No abstract available.
Spine*

Congenital kyphoscoliosis is an abnormal curvature of spine that is due to presence of vertebral anomalies which cause an imbalance in the longitudinal growth of the spine. Congenital kyphoscoliosis is often rigid and its correction can be difficult. It is often resistant to conservative treatment and more patients require surgical treatment than those with idiopathic curvature. The indication for the conservative treatment with Milwaukee brace is much limited. Largely Milwaukee brace is a delaying tactic to correct the spinal curvature until its growth is further advanced and it is more amenable for fusion. This paper was aimed to review our experience with 49 patients with congenital scoliosis, kyphosis and kyphoscoliosis who were treated surgically with various methods of preoperative correction, from Jan. 1968 to Dec. 1983, in special reference to new classification, proposed for common application to both kyphosis and scoliosis, and following results were obtained. 1.The average age when scoliosis was observed was 6.9 years, but the average age of surgery was deferred until 15.2 years. 2. The distribution of curve pattems were 1 cervicothoracic, 24 thoracic, 12 thoracolumbar, 7 lumbar and 1 lumbosacral curve in 45 scoliotic curves and 13 thoracic, 13 thoracolumbar and 4 lumbar curves in 30 kyphotic curves. The average degrees of deformity were most severe in thoracolumbar curves both in kyphosis and scoliosis. 3. The new morphological classification, which could be applicable to both kyphosis and scoliosis, was proposed. The type of unsegmented bar with contralateral hemivertebra was most common both in kyphosis and scoliosis. 4. Preoperative average degrees of scoliosis was 58.7 degrees and final correction was 20.6 degrees (35.1%) with loss of comection of 3.7 degrees (6.3%). Preoperative average degrees of kyphosis was 63.7 degrees and final correction was 20.1 degrees (42.5%) with loss of correction of 7.0 degrees (11.0%). 5. The surgical method with anterior and posterior fusion was the best treatment of severe kyphoscoliossis, in the aspect of final correction and loss of correction. 6. The lumbar curve was most amenable to treatment with the best final correction and the least loss of correction.
Braces ; Classification ; Congenital Abnormalities ; Humans ; Kyphosis ; Methods ; Scoliosis ; Spinal Curvatures ; Spine

Tentative diagnosis of meniscal pathology is very helpful for the successful operative management including arthroscopy. Conventional arthrography has long been used to meet this purpose, but it has some limitations due to complex views and some difficulties in imaging the whole anatomical structures. Recent diagnostic advancement produced post-arthrographic HRCT and MRI for the compensation of these problems of conventional arthrography. Arthrography and post-arthrographic HRCT has been carried out on 49 knees in 43 patients. 38 knees among them could be confirmed by arthroscopy and following results were obtained. 1. Diagnostic accuracies of post-arthrographic HRCT for medial and lateral meniscal injuries of knee were 94.7% and 92.1% repectively. 2. Shape, contour of torn meniscus and the relationships between the torn fragments were better demonstrated with HRCT. 3. Horizontal tear could also be suspected by HRCT. 4. Peripheral detachment could be differentiated with synovial recess on the HRCT, especially in the reformat view, but was more clearly visible in arthrography. 5. Arthrography and HRCT can be used as a good complementary study for the evaluation of meniscal injuries.
Arthrography ; Arthroscopy ; Compensation and Redress ; Diagnosis ; Humans ; Knee ; Magnetic Resonance Imaging ; Pathology ; Tears

No abstract available in English.
Orthopedics

BACKGROUND: This study was carried out to evaluate the efficacy of desferrioxamine as a chelating agent in iron overloaded patients with severe aplastic anemia due to multiple transfusion. METHODS AND MATERIALS: From Oct. 1995 to Aug. 1996, 15 patients with aplastic anemia, diagnosed from May 1995 to Jan. 1996 at St. Mary's Hospital, who had a transfusional hemosiderosis were included in this study. They received 19 courses of high-dose desfer-rioxamine therapy for 6 days(20 to 30 mg/kg daily as a 24-hour intravenous infusion) . Before and after treatment, we measured serum ferritin, iron, TIBC, 24-hour urinary excretion of iron. RESULTS: 1) The range of iron load before treatment was between 4.5 and 20.0 gram. 2) Because of limit of detection(1,800 microgram/L), it was difficult to compare the changes of serum ferritin level after therapy to those of before therapy. 3) There was no significant differences between the levels of serum iron before and after therapy(214.3+/-62.8 vs 220.0+/-53.3). And there was no significant differences between TIBC before and after therapy(235.8+/-64.6 vs 259.4+/-60.1). 4) Iron/TIBC ratios were significantly deceased after desferrioxamine treatment compared to those of before therapy(0.90+/-0.04 vs 0.85+/-0.04, P<0.001) and mean urinary excretions of iron were increased by high-dose desferrioxamine compared to those by test dose(6.5+/-7.6 vs 29.1+/-14.3, P<0.001) CONCLUSION: High-dose desferrioxamine therapy is very effective for chelating and excretion of iron in iron overloaded patients with severe aplastic anemia due to multiple transfusion. A repeat administration of desferrioxamine is necessary for the iron overloaded patient to eliminate the risk of a transfusional hemosidersis.
Anemia, Aplastic* ; Deferoxamine* ; Ferritins ; Hemosiderosis* ; Humans ; Iron ; Iron Overload

No abstract available.
Intervertebral Disc* ; Zygapophyseal Joint*

No abstract available.
Debridement* ; Knee* ; Osteoarthritis* ; Osteotomy*

BACKGROUND: Cord blood is a practical source of hematopoietic stem cells for transplantation. However, there are concerns that cord blood might be contaminated with maternal cells that could lead to graft-versus-host disease. MATERIAL AND METHODS: In the present study, we used the polymerase chain reaction (PCR) amplification of two minisatellite sequences (YNZ 22 and 33.6) and fluorescence in situ hybridization (FISH), to ascertain the presence of maternal cells in the cord blood. RESULTS: The results were as follows; 1) Maternal-specific allele was present in 1 of the 16 cord bloods (6.25%) by PCR. 2) We determined the sensitivity of this methods for detecting a maternal specific allele in the cord blood sample, which demonstrated as 0.2% (YNZ 22 and 33.6). 3) Maternal cells were found in 11 of the 20 cord bloods (55%), and 35 XX maternal cells were observed in 19,138 nuclei in the cord blood by FISH. 4) The range of maternal cells in the 11 positives was 0.1~8.6% and median value of maternal cells was 0.2%. CONCLUSION: These results suggest that maternal cells are very rarely present in the cord blood collected at birth. However, although small, this amount of cells may result in GVHD in a susceptible recipient. These methods we used allow the detection of maternal cells within cord blood from 104 nucleated cells by FISH but it was difficult to detect maternal cells within female cord blood by PCR, then it needs the use of a more reliable tool in a cord blood banking perspective.
Alleles ; Female ; Fetal Blood* ; Fluorescence* ; Graft vs Host Disease ; Hematopoietic Stem Cells ; Humans* ; In Situ Hybridization* ; Minisatellite Repeats ; Parturition ; Polymerase Chain Reaction* ; Umbilical Cord*

Background: Umeclidinium/vilanterol (UMEC/VI; ANORO ELLIPTA, GSK) is a commonly used dual bronchodilator. This study evaluated the safety and effectiveness of UMEC/VI in Korean patients with chronic obstructive pulmonary disease (COPD) over a 6-year period. Methods: This was an open-label, multicentre, observational, post-marketing surveillance study. A total of 3,375 patients were enrolled consecutively in 52 hospitals, by 53 physicians, between July 2014 and July 2020. Patients who were administered UMEC/VI (fixed-dose 62.5 μg/25 μg) at least once and were monitored for safety and effectiveness were included in the analysis. Incidence and severity of adverse events (AEs) reported after administrating at least one dose of UMEC/VI were monitored, including unexpected adverse events (UAEs) and adverse drug reactions (ADRs). Effectiveness of UMEC/VI after 24 weeks of administration was also assessed using physician’s evaluation (effective, ineffectiveo change, worsening, indeterminable) and lung function improvement. Results: Of 3,375 patients, 3,086 were included in the safety assessment group (mean age±standard deviation: 69.76±8.80 years; 85.9% male [n=2,652]; 73.1% aged ≥65 years [n=2,255]). The overall incidence of AEs was 28.8% (n=890), of which 2.2% (n=67) were ADRs. Serious AEs and UAEs were reported in 181 (5.9%) and 665 (21.6%) patients, respectively, and two patients (<0.1%) reported unexpected severe ADR. Of the 903/3,086 patients analysed for effectiveness, most (82.8%, n=748) showed overall disease improvement after UMEC/VI treatment. Conclusion This study confirmed UMEC/VI administered to Korean patients according to the prescribing information was well-tolerated and can be considered an effective option for COPD treatment.

STUDY DESIGN: Authors experienced three cases of malignant schwannoma arising from multiple neurofibromatosis and invading the vertebrae. OBJECTIVE: To report treatment results and preventive idea in three cases of malignant schwannoma transformed from neurofibromatosis within the retroperifoneal area and invading the vertebrae. SUMMARY OF BACKGROUND DATA: The patients with neurofibromatosis are clearly at increased risk to develop the malignant schwannoma. A review of Korean literature revealed no such cases. RESULTS: The first case presented in the L4 body and was treated by surgical excision and chemotherapy, but she expired due to secondary metastasis in six months after diagnosis. The second case was treated by diagnostic biopsy and chemotherapy with adriamycin, ifosfamide, DTIC, mesna. He eventually lived for 14 months. After a diagnostic biopsy, the third case died due to lung metastasis before we could begin the treatment. CONCLUSION: We recommend that neurofibromatsis patients be regularly followed-up and if necessary, CT examination of spine or abdomen should be done. If a malignant schwannoma is detected, then early treatment can be started.
Abdomen ; Biopsy ; Dacarbazine ; Diagnosis ; Doxorubicin ; Drug Therapy ; Humans ; Ifosfamide ; Lung ; Mesna ; Neoplasm Metastasis ; Neurilemmoma* ; Neurofibromatoses ; Spine*