Purpose: To evaluate and introduce the technique of C-arm guided aspiration and an injection of a mixture of corticosteroid and local anesthesia for the treatment of calcific tendinitis of the rectus femoris around the hip joint. Materials and Methods: Between March 2003 and May 2005, C-arm guided aspiration and an injection of a mixture of corticosteroid and local anesthesia were performed on 5 patients and a local excision were performed in 1 patient for the treatment of calcific tendinitis of the rectus femoris. The minimum follow-up period was 6 months. The radiology evaluation revealed the presence and size of the calcification. The clinical evaluation involved checking the level of pain relief, range of motion, recurrence, complications. Results: The hip pain improved immediately after treatment. There were no recurrences or complications. Conclusion: The combined treatment of C-arm guided aspiration and an injection of a mixture of corticosteroid and local anesthesia is an effective method for treating calcific tendinitis of the rectus femoris, which can induce rapid symptom relief without any surgical morbidity.
Anesthesia, Local ; Follow-Up Studies ; Hip Joint* ; Hip* ; Humans ; Quadriceps Muscle* ; Range of Motion, Articular ; Recurrence ; Tendinopathy*

Relapsing polychondritis is a rare inflammatory disorder affecting the cartilaginous structures throughout the body. Although there is no pathognomonic laboratory tests, clinical features, when coupled with histopathologic findings, enable one to make a diagnosis of relapsing polychondritis. A 26-year-old man presented with purplish, swollen, and tender auricles and injected eyes. His symptoms had developed eight months ago and fluctuated irrespective of various medications such as corticosteroids and antibiotics. Histopathologic examination revealed loss of basophilic staining of the cartilage with some dissolution of its structures. Treatment was initiated with dapsone, However, the remission was too immediate to be considered as a effect of dapsone.
Adrenal Cortex Hormones ; Adult ; Anti-Bacterial Agents ; Basophils ; Cartilage ; Dapsone ; Diagnosis ; Humans ; Polychondritis, Relapsing*

There have been many debates concerning operative decompression of treatment of thoracolumbar burst fractures with retropulsed bone fragment. From March 1988 to February 1992, authors treated thirty-three thoracolumbar burst fractures by using transpedicular screw fixation and posterior fusion via the posterior approach. We attempted to reduce retropulsed fragment by ligamentotaxis alone and not to do posterolateral nor anterior decompression. After the reduction of fractured spine by posterior instrumentation, we tried to determine the efficiency of reduction of the retropulsed fragment by ligamentaxis along. As a method, we compared the change of anteroposterior, transverse to diameter and area of spinal canal of fractured spine between preoperative and the postoperative situation. The results were as follows; 1. The mean anteroposterior and transverse diameter of the spinal canal on computed tomogram film was 10.1mm & 21.8mm preoperatively & 12.4mm & 23.2mm postoperatively, showing an increase. 2. The area of spinal canal of involved spine on CT film was evaluated preoperatively & post-operatively, the mean spinal canal invasion rate decreased from 36.3% preoperatively to 14.3% postoperatively. 3. The degree of reduction of middle height on plain x-ray and reduction of spinal canal invasion on computed tomogram were statistically correlated(p < 0.01). 4. There was no correlation between the degree of canal narrowing and degree of neurologic impairment. also, there was no correlation between the reduction of retropulsed fragments and subsequent neurologic impairment. 5. There was the relatively satisfactory enlargement of the spinal canal on computed tomogram at the follow-up So we suggest that it is possible to get enough decompression through reduction of retropulsed fragment by ligamen to taxis alone without posterolateral decompression.
Decompression ; Follow-Up Studies ; Methods ; Spinal Canal ; Spine

Interposition arthroplasty of the hip is to create a new joint by interposing an inert and durable substance between the reshapened ends of the femoral head and acetabulum, usually for the treatment of the primary and secondary osteoarthritis of the hip. The major goals of arthroplasty of the hip are to relieve pain, restore joint motion, correct deformity, and to provide stability of the joint. We reviewed the follow-up results of 23 Smith-Patersen vitallium cup arthroplasties in a consecutive series of 20 patients with various arthritides of the hip, who were treated at the National Medical Center between January 1962 and December 1970. Average duration of follow-up was 2 year and 10 months. 1. Male to female ratio was 12:8. Average of the patients was 30 years. 2. Seven patients had rheumatoid arthritis or ankylosing spondylitis and five patients had ankylotic hips. Three patients had primary osteoarthritis and another three osteoarthritis secondary to Legg-Calve-Perthes disease. There were one case each of tuberculous arthritis and traumatic dislocation. 3. Average duration of admission was 7 weeks. 4. Weight bearing was started gradually at 12 weeks post-operatively in majority of the cases. 5. Over-all results of the 20 patients were satisfactory in 12 (60%), and unsatisfactory in 8 (40%). 6. Results of cup arthroplasty in patients with primary osteoarthritis and osteoarthritis secondary to Legg-Calve-Parthes disease were satisfactory in all 6 cases, but were unsatisfactory in 5 out of the 7 cases of the rheumatoid arthritis and ankylosing spondylitis. 7. Three patients with bilateral cup arthroplasties yielded poor results. 8. Complications included eight infections and one each of early dislocation of the cup and periarticular new bone formation.
Acetabulum ; Arthritis ; Arthritis, Rheumatoid ; Arthroplasty ; Congenital Abnormalities ; Dislocations ; Female ; Follow-Up Studies ; Head ; Hip ; Humans ; Joints ; Legg-Calve-Perthes Disease ; Male ; Osteoarthritis ; Osteogenesis ; Spondylitis, Ankylosing ; Vitallium ; Weight-Bearing

PURPOSE: To evaluate the efficacy of trabeculectomy using modified scleral flap suture technique METHODS: We retrospectively reviewed the medical records of 52 patients (55 eyes) who had undergone trabeculectomy from January 2003 to January 2007. Standard trabeculectomy was performed for 29 eyes of 27 patients, modified trabeculectomy for 26 eyes of 25 patients. We changed suture site of scleral flap corner about 1mm medially from original site and added tight suture to both lateral margins of scleral flap to prevent overflow in modified group. In both groups, most of patients were injected 0.1 ml of 0.02 mg/ml mitomycin-C (MMC) subconjunctivally and the others 0.1 ml of 0.04 mg/ml MMC. We evaluated intraocular pressure (IOP), complication, morphology of filtering bleb, cumulative success rates. RESULTS: Argon laser suturelysis was performed postoperatively in about half cases of both groups. The IOPs of modified group were consistently lower than those of standard group for 24 months except postoperative 1 day and 1 week. There was a significant difference of IOP at postoperative 2 months and 12 months (p<0.05). No significant difference of complications was found between two groups. The diffuse bleb with microcyst was found in 19 eyes (73%) of modified group and 17 eyes (59%) of standard group. From Kaplan-Meier survival analysis, cumulative success rates of modified group were higher than those of standard group (p<0.05). CONCLUSIONS: Trabeculectomy using modified scleral flap suture appears to give better IOP control than standard trabeculectomy.
Argon ; Blister ; Eye ; Humans ; Intraocular Pressure ; Medical Records ; Mitomycin ; Retrospective Studies ; Suture Techniques ; Sutures ; Trabeculectomy

A large number of viruses belonging to Genus Hantavirus in Family Bunyaviridae are etiologic agents for hemorrhagic fever with renal syndrome (HFRS), or hantavirus pulmonary syndrome (HPS). Hantaan (HTN), Seoul (SEO), Belgrade (BEL), Puumala (PUU) serotype viruses are well known causative agents for HFRS in Eurasian continent. Among those viruses Hantaan and Seoul serotypes are well known to cause HFRS in Korea, but there are some sporadic incidence by other than Hantaan or Seoul viruses. Recently we have developed the combined Hantaan-Puumala virus vaccine to prevent world-wide occurring HFRS. This combined vaccine is formalin inactivated, suckling mouse and suckling hamster brain extracts for Hantaan and Puumala viruses, respectively. Protein contents of this purified candidate vaccine is 27 microgram/ml, which contains 1,024 ELISA antigen units to each virus, but content of myelin basic protein which is causing experimental allergic encephalomyelitis is legs than 0.1 ng/ml. Thirty hamsters were given twice at one month interval intra-muscularly and bled on 30 days after each vaccination from retro-orbital sinus vein. Antibody titers were tested against 5 major serotype viruses, Hantaan, Seoul, Belgrade, Puumala and Sin Nombre viruses by IFA and PRNT. The mean IF antibody titers on 30 days after primary shot were 78.4, 68.8, 68.8, 37.9, and 15.6; mean neutralizing antibody titers were 65.4, 12, 6.1, 65.6 and 0.5 against Hantaan, Seoul, Belgrade, Puumala and Sin Nombre viruses, respectively. The mean IF antibody titers on 30 days after booster shot were 686.9, 567.5, 550.4, 516.3, and 430.9; and neutralizing antibody titers were 710.8, 41.9, 24.3, 409.9, and 1.6 against Hantaan, Seoul, Belgrade, Puumala and Sin Nombre viruses, respectively.
Animals ; Antibodies, Neutralizing ; Brain ; Bunyaviridae ; Cricetinae* ; Encephalomyelitis, Autoimmune, Experimental ; Enzyme-Linked Immunosorbent Assay ; Formaldehyde ; Hantavirus ; Hantavirus Pulmonary Syndrome ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Incidence ; Korea ; Leg ; Mice ; Myelin Basic Protein ; Puumala virus ; Seoul ; Seoul virus ; Sin Nombre virus ; Vaccination ; Veins

Idiopathic arterial hypertension, termed "essential" or "neurogenic", is a common generalized cardiovascular syndrome comprised of a sequence of pathologic changes and accommodations. Although an extensive literature exists concerning that, the primary etiology has been unclear yet. However, Jannetta and coworkers have reported a possible etiological connection between essential hypertension and intraoperatively observed neurovascular compression of the ventrolateral medulla at the level of the root entry zone of the ninth and tenth cranial nerves on the left, recently. They have also introduced one of new therapeutical concept for essential hypertension by microvascular decompression(MVD) of offending vessels. Based on Jannetta and coworker's hypothesis, the authors have made some operations for the control of hypertension. Seven essential hypertensive patients have been underwent retromastoid craniectomy and MVD in the left ventrolateral medulla between July 1992 and June 1993. Five of them showed multiple episodes of intracerebral hemorrhages, one was an intractable hypertension case and the other one had a left hemifacial spasm with essential hypertension. The most common offending vessel was the posterior inferior cerebellar artery and it had been confirmed during operation. Postoperatively, in three cases, blood pressure was lowered to normal without medications. Of remaining four cases, blood pressure was significantly improved in one and slightly improved in three. There were no major complications in patients with surgery and no poor outcomes. These results indicate that the MVD for essential hypertension is relatively safe procedure and alternative choice as one of the management of intractable essential hypertension, repeated hypertensive intracerebral hemorrhages and left cranial nerve hyperfunction disorders combined with essential hypertension.
Arteries ; Blood Pressure ; Cerebral Hemorrhage ; Cranial Nerves ; Hemifacial Spasm ; Humans ; Hypertension* ; Intracranial Hemorrhage, Hypertensive ; Microvascular Decompression Surgery* ; Vagus Nerve

Although the management of fractures of the calcaneus still remains controversial, open reduction and internal fixation is gaining in popularity as the method of choice for the treatment of displaced intraarticular calcaneal fractures. However, open methods can make several complications such as neurovascular injury and infection. Thus we have performed the new technique of arthroscopic reduction and minimal internal fixation for displaced intraarticular calcaneal fractures in 5 cases. The results were evaluated between 12 and 16 months after surgery. A Bohler angle was restored to 25degrees-40degrees in all cases. Anatomical reduction of articular surface were obtained from 4 cases out of 5. No complications were found except 1 peroneal tendinitis. The clinical results by Creighton-Nebraska health foundation assessment for fractures of the calcaneus were 3 excellent, 1 good and 1 fair. Even though this was a few case and a short term follow-up study, the arthroscopic assisted management of displaced intraarticular calcaneal fracture induced a little complications and satisfactory results.
Calcaneus ; Follow-Up Studies ; Tendinopathy

BACKGROUND AND OBJECTIVES: Hyperfunctional voice disorders caused by the over-adduction of the vocal cords have various supraglottic movements during phonation. These various hyperkinetic supraglottic movements will be able to affect the vocal sound production. The aim of this study is to evaluate the relation between supraglottic movements and movement of extralaryngeal muscles using surface laryngeal EMG. MATERIALS AND METHODS: The subject who had normal anatomic and physiologic laryngeal function produced the vocal sounds of the 3 types of supraglottic movement. In each type, when three different pitch sounds were produced, surface laryngeal EMG was recorded and perceptual and acoustic analysis of vocal sound were performed. RESULTS: Voice with contracted supraglottic movement had strained sound in perceptual analysis, increased jitter and shimmer in MDVP, and increased amplitude in surface laryngeal EMG. Voice with lowered and widened supraglottic movement had resonant sound in perceptual analysis, decreased jitter and shimmer in MDVP, decreased amplitude in surface laryngeal EMG. CONCLUSION: Voice was different with various types of supraglottic movements and surface laryngeal EMG findings were also different with various types of supraglottic movements.
Acoustics ; Muscles ; Phonation ; Vocal Cords ; Voice ; Voice Disorders

PURPOSE: This study aimed to evaluate the surgical outcomes of biologic plating using locking compression plate-distal femur (LCP-DF) in patients with subtrochanteric fracture of the femur. MATERIALS AND METHODS: Between January 2010 and December 2013, 28 consecutive patients with subtrochanteric fractures of the femur, treated with biologic fixation using LCP-DF, were enrolled. Preoperative values, including patient age, sex, body mass index, fracture type, type of lung injury, and surgical timing from injury to surgery, were retrospectively evaluated. Radiologic assessments included time to union, coronal alignment, rotational alignment, and complications such as implant breakage and screw breakage. Adverse events, including postoperative fat embolism and adult respiratory distress syndrome, infection during the follow-up period, and walking ability at the last follow-up visit, were assessed. RESULTS: Union was achieved in 27 patients (96.4%) after a mean duration of 5.4 months (range, 3-14 months). No patients developed fat embolism or adult respiratory distress syndrome during the hospitalization period of this study. CONCLUSION: Biologic fixation using locking compression plates may represent a safe surgical option which can be utilized in patients with subtrochanteric fracture regardless of injury severity, surgical timing, fracture type, and presence of lung injury.
Body Mass Index ; Embolism, Fat ; Femur ; Follow-Up Studies ; Hip Fractures ; Hospitalization ; Humans ; Lung Injury ; Respiratory Distress Syndrome, Adult ; Retrospective Studies ; Walking