffusion and indirect immunofluorescence, respectively. RESULTS: The results of HLA class I antigen typing showed that the frequencies of HLA-A24, B52 and B62 were increased, whereas those of A33, B44 and B58 were decreased in SSc patients compared to healthy controls. The frequency of HLA-DR2 was significantly increased, whereas that of HLA-DR13 was decreased in patients with SSc compared to controls. Among HLA-DR2 alleles, both HLA-DRB1*1501 and *1502 were increased in SSc patients compared to controls. According to clinical status, HLA-DRB1*1501 was increased in limited SSc patients and that of DRB1*1502 was increased both in diffuse and limited SSc patients compared to controls. According to autoantibody status, HLA- DRB1 1502 was significantly increased in anti-Scl-70-positive SSc patients and that of DRB1 1501 was increased in anti-Scl-70-negative SSc patients compared to controls. The association of HLA-DR2 alleles with SSc according to clinical subsets and anti-Scl-70 antibody status revealed that the frequency of HLA- DRB1 *1501 was significantly increased in anti-Scl-70-negative limited SSc patients compared to controls. CONCLUSIONS: These results suggest that different HLA-DR2 alleles are associated with different types of SSc in Koreans. HLA-DRB1 1502 shows strong association with anti-Scl-70-positive SSc, and DRB1 1501 with anti-Scl-70-negative limited SSc. It is concluded that the pathogenesis of SSc in Koreans is in part, based on the same genetic background.
Alleles ; Antibodies ; Asian Continental Ancestry Group ; DNA Fingerprinting ; Fluorescent Antibody Technique, Indirect ; HLA-A Antigens ; HLA-A24 Antigen ; HLA-DR Antigens ; HLA-DR2 Antigen ; HLA-DRB1 Chains ; Humans ; Immunodiffusion ; Scleroderma, Systemic*