Reduction in the extremity length of more than three to four centimeters has significant effect on both gait disturbance and aesthetic change. The method of Anderson has been one of the most successful procedures of surgical leg elongation but requires long period of bed rest and immobilization. Also. the lengthening occurs the tibia, although shortening occurs twice as frequently in the femur as in the tibia. Wagner in 1971 reported his experience with the technique that allows correction in both the femur and tibia yet does not require prolonged immobilizaton. This involves a two stage procedure with rigid external fixation and lengthening of 1.5mm per day. The second stage is for osteosynthesis and may be suppleniented by bone graft. We began using the Wagner's technique of leg lengthening at Chonju Presbyterian Medical Center about 18 months age. Two patients are presented with 7 and 9 month follow-ups after femoral lengthening of 5 cm each. Both femurs united well and the leg length discrepancy was corrected. These cases indicate that this method is a good addition to the armamentarium of treating leg length discrepancy. A subsequent review of more cases and their follow-up using this tretment program shall be forthcoming.
Bed Rest ; Extremities ; Femur ; Follow-Up Studies ; Gait ; Humans ; Immobilization ; Jeollabuk-do ; Leg ; Methods ; Protestantism ; Tibia ; Transplants

The skeleton is a frequent site of bone tumor metastasis. Radiographic examination Is not sufficiently reliable in early detection since an abnormality is unlikely to be observed until more than 50% of the bone material has been lost. Therefore there was much effort to discover radiographic materials for use in scanning. At the present tirne, 99m Tc-labeled diphosphonate is the best available material for bone scanning. We applied whole body scanning with 99m Tc-to 40 patients who had bone tumors (primary or secondary), infection and other cases. The results obtained are as follow: 1. The scan can detect the extensiveness of the tumor better than plain X-ray in the early stage. 2. In metastatic disease, 60% of all patients were positive in the scan and all of there were negative in X-ray. 3. In cases of cancer, definitive treatment planning can be facilitated by the information obtained from whole body scanning. 4. In inflammatory disease, we can differentiate osteomyelltis from cellulitis or pyogenic arthritis in the early stage. 5. In fibrous dysplasia, it was possible to differentiate monostatic from polyostotic disease. 6. In nonunion of bone, scan was positive but X-ray was eouivocal.
Arthritis ; Cellulitis ; Humans ; Neoplasm Metastasis ; Skeleton ; Whole Body Imaging

INTRODUCTION: Numerous heart failure risk scores have been developed but there is none for Asians. We aimed to develop a risk calculator, the Singapore Heart Failure Risk Score, to predict 1- and 2-year survival in Southeast Asian patients hospitalised for heart failure. MATERIALS AND METHODS: Consecutive patients admitted for heart failure were identified from the Singapore Cardiac Databank Heart Failure registry. The follow-up was 2 to 4 years and mortality was obtained from national registries. RESULTS: The derivation (2008-2009) and 2 validation cohorts (2008-2009, 2013) included 1392, 729 and 804 patients, respectively. Ten variables were ultimately included in the risk model: age, prior myocardial infarction, prior stroke, atrial fibrillation, peripheral vascular disease, systolic blood pressure, QRS duration, ejection fraction and creatinine and sodium levels. In the derivation cohort, predicted 1- and 2-year survival was 79.1% and 68.1% compared to actual 1- and 2-year survival of 78.2% and 67.9%. There was good agreement between the predicted and observed mortality rates (Hosmer-Lemeshow statistic = 14.36, = 0.073). C-statistics for 2-year mortality in the derivation and validation cohorts were 0.73 (95% CI, 0.70-0.75) and 0.68 (95% CI, 0.64-0.72), respectively. CONCLUSION We provided a risk score based on readily available clinical characteristics to predict 1- and 2-year survival in Southeast Asian patients hospitalised for heart failure via a simple online risk calculator, the Singapore Heart Failure Risk Score.