PURPOSE: As well as patient survival, the restoration of postoperative function such as ambulation is important in limb salvage operations for treatment of malignant bone tumors involving the proximal femur. The authors analyzed clinical outcomes of limb salvage operations using tumor prostheses for metastatic or primary malignant bone tumors in the proximal femur. MATERIALS AND METHODS: From February 2005 to January 2014, 20 cases (19 patients) with malignant bone tumor involving the proximal femur with pain or complicated pathologic fracture were treated with segmental resection and limb salvage operations with tumor prostheses. Mean age was 63.1 years (range 35-86). Fourteen patients were male and six ones were female. The mean follow-up period was 20 months (1-94 months). There were 15 cases of metastatic bone tumor, 4 cases of osteosarcoma, and 1 case of multiple myeloma. The primary tumors of the metastatic bone tumors included 4 lung cancers, 3 hepatocellular carcinomas, and 3 renal cell carcinomas. Other primary tumors were breast cancer, thyroid cancer, colon cancer, prostate cancer, and malignant spindle cell tumor, each in 1 case. Modular tumor prostheses were used in all cases; (Kotz's(R) Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey) in 3 cases, MUTARS(R) proximal femur system (Implantcast, Munster, Germany) in 17 cases). Perioperative pain was assessed with Visual Analogue Scales (VAS). Postoperative functional outcome was assessed with Musculoskeletal Tumor Society (MSTS) grading system. RESULTS: Out of 20 cases (19 patients), 11 cases (10 patients) survived at the last follow-up. Average postoperative survival of the 9 deceased patients was 10.1 months (1-38 months). VAS score improved from pre-operative average of 8.40 (5-10) to 1.35 (0-3) after operation. Average postoperative MSTS function score was 19.65 (65.50%, 7-28). The associated complications were 2 local recurrences, 3 hematomas, 3 infections, 2 scrotal swellings, and 1 dislocation. There was no case of periprosthetic fracture or loosening. CONCLUSION: Limb salvage operation with tumor prosthesis is an appropriate treatment for early pain reduction and functional restoration in malignant bone tumors in the proximal femur with pain an/or complicated pathologic fractures.
Breast Neoplasms ; Carcinoma, Hepatocellular ; Carcinoma, Renal Cell ; Colonic Neoplasms ; Dislocations ; Female ; Femur* ; Follow-Up Studies ; Fractures, Spontaneous ; Hematoma ; Humans ; Limb Salvage* ; Lung Neoplasms ; Male ; Multiple Myeloma ; Osteosarcoma ; Periprosthetic Fractures ; Prostatic Neoplasms ; Prostheses and Implants* ; Recurrence ; Thyroid Neoplasms ; Walking ; Weights and Measures

A ICL TM(STAAR Collamer Posterior chamber Implantable Contact Lens) lents ranging from -11D to -21.3D. And then we investigated the visualwas implanted in 12 eyes of 7 patients with preoperative spherical equivalents ranging from -11 D to -21.3 D. And then we investigated the visual acuity, mean endothelial cell loss, change of refractive error and postoperative complications.Average follow-up was 28.1 months. In the immediate postoperative days, all eyes had a significant increase in uncorrected visual acuity and the best corrected visual acuity was improved in 7 eyes(58.3%). Mean percent difference between preoperative and postoperative endothelial cell count was 3.22+/-0.05% . The mean preoperative spherical equivalent refraction was -15.65+/-2.78 D. At a mean follow-up of 1 month, mean spherical equivalent refraction was -1.67+/-0.72D, at a 6months, 12 months, 24 months, mean spherical equivalent refraction was each -1.56+/-0.72D, -1.63+/-0.68D, -1.73+/-0.76D. During follow-up days one eye developed an faint anterior subcapsular cataract but the patient remained symptom free. Other reported complication was transient increased intraocular pressure. Although the follow-up in our study was limited cases(12 eyes), from our experience, the posterior chamber implantable contact lens was efficacious and safe in the correction of high myopic refraction errors.
Cataract ; Endothelial Cells ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Lenses, Intraocular* ; Refractive Errors ; Refractive Surgical Procedures ; Visual Acuity

Myofascial pain syndrome, which has trigger points, is one of the most common causes of acute and chronic musculoskeletal pain. The trigger points formed by damage to the muscle fibers are focal areas of taut bands in the skeletal muscle that are hypersensitive to palpation. When manual pressure is applied over a trigger point, it produces distinct local and referred pain. Although various modalities have been used to treat trigger points, trigger point injection is the most effective treatment modality to inactivate trigger points. This article reviews the diagnosis and treatment of myofascial pain syndrome and the technique of trigger point injection.

Myofascial pain syndrome, which has trigger points, is one of the most common causes of acute and chronic musculoskeletal pain. The trigger points formed by damage to the muscle fibers are focal areas of taut bands in the skeletal muscle that are hypersensitive to palpation. When manual pressure is applied over a trigger point, it produces distinct local and referred pain. Although various modalities have been used to treat trigger points, trigger point injection is the most effective treatment modality to inactivate trigger points. This article reviews the diagnosis and treatment of myofascial pain syndrome and the technique of trigger point injection.

Myofascial pain syndrome, which has trigger points, is one of the most common causes of acute and chronic musculoskeletal pain. The trigger points formed by damage to the muscle fibers are focal areas of taut bands in the skeletal muscle that are hypersensitive to palpation. When manual pressure is applied over a trigger point, it produces distinct local and referred pain. Although various modalities have been used to treat trigger points, trigger point injection is the most effective treatment modality to inactivate trigger points. This article reviews the diagnosis and treatment of myofascial pain syndrome and the technique of trigger point injection.

Myofascial pain syndrome, which has trigger points, is one of the most common causes of acute and chronic musculoskeletal pain. The trigger points formed by damage to the muscle fibers are focal areas of taut bands in the skeletal muscle that are hypersensitive to palpation. When manual pressure is applied over a trigger point, it produces distinct local and referred pain. Although various modalities have been used to treat trigger points, trigger point injection is the most effective treatment modality to inactivate trigger points. This article reviews the diagnosis and treatment of myofascial pain syndrome and the technique of trigger point injection.

Acute bilateral renal cortical necrosis (BRCN) is a rare cause of renal failure. It has been reported that contrast-enhanced computed tomography provides characteristic findings of BRCN which correlates well with the histopathology making it an important non-invasive diagnostic modality during early phase of BRCN, improving survival rate and prognosis with early diagnosis and treatment. This report presents a case of 73-year old woman with BRCN due to hemolytic uremic syndrome. The patient recovered from anuria and showed complete recovery to normal renal function of her age and serum creatinine level after early initiation of hemodialysis. Furthermore, a normal radiologic finding of kidney was obtained after 52 days from onset of the disease by contrast-enhanced computed tomography. At present, she is preserved within the normal range renal function without renal replacement therapy.
Anuria ; Creatinine ; Early Diagnosis ; Female ; Hemolytic-Uremic Syndrome ; Humans ; Kidney ; Kidney Cortex Necrosis ; Prognosis ; Reference Values ; Renal Dialysis ; Renal Insufficiency ; Survival Rate

Cerebrovascular disease and coronary heart disease are the first and the fourth common causes of death among adults in Korea. Reported risk factors of one of these diseases may prevent other diseases. Therefore, we tried to compare and discriminate the risk factors of these diseases. We recruited four case groups and four control groups among the inpatients who were admitted to Wonju Christian Hospital from March, 1994 to November, 1995. Four control groups were matched with each of four case groups by age and sex. The number of patients in each of four case and control groups were 106 and 168 for acute myocardial infarction(AMI), 84 and 133 for subarachnoid hemorrhage(SAH), 102 and 148 for intracerebral hemorrhage(ICH), and 91 and 182 for ischemic stroke(IS) respectively. Factors whose levels were significantly higher in AMI and IS than in responding control group(RCG) were education, economic status, and triglyceride. Factors whose levels were significantly lower in hemorrhagic stroke than in RCG were age of menarch, and prothrombin time. The factor whose level was higher in AMI than in RCG was uric acid. The factor whose level was higher in AMI, ICH, and SAH than in RCG was blood sugar. Factors whose levels were significantly higher in all the case groups than in RCG were earlobe crease, Quetelet index, white blood cell count, hemoglobin, hematocrit, and total cholesterol. The list of risk factors were somewhat different among the four diseases, though none of the risk factors to the one disease except prothrombin time acted as a preventive factor to the other diseases. The percent of grouped cases correctly classified was higher in the discrimination of ischemic diseases(AMI and IS) from hemorrhagic diseases(SAH and ICH) than in the discrimination of cerebrovascular disease from AMI. The factors concerned in the discrimination of ischemic diseases from hemorrhagic diseases were prothrombin time, earlobe crease, gender, age uric aci, education, albumin, hemoglobin, the history of taking steroid, total cholesterol, and hematocrit according to the selection order through forward selection.
Adult ; Blood Glucose ; Body Mass Index ; Case-Control Studies* ; Cause of Death ; Cholesterol ; Coronary Disease* ; Discrimination (Psychology) ; Education ; Gangwon-do ; Hematocrit ; Humans ; Inpatients ; Korea ; Leukocyte Count ; Prothrombin Time ; Risk Factors* ; Stroke ; Triglycerides ; Uric Acid

During the recent epidemic period (1995~1996), seven strains of rubella virus were isolated in Korea. To analyze phylogenetic relationship between seven Korean strains and rubella virus strains from other different geographical areas, structural genes (E1, E2 and C) of Korean strains were enzymatically amplified and automatically sequenced. The sequence similarities of the E1, E2 and C genes of the cosmopolitan types were 95.8~98.1%, 92.6~99.2% and 96.4~99.3% based on 1,441, 122 and 139 nucleotides and 96.9~98.5%, 90~100% and 97.8~100% based on 480, 40 and 46 amino acids compared to the sequences of strain RA27/3, respectively. In contrast, the sequence similarities of the E1, E2 and C genes of the Asian types were 91.5~92.1%, 83.6~88.5% and 91.4% based on nucleotides ad 96.9~97.7%, 85.5% and 97.8% based on amino acids compared to the sequences of strain RA27/3. respectively. However, immunodominent epitopes of the E1 gene of the cosmopolitan and Asian types were well conserved, and the growth patterns in cell culture and immunofluorescent antibody titers in cross-reaction test showed no differences between two different types. In phylogenetic analysis based on nucleotide sequences of each gene regions, the comopolitan and Asian types formed tow distinct phylogenetic lineages. These data showed two distinct genotypes of rubella viruses cocirculated in Korea, but no significant differences in the antigenicity of two different rubella virus strains were found.
Amino Acids ; Asian Continental Ancestry Group ; Base Sequence ; Cell Culture Techniques ; Epitopes ; Genotype ; Humans ; Korea ; Nucleotides ; Rubella virus* ; Rubella* ; Sequence Analysis*

Distal radioulnar dislocation is commonly associated with radius fracture. Most common dislocation pattern is the dorsal dislocation. We present the unique case of volar dislocation of the distal radioulnar joint blocked by displaced dorsal Barton fracture of distal radius and discuss the injury mechanism and anatomic lesions.
Dislocations* ; Joints* ; Radius ; Radius Fractures