Osteochondritis dissecans is a condition in which part of the articular surface of a joint separates, due to a plane of cleavage through the subchondral bone. It is found most commonly in the knee although other joint can be affected, notably the elbow, ankle and hip. The etiology remains unclear, and treatment still provokes controversy in the orthopedic community. This review is confined to osteochondritis dissecans of the knee and reports the result of different methods of treatment including arthroscopic drilling. The authors experienced 7 cases of osteochondritis dissecans with received treatment at C.A.F.G.H. from May 1982 to November 1984. The results were obtained as follows: 1. Common symptoms and signs were pain, limitation of motion, quadriceps atrophy and weakness. 2. Five of six cases had histories of trauma. 3. The methods of treatment were as follows: Curettage and drilling................................................... 2 Excision ...................................................................... 2 Curettage and bone graft .............................................2 Arthroscopic drilling .................................................... 1
Ankle ; Atrophy ; Curettage ; Elbow ; Hip ; Joints ; Knee ; Orthopedics ; Osteochondritis Dissecans ; Osteochondritis ; Transplants

Cleft Lip ; Congenital Abnormalities ; Humans ; Jaw Abnormalities ; Malocclusion ; Nose ; Palate ; Rhinoplasty ; Succinates

Electromyography ; Facial Nerve ; Facial Paralysis ; Follow-Up Studies ; Humans ; Neural Conduction ; Orthognathic Surgery ; Osteotomy, Sagittal Split Ramus ; Paralysis ; Prognathism

Background: Acute pulmonary thromboembolism (APTE) is often confused with myocardial infarction. Previous studies have shown that patients with APTE exhibit lower initial and peak cardiac troponin I (CTI) levels, but higher D-dimer (DD) levels, than patients with myocardial infarction. The present study aimed to reaffirm the tree model algorithm using an entirely new set of data. Methods: We reviewed retrospective clinical and laboratory data from patients who were diagnosed with APTE or non-ST-elevation myocardial infarction (NSTEMI) between 2015 and 2016. Subjects who were not classified with a diagnosis or did not have their CTI or DD levels assessed were excluded. We categorized patients according to the previous algorithm and compared the outcomes with the previous test dataset. Results: The analysis involved data from 156 patients with APTE and 363 patients with NSTEMI. In the validation data set, the APTE group showed higher initial DD levels (9.80±10.84 μg/mL) and lower initial CTI levels (0.17±0.54 μg/mL) than the NSTEMI group. The accuracy rate for the test dataset and the validation set were similar. The test set accuracy rate was 91.0%, while the accuracy rate in the validation set improved to 88.6%. Conclusions Patients with APTE exhibited lower initial and peak CTI levels, but higher DD levels than NSTEMI patients. The accuracy rate estimates were similar between the test set obtained from the tree model algorithm and the validation set. The study findings demonstrate that the assessment of cardiac biomarkers can be useful for differentiating between APTE and NSTEMI.

Vitamin D (vit-D) is essential for bone health, although many osteoporosis patients have low levels of 25-hydroxy-vit-D [25(OH)D]. This randomized, open-label study compared the effects of once weekly alendronate 70 mg containing 5600 IU vit-D3 (ALN/D5600) to alendronate 70 mg without additional vit-D (ALN) on the percent of patients with vit-D insufficiency [25(OH)D <15 ng/mL, primary endpoint] and serum parathyroid hormone (PTH, secondary endpoint) levels in postmenopausal, osteoporotic Korean women. Neuromuscular function was also measured. A total of 268 subjects were randomized. Overall, 35% of patients had vit-D insufficiency at baseline. After 16-weeks, there were fewer patients with vit-D insufficiency in the ALN/D5600 group (1.47%) than in the ALN group (41.67%) (p<0.001). Patients receiving ALN/D5600 compared with ALN were at a significantly decreased risk of vit-D insufficiency [odds ratio=0.02, 95% confidence interval (CI) 0.00-0.08]. In the ALN/D5600 group, significant increases in serum 25(OH)D were observed at weeks 8 (9.60 ng/mL) and 16 (11.41 ng/mL), where as a significant decrease was recorded in the ALN group at week 16 (-1.61 ng/mL). By multiple regression analysis, major determinants of increases in serum 25(OH)D were ALN/D5600 administration, seasonal variation, and baseline 25(OH)D. The least squares mean percent change from baseline in serum PTH in the ALN/D5600 group (8.17%) was lower than that in the ALN group (29.98%) (p=0.0091). There was no significant difference between treatment groups in neuromuscular function. Overall safety was similar between groups. In conclusion, the administration of 5600 IU vit-D in the ALN/D5600 group improved vit-D status and reduced the magnitude of PTH increase without significant side-effects after 16 weeks in Korean osteoporotic patients.
Adult ; Aged ; Alendronate/adverse effects/*therapeutic use ; Cholecalciferol/adverse effects/deficiency/*therapeutic use ; Female ; Humans ; Middle Aged ; Osteoporosis, Postmenopausal/*drug therapy ; Vitamin D Deficiency/*drug therapy