PURPOSE: This study examined the effect of a varus positioned femoral stem after cementless proximal fitting total hip arthroplasty. MATERIALS AND METHODS: A total of 144 hips in 136 patients who underwent cementless total hip arthroplasty, were followed-up. Twenty-one varus positioned hips were compared with 123 neutral positioned hips. The clinical results were analyzed according to the level of thigh pain and the Harris Hip score. The radiological outcome was assessed according to osteolysis, loosening and stem failure. RESULTS: In the varus positioned hips, thigh pain was present in 1 hip, and the average Harris Hip Score was 96 points. None of the implants showed radiological evidence of loosening or impending failure. Localized osteolysis was identified in 1 hip, non-progressive radiolucencies in 2 hips, and cortical hypertrophy in 1 hip. In the neutral positioned hips, thigh pain was present in 6 hips, and the average Harris Hip Score was 97 points. Localized osteolysis was identified in 8 hips, non-progressive radiolucencies in 7 hips, cortical hypertrophy in 9 hips. CONCLUSION: Patients with varus alignment of the stem did not present poorer clinical outcomes than those with neutral alignment of the stem.
Arthroplasty, Replacement, Hip* ; Hip ; Humans ; Hypertrophy ; Osteolysis ; Thigh

Testicular granulosa cell tumor(GCT) is a rare neoplasm. We report here on an incidentally discovered testicular granulosa cell tumor in a 36-year-old man. The serum tumor markers were within the normal limits. The ultrasonographic findings revealed a mass with a heterogenous hypoechoic echotexture, including multiple variable sized cystic components. The histology on the orchiectomy specimen demonstrated a gonadal stromal tumor with granulosa cell features. Testicular granulosa cell tumor of the adult type is a very rare tumor, and there have been several isolated case reports and small serial studies described in the literature.
Adult ; Female ; Gonads ; Granulosa Cell Tumor ; Granulosa Cells ; Humans ; Orchiectomy ; Testicular Neoplasms ; Testis ; Biomarkers, Tumor

PURPOSE: The purpose of this study was to report on the incidence and risk factors of perioperative delirium in elderly patients with hip fracture. MATERIALS AND METHODS: There were seventy four patients who were older than 65 years and who underwent an operation for hip fracture between April 2006 and February 2008. All the patients were tested with the Mini-Mental State Examination Korean version after admission and they were checked daily for the duration of their hospitalization. We diagnosed delirium by the Confused Assessment Method and we evaluated the risk factors for perioperative delirium. RESULTS: Delirium occurred in 21 patients (28.4%). The delirium group had a lower Mini-Mental State Examination Korean version score compared with that of the control group. The percentage of patients cared for in the intensive care unit (ICU) was significantly higher in the delirium group. There were statistically significant differences between the delirium group and the control group for the serum electrolytes, albumin and a past history of diabetes, stroke and CNS medications. CONCLUSION: Delirium is common in the elderly patients with hip fracture. Electrolyte disequilibrium and a low albumin level showed significant positive correlation between the delirium group and the control group. A history of stroke, diabetes and CNS medications are risk factors for delirium.
Aged ; Delirium ; Electrolytes ; Hip ; Hospitalization ; Humans ; Incidence ; Intensive Care Units ; Prospective Studies ; Risk Factors ; Stroke

STUDY DESIGN: A retrospective study on the outcomes of surgical treatment for pyogenic lumbar spondylodiscitis. OBJECTIVES: To report the clinical outcomes of the surgical treatment of pyogenic lumbar spondylodiscitis using a one stage posterior approach. SUMMARY OF LITERATURE REVIEW: There are few reports on the treatment of pyogenic lumbar spondylodiscitis through a one stage posterior approach. MATERIALS AND METHODS: Between June 1999 and June 2005, this study examined the history of 12 patients with pyogenic lumbar spondylodiscitis treated by simultaneous posterior debridement, autogenous iliac bone graft and pedicle screw fixation. The clinical outcomes were evaluated in terms of the pain level, neurological status, hematological parameters and radiology findings. RESULTS: The clinical symptoms improved in all cases after surgery. There was no case of the infection recurring. The mean time for postoperative antibiotics and hospitalization was 6 weeks and 41.6 days, respectively. Radiological bony fusion was observed at 5.5 months on average. The mean preoperative, immediate postoperative and final follow-up sagittal angles were 4.6, 8.6 and 6.9degrees. CONCLUSION: One stage posterior interbody fusion and instrumentation for the treatment of pyogenic lumbar spondylodiscitis can provide radical debridement, bone graft and immediate stability without prohibiting the control of infection. Therefore, it can be used in selected cases.
Anti-Bacterial Agents ; Debridement* ; Discitis* ; Follow-Up Studies ; Hospitalization ; Humans ; Retrospective Studies ; Transplants

A spontaneous rupture of the extensor pollicis longus (EPL) tendon is associated with rheumatoid arthritis, fractures of the wrist, systemic or local steroids and repetitive, and excessive abnormal motion of the wrist joint. The authors encountered a case of a spontaneous rupture of the EPL tendon. The patient had no predisposing factors including trauma or steroid injection. Although the patient had a positive rheumatoid factor, he did not demonstrate other clinical or radiological findings of rheumatoid arthritis. During surgery, the EPL tendon was found to be ruptured at the extensor retinaculum (third compartment). Reconstruction of the extensor tendon using the palmaris longus tendon was performed. At the 18-month follow-up, the patient showed satisfactory extension of the thumb and 40degrees extension and flexion at the wrist.
Adult ; Cumulative Trauma Disorders/*complications ; Humans ; Male ; Occupational Diseases/*complications ; Rupture/etiology/surgery ; Tendon Injuries/*etiology/*surgery

PURPOSE: To retrospectively evaluate the improvement of symptoms and diagnosis using selective nerve root block (SNRB) for radiating pain after spine surgery. MATERIALS AND METHODS: From October 2012 to October 2013, 112 patients with failed back surgery syndrome (41 male and 71 female, with the mean age of 62.4 years and range of 35 to 78 years), who were admitted and underwent SNRB, were included. All patients were followed-up for more than 12 months. Three groups were classified: Group 1 included patients with no improvement or aggravation of symptoms, group 2 included those with improvement of radiating pain, and group 3 included those with recurrence of radiating. RESULTS: Among the 112 patients, there were 15 patients in group 1, 59 patients in group 2, and 38 patients in group 3. Laminectomy was the highest surgical procedure, inducing failed back surgery syndrome. In group 2, the occurrence of failed back surgery syndrome was higher in case that radiating pain was complained more than 1 year before the first surgery. There is statistically significant symptom improvement in accordance with the visual analogue scale and Korean version of Oswestry disability index on every group after SNRB (p<0.05). CONCLUSION: It is considered that SNRB is expected to improve the symptoms and to find the cause of symptoms as a diagnostic value even after spine surgery.
Diagnosis ; Failed Back Surgery Syndrome* ; Female ; Humans ; Laminectomy ; Male ; Recurrence ; Retrospective Studies ; Spine

PURPOSE: This study investigated the role of extracellular superoxide dismutase (EC-SOD), which is a major extracellular antioxidant enzyme in skeletal muscle ischemia and reperfusion (I/R) injury. MATERIALS AND METHODS: The pedicled cremaster muscle flaps from homozygous EC-SOD knockout (EC-SOD-/-), heterozygous CuZn-SOD knockout (CuZn-SOD+/-) and wild-type (WT) mice were subjected to 4.5 hour ischemia followed by 90 min reperfusion. The pedicled cremaster muscle flaps were examined by functional analysis during the reperfusion. The mRNA and protein expressions of each SOD after I/R were evaluated using quantitative real-time PCR and western blot. RESULTS: The results showed that the EC-SOD-/- mice had a more profound I/R injury than the CuZn- SOD+/- or WT mice. In particular, there was a delayed and incomplete recovery of the arterial diameter and blood flow during reperfusion and as well as there being more severe inflammation. After 90 min reperfusion, the EC-SOD mRNA levels increased more in the CuZn-SOD+/- mice than in the WT mice. However, the CuZn-SOD and Mn-SOD mRNA levels decreased similarly in all 3 groups. The CuZn-SOD protein levels decreased in all groups. The EC-SOD protein levels decreased in the CuZn-SOD+/- and WT mice, but the Mn-SOD protein levels were unchanged or slightly increased in all groups. The histological results showed diffuse edema and inflammatory cell infiltration around the muscle fibers and these changes were more severe in the EC-SOD-/- mice. CONCLUSION: EC-SOD plays an important role in protecting the skeletal muscle from I/R injury caused by the excessive generation of reactive oxygen species.
Animals ; Blotting, Western ; Edema ; Inflammation ; Ischemia ; Mice ; Muscle, Skeletal* ; Reactive Oxygen Species ; Real-Time Polymerase Chain Reaction ; Reperfusion ; Reperfusion Injury* ; RNA, Messenger ; Superoxide Dismutase* ; Superoxides*

There are some errors in the published article. The authors would like to make corrections in the original version of the article.

PURPOSE: There are many reports about facial bone fractures, but limited to retrospective data of a single hospital. Etiology and severity of the facial bone fracture have been changed and treatment method and materials have been advanced. In order to reflect those changes and provide up-to-date data of the facial bone fractures in Daegu, we gathered the data and analyzed the epidemiologic study. METHODS: The medical records of 1058 fractures in 895 patients were gathered from 5 general hospitals in Daegu during last year and these data were analyzed by following parameters: age, sex, place of residence, occupation, cause of injury, time of injury, location of fracture, length of in-hospital stay, time of operation, treatment method, associated injury, complication. Statistical analysis was performed using the Chi-square test. RESULTS: Most commonly involved age group was 20s(26%) and the sex ratio was 3.4:1(male predominance). Fractures were occurred more in unban and white-color workers. Among variable etiology of injury, traffic accident was the most common cause. Time of injury was heighest at 6 to 7 P.M., on Sunday, in July. Locations of fractures were following sequence: nasal, zygoma, mandible, orbit, maxilla. Mean length of in- hospital stay and time of operation after injury were 6.3 and 3.2 days, respectively. In treatment methods, operative methods were dominant than conservative management and general anesthesia were favored than local anesthesia. Associated injuries were noticed in 188 cases(21.2%) and complications were in 94 cases(8.9%) and among them, ocular problem were common. CONCLUSION: Compared to previous studies, mean age of occurrence was lowered and the etiologies showed age-specific pattern and reflected the change of lifestyle. In young age groups, sports injury, violence were more dominant and the other hand, traffic accident and fall were dominant in older groups.
Accidents, Traffic ; Anesthesia, General ; Anesthesia, Local ; Athletic Injuries ; Daegu* ; Epidemiologic Studies* ; Facial Bones* ; Facial Injuries ; Hand ; Hospitals, General ; Humans ; Length of Stay ; Life Style ; Mandible ; Maxilla ; Maxillofacial Injuries ; Medical Records ; Occupations ; Orbit ; Retrospective Studies ; Sex Ratio ; Violence ; Zygoma

BACKGROUND/AIMS: Effective bowel preparation is essential for accurate diagnosis of colon disease. We investigated efficacy and safety of 2 L polyethylene glycol (PEG) solution with 90 mL sodium phosphate (NaP) solution compared with 4 L PEG method. METHODS: Between August 2009 and April 2010, 526 patients were enrolled who visited Seoul National University Bundang Hospital for colonoscopy. We allocated 249 patients to PEG 4 L group and 277 patients to PEG 2 L with NaP 90 mL group. Detailed questionnaires were performed to investigate compliance, satisfaction and preference of each method. Bowel preparation quality and segmental quality were evaluated. Success was defined as cecal intubation time less than 20 minutes without any help of supervisors. RESULTS: Both groups revealed almost the same baseline characteristics except the experience of operation. PEG 4 L group's compliance was lower than PEG 2 L with NaP 90 mL group. Success rate and cecal intubation time was not different between two groups. Overall bowel preparation quality of PEG 2 L with NaP 90 mL group was better than PEG 4 L group. Segmental bowel preparation quality of PEG 2 L with NaP 90 mL group was also better than PEG 4 L group in all segments, especially right side colon. Occurrence of hyperphosphatemia was higher in PEG 2 L with NaP 90 mL group than PEG 4 L group. However, significant adverse event was not reported. CONCLUSIONS: PEG 2 L with NaP 90 mL method seems to be more effective bowel preparation than PEG 4 L method.
Administration, Oral ; Adult ; Aged ; Colonic Diseases/diagnosis ; Colonoscopy/*methods ; Humans ; Male ; Middle Aged ; Patient Compliance ; Phosphates/*administration & dosage ; Polyethylene Glycols/*administration & dosage ; Questionnaires ; Solutions ; Therapeutic Irrigation