BACKGROUND: To evaluate the utility of additional fixation methods and to suggest a method of reduction in the treatment of unstable pertrochanteric femur fractures with a sliding hip screw (SHS). METHODS: A retrospective study was performed on thirty patients with unstable pertrochanteric femur fractures, who were operated on with a SHS between September 2004 and September 2009 and were followed up for at least 6 months. The additional fixation devices were as follows; antirotation screw (21 cases), fixation of displaced fractures of the posteromedial bone fragment (cerclage wiring, 21 cases and screw, 2 cases) and trochanter stabilizing plate (27 cases). Clinically, the Palmer's mobility score and Jensen's social function group were used. Radiologically, alignment and displacement were observed. The tip-apex distance (TAD) and sliding of the lag screw were measured, and the position of the lag screw within the femoral head was also examined. RESULTS: The mean age at the time of surgery was 76 years (range, 56 to 89 years) and the average follow-up period was 25 months (range, 6 to 48 months). At the last follow-up, the average mobility and social function score was 6.2 (+/- 3.5) and 2.3 (+/- 1.5). Postoperatively, the alignment and displacement indices were adequate in almost all the cases. The mean amount of lag screw sliding and the mean TAD was 5.1 mm (range, 2 to 16 mm) and 6 mm (range, 3 to 11 mm) respectively. The lag screws were located in the center-center zone in 21 cases. The average period to union was 18.7 weeks without any cases of nonunion or malunion. Mechanical failure was noted in one case with breakage of the lag screw and clinical failure was noted in another case with persistent hip pain related to excessive sliding (16 mm). CONCLUSIONS: With additional fixations, the unstable pertrochanteric femur fractures could be well stabilized by SHS until bone union.
Aged ; Aged, 80 and over ; Bone Plates ; *Bone Screws ; Bone Wires ; Female ; Fracture Fixation, Intramedullary/*methods ; Hip Fractures/radiography/*surgery ; Humans ; Male ; Retrospective Studies ; Treatment Outcome

PURPOSE: The purpose of this study is to find out the normal distal tibial articular surface angle in coronal plane in Koreans. This would be helpful as the basic data for ankle reconstruction after trauma or deformity correction. MATERIALS AND METHODS: Weight bearing anteroposterior radiographs of 123 normal ankles were reviewed. A line parallel to the shaft of the tibia was made. Another line was drawn parallel to the articular surface of the distal tibia. The superolateral angle that subtended by these two lines was measured. RESULTS: There were 72 males and 51 females. The mean age overall was 35.7 years old. The mean age for males was 31.9 (28~36) years old. The mean age for females was 41.1 (37~45) years old. The mean distal tibial articular surface angle was 90.8 degrees. The mean distal tibial articular surface angle for males was 91.5 degrees and for females 89.9 degrees. CONCLUSION: The mean distal tibial articular surface angle in coronal plane for Koreans is 90.8 degrees. We can avoid the error of the varization at the ankle alignment when the correction was performed vertical or minimal valgus to tibia tuberosity axis in Korean people.
Ankle ; Axis, Cervical Vertebra ; Congenital Abnormalities ; Female ; Humans ; Male ; Tibia ; Weight-Bearing

Neurofibromatosis type 1 (NF1) is one of the most commonly inherited autosomal dominant disorders. In order to determine whether genomic alterations and/or chromosomal aberrations involved in the malignant progression of NF1 were present in a Korean patient with NF1, molecular and cytogenetic analyses were performed on the pathologically normal, benign, and malignant tissues and primary cells cultured from those tissues of the patient. The comparative genomic hybridization (CGH) array revealed a Y chromosome loss in the malignant peripheral nerve sheet tumor (MPNST) tissue. G-banding analysis of 50 metaphase cells showed normal chromosomal patterns in the histopathologically normal and benign cultured cells, but a mosaic Y chromosome loss in the malignant cells. The final karyotype for the malignant cells from MPNST tissue was 45,X,-Y[28]/46,XY[22]. The data suggest that the somatic Y chromosome loss may be involved in the transformation of benign tumors to MPNSTs.
Chromosomes, Human, Y/*genetics ; Humans ; Nerve Sheath Neoplasms/*genetics ; Neurofibromatosis 1/*genetics ; Young Adult

PURPOSE: We evaluate the results of subtalar arthroereisis with Kalix(R) implant (Newdeal, Lyon, France) that were performed in painful flatfoot deformity. MATERIALS AND METHODS: We performed the subtalar arthroereisis on 16 feet of children symptomatic flexible flat feet after more than 6 months of conservative treatment. Average age was 11 years (8-14 years) old. We checked the functional status with AOFAS functional score in pre-operatively and at final follow-up. Radiologically, we took weight bearing anterior to posterior and lateral view of the feet, and measured the talo-1st metatarsal angle, calcaneal pitch angle, cuboid-surface height. Finally, we asked to patient's parents for satisfaction of the surgery. RESULTS: Mean follow up period was 34.1 months. Average AOFAS score improved from preoperatively 71.9 to postoperatively 91.3. Only one patient has subtalar pain. Average lateral 1st metatarsal angle reduced from -18.2 degrees preoperatively to -4.6 degrees at final follow-up. Average anterior to posterior 1st metatarsal angle was reduced from 18.9 degrees preoperatively to 6.5 degrees at final follow-up. Average calcaneal pitch angle was increased from 8.6 degrees preoperatively to 12.6 degrees at final follow-up. Average cuoboid-surface height was improved from 12.1 mm preoperatively to 16.0 mm at final follow-up. All patients had excellent or good satisfaction. CONCLUSIONS: Subtalar arthroereisis with Kalix(R) implant is a viable surgical alternative for painful flatfoot deformity of children.
Child* ; Congenital Abnormalities ; Flatfoot* ; Follow-Up Studies ; Foot ; Humans ; Metatarsal Bones ; Parents ; Weight-Bearing

OBJECTIVE: Korean American Elderly (KAE) have high rates of depression but underuse mental health services. The purpose of this study was to assess the meaning of depression and help seeking among KAE residing in the United States who have clinically significant depressive symptoms. METHODS: As a follow up to the Memory and Aging Study of Koreans (MASK; n=1,118), a descriptive epidemiological study which showed that only one in four of KAE with clinically significant depressive symptoms (Patient Health Questionnaire-9≥10) used mental health services, we conducted a qualitative study using semi-structured interviews with participants with clinically significant depressive symptoms regarding the meaning of depression and beliefs about help seeking. Ten participants with clinically significant depressive symptoms were approached and 8 were recruited for semi-structured interviews. RESULTS: KAE did not identify themselves as depressed though experiencing clinically significant depressive symptoms. They associated depression with social discrimination, social isolation, and suicide in the extreme circumstance. They attributed depression to not achieving social and material success in America and strained relationships with their children. Participants attempted to self-manage distress without telling others in their social network. However, KAE were willing to consult with mental health professionals if the services were bilingual, affordable, and confidential. CONCLUSION: KAE with clinically significant depressive symptoms are a vulnerable group with need and desire for linguistically and culturally relevant mental health services who are isolated due to a complex array of psychological and social factors.
Aged* ; Aging ; Americas ; Asian Americans* ; Child ; Depression* ; Epidemiologic Studies ; Follow-Up Studies* ; Humans ; Memory ; Mental Health ; Mental Health Services ; Qualitative Research ; Social Discrimination ; Social Isolation ; Suicide ; United States

Occasionally, extensor hallucis longus tendon (EHL) ruptures becames open by laceration and spontaneous rupture of EHL that has previous story of diabetes mellitus, steroid injection, systemic steroid administration, operation and rheumatoid arthritis. But, closed traumatic EHL ruptures are reported rarely. Especially, we diagnosed the closed EHL ruptures in TaeKwonDo players. We reported the 2 patients, differently treated end to end anastomosis and EHL transfer, had the course and treatment methods. Be care the prognosis can be altered according to the treatment time and method.
Arthritis, Rheumatoid ; Diabetes Mellitus ; Humans ; Lacerations ; Prognosis ; Rupture* ; Rupture, Spontaneous ; Tendon Transfer ; Tendons*

BACKGROUND/AIMS: The incidence of gastroesophageal reflux disease (GERD) is increasing in Korea. The aim of this study was to evaluate the relationship between GERD symptoms and dietary factors in Korea. METHODS: From January 2007 to April 2008, 162 subjects were enrolled (81 in GERD group and 81 in control group). They were asked to complete the questionnaires about GERD symptoms and dietary habits. The symptom severity score was recorded by visual analogue scale. RESULTS: Subjects with overweight or obesity had an increased risk for GERD (OR, 2.52; 95% CI, 1.18-5.39). Irregular dietary intake was one of the risk factors for GERD (OR, 2.33; 95% CI, 1.11-4.89). Acid regurgitation was the most suffering (2.85 +/- 2.95 by visual analogue scale) and frequent reflux-related symptom (57.5%) in GERD. Noodles (OR, 1.22; 95% CI, 1.12-1.34), spicy foods (OR, 1.09; 95% CI, 1.02-1.16), fatty meals (OR, 1.20; 95% CI, 1.09-1.33), sweets (OR, 1.42; 95% CI, 1.00-2.02), alcohol (OR, 1.16; 95% CI, 1.03-1.31), breads (OR, 1.17; 95% CI, 1.01-1.34), carbonated drinks (OR, 1.69; 95% CI, 1.04-2.74) and caffeinated drinks (OR,1.41; 95% CI, 1.15-1.73) were associated with symptom aggravation in GERD. Among the investigated noodles, ramen (instant noodle) caused reflux-related symptoms most frequently (52.4%). CONCLUSIONS: We found that noodles, spicy foods, fatty meals, sweets, alcohol, breads, carbonated drinks and caffeinated drinks were associated with reflux-related symptoms.
Bread ; Carbonated Beverages ; Diet ; Food Habits ; Gastroesophageal Reflux ; Incidence ; Korea ; Meals ; Obesity ; Overweight ; Surveys and Questionnaires ; Risk Factors ; Stress, Psychological

In diabetic foot with arterial occlusive disease, skin defect on heel was tried to treat with free flap or local flap, but couldn't be treated well. Therefore below knee amputation was perfomed mostly. But we treated a patient of large heel defect with using of artificial bypass graft and antero-lateral thigh perforator flap.
Amputation ; Arterial Occlusive Diseases ; Diabetic Foot ; Free Tissue Flaps ; Heel* ; Humans ; Knee ; Perforator Flap* ; Skin ; Thigh* ; Transplants*

Although Achilles tendinitis is a relatively common disease, tuberculous involvement of Achilles tendon is rare. We report a case of tuberculous Achilles tendinitis, which was successfully treated with chemotherapy and a combined surgical procedure (Achilles tendon parital excision and FHL tendon transfer).
Achilles Tendon ; Drug Therapy ; Tendinopathy* ; Tendons

Although Achilles tendinitis is a relatively common disease, tuberculous involvement of Achilles tendon is rare. We report a case of tuberculous Achilles tendinitis, which was successfully treated with chemotherapy and a combined surgical procedure (Achilles tendon parital excision and FHL tendon transfer).
Achilles Tendon ; Drug Therapy ; Tendinopathy* ; Tendons