No abstract available.
Melanoma* ; Spine*

We present the first case report of fragile X-associated tremor ataxia syndrome (FXTAS) in the Republic of Korea. A 75-year-old male developed progressive gait ataxia, parkinsonism, and a mood disorder. Magnetic resonance imaging revealed T2 high signal intensity within the middle cerebellar peduncles. Analysis of the fragile X mental retardation 1 gene revealed a CGG trinucleotide repeat number of 136. FXTAS should be considered when a patient has atypical parkinsonism, cerebellar ataxia, and specific MRI abnormalities.

Genu recurvatum deformity of the knee can be due to the deformity of the bone of the proximal end of the tibia or to the changes in the soft tissues, or both. The causes of acquired genu recurvatum include trauma, wire traction of the tibia, operative procedures involving the proximal tibial physis, Osgood-Schlatter's disease, osteomyelitis and prolonged immobilization. The most frequent symptoms of genu recurvatum are weakness, pain and instability of the knee, genu valgus, and shortening of the affected lower extremity. Operative treatment consists of tibial osteotomy and soft tissue procedures performed on the capsule and ligaments, and recently percutaneous corticotomy of the proximal tibia and gradual correction by the Ilizarov external fixator became one of the treatment modalities. From Nov. 1990 to June 1993, the authors have performed gradual correction by the Ilizarov external fixator in 6 patients of genu recurvatum and the results were as follows. 1. The mean age was 14 years ranging from 11 to 21. And there were 2 males and 4 females. 2. In the past history, there were ipsilateral femur fractures in 5 cases in which 4 cases were treated with skeletal pin traction on the proximal tibia, and one case had ipsilateral open tibiofibular fracture. 3. After Ilizarov external fixation, proximal tibial corticotomy just inferior to the tibial tuberosity were performed in all 6 cases. 4. The follow up period was 19 months in average. 5. The results were evaluated according to a scoring system that was suggested by Lecuire et al.: 2 cases were excellent, 3 cases were good and 1 case was fair. 6. Ilizarov gradual correction was very effective not only in the treatment of genu recurvatum but also in the concurrent correction of limb length inequality and mechanical axis deviation of the lower extermity.
Congenital Abnormalities ; External Fixators ; Extremities ; Female ; Femur ; Follow-Up Studies ; Humans ; Immobilization ; Knee ; Ligaments ; Lower Extremity ; Male ; Osteomyelitis ; Osteotomy ; Socioeconomic Factors ; Surgical Procedures, Operative ; Tibia ; Traction

Congenital scoliosis is a structural deformity due to congenital anomaly of the spine. After Winter's report in 1973, congenital scoliosis is said to be progressive in 75% of cases, and 50% are rapidly progressive, serious and demand treatment. And thus, most of them need more aggressive and early treatment compared with idiopathic scoliosis. The prognosis depends on the type, angle and flexibility of the curvature, and the age of patient. The authors reviewed the results of operative treatment for the congenital scoliosis that had been treated from Jan. 1984 to Dec. 1993 at the orthopedic department of Yonsei University College of Medicine, and the results as follows. 1. The age distribution of the patients was from 2 years to 14 years, and the mean was 8.4 years. Five male patients and two female patients were operated. 2. The involved spinal segments of the primary curve were 2 cases of thoracolumbar, 3 cases of lumbar. There were two cases of double major curves. 3. According to MacEwen's classification, the types of vertebral anomaly were 4 cases of hemivertebra, 2 cases of miscellaneous and one case of wedge vertebra. 4. The levels of apical vertebra were each 1 case of T3, T9, Ll, L2, L4 respectively and each 2 cases of T12, L3 respectively. 5. The methods of operation included 1 case of resection of rib, 4 cases of posterior fusion, 1 case of combined anterior and posterior hemiepiphysiodesis and fusion, and 1 case of hemivertebra excision with spine fusion. 6. The curvature of spine on admission ranged form 10 degrees to 63 degrees, and the mean angle was 35.5 degrees. And, we followed up postoperatively from 1 year to 10 years, and the mean follow up period was 32 months. The final correction angles were from
Age Distribution ; Classification ; Congenital Abnormalities ; Female ; Follow-Up Studies ; Humans ; Male ; Orthopedics ; Pliability ; Prognosis ; Pseudarthrosis ; Ribs ; Scoliosis ; Spine

PURPOSE: To establish a general guide line in the treatment of the patellar fracture MATERIALS AND METHODS: Twenty three patellar fractures followed for 2.2 years in average, treated with internal fixation were evaluated retrospectively. The primary fixations were the metal screw fixation in 7, the Dall-Miles' cable circumferential fixation in 14 and combination of both methods in 2 cases. The additional fixations were the tension band wiring in 9, the load sharing cable fixation in 3 and combination of both methods in 5 cases. The initial postoperative immobilazation of the knee joint in flexion, preferably 90degrees, for 7 days was effective to gain full range of motion RESULTS: Complete union without displacement was achieved in all cases. Full ROM was achieved in all cases except one. CONCLUSION: The choice of internal fixation need to be individualized according to the level of comminution, bone strength, fracture site and soft tissue damage. A strong internal fixation, initial immobilization in flexion followed by early ROM exercise were important factors to gain good result.
Immobilization ; Knee Joint ; Patella ; Range of Motion, Articular ; Rehabilitation ; Retrospective Studies

PURPOSE: We wanted to evaluate the efficacy of MIPO (minimal invasive plate osteosynthesis) technique by LCP (locking compression plate) for treating proximal tibia fractures. MATERIALS AND METHODS: Twenty-three patients, who had operation due to proximal tibia fracture and available for follow up for more than 1 year were included in this study. Cause of injury and accompanied injuries were checked. Operation time, period to bone union, range of joint motion and alignment were evaluated with complications. RESULTS: Mean bone union time was 13.7 weeks (10~20). Twenty-one cases of the patients showed angulation of less than 5 degrees and 17 cases had normal range of motion. Five cases showed skin irritation by the plate and 2 cases had superficial infection. CONCLUSION: LCP by MIPO technique for treating proximal tibia fracture showed excellent results. Delicate technique is required for the proper adjustment of LCP and the alignment of the lower leg.
Follow-Up Studies ; Humans ; Joints ; Leg ; Reference Values ; Skin ; Tibia

BACKGROUND: The quick and accurate radiologic evaluation is essential to minimize the sequelae of temporal bone trauma. High resolution computed tomography(HRCT) is regarded as a method of choice in the evaluation of the head trauma including temporal bone fractures. Although the diagnosis of ossicular dislocation with HRCT has been described, we could find only one report on the usefulness of coronal sections in the diagnosis of lateral displacement of the incus. OBJECTIVES: The purpose of this study is to evaluate the usefulness of a recently reported radiologic sign, named the "Y" sign, for the diagnosis of lateral dislocation of the incus on the coronal HRCT sections of the temporal bones. MATERIALS AND METHODS: We retrospectively reviewed the axial and coronal HRCT sections of 13 cases who the laterally dislocated incus was confirmed operatively. RESULTS: In the axial HRCT sections, abnormal ice cream cone was shown in only 3 cases, but normal ice cream cone was shown in 10 cases. In the coronal HRCT sections, the Y-sign was shown in 11 cases-open Y-sign: 3 cases, closed Y-sign: 8 cases, in contrast, only 2 cases did not shown Y-sign. CONCLUSION: The Y-sign in the coronal sections is more correlated with the dislocated incus than with abnormal ice cream cone configuration in the axial sections. So, the Y-sign seems to be very useful in the diagnosis of the dislocated incus.
Craniocerebral Trauma ; Diagnosis* ; Dislocations* ; Ice Cream ; Incus* ; Retrospective Studies ; Temporal Bone

The treatment strategy for children with attention deficit/hyperactivity disorder (ADHD) mainly involves medication, although research on non-pharmaceutical treatments steadily continues. Neurofeedback is considered as a nonpharmacological treatment strategy for children with ADHD. In this review, the concept and principles of neurofeedback, the electroencephalography characteristics of children with ADHD, and the background for application of neurofeedback therapy in these subjects are described. The results of the latest studies are presented, showing that neurofeedback treatment seems to be effective in improving some symptoms, and that it can be useful as a complementary treatment. However, further research is needed to investigate whether neurofeedback alone may be as effective as drug treatments.

Further studies are needed to identify whether muscle mass, muscle strength, or sarcopenia is the best indicator of survival in patients undergoing peritoneal dialysis (PD). We aimed to compare the association of sarcopenia and its components with survival in patients undergoing PD. Methods: We identified all patients with PD (n = 199). We routinely recommended handgrip strength (HGS) and lean mass measurements using dual energy X-ray absorptiometry in all patients with PD. Sarcopenia was defined using cutoff values from the Asian Working Group for Sarcopenia. We evaluated the patient and technique survival rates. Results: The number of patients with low HGS was 95 (47.7%). The median follow-up interval was 17 months (interquartile range, 13–21 months). Kaplan-Meier curve analysis showed that patients with low HGS or sarcopenia had poorer patient and technique survival compared with patients with normal HGS or without sarcopenia. Cox regression analysis showed that patients with low HGS had greater hazard ratios for patient death and technique failure compared with those with normal HGS. However, patients with low muscle mass were not significantly higher hazard ratios for patient death or technique failure compared with those with normal muscle mass. Patients with sarcopenia had significantly greater hazard ratios for patient death or technique failure than those without sarcopenia only in univariate analysis. Conclusion: The present study demonstrated that HGS may be superior to muscle mass or sarcopenia for predicting patient or technique survival in patients undergoing PD.

Purpose: We report a rare case of allergic contact dermatitis after the use of a non-preservative 0.5% moxifloxacin ophthalmic solution.Case summary: A 60-year-old male presented with bacterial corneal ulceration of the right eye. He was treated with 50 mg/mL of fortified cefazolin and 14 mg/mL of tobramycin that were tapered as the corneal lesion improved after 1 month, and 0.5% moxifloxacin application was started. After 2 weeks of moxifloxacin treatment, the patient developed conjunctival injection, lid swelling, redness, and itching in the right eye. An allergic reaction was suspected and moxifloxacin administration was immediately stopped. The symptoms improved after the administration of oral antihistamines, 0.5% loteprednol eye drops, and steroid combination ointment. Conclusions Patients treated with 0.5% topical moxifloxacin should be monitored for allergic contact dermatitis, even if preservative-free eye drops are used.