OBJECTIVE: To evaluate the association between baseline characteristics, three physical performance tests and fall history in a sample of the elderly from Korean population. METHODS: A total of 307 participants (mean age, 76.70±4.85 years) were categorized into one of two groups, i.e., fallers and non-fallers. Fifty-two participants who had reported falling unexpectedly at least once in the previous 12 months were assigned to the fallers group. Physical performance tests included Short Physical Performance Battery (SPPB), Berg Balance Scale (BBS), Timed Up and Go test. The differences between the two study groups were compared and we analyzed the correlations between fall histories and physical performance tests. RESULTS: SPPB demonstrated a significant association with fall history. Although the BBS total scores did not show statistical significance, two dynamic balance test items of BBS (B12 and B13) showed a significant association among fallers. CONCLUSION: This study suggests that SPPB and two dynamic balance test items of the BBS can be used in screening for risk of falls in an ambulatory elderly population.
Accidental Falls ; Aged* ; Cross-Sectional Studies* ; Humans ; Mass Screening

PURPOSE: The purpose of this study is to present the effective design of N-plasty of the iliotibial band and surgical results of its use as a treatment for refractory external snapping hip. MATERIALS AND METHODS: We evaluated 17 patients (24 cases) with external snapping hip who underwent N-plasty between October 2013 and May 2016 and who were followed up for at least 12 months. All patients were male and the mean age was 20.8 years. The mean duration of symptoms prior to surgical intervention was 28.5 months with an average follow up of 24.5 months. Surgery was defined as being successful when patients could carry out their daily activities and exercise without a clicking sensation or pain 6 months after surgery until their last follow-up. Failure was defined when either a clicking sensation or pain was present. The visual analog scale (VAS) and modified Harris hip score (mHHS) were measured and compared preoperatively and at last follow-up. RESULTS: All patients had complete resolution of pain and snapping. The VAS decreased from 6.77 preoperatively to 0.09 postoperatively and mHHS improved from 69.5 to 97.8 after surgery. CONCLUSION: Modified designed N-plasty is considered to be an excellent treatment method facilitating operation reproducibility with maximum elongation effect of the iliotibial band.
Follow-Up Studies ; Hip* ; Humans ; Male ; Methods ; Sensation ; Visual Analog Scale

PURPOSE: The purpose of this study is to present the effective design of N-plasty of the iliotibial band and surgical results of its use as a treatment for refractory external snapping hip. MATERIALS AND METHODS: We evaluated 17 patients (24 cases) with external snapping hip who underwent N-plasty between October 2013 and May 2016 and who were followed up for at least 12 months. All patients were male and the mean age was 20.8 years. The mean duration of symptoms prior to surgical intervention was 28.5 months with an average follow up of 24.5 months. Surgery was defined as being successful when patients could carry out their daily activities and exercise without a clicking sensation or pain 6 months after surgery until their last follow-up. Failure was defined when either a clicking sensation or pain was present. The visual analog scale (VAS) and modified Harris hip score (mHHS) were measured and compared preoperatively and at last follow-up. RESULTS: All patients had complete resolution of pain and snapping. The VAS decreased from 6.77 preoperatively to 0.09 postoperatively and mHHS improved from 69.5 to 97.8 after surgery. CONCLUSION: Modified designed N-plasty is considered to be an excellent treatment method facilitating operation reproducibility with maximum elongation effect of the iliotibial band.
Follow-Up Studies ; Hip* ; Humans ; Male ; Methods ; Sensation ; Visual Analog Scale

Internal impingement syndrome is characterized by the posterior shoulder pain when the arm is abducted and external rotated, and articular partial rotator cuff tear with posterosuperior labral fraying in throwing athletes. Osteochondral lesion of humeral head as an associated lesion is reported in some cases but, not considered to be a main origin of the symptoms. We found the similar features of osteochondral lesion on humeral head in three cases of internal impingement syndrome irrespective of conservative treatment for over three months and report good results obtained from arthroscopic debridement and microfracturing for these lesions with a review of the literatures.
Arm ; Athletes ; Cartilage Diseases ; Debridement ; Humans ; Humeral Head* ; Rotator Cuff ; Shoulder Pain ; Shoulder*

A 73-year-old male was admitted for unhealed wound. Eight months ago, the patient had been operated for excision of soft tissue mass on left distal thigh area in previous hospital and after 4 months from first operation, had been reoperated because of recurrence. The pathologic diagnosis of previous operation was simple cyst. In operating finding, the mass invaded the vastus lateralis fascia and had irregular margin and adhesion. We carried out simple excision with retaining 5 cm of free margin from the mass. The pathologic diagnosis of our hospital was malignant fibrous histiocytoma, and then the patient was performed radiation therapy. In 1 year follow-up, there was no significant finding either increasing mass size or metastasis. We misdiagnosed as simple cyst and then performed simple excision, however finally pathologic diagnosis confirmed as malignant fibrous histiocytoma. It is considered to operate a mass that preoperative proper evaluation and diagnosis are required.
Fascia ; Follow-Up Studies ; Histiocytoma, Benign Fibrous ; Histiocytoma, Malignant Fibrous ; Humans ; Male ; Neoplasm Metastasis ; Quadriceps Muscle ; Recurrence ; Thigh

PURPOSE: The aim of this study was to evaluate the usefulness of a method for positioning the femoral stem in neutral position refer to the measured value of "lateral distance" in pre-operative templating and the femoral stem position post-operatively. MATERIALS AND METHODS: A total of 81 hips in 76 patients underwent cementless total hip arthroplasty between March 2008 and April 2012 using the C2 stem (Lima Corporate S.P.A, Udine, Italy). We measured the perpendicular distance from the lateral outermost part of the greater trochanter to the lateral outermost part of the femoral stem (lateral distance, LD) in pre-operative templating. We aimed to insert the femoral stem in neutral position by comparing LD measured intra-operatively. We evaluated the position of the femoral stem on post-operative plain radiography. We compared the result of post-operative re-measurement of the LD with that of pre-operative measurement. RESULTS: In all of the 81 cases, the femoral stem was inserted in neutral position, defined as the femoral stem position within 3degreesvalgus or varus. The average angle of the inserted femoral stem was 1.20degrees(0.003-2.85degrees). LD measured in preoperative templating was 15.6 mm(10-21.5 mm), and it showed no correlation ratio with LD; LD re-measured post-operatively was 15.9 mm(10.3-23.5 mm) (P=0.781). CONCLUSION: Measuring LD pre-operatively and using the value intra-operatively is an effective method for insertion of the femoral stem in neutral position.
Arthroplasty ; Femur ; Hip ; Humans

Leptomeningeal metastasis occurs in approximately 1% of patients with non-small cell lung cancer and this is an extremely serious complication. Without treatment, the median survival of patients is 4~6 weeks. The treatment options currently available are limited and achieve only modest results. Gefitinib was recently approved for the treatment of advanced/refractory non-small cell lung cancer. In addition, there have been case reports showing activity of gefitinib against brain metastasis in non-small cell lung cancer patients. However, there is limited data on the ability of gefitinib to cross the blood-brain barrier. We report the case of a patient with leptomeningeal metastasis from adenocarcinoma of the lung that had a dramatic response to gefitinib treatment.
Adenocarcinoma ; Blood-Brain Barrier ; Brain ; Carcinoma, Non-Small-Cell Lung ; Humans ; Lung ; Neoplasm Metastasis ; Quinazolines

Human listeriosis is a relatively rare but serious disease with mortality rate 20~40%. Listeria monocytogenes affects patients with decreased cell mediated immunity such as the elderly, transplant recipients, cancer patients, renal failure, diabetes, HIV, pregnant women and unborn child, neonate. We experienced a case of listeriosis in twin pregnant woman at 35th weeks without preterm labor. The pregnant woman present sepsis with fever at first time. Sepsis progress to MODS (multiple organ dysfunction syndrome) and combined endocarditis. We reported it with brief of literatures.
Aged ; Child ; Endocarditis ; Female ; Fever ; HIV ; Humans ; Immunity, Cellular ; Infant, Newborn ; Listeria ; Listeria monocytogenes ; Listeriosis ; Multiple Organ Failure ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Trimester, Third ; Pregnancy, Twin ; Pregnant Women ; Renal Insufficiency ; Sepsis

Henoch-Schonlein purpura (HSP) is a leukocytoclastic vasculitis of small vessels with deposition of IgA, commonly resulting in skin, joint, gastrointestinal, and kidney involvement. HSP is an uncommon disorder in adults and accounts for 0.6% to 2% of adult nephropathy. We report a case of HSP with acute renal failure successfully treated with corticosteroid. In this case, the patient presented with vasculitic purpuric rash on lower extremity, arthralgia in the wrist, abdominal pain, hematochezia, oliguria and azotemia. Abdominal CT showed wall thickening of the small and large bowels. Skin biopsy revealed leukocytoclastic vasculitis. Percutaneous renal biopsy showed no crescent formation, but mesangial IgA and C3 deposits were observed by immunofluorescence. The patient was treated with corticosteroid (1mg/kg per day) and hemodialysis. After treatment, renal function improved and purpuric lesion, arthralgia and abdominal pain disappeared. Thus, when adults present with purpuric rash and rapidly progressive glomerulonephritis (RPGN), HSP should be a diagnostic consideration.
Abdominal Pain ; Acute Kidney Injury ; Adult ; Arthralgia ; Azotemia ; Biopsy ; Exanthema ; Fluorescent Antibody Technique ; Gastrointestinal Hemorrhage ; Glomerulonephritis ; Humans ; Immunoglobulin A ; Joints ; Kidney ; Lower Extremity ; Oliguria ; Purpura ; Purpura, Schoenlein-Henoch ; Renal Dialysis ; Skin ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous ; Wrist

OBJECTIVES: This multicenter clinical trial involving 13 hospital sites compared the safety of switching to olanzapine between 'direct switching method' and 'start-tapering switching method'. METHOD: This study included both inpatients and outpatients who fulfilled the criteria for schizophrenia as defined in the ICD-10, and were in need to be appropriate for switching antipsychotics. Subjects were randomly assigned to one of the two switching methods. For 'direct switching method' group, previous antipsychotics were abruptly discontinued and 10mg of olanzapine was administered, whereas for 'start-tapering switching method' group, initially 10mg of olanzapine was administered and previous antipsychotics was gradually tapered for 2 weeks. Olanzapine was used for 6 weeks and the dose was adjusted within the range of 5-20mg. The safety of switching to olanzapine was measured with vital signs including body weight, adverse events reported spontaneously, laboratory tests, and various scales such as Simpson-Angus Scale(SAS), Barnes Akathisia Rating Scale(BARS), Abnormal Involuntary Movement Scale(AIMS), and Liverpool University Neuroleptic Side Effect Rating Scale(LUNSERS). RESULTS: 103 patients were switched to olanzapine in this study. The comparison between two switching methods did not show any significant difference in the dosage of olanzapine used, the concomitant use of benzodiazepine, the rate and reasons of drop-out, the adverse events, vital signs, laboratory tests, and most scales for measuring side-effects. However, the decrease in AIMS scores was significantly lower in 'direct switching method' group, and the concomitant use of anticholinergics was comparatively greater in 'start-tapering switching method' group. At baseline, SAS and BARS scores were 3.5 and 1.8 points respectively, and more than 70% of the subjects showed hyperprolactinemia. After switching to olanzapine, SAS, BARS, and AIMS scores were significantly decreased and the proportion of the patients with hyperprolactinemia was also decreased to less than 30%. However significant weight gain after the treatment of olanzapine was observed regardless of switching method. CONCLUSION: This study may suggest that switching to olanzapine can be done with relatively high safety regardless of switching methods and olanzapine can significantly decrease some side-effects induced by other antipsychotics.
Antipsychotic Agents ; Benzodiazepines ; Body Weight ; Cholinergic Antagonists ; Dyskinesias ; Humans ; Hyperprolactinemia ; Inpatients ; International Classification of Diseases ; Outpatients ; Psychomotor Agitation ; Schizophrenia ; Vital Signs ; Weight Gain ; Weights and Measures