No abstract available.

The radiological findings of various cervical spine fractures were analized on the basis of J.Harrisclassification. It appears to be important for the radiologist to be familiar with radiographic findings ofcervical spine fractures, particularly those of unstable fractures which can result in serious medical problems ifimproperly handled in the department of radiology. 68 cases of cervial spine fracures were analized. The resultsare as follows; 1. Stable and unstable fracures were about equal in incedence. 2. Anterior subluxation accountsfor 43.4% of stable fractures, 19% of all fractures. 3. Bilateral interfacetal dislocation accounts for 51.1% ofunstable fractures, 255 of all fractures. 4. Associated fracture were involved in skull, scapula, mandible andfemur. 5. About 80% of the patients is in third through fifth decade.
Dislocations ; Humans ; Mandible ; Scapula ; Skull ; Spine

Calcific tendinitis is most common seen within the rotator cuff of the shoulder, although it may develop around the hip, wrist, elbow, knee, forefoot, and neck. However, there has been no report in the medical literature regarding calcific tendinitis of the common extensor tendon. We present a case of a 26-year-old woman who had calcific tendinitis of the common extensor tendon. Intraoperatively, partial rupture and calcific deposit at the insertion of the common extensor tendon were seen. We were removed calcific deposit and ruptured tissue of common extensor tendon, and then ruptured common extensor tendon was sutured. The patient showed excellent result two years postoperatively with return to range in a degree of activity levels.
Adult ; Elbow ; Female ; Hip ; Humans ; Knee ; Neck ; Rotator Cuff ; Rupture ; Shoulder ; Tendinopathy ; Tendons ; Wrist

PURPOSE: To evaluate the incidence, risk factors and prognosis of delirium in elderly patients with intertrochanteric fractures of femur. MATERIALS AND METHODS: 162 patients who underwent operation for intertrochanteric fracture of femur from July 2005 to January 2007 were reviewed retrospectively. Delirium was diagnosed by using Confusion Assessment Method (CAM). Medical records were reviewed for the information of the patients, Gross motor function classification of Palisano et al. was used for the evaluation of ambulatory status. Univariate analysis and multivariate analysis were done to find out the risk factors. RESULTS: 2 cases out of 162 (1.2%) met the criteria of delirium at admission, and 39 cases (24.1%) after surgery. Univariate analysis and multivariate analysis identified age, hematocrit, dementia, the duration of opiate use, and pulmonary complication as risk factors. Hospital stay was longer and postoperative ambulatory status was worse in the patients with delirium. CONCLUSION: Delirium is a frequent complication of intertrochanteric fractures of old age and associated with worse results. Cognitive function as well as physical status should be evaluated before and after surgery. Delirium needs more active prevention and treatment for better results.
Aged ; Delirium ; Dementia ; Femur ; Hematocrit ; Hip Fractures ; Humans ; Incidence ; Length of Stay ; Medical Records ; Multivariate Analysis ; Prognosis ; Retrospective Studies ; Risk Factors

Patellofemoral joint problems refer to a spectrum of conditions affecting the patellofemoral joint, which is the joint between the patella and femur. These conditions can cause pain and instability in the knee and affect an individual’s ability to perform daily activities. Patellofemoral joint problems commonly cause knee pain, particularly among young athletes and physically active individuals. This review article discusses current patellofemoral joint problems, including their epidemiology, pathophysiology, diagnosis, and management.Current Concepts: Patellofemoral joint problems are presented as clinical symptoms of pain and instability. Dividing the diagnostic criteria into anterior knee pain, patella instability, and patellofemoral arthritis is useful. Anterior knee pain is diagnosed after excluding possible causes. Patellar instability is classified into recurrent dislocation, habitual dislocation (extension and flexion types), and permanent dislocation. Moreover, patellar instability can progress to the final stage of patellofemoral arthritis. Thus, patellar instability should be treated according to the Dejour criterion, and patellofemoral arthritis treatment requires artificial joint replacement surgery.Discussion and Conclusion: The pathological mechanism of patellofemoral joint problems still needs to be properly established, and multifactorial causes make it difficult to treat patellofemoral joint problems. Accurate diagnosis is considered an essential factor for successful treatment.

In order to investigate the anti-proliferative effect of 3-hydroxy-3-methylglutaryl coenzyme. A reductase inhibitor, we evaluated the effects of lovastatin on DNA replication and the proliferation of rat mesangial and aortic smooth muscle cells, both of which were mesenchymal origin cells. Proliferations were determined by measuring [3H]thymidine uptake, and counting the number of cells. Growth-arrested mesangial and aortic smooth muscle cells were exposed to platelet-derived growth factor (PDGF), endothelin (ET) and angiotensin II (Ang II) to stimulate mitogenesis. All agents exhibited dose-dependent stimulation of [3H] thymidine uptake. PDGF was more potent than the others. Ang II increased [3H] thymidine uptake without demonstrable mitogenic activity. Lovastatin inhibited PDGF (10 ng/ml in mesangial cell, 25 ng/ml in smooth muscle cell)-, ET (10(-7)M)- and Ang II (10(-7)M)-induced [3H] thymidine uptake significantly in a dose-dependent manner in both cells. The increase of cell number in response to PDGF and ET treatment were also inhibited at 10 microM of lovastatin. The inhibitory effect of lovastatin was largely overcome in the presence of exogenous mevalonate at 200 microM, with 75.5% restoration from lovastatin-induced inhibition on PDGF-induced [3H] thymidine uptake in mesangial cells (77.8% in aortic smooth muscle cells). However, the addition of cholesterol did not prevent inhibition by lovastatin. In conclusion, lovastatin had an inhibitory effect on mesangial and aortic smooth muscle cell proliferation, and mevalonate was essential for DNA replication in both types of cells. Lovastatin may reduce glomerular and atherosclerotic injury through an anti-proliferative effect on mesangial and vascular smooth muscle cells, in addition to lowering circulating lipids.
Angiotensin II/pharmacology ; Animal ; Aorta/cytology/drug effects ; Cell Division/drug effects ; Cells, Cultured ; Endothelins/pharmacology ; Glomerular Mesangium/cytology/*drug effects ; Lovastatin/*pharmacology ; Male ; Muscle, Smooth, Vascular/cytology/*drug effects ; Platelet-Derived Growth Factor/pharmacology ; Rats ; Rats, Sprague-Dawley ; Support, Non-U.S. Gov't ; Thymidine/metabolism

PURPOSE: The authors evaluated the differences between K-wires and Bold screw for fixing the proximal metatarsal chevron osteotomy of moderate and severe hallux valgus. MATERIALS AND METHODS: There were 59 patients (81 feet) who were moderate and severe degree hallux valgus according to the classification of Mann. They all got the proximal chevron osteotomy when correcting the deformity. All patients were followed up at least 6 months. We divided the patients into 2 groups, K-wires fixed group as A, Bold screw fixed group as B. Group A were 42 patients (63 feet) and Group B were 18 patients (19 feet). Among the Group B, 2 feet who were failed to fix the oetotomy site with Bold screw, were fixed with K-wires during operation. We measured the AOFAS score preoperatively, postoperatively and at final follow-up, VAS score at 2 weeks after the operation. Also preoperative, postoperative and follow-up hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured for each patients. RESULTS: Mean follow up period was 1.34 year (range: 6 months-6.16 years). Mean VAS score of group A was 3.21+/-1.7 and group B 1.76+/-1.0. Preoperative mean AOFAS score of group A was 45.61+/-8.3, group B 44.41+/-8.9, the final mean score of group A was 88.87+/-8.3 and group B 92.47+/-4.4. Preoperative mean HVA was 30.82+/-6.6 degrees in group A and 32.88+/-14.5 degrees in group B, the final mean angle of group A was 14.89+/-8.3 degrees and group B 17+/-4.4 degrees. The preoperative mean IMA of group A was 13.69+/-3.6 degrees and group B 12.35+/-5.2, the final mean angle of group A was 9.26+/-3.6 degrees and group B 12.35+/-5.8 degrees. CONCLUSION: There were no statistical differences in radiologic and clinical results (p>0.05) but, group B exceeded group A in VAS score (p=0.0007) and had no statistical significance in terms of reduction angle loss (p=0.06). Early returning to normal life activity may be possible for patients using Bold screws.
Congenital Abnormalities ; Follow-Up Studies ; Foot ; Hallux ; Hallux Valgus ; Humans ; Metatarsal Bones ; Osteotomy

BACKGROUND: PVD is a risk marker for coronary disease, cerebrovascular disease and many other conditions. One of the simplest, noninvasive and most useful parameters to objectively assess PVD is the ankle-brachial index (ABI). The aim of our study was to explore the frequency, severity and the risk factors of peripheral vascular disease in dialysis patients, especially according to dialysis modality. METHODS: We studied 85 maintenance dialysis patients (HD 50 patients, PD 35 patients) and control (n=73) who has normal serum creatinine without DM, hypertension. ABI was tested during about 2 hrs into the hemodialysis by doppler ultrasono (Smartdop 30, HADECO, Japan). The severity of PVD was stratified into 3 groups based upon ABI [normal (0.9< or =ABI<1.5), moderate (0.5< or =ABI<0.9), severe (ABI< 0.5)]. RESULTS: ABI was significantly lower in the dialysis patients than control (0.85+/-0.23 vs 1.13+/-0.25, p<0.001). HD patients had lower ABI (0.80+/-0.24 vs 0.94+/-0.18, p<0.01) and lower BMI (corrected by PD dialysate weight; 21.9+/-3.6 vs 24.0+/-3.3, p<0.05) compared with PD patients. DM pts (%), hypertension pts (%), age, duration of dialysis and smoking amount were not different between HD and PD pts. The patients number of major PVD was significantly higher in HD than PD (14% vs 0%, p<0.001). Univariate regression analysis in dialysis pts demonstrated that old age (> or =55 yrs), duration of dialysis and HD were negatively correlated with ABI: r= -0.309; p<0.01 for HD modality. Multiple regression analysis demonstrated that HD modality (than PD) predicted ABI with an adjusted R2=0.206 and p<0.01. CONCLUSION: We conclude that ABI was significantly decreased in HD pts than PD pts. The frequency of severe PVD was significantly higher in HD pts than PD pts. These findings suggest that dialysis modality may be related to the severity of PVD in the maintenance dialysis patients. Further studies are needed to understand the association between PVD and nutrition factors, inflammation markers and dialysis- or uremia-related factors in maintenance dialysis patients.
Ankle Brachial Index ; Coronary Disease ; Creatinine ; Dialysis* ; Humans ; Hypertension ; Inflammation ; Peripheral Vascular Diseases* ; Renal Dialysis ; Risk Factors* ; Smoke ; Smoking

STUDY DESIGN: A radiographic study of normal subjects. OBJECTIVES: To analyze sagittal spinal parameters according to the size of pelvic incidence (PI). SUMMARY OF LITERATURE REVIEW: There has been no previous study about the classification of spinopelvic parameters that has used a large cohort of asymptomatic older men with the same ethnic background as those in the current study. MATERIALS AND METHODS: We examined 160 males aged over 50 without disease, trauma, or history of operation on spine or lower extremities. Sagittal standing radiographs of the whole spine on 36-inch film were taken. Group 1 (n=30) had a PI of less than 40degrees. Group 2 (n=71) had PI between 40degrees and 50degrees, and group 3 (n=59) had a PI greater than 50degrees. Thoracic kyphosis, thoracolumbar kyphosis, lumbar lordosis, the vertebral slope of T12, sacral slope, and pelvic incidence were measured. The distances from the plumb line of C7, T12, and the lumbar apex to the posterosuperior corner of the sacrum were also measured. RESULTS: Subjects' average age was 64.1(53~83).Lumbar lordosis, sacral slope and pelvic tilt were all significantly increased in group 3. Thoracic kyphosis and the vertebral slope of T12 were not different between groups. The distances from the plumb line of C7, T12, and the lumbar apex to the posterosuperior corner of the sacrum were significantly translated anteriorly in group 3. CONCLUSIONS: Group 3, who had the largest PI, demonstrated the largest lumbar lordosis and the most forward transition of trunk. However there were no differences in thoracic kyphosis and the vertebral slope of T12 among the three groups.
Aged ; Animals ; Cohort Studies ; Humans ; Incidence ; Kyphosis ; Lordosis ; Lower Extremity ; Male ; Pelvis ; Sacrum ; Spine

PURPOSE: Expression levels of tumor necrosis factor (TNF)-alpha expression on the mucosa of the small intestine is increased in patients with villous atrophy in food protein-induced enterocolitis syndrome (FPIES). TNF-alpha has been reported to induce apoptotic cell death in the epithelial cells. We studied the TNF family and TNF-receptor family apoptosis on the duodenal mucosa to investigate their roles in the pathogenesis of FPIES. METHODS: Fifteen infants diagnosed as having FPIES using standard oral challenge test and 5 controls were included. Terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) staining was performed to identify the apoptotic cell death bodies. Immunohistochemical staining of TNF-alpha, Fas ligand (FasL) for TNF family and TNF-related apoptosis-including ligand (TRAIL) receptor 1 (DR4), TRAIL receptor 2 (DR5), and Fas for TNF-receptor family were performed to determine the apoptotic mechanisms. RESULTS: TUNEL+ was significantly more highly expressed in the duodenal mucosa of FPIES patients than in controls (P=0.043). TNF-alpha (P=0.0001) and DR4 (P=0.003) were significantly more highly expressed in FPIES patients than in controls. Expression levels of FasL, Fas, and DR5 were low in both groups and were not significantly different between the 2 groups. CONCLUSION: These results suggest that FPIES pathogenesis is induced by apoptosis, and that TNF-alpha expression and DR4 pathway may have an important role in apoptosis.
Apoptosis ; Atrophy ; Cell Death ; Enterocolitis ; Epithelial Cells ; Fas Ligand Protein ; Humans ; Infant ; Intestine, Small ; Mucous Membrane ; Receptors, TNF-Related Apoptosis-Inducing Ligand ; Tumor Necrosis Factor-alpha ; Up-Regulation