PURPOSE: To evaluate the usefulness of the West point view, we investigated the osseous pathology of the glenoid rim associated with shoulder instability and estimate the inter-observer reliability. MATERIALS AND METHODS: The West point views of sixty-seven patients with labral lesion confirmed by operation were mixed with those of thirty-three normal controls. Six observers independently reviewed the mixed radiographs and checked the lesion by identifying the glenoid erosion, bony defect, ectopic ossification and Hill-Sachs lesion. The incidence of osseous lesions suggesting instability was estimated. Sensitivity in the patient group, specificity in the normal control and inter-observer reliability were calculated to evaluate study susceptibility. RESULTS: The sensitivity of 67 patients group was 81.8% on average (73-94%), the specificity of 33 member control group was 85.2% (82-94%). The most frequent finding was glenoid erosion, with an average of 54.7%, which providing a sensitive clue of shoulder instability. Inter-observer reliability analyzed by using Kappa values showed significant agreement. (alpha=0.1 significant level). CONCLUSION: The West point view is considered to be a reliable diagnostic modality for shoulder instability. The additional sophisticated method is indicated only when a discrepancy between physical examination and radiologic findings exists.
Humans ; Incidence ; Ossification, Heterotopic ; Pathology ; Physical Examination ; Sensitivity and Specificity ; Shoulder*

Cubitus varus deformity of the elbow may not only cause cosmetic problems, but delayed functional deficiencies also. This case report demonstrated delayed posterolateral rotatory instability due to lateral collateral ligament complex avulsion long after posttraumatic cubitus varus. Satisfactory results were obtained using cubitus varus correction and reattachment of the lateral collateral ligament complex to the lateral epicondyle of the humerus.
Congenital Abnormalities ; Elbow* ; Humerus ; Lateral Ligament, Ankle

Hyponatremia resulting from ingestion of large volumes of bowel preparation solution has been reported in patients with alternated renal water handling like renal failure or old age. Colonoscopy-induced hyponatremia was known to be related with an increase in serum arginine vasopressin concentration. Ingestion of bowel preparation solution can lead to diarrhea associated with nausea, vomiting and dehydration, often resulting in raised plasma concentrations of antidiuretic hormone. Besides, non- osmotic stimuli for arginine vasopressin concentrations can be provoked by nausea, vomiting, and intestinal hyperactivity during bowel preparation and colonoscopic procedure. We have experienced three cases of hyponatremia resulting from ingestion of bowel preparation solution for colonoscopy. The factors leading to increased arginine vasopressin secretion seem to be nausea, vomiting and intestinal hyperactivity during bowel preparation for colonoscopy.
Arginine Vasopressin ; Colonoscopy* ; Dehydration ; Diarrhea ; Eating* ; Humans ; Hyponatremia* ; Nausea ; Plasma ; Renal Insufficiency ; Vomiting

The Harris line (HL), caused by bone-growth arrest and manifesting on X-rays as a radiopaque transverse line in the metaphysis of the long bones, is an indicator reflecting stress conditions such as disease or malnutrition. HL frequency has been assumed to differ between pre-modern and modern societies, as reflective of increased caloric intake and overall nutritional improvements attendant on industrialization. To determine if such a change occurred in Korea, in the present study we compared the respective HL statuses in medieval Joseon and modern Korean population samples. HLs were found in 39.4% (28/71) of the Joseon Koreans. Whereas only 27.5% (11/40) of the males showed an HL, fully 54.8% (17/31) of the females exhibited it. Notably, HLs were observed in only 16.4% (35/213) of the modern Koreans; more remarkably still, the HL rate was almost the same between the sexes, 16.7% (20/120) for the males and 16.1% (15/93) for the females. The HL frequency was much higher in the Joseon Koreans than in their modern counterparts, reflecting the improvement of nutritional status that had been achieved in the course of South Korea's modernization. This HL-frequency decrease was much more obvious in the female populations. The higher HL frequency among the Joseon females might reflect the relatively poor nutritional condition of females in pre-modern Korean society.
Energy Intake ; Female ; Humans* ; Korea* ; Male ; Malnutrition ; Nutritional Status ; Republic of Korea ; Skeleton* ; Social Change ; Tibia

Sjogren's syndrome is an autoimmune disease causing eye or dry mouth from the lymphocytic infiltration in the lacrimal gland and the salivary gland, and is classified as primary or secondary based on the absence or presence of complicating systemic rheumatic diseases. Extraglandular systemic lesions involving organs such as the lungs, liver, and kidney are seen, and renal involvement of these is reported to occur in 20% to 50% of patients with primary Sjogren's syndrome, and most commonly manifested with a tubulointerstitial nephritis. But a little over 20 cases with glomerulonephritis have been reported in the literature review, and only one case was reported in Korea. Glomerulonephritis is a late sequelae in the course of the disease, and is most attributed to deposition of immune complexes. Membranoproliferative glomerulonephritis are the most common glomerular lesions and only one case of minimal change nephrotic syndrome was reported in the literature review, and no previous case was reported in Korea. We report a minimal change nephrotic syndrome that is concurrently manifested with sicca complex in a case of Sjogren's syndrome.
Antigen-Antibody Complex ; Autoimmune Diseases ; Glomerulonephritis ; Glomerulonephritis, Membranoproliferative ; Humans ; Kidney ; Korea ; Lacrimal Apparatus ; Liver ; Lung ; Mouth ; Nephritis, Interstitial ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Rheumatic Diseases ; Salivary Glands ; Sjogren's Syndrome*

PURPOSE: To evaluate the magnetic resonance (MR) imaging characteristics of ganglionic cysts related to thescapula. MATERIAL AND METHOD: We retrospectively reviewed 15 ganglionic cysts diagnosed by MR imaging in 14pa-tients who subsequently underwent surgical excision (n=8) or needle aspiration (n=1). Five other patients whoselesion-related symptoms were not too severe to manage underwent conservative treatment. We ana-lyzed MR findingswith regard to the size, shape and presence of internal septa, the location and signal intensity of the lesion,and associated findings such as change of rotator cuff muscle, labral tear and bone erosion. We also evaluated thepresence of tear of rotator cuff tendon, tendinosis, and subacromial enthesophyte. RESULTS: The diameter ofganglionic cysts was 0.5 -5.5 (mean, 2.8)cm, and they were round (n=2), ovoid (n=6), or elongated (n=7). Whereinternal septa were present (n=13), cysts were lobulated. Lesions were located in both scapular and spinoglenoidnotches (n=9), only in the scapular notch (n=2), only in the spinoglenoid notch (n=2) or within the bone (n=2). Ineleven cases they were very close to the superoposterior aspect of the glenoid labrum (n=11). On T1-weightedimages, all lesions were seen to be iso- or hypointense to mus-cle, while on T2-weighted images, they werehyperintense, resembling joint fluid (n=14), except in one patient with hemorrhage. Associated findings were edemaof the infraspinatus muscle (n=4), pressure erosion of the scapular neck (n=1), and labral tear (n=1). A tornsupraspinatus tendon (n=2), supraspinatus tendinosis(n=3), and subacromial enthesophyte (n=2) were also present.CONCLUSION: MR imaging was helpful in diagnosing ganglionic cysts and detecting associated lesions.
Ganglion Cysts* ; Hemorrhage ; Humans ; Joints ; Magnetic Resonance Imaging ; Neck ; Needles ; Retrospective Studies ; Rotator Cuff ; Scapula* ; Tendinopathy ; Tendons

PURPOSE: To analyze clinical and radiological results of patients who underwent treatment for a femur supracondyle fracture following total knee arthrosplasty(TKA). MATERIALS AND METHODS: Between January 1991 and March 2005, A total of 33 knees of 30 patients(2 male, 31 female knees) were treated for periprosthetic supracondyle fractures following TKA. The mean age of patients was 60.5 years and the mean follow-up period was 3.5 years(range, 1 year~9 years and 1 month). In accordance with the modified Neer classification, 3 cases were classified as Type 1; 23 cases, Type 2; 4 cases, Type 3; and 3 cases, Type 4. Treatment methods included closed reduction and cast immobilization in 8 cases, Ender nailing in 8 cases, open reduction and internal fixation in 14 cases, and total knee arthroplasty using a long stem in 3 cases. RESULTS: Among 2,325 knees with primary TKA, 33 cases occurred a supracondylar fracture. The incidence of 1.4%. The range of motion reduced from the mean of 113.1 degrees before the fracture to the mean of 94.3 degrees at the last follow-up. The conservative group reduced from 112.3 degrees to 71.9 degrees while the operative group decreased from 113.3 degrees to 102.0 degrees. The HSS knee rating score declined from the mean of 88.1 points before the fracture to the mean of 81.4 points at the last follow-up. The score of the conservative group was down to 70 points from 87.5 points and that of the operative group decreased to 85.4 points from 88.3 points. The femorotibial angle, which was 6.39 degrees of varus before the fracture, was measured 3.07 degrees of varus at the last follow-up. The femorotibial angle decreased from 6.2 degrees to 1.1 degrees of valgus in the conservative group and from 6.5 degrees to 3.7 degrees of valgus in the operative group. Only one of the total 33 cases had nonunion. CONCLUSION: In the treatment for the supracondylar fractures of TKA, the decreased amount of postoperative ROM, HSS score and femorotial angle were all less in an operative treatment than conservative treatment. Revision arthroplasty using a long stem showed satisfactory results in patients with component loosening.
Arthroplasty* ; Classification ; Female ; Femur ; Follow-Up Studies ; Humans ; Immobilization ; Incidence ; Knee* ; Male ; Periprosthetic Fractures ; Range of Motion, Articular

As a technique mainly hiring in forensic investigation field to identify the descents, craniofacial reconstruction (CFR) is also used in archaeology to create the faces from ancient or medieval human remains, when there is little information about his/her appearance. Eung-Cheok Ko (1531–1605) was a writer and scholar in the mid Joseon period. In January of 2019, His mummified body was found at Gumi, Kyeonsangbuk-do, Korea. The remains were anthropologically examined, and archaeological CFR was also requested for this case. This report reveals the case’s facial reconstruction process and his portrait that is drawn based on the 3-dimensional CFR result.

The coronavirus disease 2019 (COVID-19) pandemic has caused more than 100 million infections and 2 million deaths worldwide. In up to 20% of cases, COVID-19 infection can take a severe, life-threatening course. Therefore, preventive measures such as mask-wearing, hand hygiene, and social distancing are important. COVID-19 vaccines that use novel vaccine technology can prevent up to 95% of infections. However, the uncertainty regarding the efficacy and safety of vaccination in patients with autoimmune inflammatory rheumatic disease (AIIRD), who are immunocompromised due to underlying immune dysfunction and concomitant immunosuppressive treatment, warrants clear guidance. A task force of the Korean College of Rheumatology formulated a set of vaccination guidance based on the currently available data and expert consensus. The currently available COVID-19 vaccines are considered to be safe and effective. Every patient with AIIRD should receive one of the available COVID-19 vaccines unless contraindicated for medical reasons such as prior allergy/anaphylaxis to the COVID-19 vaccine or its components. Patients should continue immunosuppressive treatment for their underlying AIIRD, including biological and targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs). Corticosteroids should be reduced to the lowest dose possible without aggravating the AIIRD. To improve the vaccine response, methotrexate can be withheld for 1–2 weeks after each vaccination, and the timing of rituximab and abatacept infusion should be adjusted if clinically acceptable.Rheumatologists should play a leading role in educating and vaccinating patients with AIIRD.