BACKGROUND: Diagnosing impingement syndrome without rotator cuff tear usually depends on the physical examination and roentgenography, and obtaining objective evidence for this condition is at best difficult. The purpose of this study was to ascertain whether quantitatively assessing this condition with using single photon emission computerized tomography (SPECT) can diagnose impingement syndrome and predict the postoperative results. METHODS: Before executing arthroscopic or open treatment, SPECT was performed on 73 patients and 24 volunteers and these people were followed up for 2 years. Any increased uptake on SPECT was investigated by using the axial view, which demonstrated the greatest uptake for the acromion, distal clavicle, greater tuberosity, lesser tuberosity and the coracoid process of the operated and non-operated sides. RESULTS: The patients who were diagnosed as having impingement syndrome with or without rotator cuff tear showed increased uptake on the operative side compared to the non-operated side in the assessed locations. The greater tuberosity of the humerus could be used for quantitative measurement as a postoperative prognostic factor. CONCLUSIONS: The bone SPECT method is useful for making the diagnosis of patients with impingement sydrome, and the results of quantitative assessment at the greater tuberosity can be used for evaluating the prognosis following the operation.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Humeral Head/*radionuclide imaging ; Male ; Middle Aged ; Pain Measurement ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Rotator Cuff/*injuries ; Shoulder Impingement Syndrome/physiopathology/*radionuclide imaging/surgery ; *Tomography, Emission-Computed, Single-Photon

Malignant salivary gland tumors only represent 0.08% of all childhood tumors and mucoepidermoid carcinoma (MEC) is the most common histologic type. Although there are many reports describing second malignant neoplasm (SMN) in patients treated for childhood cancer, salivary gland tumors rarely appears. In Korea, there has been no report about MEC that developed in children as a SMN. We report a MEC in a 4 years and 8 months old female child that developed after completing treatment for yolk sac tumor of lower abdomen. The primary tumor presented with metastasis at the time of diagnosis, and therefore, the child underwent high-dose chemotherapy with autologous peripheral blood stem cell transplantation along with surgery and radiotherapy. Three years and five months after completing treatment, MEC developed in her submandibular gland. She was treated with surgery and radiotherapy and is in disease free state for 5 months at the time of this writing.
Abdomen ; Carcinoma, Mucoepidermoid ; Child ; Diagnosis ; Drug Therapy ; Endodermal Sinus Tumor ; Female ; Humans ; Korea ; Neoplasm Metastasis ; Peripheral Blood Stem Cell Transplantation ; Radiotherapy ; Salivary Gland Neoplasms ; Salivary Glands ; Submandibular Gland ; Writing

No abstract available.
Shoulder*

OBJECTIVES: We aimed to compare and distinguish the characteristics of anaphylaxis and angioedema, especially with oral mucosal involvement and treatment of patients who visited the Pediatric Emergency Department. METHODS: We retrospectively analyzed patients under age 18-year-old who were diagnosed with anaphylaxis and angioedema with oral mucosal involvement and treated with epinephrine from May 2008 to May 2013 in a single Pediatric Emergency Department in Seoul, Korea. We evaluated their past history, possible triggering causes, symptoms, vital signs and treatment and discharge with education. RESULTS: During the study period the total cases of anaphylaxis were 79 and angioedema with oral mucosal involvement were 218. The age of patients with anaphylaxis was significantly higher (6.6+/-4.9 years vs. 4.1+/-3.3 years). The heart rate relative to age was significantly higher in the anaphylaxis group (49.4% vs. 36.2%). After discharge from the Emergency Center, 3.8% of anaphylaxis patients were prescribed an epinephrine injection. Education to avoid the triggering factor was provided in 32.9% of anaphylaxis group and 17.4% in the angioedema group. CONCLUSION: Besides blood pressure, we should pay attention to the heart rate in pediatric patients with severe allergic reactions. More active follow-up of anaphylaxis and angioedema with oral mucosal involvement is needed to educate parents and prescribe emergency medication.
Adolescent ; Anaphylaxis* ; Angioedema* ; Blood Pressure ; Child ; Education ; Emergencies ; Emergency Service, Hospital* ; Epinephrine ; Heart Rate ; Humans ; Hypersensitivity ; Korea ; Parents ; Retrospective Studies ; Seoul ; Vital Signs

BACKGROUND/AIMS: Inflammatory bowel disease (IBD) management guidelines have been released from Western countries, but no adequate data on the application of these guidelines in Asian countries and no surveys on the treatment of IBD in real practice exist. Since there is a growing need for a customized consensus for IBD treatment in Asian countries, Asian Organization of Crohn's and Colitis performed a multinational survey of medical doctors who treat IBD patients in Asian countries. METHODS: A questionnaire was developed between August 2013 and November 2013. It was composed of 4 domains: personal information, IBD diagnosis, IBD treatment, and quality of IBD care. Upon completion of the questionnaire, a web-based survey was conducted between 17 March 2014 and 12 May 2014. RESULTS: In total, 353 medical doctors treating IBD from ten Asian countries responded to the survey. This survey data suggested a difference in available medical treatments (budesonide, tacrolimus) among Asian countries. Therapeutic strategies regarding refractory IBD (acute severe ulcerative colitis [UC] refractory to intravenous steroids and refractory Crohn's disease [CD]) and active UC were coincident, however, induction therapies for mild to moderate inflammatory small bowel CD are different among Asian countries. CONCLUSIONS: This survey demonstrated that current therapeutic approaches and clinical management of IBD vary among Asian countries. Based on these results and discussions, we hope that optimal management guidelines for Asian IBD patients will be developed.
Asia* ; Asian Continental Ancestry Group* ; Colitis* ; Colitis, Ulcerative ; Consensus ; Crohn Disease ; Diagnosis ; Hope ; Humans ; Inflammatory Bowel Diseases* ; Seoul* ; Steroids

In this article, the third author's name was spelled incorrectly.

In this article, the third author's name was spelled incorrectly.

STUDY DESIGN: A retrospective study OBJECTIVES: To evaluate the clinical and radiological results of a transforaminal lumbar interbody fusion for the treatment of non-union after a posterolateral spinal fusion. LITERATURE REVIEW SUMMARY: In the case of nonunion after a posterolateral spinal fusion, the anterior column should be reconstructed. However, due to epidural scarring and fibrosis, the approach to the anterior column by conventional posterior lumbar interbody fusion (PLIF) is difficult. The authors have modified the original transforaminal lumbar interbody fusion (TLIF) developed by Dr. Harms, which offers potential advantages and provides a surgical alternative to the traditional methods. MATERIALS AND METHODS: Between January 2002 and August 2003, 10 cases of TLIF for the treatment of non-unions after a posterolateral spinal fusion were performed. There were 8 male and 2 female cases. The mean age of the patient was 63.3 years, ranging from 53 to 75 years. The levels of the TLIF were the L4-5 and L5-S1 in 9 and 1 cases, respectively. The mean interval between the revision and previous operations was 21.3 months, ranging 12 to 48 months. In the preoperative radiography, bony defect in posterolateral fusion mass, halos around screws and abnormal motions in the stress view were observed. Using the previous midline approach, exposure of the bilateral articular and transverse processes were performed. With a small osteotome, the superior articular process was removed along a line parallel to the superior margins of the pedicular screw head, to allow access to the neural foramen and lateral aspect of the disc space. The TLIF was performed through this space by inserting cages. The loosened screw was replaced by one that was thicker, coupled with a cancellous bone graft in the foramen. RESULTS: The average operation time and blood loss were 224 min. and 727 cc, respectively. Using Kirkaldy-Willis categories, the results were excellent in 1 case, good in 7, fair in 1 and poor in a further 1 case, with 1 case of nonunion was observed postoperatively. CONCLUSIONS: The transforaminal lumbar interbody fusion for the treatment of nonunion after a posterolateral spinal fusion is a reliable and safe technique, which seems to have the merit of less morbidity.
Cicatrix ; Female ; Fibrosis ; Head ; Humans ; Male ; Radiography ; Retrospective Studies ; Spinal Fusion ; Transplants

STUDY DESIGN: A retrospective study OBJECTIVES: To evaluate the clinical and radiological results of a transforaminal lumbar interbody fusion for the treatment of non-union after a posterolateral spinal fusion. LITERATURE REVIEW SUMMARY: In the case of nonunion after a posterolateral spinal fusion, the anterior column should be reconstructed. However, due to epidural scarring and fibrosis, the approach to the anterior column by conventional posterior lumbar interbody fusion (PLIF) is difficult. The authors have modified the original transforaminal lumbar interbody fusion (TLIF) developed by Dr. Harms, which offers potential advantages and provides a surgical alternative to the traditional methods. MATERIALS AND METHODS: Between January 2002 and August 2003, 10 cases of TLIF for the treatment of non-unions after a posterolateral spinal fusion were performed. There were 8 male and 2 female cases. The mean age of the patient was 63.3 years, ranging from 53 to 75 years. The levels of the TLIF were the L4-5 and L5-S1 in 9 and 1 cases, respectively. The mean interval between the revision and previous operations was 21.3 months, ranging 12 to 48 months. In the preoperative radiography, bony defect in posterolateral fusion mass, halos around screws and abnormal motions in the stress view were observed. Using the previous midline approach, exposure of the bilateral articular and transverse processes were performed. With a small osteotome, the superior articular process was removed along a line parallel to the superior margins of the pedicular screw head, to allow access to the neural foramen and lateral aspect of the disc space. The TLIF was performed through this space by inserting cages. The loosened screw was replaced by one that was thicker, coupled with a cancellous bone graft in the foramen. RESULTS: The average operation time and blood loss were 224 min. and 727 cc, respectively. Using Kirkaldy-Willis categories, the results were excellent in 1 case, good in 7, fair in 1 and poor in a further 1 case, with 1 case of nonunion was observed postoperatively. CONCLUSIONS: The transforaminal lumbar interbody fusion for the treatment of nonunion after a posterolateral spinal fusion is a reliable and safe technique, which seems to have the merit of less morbidity.
Cicatrix ; Female ; Fibrosis ; Head ; Humans ; Male ; Radiography ; Retrospective Studies ; Spinal Fusion ; Transplants

PURPOSE: To assess the meaning of the unstable intertrochanteric fracture of femur with involvement of lateral cortex by analysing the radiologic result of the surgical treatment using a compression hip screw. MATERIALS AND METHODS: Classifing patients (who has taken the surgical treatment for intertrochanteric fracture of femur using compression hip screw from January 1999 to June 2002) in our hospital with 24 patients who had not much difference statistically in the compression screw located within the femur, Tip-Apex distance (TAD) the Singh Numerical Value of osteoporosis. The results were divided into two groups, group A (without fracture extends through lateral cortex of femur: 16 cases) and B (fracture extends through lateral cortex of femur: 8 cases), when analyzing it. And then analyzed the final examination in the evaluation of electrical potential level by radiology, change of the inside and outside of neck-shaft angle, descent level of the screw and the change of the neck-shaft angle. RESULTS: In the latest follow up, the sliding amount of the screw in group B, the average was 14.9+/-9.3 mm, and 6.7+/-3.6 mm in group A. There was no difference statistically (p value>0.05). In the varus change in group B, the average was 8.00+/-8.12degrees and in group A it ws 2.75+/-2.63degrees There was statistical difference(p value<0.05). In displacement after operation, it was 7.60+/-2.61 mm in group B and 0.5+/-1.80 mm in group A. There was statistical difference (p value<0.05). CONCLUSION: The intertrochanteric fracture with involvement of lateral cortex of femur have to be considered as unstable fracture having tendency of displacement.
Femur ; Follow-Up Studies ; Hip* ; Humans ; Osteoporosis