42 knees with degenerative arthritis underwent arthroscopic lavage and 7 knees underwent arthroscopic lavage combined with multiple bone drilling in between 1994 and 1995 and followed average 12 months. Clinical evaluation using the hospita1 for specia] surgery knee scores (HSS scores) was done at last follow up and classified into 4 groups: excellent (90-99), good (80-89), fair (70-79) and poor (less than 70). The results were as follows: l. Of the 42 knees of the lavage group, 6 knees (16%) was excellent, 14 knees (33%) good, ]7 knees (40%) fair and 5 (11%) knees poor. Success group (Excellent & Good) were achived in 20 knees (49%). 2. Of 17 knees treated with arthroscopic lavage comhined with multiple bone drillig resulted in excellent in 9 knees (53%), good in 4 knees (23%), fair in 2 knees (12%) and poor in 2 knees (12%). Success group were achived in 13 knees (76%). 1n conclusion, we helieve that multiple bone drilling in conjunction with arthroscopic lavage has more favorable effect on the pain relief for degenerative osteoarthritis of the knee than arthroscopic lavage only.
Follow-Up Studies ; Humans ; Knee* ; Osteoarthritis* ; Therapeutic Irrigation*

No abstract available.
Spondylitis*

STUDY DESIGN: Case report.OBJECTIVES: We report a case of 3-column fracture caused by low-energy trauma in a patient with Baastrup disease who complained of acute radiating pain and motor weakness in the lower limbs after 3 weeks of conservative treatment. Subsequently, posterior fusion surgery was performed.SUMMARY OF LITERATURE REVIEW: Baastrup disease is characterized by enlargement and close approximation of adjacent spinous processes, and it mostly affects the L4-5 level of the spine. In patients with Baastrup disease affecting multiple levels of the lumbar spine, low-energy trauma can cause an unstable 3-column fracture with neurological compromise. Early recognition and surgical treatment prior to the emergence of a neurological deficit are required.MATERIALS AND METHODS: An 84-year-old woman presented with back pain after falling down backward and colliding with the edge of a shelf at ground level. Considering the patient's general condition and age, she was initially treated with close observation and placement of a spinal brace with serial radiographic follow-up.RESULTS: Computed tomography found 3-column fracture at the T11 level, which is quite rare in cases of minor trauma. At a 3-week follow-up, she complained of gradual lower extremity weakness, and her general lower extremity motor function decreased to grade 1–2. The patient underwent posterior fusion 2 levels above and below the affected vertebral body (T9-10-12-L1). Surgery was uneventful and the patient's motor function recovered.CONCLUSIONS: In patients with Baastrup disease affecting multiple levels of the lumbar spine, based on our experience, low-energy trauma can cause an unstable 3-column fracture with neurological compromise. We highly recommend scrutiny of the interspinous space in elderly patients, especially those with a spinal fracture caused by low-energy trauma.
Accidental Falls ; Aged ; Aged, 80 and over ; Back Pain ; Braces ; Female ; Follow-Up Studies ; Humans ; Lower Extremity ; Spinal Fractures ; Spine

OBJECTIVES: We report a case of 3-column fracture caused by low-energy trauma in a patient with Baastrup disease who complained of acute radiating pain and motor weakness in the lower limbs after 3 weeks of conservative treatment. Subsequently, posterior fusion surgery was performed.SUMMARY OF LITERATURE REVIEW: Baastrup disease is characterized by enlargement and close approximation of adjacent spinous processes, and it mostly affects the L4-5 level of the spine. In patients with Baastrup disease affecting multiple levels of the lumbar spine, low-energy trauma can cause an unstable 3-column fracture with neurological compromise. Early recognition and surgical treatment prior to the emergence of a neurological deficit are required. MATERIALS AND METHODS: An 84-year-old woman presented with back pain after falling down backward and colliding with the edge of a shelf at ground level. Considering the patient's general condition and age, she was initially treated with close observation and placement of a spinal brace with serial radiographic follow-up. RESULTS: Computed tomography found 3-column fracture at the T11 level, which is quite rare in cases of minor trauma. At a 3-week follow-up, she complained of gradual lower extremity weakness, and her general lower extremity motor function decreased to grade 1–2. The patient underwent posterior fusion 2 levels above and below the affected vertebral body (T9-10-12-L1). Surgery was uneventful and the patient's motor function recovered. CONCLUSIONS In patients with Baastrup disease affecting multiple levels of the lumbar spine, based on our experience, low-energy trauma can cause an unstable 3-column fracture with neurological compromise. We highly recommend scrutiny of the interspinous space in elderly patients, especially those with a spinal fracture caused by low-energy trauma.

STUDY DESIGN: Retrospective study. PURPOSE: To estimate the usefulness of bone scan and magnetic resonance imaging (MRI) for the diagnosis of new fracture in osteoporotic vertebral fractures. OVERVIEW OF LITERATURE: The diagnosis of new fractrure in osteoporotic vertebral fractures requires simple X-ray and supplementary studies. METHODS: We analyzed 87 vertebrae in 44 patients, who diagnosed with osteoporotic vertebral fractures using bone scan and MRI within 2 months interval between August 2001 and July 2008. We compared hot uptakes in bone scan with MRI findings such as new fractures, old fractures and degenerative lesions. RESULTS: Hot uptakes in bone scan was matched to 48 new fractures, 26 old fractures and 13 degenerative lesions in MRI findings. It was 55% of concordance between hot uptakes in bone scan and new fractures in MRI. The rate of new vertebral fractures confirmed by MRI according to 1 level hot uptakes in bone scan was 96%, 2 levels was 50% and 3 more levels was 36%. CONCLUSIONS: The diagnosis of new fracture in osteoporotic vertebral fractures requires simple X-ray and supplementary studies such as bone scan and MRI. We recommend more careful interpretation in multiple osteoporotic vertebral fracture patients about hot uptake lesions of bone scan.
Fractures, Compression ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Spine

Human carboxylesterase 1 (CES1) is a serine esterase that hydrolyzes various exogenous compounds. Single nucleotide polymorphisms (SNPs) of CES1 may lead to inter-individual metabolic variability of its substrates. The allele and haplotype frequencies of known SNPs have been demonstrated to vary among ethnic groups. We analyzed genetic variations of CES1 in a Korean population. Direct sequencing of all exons and flanking regions of the CES1 gene was performed on samples obtained from 200 Koreans. We identified 41 SNPs. The most frequent SNPs was -914G>C (frequency: 99.5%), followed by 4256G>A (frequency: 65.8%), -75T>G (frequency: 59.3%). Haplotype analysis using the identified SNPs revealed fifteen haplotypes (> or =1% haplotype frequency) in our samples. The most frequent haplotype was Hap1 (frequency: 15.4%). Among the identified 41 SNPs, nine of which are novel variants and 14 SNPs were nonsynonymous variants. Using the functional predictive software PolyPhen-2, the G19V, E221G, and A270S variants were predicted to be most likely damaging to the function and structure of CES1. In-vitro analyses for two of these variants have been previously performed; however, functional evaluation of E221G (11657A>G, rs200707504) still needs to be conducted. Therefore, further studies are warranted to characterize the functional impact of E221G on CES1 activity.
Alleles ; Asian Continental Ancestry Group ; Carboxylesterase* ; Ethnic Groups ; Exons ; Genetic Variation ; Haplotypes ; Humans ; Polymorphism, Genetic* ; Polymorphism, Single Nucleotide ; Serine

PURPOSE: To evaluate whether progression of compression correlates with bone densiometry index in patients who were treated conservatively for osteoporotic compression fracture of thoracolumbar spine. MATERIALS AND METHODS: Using the results of bone densiometry, 30 patients who were treated conservatively for osteoporotic compression fracture of thoracolumbar spine between March 2002 to March 2005 were categorized into 4 groups; above 80%, 70 to 80%, 60 to 70%, and below 60%. We compared the measurements of sagittal index and anterior vertebral height from the plain radiographs taken at the time of injury and following three consecutive months after the injury. RESULTS: Patients with lower bone densiometry index had greater amount of compression at the time of injury and more rapid progression of compression. We also found that progression of compression was lowest during the first month after injury in all groups. CONCLUSION: Patients with low bone densiometry index in osteoporotic thoracolumbar compression fracture are susceptible to more rapid progression of compression and should have early brace application and longer duration of treatment for osteoporosis.
Bone Density ; Braces ; Fractures, Compression* ; Humans ; Osteoporosis ; Spine*

PURPOSE: Idoxifene is currently entering phase II clinical trials for the treatment of advanced breast cancer. The radiolabeled idoxifene using 123I provides an opportunity for clinical pharmacology with single photon emission computed tomography (SPECT). The purpose of this study was to prepare radiolabeled idoxifene using 123I and to determine its cell uptake of breast cancer cell line. MATERIALS AND METHODS: With a view to evaluating new anticancer drugs, we are investigating the novel antiestrogen pyrrolidino- 4-iodotamoxifen (idoxifene). [123I]Idoxifene has been prepared in no-carrier-added form using a tributyl stannylated precursor which has been synthesized by means of (2-chloroethoxy)benzene with (+/-)-2- phenylbutanoic acid on the basis of previously reported standard methods. The biodistribution and dynamic behavior of the compound were investigated using the comparative breast cancer cell line, MCF-7 (estrogen receptor-positive) and MDA-MB-468 (non-estrogen receptor). RESULTS AND CONCLUSION: Acylation of (2-chloroethoxy)benzene with (+/-)-2-phenylbutanoic acid gave the versatile ketone (81%) which reacted with 1,4-diiodobenzene to give triphenylethylene as a mixture of E and Z geometric isomers, which were separated by the recrystallization in ethanol. The E-isomer was treated with pyrrolidine to give idoxifene (67%). In order to incorporate radioactive iodine into the 4-position, the 4-stannylated precursor was prepared (30%). The yield of radioiodination was 90-92% with a high radiochemical purity greater than 98%. The ratio of tumor uptake of the breast cancer cell line between MCF-7 and MDA-MB-468 was about 1.7.
Acylation ; Breast Neoplasms* ; Breast* ; Cell Line ; Estrogen Receptor Modulators ; Ethanol ; Iodine ; Pharmacology, Clinical ; Tomography, Emission-Computed, Single-Photon

STUDY DESIGN: We retrospectively reviewed the preoperative and postoperative radiographs of patients who underwent anterior cervical discectomy and fusion. OBJECTIVES: We wanted to determine whether the preoperative Magnetic Resonance Imaging (MRI) findings of the levels adjacent to the level of fusion correlated with the postoperative degenerative changes seen on X-ray after anterior cervical discectomy and fusion. SUMMARY OF LITERATURE REVIEW: Anterior cervical fusion causes acceleration of the degenerative changes at the levels below or above the fused segment. These changes may be accelerated if preoperative MRI shows degenerative changes at the levels adjacent to the segment to be fused. MATERIALS AND METHODS: Twenty-two patients (forty-four adjacent levels) who underwent anterior cervical discectomy and fusion from January 1998 to August 2002 (average follow up: 2 years and 6 months, range: 2 to 4 years) were enrolled in this study. Preoperatively, all the patients had no degenerative changes at adjacent levels on the plain radiographs, but they had at least one adjacent level with degenerative findings on MRI. The patients were grouped according to the findings of the adjacent levels seen on MRI: low signal changes on the T2 weighted image (group A), disc bulging on the sagittal and axial images (group B), annular tear seen on the axial image (group C), osteophyte formation (group D), and no abnormalities (group E). RESULTS: Out of 44 cases of 22 patients, 14 cases (31.8%) showed degenerative changes. 2 out of 7 in group A, 6 out of 11 in group B, 3 out of 4 in group C, 2 out of 3 in group D and 1 out of 19 in group E showed degenerative changes on X-rays at the final follow up. CONCLUSION: Our findings suggest that abnormalities on the levels adjacent to the level to be fused, as seen on preoperative MRI, predispose these levels to degenerative changes postoperatively.
Acceleration ; Diskectomy ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Osteophyte ; Retrospective Studies ; Tears

PURPOSE: The diagnosis of Mycoplasma pneumoniae (M. pneumoniae) infection is usually based on serology using complement fixation assay (CFA), particle agglutination test (PA), enzyme immunoassay (EIA) and polymerase chain reaction (PCR). The objective of this study is to compare the performance of EIA and PCR in diagnosis of M. pneumoniae infection. We also evaluated the usefulness of EIA which were checked on short-term follow-up (3-5 days). METHODS: We included 234 pneumonia children. We used serum specimens for EIA test, which were obtained on admission and 3-5 days after admission. We collected throat swabs or sputums for PCR test, which were obtained on admission or next morning after admission. RESULTS: Of 234 patients, 124 (53.0%) met the diagnostic criteria. The median age was 6 years (from 10 months to 12 years). On admission, the sensitivity and specificity of EIA-specific IgM were 46.1% and 72.8%, respectively. The rate of agreement between PCR and EIA was 64.1%.(kappa=0.187, P=0.004) On 3-5 days after admission, the sensitivity and specificity rates of EIA specific IgM were 85.5%, 69.6%, respectively. The rate of agreement between PCR and EIA was 74.8%.(kappa=0.490, P=0.000) Days after onset had no relation with sensitivity of EIA.(P>0.05) The sensitivity and specificity rates of PCR were 57.5% and 90.0%, respectively. CONCLUSION: This study suggests that PCR and EIA may be the useful diagnostic methods for detecting early phase of M. pneumoniae infection. And EIAs which checked on short-term follow up is also useful. PCR has shown a higher specificity but lower sensitivity. Therefore, PCR must be performed with serologic tests.
Agglutination Tests ; Child ; Complement System Proteins ; Follow-Up Studies ; Humans ; Immunoenzyme Techniques ; Immunoglobulin M ; Mycoplasma ; Mycoplasma pneumoniae ; Pharynx ; Pneumonia ; Pneumonia, Mycoplasma ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Serologic Tests ; Sputum