No abstract available.
Dislocations* ; Tendons*

Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) is a syndrome with complex genetics and diverse manifestations. Diffuse alveolar hemorrhage is caused by alveolar microcirculation injury associated with lung illness or systemic disorders. To date, the relationship between diffuse alveolar hemorrhage and MELAS has not been reported. We report a MELAS patient who presented complications with diffuse alveolar hemorrhage.

High tibial osteotomy is a useful procedure in the treatment of early stage osteoarthritis of the knee which is confined to the medial compartment. But long term follow-up study of high tibial osteotomy has not been provided yet and its prerequisite for a successful result still remains unrevealed. Since the osteoarthritis can progress after the osteotomy, it may result in the loss of correction and recurrence of pain and require conversion to total knee replacement arthroplasty. We studied clinically and radiologically the long term result of high tibial osteotomy in 11 patients(16 knees) who had been treated at the Department of Orthopaedic surgery of Seoul Paik Hospital during the period from January, 1978 to May, 1989, and follow-up for longer than 4 years. Preoperative mean varus angle was 6.4 degrees and immediate postoperative mean valgus angle was 8.6 degrees and final mean valgus angle was 4.7 degrees. The average loss of correction angle was 3.9 degrees. At 2-year follow-up, the results of 16 knees were as follows; excellent in six knees, good in seven knees. The final results at average 7.2-year follow-up were excellent in four knees, good in six knees and one knee was converted to total knee replacement arthroplasty. The results showed deterioration of clinical results and loss of correction with time after osteotomy. However, in more than half of the cases the results were good or excellent at the final follow-up, We, therefore, conclude that high tibial osteotomy is still a useful procedure in osteoarthritis of the knee if performed with a precise surgical technique and an adequate overcorrection more than 10 degrees.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Follow-Up Studies ; Knee ; Osteoarthritis ; Osteotomy ; Recurrence ; Seoul

The location of the sigmoid colon varies within the abdominal cavity, but its mesocolon is fixed to the left side. Right side fixation of the sigmoid colon is a very rare congenital positional anomaly. In addition, it has been reported that hepatocolic fistula is also a very rare disease that may present lower gastrointestinal bleeding. Here, the authors describe a case of a 71-year-old man who underwent surgery for hepato-sigmoidocolic fistula complicated by hepatocellular carcinoma and the right side fixation of the sigmoid colon.
Abdominal Cavity ; Carcinoma, Hepatocellular ; Colon, Sigmoid ; Fistula ; Hemorrhage ; Humans ; Mesocolon ; Rare Diseases

BACKGROUND: In the Republic of Korea, Plasmodium vivax malaria, which had disappeared since 1984, re-emerged in 1993. Currently, malaria is becoming a serious public health problem in the Republic of Korea. The diagnosis of malaria has relied on microscopic examination such as thin and thick blood smears. However, even for expert microscopists, this test is a laborious and time-consuming procedure. Therefore, the development of a reliable, easy, and convenient diagnostic test is crucial. Recently, the LG malaria anti-PvTM enzyme-linked immunosorbent assay (ELISA) kit for the detection of a specific antibody against the merozoite surface protein (MSP) of P. vivax was developed. The aim of this study was to evaluate the diagnostic kit for P. vivax malaria in the Republic of Korea. METHODS: To determine the usefulness of the LG malaria anti-PvTM as a diagnostic kit for vivax malaria, a total of 59 serum samples from patients with P. vivax malaria were tested. The patients were diagnosed microscopically and the parasitemia index of their blood was calculated. Sera from 203 uninfected healthy blood donors, which were microscopically negative for Plasmodium vivax, were used as negative controls. RESULTS: The sensitivity and specificity of the LG malaria anti-PvTM were 98.31% (58/59) and 98.03% (199/203), respectively. The false-positive and false-negative rates were 1.97% (4/203) and 1.69% (1/59), respectively. CONCLUSIONS: The diagnostic kit, LG malaria anti-PvTM, might be a useful tool for diagnosis and screening of P. vivax malaria in Korea.
Blood Donors ; Diagnosis* ; Diagnostic Tests, Routine ; Enzyme-Linked Immunosorbent Assay ; Humans ; Korea ; Malaria* ; Malaria, Vivax* ; Mass Screening ; Merozoites ; Parasitemia ; Plasmodium vivax* ; Plasmodium* ; Public Health ; Republic of Korea* ; Sensitivity and Specificity

PURPOSE: The aim of the study was to identify the relationships among age, activities of daily living and health-related quality of life (HRQoL) for centenarians in Busan. METHODS: Forty-nine centenarians (2 males and 47 females) participated in the study, done from April to July, 2006. Pace-to-face interviews were used to collect data. Activities of daily living were measured using K-ADL, K-IADL and health-related quality of life, using the Short Form Health Survey (SF-36). RESULTS: Over 50% of the centenarians reported independence for six-items but not for bathing. With regard to type of dependency, 77.6% were independent in transferring, 71.4%, in using the toilet, 67.3%, in feeding and in continence and 57.1% in dressing but just 24.5% were independent in bathing. Age was significantly associated with K-IADL (r= -.303, p= .03). The centenarians were more impaired in physical health components compared to mental health components for health-related quality of life. CONCLUSION: These results may contribute to a better understanding of activities of daily living and health-related quality of life of centenarians. The findings are relevant to health professionals, in particular professionals who are developing wellness programs to optimize health-related quality of life and functional status for the extremely old age population.
Activities of Daily Living ; Aged, 80 and over ; Bandages ; Baths ; Dependency (Psychology) ; Health Occupations ; Health Promotion ; Health Surveys ; Humans ; Male ; Mental Health ; Quality of Life

Colonoscopy is a safe and standard procedure for diagnosis and therapy of colonic disorders. Iatrogenic colonic perforation during diagnostic colonoscopy, a rare abdominal emergency, has an 0.3~0.8% incidence rate. The choice of treatment for this complication remains controversial. Prompt operative intervention is preferred to minimize morbidity and mortality. However, operative intervention is invasive and needs a long-term recovery period. Conservative treatment is less invasive but can lead to more extensive surgery in case of treatment failure. Very important point on the treatment of iatrogenic perforation of the colon during diagnostic colonoscopy is to avoid the leaking of intestinal contents into the intraperitoneal cavity. We report here a case in which an iatrogenic perforation of the colon during diagnostic colonoscopy was successfully treated by endoscopic clip therapy.
Colon* ; Colonoscopy* ; Diagnosis ; Emergencies ; Gastrointestinal Contents ; Incidence ; Mortality ; Treatment Failure

PURPOSE: Plasma fibrin D-dimer (D-dimer) has been suggested as a potential screening marker of acute aortic syndrome (AAS) in the emergency department (ED). However, the appropriate thresholds of D-dimer for AAS have not yet been defined. Moreover, studies reporting determinants of D-dimer concentrations in AAS are scarce. METHODS: Data were collected retrospectively on patientsfor whom a D-dimer assay and enhanced computed tomography (CT) had been performed for differential diagnosis in the ED. The D-dimer assay used during the study was the quantitative latex agglutination assay. The study was conducted in a university ED with an annual census of 67,500 between March 2004 and February 2006. A receiver operating characteristics curve was used to find the optimal cutoff of the D-dimer to predict AAS in the ED. A multivariable linear regression analysis was used to identify factors associated with increased D-dimer concentrations in AAS. RESULTS: The enrolled patients (n=105) were divided into 2 groups according to enhanced CT findings: an AAS group (n=65) and a non-AAS group (n=40). The mean D-dimer level was higher in the AAS group (10.7+/-12.8 ug/mL) than in the non-AAS group (0.6+/-0.3 ug/mL)(p<0.001). The Ddimer test showed a 92.3% sensitivity, an 85.0% specificity, a 90.9% positive predictive value, an 87.2% negative predictive value, and a 90.5% accuracy for detection of AAS at a discriminate level of 1.0 ug/mL. Stratified age, smoking, extent of AAS, complications associated with AAS, and the time interval from symptoms to D-dimer testing were independently associated with D-dimer concentrations in AAS. CONCLUSION: At a discriminate level of 1.0 ug/mL, the Ddimer assay is a sensitive and specific test for the detection of AAS in the ED. D-dimer concentrations in AAS were significantly associated with stratified age, smoking, extent of AAS, complications associated with AAS, and the time interval from symptom onset to testing.
Agglutination ; Aorta ; Censuses ; Diagnosis, Differential ; Emergencies* ; Emergency Service, Hospital* ; Fibrin* ; Humans ; Latex ; Linear Models ; Mass Screening ; Plasma* ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Smoke ; Smoking ; Universities

As the incidence of early gastric cancer increases, laparoscopic surgery has become one of the treatments of choice for gastric cancer. With the increase of laparoscopic surgery, the chance of discovering aberrant anatomy during the operation also increases. We present a case of laparoscopic total gastrectomy in gastric cancer patients with intestinal malrotation. Intestinal malrotation occurs in one in every 500 births. We found that laparoscopic total gastrectomy in such patients can be performed successfully when it is performed with a proper Roux limb orientation through an alternative minilaparotomy.
Extremities ; Gastrectomy ; Humans ; Incidence ; Intestinal Volvulus ; Laparoscopy ; Laparotomy ; Orientation ; Parturition ; Stomach Neoplasms

As the incidence of early gastric cancer increases, laparoscopic surgery has become one of the treatments of choice for gastric cancer. With the increase of laparoscopic surgery, the chance of discovering aberrant anatomy during the operation also increases. We present a case of laparoscopic total gastrectomy in gastric cancer patients with intestinal malrotation. Intestinal malrotation occurs in one in every 500 births. We found that laparoscopic total gastrectomy in such patients can be performed successfully when it is performed with a proper Roux limb orientation through an alternative minilaparotomy.
Extremities ; Gastrectomy ; Humans ; Incidence ; Intestinal Volvulus ; Laparoscopy ; Laparotomy ; Orientation ; Parturition ; Stomach Neoplasms