STUDY DESIGN: The lumbar segmental motions were analysed in asymptomatic volunteers. OBJECTIVES: To obtain normative data on flexibility and Graf's instability degree in sagittal plan of the normal lumbar spine. SUMMARY OF LITERATURE REVIEW: Although several clinical and radiological measurement tech niques are available, little is known about the normal range of lumbar spine motion. As a consequence, the diagnostic evaluation of radiographs are frequently based on subject opinions rather than object reality. MATERIALS AND METHODS: The authors have checked lumbar flexion-extension Yiews of 95asymptomatic volunteers who were divided into 5 groups by the age, and then their flexibility and Graf's instability degree were calculated by Graf's method with using Graf/Bar Mark II(digitalizing table) and personal computer program(RachisR). Evaluation of the sexual difference and comparison of the difference of each age group in spine level were done RESULTS: 1. There were significant differences in flexibility among age groups(p<0.05) and highest flexibility was observed in group 1 (age: 15-19yrs) and 15-19 segment 2. Flexibility was not different between male and female(p>0.05). 3. Graf's instability degree was not different among 5 age groups(p>0.05), and between male and female(p>0.05). 4. The mean Craf's instability degree was below 8o in L2-3, L3-4, and L4-5 segment, but above 8 in L5-S1 segment(male: 11.62+/-9.27 , female. 11.11+/-8.70). CONCLUSIONS: Although we observed small subjects, these results are the basic steps toward more objective and careful interpretation of flexibilty and Graf's instability degree.
Female ; Humans ; Male ; Microcomputers ; Pliability* ; Reference Values ; Spine ; Volunteers

Congenital brachymetatarsia causes minor disability in daily life. However, patients suffer cosmetically or psychologically and often demand correction of the deformity when they reach adolescence. Thirty-eight skeletal lengthenings were performed on twenty-three patients with congenital brachymetatarsia between March 1992 and July 1993. Short metatarsal bones were osteotomized subperiosteally, and held by a small external fixator and then subjected to slow axial distraction. All the patients were female with an average age of patients at the time of operation was twenty-one years. The average lengthenings was 15.8mm. The average healing index was 80.6(day/cm). The average lengthenings percentage was 35.2%. There was a metatarso-phalangeal joint subluxation with pain in one patient. We believe that the callotasis method was no need for bone grafting and permitted early weight bearing. The result was good cosmetically.
Adolescent ; Bone Transplantation ; Congenital Abnormalities ; External Fixators ; Female ; Humans ; Joints ; Metatarsal Bones ; Methods ; Osteogenesis, Distraction ; Weight-Bearing

PURPOSE: To report the clinical, radiological and surgical findings of iliopsoas bursitis, and to suggest an indication for diagnosis and treatment. MATERIALS AND METHODS: We report two patients with iliopsoas bursitis who underwent THA in between June 1998 to June 2003. All presented with late onset hip joint discomfort, and their diagnosis were confirmed after interdepartmental consultations and with the help of investigations such as interventional angiography and MRI. Their signs, symptoms, investigations and surgical findings were reviewed retrospectively. RESULTS: Iliopsoas bursitis presented with hip pain, leg edema, palpable inguinal mass and ecchymosis, femoral nerve irritation and flexion contracture of hip. The radiographs provided no diagnostic clues but the MRI revealed a well marginated cystic lesion filled with fluid signals. Ultrasonography revealed the anatomic location that enabled guided aspiration and even ruled out vascular compromise. Two patients were treated with USG guided aspiration. One aspirate was serosanguinous and the other was old blood tinged fluid. One patient underwent surgical debridement of the cyst. Surgery revealed an intrapelvic hemorrhagic bursa with an ill-defined cystic wall and intramuscular extension into the iliacus. CONCLUSION: It is important for surgeons to rule out iliopsoas bursitis when a patient presents with vague hip pain after total hip arthroplasty without any evidence of infection or loosening. A diagnosis of iliopsoas bursitis can be made from the clinical features and ultrasonography.
Angiography ; Arthroplasty* ; Arthroplasty, Replacement, Hip* ; Bursitis* ; Contracture ; Debridement ; Diagnosis ; Ecchymosis ; Edema ; Femoral Nerve ; Hip ; Hip Joint ; Humans ; Leg ; Magnetic Resonance Imaging ; Referral and Consultation ; Retrospective Studies ; Tolnaftate ; Ultrasonography

PURPOSE: The purpose of this study is to elucidate the clinical feature of the hasbitual patella dislocation in the skeletally immature patients and evaluate the result of modified Galeazzi procedure. MATERIAL AND METHODS: From Aug, 1997 to Jan, 2002 we operated 9 knees in 7 patients. Mean age at surgery was 13.3 years. There were 3 males with 3 knees and 4 females with 6 knees. The lateral retinaculum was released and the medial retinaculum was reefed. Patella was tenodesed with semitenidinosus tendon. The operated knees were immobilized with plaster of cast for 3 weeks and progressive range of motion exercise with hinged brace was permitted. RESULTS: Based on the clinical and radiological evaluation, there were improved results. Especially congruence angle was decreased from preoperative +72 degrees to postoperative +20 degrees. There was 1 recurrence that had increased femoral anteversion and 1 arthrofibrosis that had past history of ipsilateral thigh infection. CONCLUSION: Satisfactory clinical results were obtained with modified Galeazzi procedure for treatment of habitual patella dislocation in skeletally immature patient.
Braces ; Dislocations* ; Female ; Humans ; Knee ; Male ; Patella* ; Range of Motion, Articular ; Recurrence ; Tendons ; Thigh

PURPOSE: To evaluate the results of surgical reconstruction of lateral capsule-ligament complex with reinforcement by periosteal flap of distal fibula and inferior extensor retinaculum for chronic lateral ankle instability. MATERIALS AND METHODS: From April 2003 to August 2006, 62 patients with chronic lateral ankle instability were operated. There were 38 males and 24 females with a mean age of 39.6 years (range, 18~61 years). Mean follow-up period was 32 months (range, 10~48 months). All patients were checked with preoperative ankle anteroposterior and lateral view, stress anterior drawer and varus test using Telos device. The clinical results were graded according to the VAS and AOFAS scale. RESULTS: VAS score improved from preoperative 8.2 points to 3.1 points. There were 38 patients who were excellent (above 90 points), 18 who were good (between 76 and 90 points), 5 who were fair (between 60 and 75 points), and 1 who was poor (below 60 points) according to the AOFAS ankle and hindfoot scale. The excellent and good results amounted to 90.3%. CONCLUSION: Surgical reconstruction of lateral capsule-ligament complex with reinforcement by periosteal flap of distal fibula and inferior extensor retinaculum is believed to be a effective method for chronic lateral ankle instability.
Ankle Joint ; Ankle* ; Female ; Fibula* ; Follow-Up Studies ; Humans ; Male

PURPOSE: The purpose of this article is to show the efficacy of a biodegradable plate for treating lateral malleolar fractures in the ankle joint. MATERIALS AND METHODS: The 20 patients who underwent an open reduction and internal fixation for lateral malleolar fractures in the ankle joint from February, 2006 to February, 2007 in our hospital were enrolled into the study. The average age of the patients was 49.7 years and the average follow-up period was 5.6 months. The cases were analyzed by radiological bone union time and clinical results according to the criteria of Meyer et al. RESULTS: Average radiological bone union time was 10.5 weeks. The clinical result was excellent in 19 cases (95%), good in 1 case (5%). There was one case of minimal displacement less than 1 mm, associated with anterior distal tibio-fibular ligament avulsion fracture. CONCLUSION: For proper patients, a biodegradable plate is an effecttive alternative implant for stabilizing lateral malleolar fractures in the ankle joint, because there is no requirement for subsequent removal and slow resorption in vivo.
Animals ; Ankle ; Ankle Joint ; Displacement (Psychology) ; Follow-Up Studies ; Humans ; Ligaments ; Smoking

The purpose of this study was to estimate the prevalence and to identify risk factors of overweight among preschool children in Korea. The study subjects were 750 children, aged 2-6, attending child care centers in Korea. A measurement of the height and weight of the children, as well as collection of wide range of variables including general characteristics, and potential factors related with dietary habit for children and their parents, were conducted. Overweight was defined based on more than 110% of ideal body weight. A logistic regression analysis was adopted to identify the factors associated with overweight. Subjects were classified into three categories according to the obesity index : underweight(PIBW<90%, n=34), normal(90%< or =PIBW<110%, n=577), and overweight(PIBW> or =110%, n=139). The overall prevalence of overweight and underweight of the subjects were 21.3% and 4.0% of the boys and 15.5% and 5.1% of the girls respectively. Parent's obesity was associated with a higher risk of overweight on girls. Subjects o the third quartile(girls) and fourth quartile(boys) of income level had a substantially higher risk of overweight than did those in the first quartile. Fast eating, overeating, and food prejudice were also associated with an increased risk of overweight. The results of a logistic regression analysis showed that the eating habits and food preferences of the children were the most influencial factors on overweight. These finding may imply the importance of early stage nutrition education on rational dietary habit to prevent prevailing obesity of preschool in Korea.
Child ; Child Care ; Child, Preschool* ; Eating ; Education ; Female ; Food Habits ; Food Preferences ; Humans ; Hyperphagia ; Ideal Body Weight ; Korea ; Logistic Models ; Obesity ; Overweight* ; Parents ; Prejudice ; Prevalence* ; Risk Factors ; Seoul* ; Thinness

Background: This study aimed to investigate the characteristics of research articles and research trends in computer-assisted orthopedic surgery (CAOS) by conducting bibliometric analyses. Methods: CAOS-related research articles published in international journals from 2002 to 2021 were collected using the PubMed database and analyzed using the bibliometric method. Their publication year, journal name, corresponding author’s country name, and the number of citations of all collected articles were noted. Contents of the articles were analyzed to evaluate the time point and anatomical site at which the digital technique was applied. Further, the 20-year period was divided into two halves of 10 years each to analyze the research trends. Results: A total of 639 CAOS-related articles were identified. An average of 32.0 CAOS-related articles were published annually, with an average of 20.6 and 43.3 published in the first half and second half, respectively. Of all articles, 47.6% were published in the top 10 journals, and 81.2% were written in the top 10 countries. The total numbers of citations were 11.7 and 6.3 in the first and second halves, respectively, but the average annual number of citations was higher in the second half than in the first one.Articles on application of digital techniques during surgery were 62.3% and those on pre-surgery application were 36.9%. Further, articles in the knee (39.0%), spine (28.5%), and hip and pelvis (21.5%) fields accounted for 89.0% of the total publications. But the increase in publications in the said period was highest in the fields of the hand and wrist (+1,300.0%), ankle (+466.7%), and shoulder (+366.7%). Conclusions Over the last 20 years, the publication of CAOS-related research articles in international journals has grown steadily. Although the knee, spine, hip, and pelvis fields account for most CAOS-related research, research in new fields is also increasing. This study analyzed the types of articles and trends in CAOS-related research and provided useful information for future research in the field of CAOS.

Strongyloides stercoralis is an intestinal nematode that infects a large portion of the world's population, especially in tropical areas and other hot, humid regions. In immunocompromised patients, the parasite is augmented by autoinfection, resulting in hyperinfection or systemic dissemination. Pulmonary hemorrhage is a rare presentation of Strongyloides hyperinfection. We experienced a case of Strongyloides hyperinfection with alveolar hemorrhage in an immunocompromised patient. A 63-year-old man with small cell lung carcinoma on chemotherapy presented with abdominal pain and dyspnea. He developed a pulmonary hemorrhage and migrating pneumonia 1 week later, and bronchoalveolar lavage cytology revealed helminthic larvae identified as Strongyloides. The patient received albendazole therapy for 6 weeks, and the Strongyloides hyperinfection and pneumonia were resolved.
Abdominal Pain ; Albendazole ; Bronchoalveolar Lavage ; Dyspnea ; Helminths ; Hemoptysis ; Hemorrhage ; Humans ; Immunocompromised Host ; Larva ; Middle Aged ; Parasites ; Pneumonia ; Small Cell Lung Carcinoma ; Strongyloides ; Strongyloides stercoralis ; Strongyloidiasis

Congenital anomalies of the coronary artery are associated with various symptoms including syncope, myocardial ischemia, and sudden cardiac death. The abnormality depends on the adjacent structure and pathway of the coronary artery. Most patients with an anomalous left coronary artery that arises from a right coronary sinus of the valsalva have no symptoms and are usually diagnosed at autopsy. Therefore, their first symptom might present as sudden death, particularly when the left coronary arterial course is between the aorta and the pulmonary trunk. Symptomatic patients could be diagnosed early with an anomalous coronary artery, and the risk of fatal events could be decreased by surgical correction. Here, we report the case of 62-year-old male who experienced a first episode of syncope with an anomalous left coronary artery arising from the right sinus of the valsalva with a separate orifice from the right coronary artery. He is alive and in good health receiving medical treatment, and has had no medical events for over 2 years.
Aorta ; Autopsy ; Coronary Sinus ; Coronary Vessel Anomalies ; Coronary Vessels* ; Death, Sudden ; Death, Sudden, Cardiac ; Humans ; Male ; Middle Aged ; Myocardial Ischemia ; Sinus of Valsalva ; Syncope*