Discoid semilunar cartilage is an abnormality in which the meniscus is discoid rather than semilunar, and first reported by Young of Glasgow in 1889. 13 cases of discoid semilunar cartilages which were experienced at the Department of Orthopedic Surgery, College of medicine, Seoul National University from Jan. 1956 till Aug. 1972 are reported with review of literature. 1) The incidence was remarkable higher in the male than in the female as 11 versus 2, and higher in the age group of second decade (Average 16.4 year old). 2) Most common site was lateral meniscus, and bilateral discoid meniscus were 3 cases. 3) 3 cases out of 13 cases had complicated rupture of semilunar cartilage, and one case had cyst of the meniscus. 4) Meniscectomy were performed in all cases with successful outcome.
Female ; Humans ; Incidence ; Male ; Menisci, Tibial ; Orthopedics ; Rupture ; Seoul

Fractures of the tibial condyles, involving as they do weight-bearing articular surfaces and important soft tissues such as collateral ligaments, cruciate ligaments and semilunar cartilages present a variety of problems in treatment and prognosis. Apley, Slee, and others maintained the opinion that most fractures of the tibial condyles could be managed conservatively. On the other hand, Rombold, Schatzker, and others seemed to consider closed treatment to be virtually a form of therapeutic nihilism and adviced open reduction. But recently most authors agree that the method of treatment has to be selected in each individual case, and recommend anatomical reduction of the fracture as possible and early knee motion. During 7 years period from January 1974 to July 1981, of the tibial condylar fractures treated at the department of orthopaedic surgery, Han Gang Shim Hospital, 41 cases that could be followed have been analysed according to the cause, classification, method of treatment and result. The following results were obtained from the analysis of 41 tibial condylar fractures. l. Of the 41 cases, 34 (83%) were male and 7 (17%) were female. 2. Of the 41 cases, 32 (78%) were due to traffic accident, 25 pedestrian, 7 occupant, 8 (20%) were due to fall from height. 3. Of the 41 cases, 31 (76%) were associated with other injuries. 4. Of the 41 cases, 30 were treated by conservative method with functionally acceptable result in 22 cases (73%) and 11 were treated by open reduction with functionally acceptable result in 9 cases (82%). 5. According to the Hohl and Luck's criteria, acceptable functional result was obtained in 31 (76%) cases.
Accidents, Traffic ; Classification ; Clinical Study ; Collateral Ligaments ; Female ; Hand ; Humans ; Knee ; Ligaments ; Male ; Menisci, Tibial ; Methods ; Prognosis ; Weight-Bearing

STUDY DESIGN: Retrospective study. PURPOSE: This study was conducted to compare vertebral body height restoration rate in rheumatoid arthritis (RA) patients who had undergone percutaneous balloon kyphoplasty (KP) with that of control group who had matched age, sex, body mass index, and bone mineral density. OVERVIEW OF LITERATURE: There is no report on result of KP in RA patients. METHODS: Postoperative height restoration rate of RA group consisting of 15 patients (18 vertebral bodies) who had undergone KP due to osteoporotic vertebral compression fracture with a 30% or higher vertebral compression rate between May 2005 and January 2013 were compared to control group consisting of 38 patients (39 vertebral bodies) who had matched age, sex, body mass index, and bone mineral density. RESULTS: No statically significant difference in age (p=0.846), sex (p=0.366), body mass index (p=0.826), bone mineral density (p=0.349), time to surgery (p=0.528), polymethylmethacrylate injection time (p=0.298), or amount (p=0.830) was found between the RA group and the control group. However, preoperative compression rate in the RA group was significantly (p=0.025) higher compared to that in the control group. In addition, postoperative height restoration rate showed significant correlation with the RA group (p=0.008). Although higher incidence of recollapse occurred in the RA group compared to that in the control group, the difference was not statistically significant (p=0.305). CONCLUSIONS: Compared to the control group, RA patients showed higher compression rate and higher vertebral restoration rate after KP, indirectly indicating weaker bone quality in patients with RA. Higher incidence of recollapse occurred in the RA group compared to that in the control group, although it was not statistically significant.
Arthritis, Rheumatoid ; Body Height ; Body Mass Index ; Bone Density ; Fractures, Compression* ; Humans ; Incidence ; Kyphoplasty* ; Polymethyl Methacrylate ; Retrospective Studies

PURPOSE: Familial hypokalemic periodic paralysis (HOKPP) is an autosomal dominant channelopathy characterized by episodic attacks of muscle weakness and hypokalemia. Mutations in the calcium channel gene, CACNA1S, or the sodium channel gene, SCN4A, have been found to be responsible for HOKPP; however, the mechanism that causes hypokalemia remains to be determined. The aim of this study was to improve the understanding of this mechanism by investigating the expression of calcium-activated potassium (KCa) channel genes in HOKPP patients. METHODS: We measured the intracellular calcium concentration with fura-2-acetoxymethyl ester in skeletal muscle cells of HOKPP patients and healthy individuals. We examined the mRNA and protein expression of KCa channel genes (KCNMA1, KCNN1, KCNN2, KCNN3, and KCNN4) in both cell types. RESULTS: Patient cells exhibited higher cytosolic calcium levels than normal cells. Quantitative reverse transcription polymerase chain reaction analysis showed that the mRNA levels of the KCa channel genes did not significantly differ between patient and normal cells. However, western blot analysis showed that protein levels of the KCNMA1 gene, which encodes KCa1.1 channels (also called big potassium channels), were significantly lower in the membrane fraction and higher in the cytosolic fraction of patient cells than normal cells. When patient cells were exposed to 50 mM potassium buffer, which was used to induce depolarization, the altered subcellular distribution of BK channels remained unchanged. CONCLUSION: These findings suggest a novel mechanism for the development of hypokalemia and paralysis in HOKPP and demonstrate a connection between disease-associated mutations in calcium/sodium channels and pathogenic changes in nonmutant potassium channels.
Blotting, Western ; Calcium ; Calcium Channels ; Channelopathies ; Cytosol ; Humans ; Hypokalemia ; Hypokalemic Periodic Paralysis* ; Large-Conductance Calcium-Activated Potassium Channels ; Membranes ; Muscle Weakness ; Muscle, Skeletal ; Paralysis ; Polymerase Chain Reaction ; Potassium ; Potassium Channels ; Potassium Channels, Calcium-Activated* ; Reverse Transcription ; RNA, Messenger ; Sodium Channels

Malignant biliary or pancreatic duct stricture is dilatated using dilatating catheter or balloon catheter but a high grade stricture is difficult to dilate by general dilatating methods. Using Soehendra stent retriever is an effective method for exchanging an impacted stent. Recently, high grade malignant biliary strictures have been dilatated by Soehendra stent retriever. We report 3 cases of successful biliary drainage in high grade malignant biliary strictures using 7 Fr Soehendra stent retriever.
Catheters ; Constriction, Pathologic* ; Drainage* ; Pancreatic Ducts ; Stents*

PURPOSE: The neutrophil-to-lymphocyte ratio (NLR) is a strong predictor of poor prognosis in patients with various types of cancer. To date, the utility of NLR for prediction of prognosis in thyroid cancer patients has not been studied. Therefore, the aim of our study was to determine whether NLR is associated with other prognostic factors of papillary thyroid carcinoma and predictive of recurrence. METHODS: We conducted a retrospective review of 367 patients who underwent thyroidectomy for papillary thyroid carcinoma from January 2005 to December 2007. We measured the white blood cell count including neutrophil and lymphocyte within one month preoperatively. The NLR was defined as the absolute neutrophil count divided by absolute lymphocyte count. Logistic regression analysis was applied for comparison of NLR with other prognostic factors, including tumor size, lymph node metastasis, multiplicity, extrathyroidal invasion, and TNM stage. We also determined the cut-off value of NLR with a prediction for recurrence. RESULTS: Median age of patients was 47 years (16~86 years) and the rate of papillary thyroid microcarcinoma was 65.7% (241/367 cases). Median follow-up period was 1,841 days (506~3,135 days). The median value of NLR was 1.68 (0.66~6.36). NLR was not related to any other prognostic factors of papillary thyroid carcinoma. The cut-off value of NLR for prediction of recurrence was 1.73, where the sensitivity was 66.7% and specificity was 69.8%. CONCLUSION: Patients with NLR equal to or higher than 1.73 showed significantly higher recurrence of papillary thyroid carcinoma. Further validation study should be conducted for clinical use of NLR as a prognostic marker.
Follow-Up Studies ; Humans ; Leukocyte Count ; Logistic Models ; Lymph Nodes ; Lymphocyte Count ; Lymphocytes ; Neoplasm Metastasis ; Neutrophils ; Prognosis ; Recurrence ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Gland ; Thyroid Neoplasms* ; Thyroidectomy

Spontaneous intramuscular hematoma of the abdominal wall is a rare condition characterized by acute abdominal pain. It is often misdiagnosed as a surgical condition. It used to be associated with risk factors such as coughing, pregnancy, and anticoagulant therapy. Most cases of abdominal wall hematomas were rectus sheath hematomas caused by the rupture of either the superior or inferior epigastric artery, but spontaneous internal oblique hematoma was extremely rare. In this report, we present a case of spontaneous internal oblique hematoma in a 69-year-old man with non-dialysis chronic kidney disease who was taking cilostazol. The patient complained of abrupt abdominal pain with a painful palpable lateral abdominal mass while sleeping. The abdominal computed tomography showed an 8 cm-sized mass in the patient's left internal oblique muscle. The administration of cilostazol was immediately stopped, and the intramuscular hematoma of the lateral oblique muscle disappeared with conservative management.
Abdominal Muscles ; Abdominal Pain ; Abdominal Wall ; Aged ; Cough ; Epigastric Arteries ; Hematoma* ; Humans ; Pregnancy ; Renal Insufficiency, Chronic* ; Risk Factors ; Rupture

BACKGROUND AND OBJECTIVE: Ventricular arrhythmia is an important cause of death in patients suffering with idiopathic dilated cardiomyopathy (IDCM). The decreased uptake or increased "washout" of 123I-metaiodobenzylguanidine (MIBG)-derived radioactivity is associated with a worse prognosis or severe disease in patients with cardiac diseases. SUBJECTS AND METHODS: Forty patients (28 men, mean age: 56.5+/-13.0 years) with angiographically proven IDCM were studied and divided into 2 groups: the patients with clinically documented ventricular tachycardia (VT) and IDCM (group A; 17 patients), and the patients without VT, but with IDCM (group B; 23 patients). The normal control group (7 men, mean age 62.4+/-7.9) was compared theses patients. 123I-MIBG was evaluated by the early (15 min) and delayed (3hours) uptake, the heart to mediastinum uptake (H/M) ratio and the global and regional washout ratio (WOR) that was defined as the [early H uptake-delayed H uptake]/early H uptake. The clinical variables, echocardiographic parameters and 123I-MIBG-derived parameters were compared among three groups. RESULTS: There were no significant differences in age and the echocardiographic parameters between the groups A and B. A significant negative correlation was present between the early inferior wall H/M ratio and the LVEDD (Spearman's correlation, r=-0.412, p=0.08), and the early inferior H/M ratio and the LVESD (Spearman's correlation, r=-0.463, p=0.03). Only the delayed lateral wall uptake was significantly lower in group A than that in group B (23.3+/-5.3 versus 27.8+/-8.4, respectively p=0.042). The regional WOR was not statically different among the three groups. CONCLUSION: Cardiac 123I-MIBG SPECT partially reflects the vulnerability for the occurrence of VT in patients suffering with IDCM. These results support the feasibility of using cardiac 123I-MIBG SPECT as a prognostic tool in IDCM patients.
Arrhythmias, Cardiac ; Cardiomyopathy, Dilated* ; Cause of Death ; Echocardiography ; Heart ; Heart Diseases ; Humans ; Male ; Mediastinum ; Prognosis ; Radioactivity ; Radionuclide Imaging ; Tachycardia, Ventricular* ; Tomography, Emission-Computed, Single-Photon

PURPOSE: Splenic injury management has shifted to non-surgical treatment to preserve the spleen because of the postoperative risks of overwhelming post-splenectomy infection. In this study, we analyzed risk factors of therapeutic options for splenic injury, using medical records of Chonnam National University Hospital. METHODS: We reviewed the medical records of 110 consecutive patients with traumatic splenic injuries admitted from January 2009 to December 2013. Demographic characteristics and therapeutic options such as conservative treatment, angiographic embolization and emergency operation and clinical parameters were analyzed in this study. RESULTS: Thirty-four patients were treated surgically and seventy-six were managed with nonsurgical treatment. Multivariate logistic regression identified age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.009~1.072; p=0.01), hematocrit (OR, 0.878; 95% CI, 0.806~0.957; p=0.003), contrast extravasation (OR, 7.644; 95% CI, 2.248~25.986; p=0.001), spleen grade (OR, 2.08; 95% CI, 1.128~ 3.836; p=0.019) as significant risk factors of emergent splenectomy. CONCLUSION: Age, hematocrit, contrast extravasation, spleen grade were significant risk factors for emergent splenectomy.
Emergencies ; Hematocrit ; Humans ; Jeollanam-do ; Logistic Models ; Medical Records ; Risk Factors ; Spleen ; Splenectomy ; Splenic Rupture

Prosthetic vascular graft infection (PVGI) is a relatively uncommon complication of peripheral vascular surgery and although rare, is the most severe complication in reconstructive vascular surgery. The early diagnosis of this complication can reduce the mortality. We report a case of aorto-femoral bypass graft infection, which was diagnosed by Tc-99m HMPAO WBC scan, complicated with infective endocarditis. A 60-year-old man had been operated with aortofemoral bypass graft because of aortojejunal fistula due to abdominal aortic aneurysm. Nine months later, he was admitted with fever of two months' duration. On echocardiolography, aortic regurgitation and vegetation were observed, and then he was diagosed with infective endocarditis. He was treated with antibiotics for 6 weeks. Recurrent bacteremia of unknown origin persisted despite antibiotic therapy. Multiple microorganisms were separately isolated from the blood cultures. He complained of intermittent right groin pain. Imaging study (CT, MRI, US) showed no definite evidence of graft infection. However, Tc-99m HMPAO WBC scan demonstrated uptake in the aortofemoral bypass graft site. The patient underwent emergent aortofemoral graft removal with axillobifemoral bypass and right femoropopliteal bypass.
Anti-Bacterial Agents ; Aortic Aneurysm, Abdominal ; Aortic Valve Insufficiency ; Bacteremia ; Early Diagnosis ; Endocarditis* ; Fever ; Fistula ; Groin ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Mortality ; Technetium Tc 99m Exametazime ; Transplants*