No abstract available.

Purpose: The purpose of this study was to evaluate the mortality of patients over eighty years old with femoral neck fractures that have been treated with bipolar endoprostheses. Materials and Methods: We retrospectively studied 37 patients out of a total of 83, who suffered from hip fractures and were treated with surgery from 2000 through December 2004. We attempted to distinguish the differences between the 8 patients who died (Group A) and the 29 patients who lived (Group B). The variables that we analyzed, were: age, sex, operative time, the time period from admission to surgery, the time period from admission to discharge, the ASA score, and any medical comorbidities. Results: In Group A, 2 patients died within 1 month, 2 died between 1 and 6 months, 1 died between 6 and 12 months, and 3 died after 1 year. There were statistical differences between Group A and Group B with respect to two variables: the time period from admission to, and medical comorbidities. Conclusion: There were significant correlations with an increase in the mortality rate among patients with lung disease, female patients in general, and delays in surgery. Therefore, particular care should be paid to patients with these variables.
Comorbidity ; Female ; Femoral Neck Fractures ; Hip Fractures ; Hip* ; Humans ; Lung Diseases ; Mortality* ; Operative Time ; Retrospective Studies

PURPOSE: To evaluate the accuracy and reliability of method for prediction of rotationally neutral state of the femur by comparing with contra-lateral lesser trochanter. MATERIALS AND METHODS: The rotationally neutral state of the femur was measured by comparing the shape of the opposite side of the lesser trochanter in a normal group of 100 adult. Each examination was performed independently by three observers. The observers predicted a position presumed to be neutral by comparing the shape of lesser trochanter with that of contra-lateral side previously recorded by the C-arm image intensifier. We evaluated the mean angular discrepancy that is different from the neutral point and assessed the inter-observer variations. RESULTS: The mean angular discrepancy (SD) was 3.4 degree(+/-2.4); 3.5 degree(+/-2.4) by observer-1,3.5 degree (+/-2.8) by observer-2, 3.2 degree(+/-2.2) by observer-3. There was no inter-observer variation (p=0.87). 77% of all observers indicated below 4 degree and no one over 15 degree. CONCLUSIONS: The method of comparing the shape of both lesser trochanters is considered to be effective in determining the rotational status of the femur. It could be used as a practical method in the operation of the femoral fracture for prevention of rotational deformity intra-operatively
Adult ; Congenital Abnormalities ; Femoral Fractures ; Femur* ; Humans ; Observer Variation

A 31-year-old man presented with dull headache and memory disturbance lasting for one week. Computed tomographic scans revealed acute hydrocephalus. The cerebrospinal fluid contained 53 leukocytes/mm3, with a mononuclear preponderance and no erythrocytes. Magnetic resonance imaging revealed hydrocephalus and leptomeningeal enhancement. Magnetic resonance angiography and digital subtraction angiography showed supraclinoid occlusion of the right internal carotid artery, which resembled unilateral moyamoya disease. Neuroendoscopic biopsy of a lesion in the septum pellucidum revealed noncaseating granulomas, which was consistent with sarcoidosis. The patient was successfully managed with intravenous methylprednisolone and ventriculoperitoneal shunting. To our knowledge, this is the first case of moyamoya-like vasculopathy associated with neurosarcoidosis.
Adult ; Angiography, Digital Subtraction ; Biopsy ; Carotid Artery, Internal ; Central Nervous System Diseases ; Erythrocytes ; Granuloma ; Headache ; Humans ; Hydrocephalus ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Memory ; Methylprednisolone ; Moyamoya Disease ; Sarcoidosis ; Septum Pellucidum ; Ventriculoperitoneal Shunt

STUDY DESIGN: Consecutive, prospective, radiographic review of adolescent idiopathic scoliosis (AIS) patients. OBJECTIVE: To analyze the change of Cobb angle according to position in AIS. SUMMARY OF BACKGROUND DATA: Cobb angle on standing radiographs was corrected spontaneously while the patients were in the supine position. However, there are few reports on Cobb angle in standing versus supine position in AIS. MATERIALS AND METHODS: We checked AP plain radiographs of 101 AIS patients, 18 male and 83 female, in standing and supine position. Sixty-three cases were under Risser stage V and 38 were Risser stage V. In standing plain radiograph, 27 cases were in Cobb angle 10-19 degrees, 35 in 20-29 degrees, 15 in 30-39 degrees, and 24 over 40 degrees. According to curve pattern, 31 curves were classified as King type I, 32 as type II, 8 as type III, 11 as type IV, 17 as type V, 1 thoracolumbar curve and 1 lumbar curve. Cobb angle reduction was measured on AP radiographs from each group, according to sex, maturation, Cobb angle and curve pattern. RESULTS: Average reduction of Cobb angle was 8.2 degrees(range, 1-21 degrees ), 6.4 degrees for male and 8.6 degrees for female (p=0.19). The reduction value according to maturation was 8.3 degrees for the growing group and 8.0 degrees for the grown group (p=0.73). The average reduction value in Cobb angle 10-19 degrees was 5.4 degrees(40.3%), 20-29 degrees was 7.1 degrees(30.9%), 30-39 degrees was 8.6 degrees(25.7%) and over 40 degrees was 12.8 degrees (23.6%) (p=0.001). The reduction rate decreased in proportion to Cobb angle measured in standing position. The reduction value was 8.2 degrees in King type I curves, 8.6 degrees in type II, 9.1 degrees in type III, 9.1 degrees in type IV and 6.2 degrees in type V (p=0.238). CONCLUSION: An average 8 degrees Cobb angle reduction in supine position, compared with standing position, can influence treatment strategy in AIS patients, because a Cobb angle change more than 5-6 degrees is a threshold value to decide curve worsening. Thus, serial Cobb angle measurement should be performed in standing position.
Adolescent* ; Female ; Humans ; Male ; Prospective Studies ; Scoliosis* ; Supine Position

In so-called primary osteoarthritic knees, there may be secondary osteoarthritis due to the instability from chronic cruciate ligament and/or meniscal tear. The purpose of this study is to compare the findings of bone single-photon emission computed tomography(SPECT) and those of simple radiography in osteoarthritic knees which we consider as primary on the status of anterior cruciate ligament(ACL). We reviewed the preoperative bone SPECT and simple radiography of forty-three osteoarthritic knees in 23 patients who underwent total knee arthroplasty between 1995 and l996. We divided the cases into two groups on the status of ACL: thirty intact ACLs(Group I), thirteen insufficient ACLs(Group II). Meniscal tear and/or ACL insufficiency were found in 38 of 43 knees, As regards with presence of osteophytes and sclerotic changes on simple radiograph, there was no significant differences between group I and II. Joint space narrowing was more prominent and diffuse in group I(medial 29, lateral 24) than group II(medial 7, lateral 6). Bone SPECT showed diffuse uptake in group I(medial 30, lateral 23), but less uptake on the lateral compartment(medial 13, lateral 3) in group II. In ACL-intact osteoarthritic knees, joint space narrowing on simple radiograph and hot uptake on bone SPECT were more prominent and diffuse than in ACL-insufficient knees. Clinical relevance is still uncertain and further investigation is needed.
Anterior Cruciate Ligament* ; Arthroplasty ; Humans ; Joints ; Knee* ; Ligaments ; Osteoarthritis ; Osteophyte ; Radiography* ; Tomography, Emission-Computed, Single-Photon*

STUDY DESIGN: We studied retrospectively the limbus vertebra by computed tomography or magnetic resonance image. OBJECTIVES: To analyze the clinical and radiologic characteristics of the limbus vertebra and to distinguish it from a fracture, infection or tumor. SUMMARY OF LITERATURE REVIEW: The limbus vertebra is common. However, the clinical manifestations including the level, symptoms and radiologic characteristics of the limbus vertebra are not understood exactly in the literatures. MATERIALS AND METHODS: We presented 25 cases of the limbus vertebra that were confirmed by plain roentgenogram combined with computed tomography (CT) or magnetic resonance imaging (MRI). Of the 25 patients, 18 were males and 7 females. RESULTS: The levels of the limbus vertebra were L3 (2 cases), L4 (13 cases), and L5 (8 cases). There were two cases of 2 level involvement (L3/4 and L4/5). All cases showed the lower lumbar lesion and complained of the lower back pain. The accompanying diseases included 10 cases of herniated intervertebral discs, 2 cases of ankylosing spondylitis, 2 cases of spinal stenosis and one spondylolisthesis. Three patients were first diagnosed as tuberculous spondylitis and 2 patient as spine fracture on plain roentgenograms. But they can be confirmed by demonstrating the herniation of disc material between the anterosuperior bony fragment and the rest of the body in CT or MRI. CONCLUSIONS: The CT or MRI could be great diagnostic modalities. The pathogenesis is thought to be the herniation of disc material into the vertebral body such as Schmorl's node and disc degeneration. Most limbus vertebra was found at the lower lumbar region and accompanied with disc bulging and degeneration. The correlation between the limbus vertebra and lower back pain is not certain.
Female ; Humans ; Intervertebral Disc ; Intervertebral Disc Degeneration ; Low Back Pain ; Lumbosacral Region ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Spinal Stenosis ; Spine* ; Spondylitis ; Spondylitis, Ankylosing ; Spondylolisthesis

BACKGROUND: Recent findings in molecular pathology suggest that genetic translocation and/or overexpression of oncoproteins is important in salivary gland tumorigenesis and diagnosis. We investigated PLAG1, SOX10, and Myb protein expression in various salivary gland neoplasm tissues. METHODS: A total of 113 cases of surgically resected salivary gland neoplasms at the National Cancer Center from January 2007 to March 2017 were identified. Immunohistochemical staining of PLAG1, SOX10, and Myb in tissue samples was performed using tissue microarrays. RESULTS: Among the 113 cases, 82 (72.6%) were benign and 31 (27.4%) were malignant. PLAG1 showed nuclear staining and normal parotid gland was not stained. Among 48 cases of pleomorphic adenoma, 29 (60.4%) were positive for PLAG1. All other benign and malignant salivary gland neoplasms were PLAG1-negative. SOX10 showed nuclear staining. In normal salivary gland tissues SOX10 was expressed in cells of acinus and intercalated ducts. In benign tumors, SOX10 expression was observed in all pleomorphic adenoma (48/48), and basal cell adenoma (3/3), but not in other benign tumors. SOX10 positivity was observed in nine of 31 (29.0%) malignant tumors. Myb showed nuclear staining but was not detected in normal parotid glands. Four of 31 (12.9%) malignant tumors showed Myb positivity: three adenoid cystic carcinomas (AdCC) and one myoepithelial carcinoma with focal AdCC-like histology. CONCLUSIONS: PLAG1 expression is specific to pleomorphic adenoma. SOX10 expression is helpful to rule out excretory duct origin tumor, but its diagnostic value is relatively low. Myb is useful for diagnosing AdCC when histology is unclear in the surgical specimen.
Adenoma ; Adenoma, Pleomorphic ; Antibody-Dependent Cell Cytotoxicity ; Carcinogenesis ; Carcinoma, Adenoid Cystic ; Diagnosis ; Immunohistochemistry ; Oncogene Proteins ; Oncogene Proteins v-myb ; Parotid Gland ; Pathology, Molecular ; Salivary Gland Neoplasms ; Salivary Glands ; SOX Transcription Factors ; Translocation, Genetic

A 31-year-old man presented with right hemiparesis, and magnetic resonance imaging revealed a small infarct at left basal ganglia. Digital subtraction angiography showed left cervical internal carotid artery (ICA) occlusion and severe stenosis of the ipsilateral external carotid artery (ECA) with collateral cerebral circulation fed by ECAs. Based on the results of a functional evaluation of cerebral blood flow, we performed preventive ECA angioplasty and stenting for advanced ECA stenosis to ensure sufficient blood flow to the superficial temporal artery. Eight weeks later, superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis was performed. His postoperative course was uneventful and no additional transient ischemic attacks have occurred. To our knowledge, this is the first report of preventive angioplasty and stenting for advanced narrowing of an ECA before STA-MCA anastomosis for ipsilateral ICA occlusion.
Adult ; Angiography, Digital Subtraction ; Angioplasty ; Basal Ganglia ; Carotid Artery, External ; Carotid Artery, Internal ; Constriction, Pathologic ; Dietary Sucrose ; Humans ; Ischemic Attack, Transient ; Magnetic Resonance Imaging ; Middle Cerebral Artery ; Paresis ; Stents ; Temporal Arteries

PURPOSE: Immune thrombocytopenic purpura (ITP) is divided into acute and chronic forms. Unfortunately, there have been no known specific laboratory or clinical predictors for the diagnosis of chronic ITP. This study was performed to elucidate the prognostic significance of various clinical and laboratory parameters, including reticulated platelet percentage. METHODS: We retrospectively analyzed 60 patients who were diagnosed as ITP at the Department of Pediatrics, Wonju Christian Hospital from January, 1989 to January, 2001. Various kind of clinical parameters such as age, sex, symptom duration, prior URI history, response to treatment, and laboratory parameters like platelet count at initial presentation, lowest platelet count, duration of thrombocytopenia, initial reticulated platelet percentage, antiplatelet antibody IgG and IgM, antinuclear antibody (ANA), direct and indirect Coombs' test were compared between acute and chronic ITP. RESULTS: Fifteen % of patients (9/60) was chronic ITP. The peak age incidence was from 1 to 3 year of age in both acute (29.4%) and chronic ITP (22.2%). The acute ITP was prevalent in spring season, May and June. There was no difference in the incidence of prior URI history between acute and chronic ITP. Higher proportion of chronic ITP patients (5/9; 55.5%) than acute ITP patients (7/51; 13%) had symptom duration longer than 1 month (P <0.05). Increased initial reticulated platelet percentage (more than 8%) was noted in 55.3% (21/38) of acute ITP and in 40% (2/5) of chronic ITP. There were no significant differences in initial platelet count, lowest platelet count, antiplatelet IgM, antiplatelet IgG, ANA and Coombs' test between two groups. The response to initial treatment were excellent in acute and chronic ITP. Six cases of acute ITP relapsed within 1 month from initial presentation. Eight cases of chronic ITP relapsed, among them 5 cases relapsed after 2 months from initial presentation. CONCLUSION: We suggest that patients with > or =1 months duration of presenting symptoms and relapse after 2 months from initial presentation have the propensity of developing chronic ITP. Reticulated platelet percentage could not discriminate acute and chronic ITP. A more accurate detection method should be developed for reticulated platelets.
Antibodies, Antinuclear ; Blood Platelets* ; Coombs Test ; Diagnosis ; Gangwon-do ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Pediatrics ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic* ; Recurrence ; Retrospective Studies ; Seasons ; Thrombocytopenia