No abstract available.
Gerbillinae

Patello-femoral problem is one of the common complications in total knee arthroplasty and whether to replace the patella or retain it has long been controversial in order to prevent the complications. 43 cases (35 patients) of total knee arthroplasty with patellar retention performed by a single surgeon between August 1993 and August 2000 were reviewed retrospectively. The follow-up period averaged 54 months (range, 24-120 months). The whole cases were divided into three groups according to the preoperative radiographs. Group A was normal patella (10 knees), Group B was borderline arthritic patella (20 knees), and Group C was severely deformed patella (13 knees). All of 43 knees, regardless of preoperative radiological degree of arthritis received patelloplasty including removal of osteophytes, subchondral shaving and lateral retinacular release was performed in 20 knees (47%). Each groups was evaluated in terms of the objective criteria of anterior knee pain, range of motion, stair climbing ability, and roentgenographic findings. All 35 patients were diagnosed as osteoarthritis in 29 and rheumatoid arthritis in 6. American Knee Society Score (KSS) was assessed for the clinical analysis and lateral patella shift and patella tilt were assessed for roentgenographic analysis. The mean Knee Society Score at final follow-up was 94 in group A, 93 in group B, and 94 in group C. Mild anterior knee pain was reported in 9.3% (Group A: 2 cases, Group C: 2 cases). patellar tilt was significantly higher in C group (oneway ANOVA test, p=0.01), representing that advanced patello-femoral arthritis caused increased patellar tilt. There was neither significant difference in terms of range of motion, and stair climbing ability nor of patellar shift among all three groups. TKA with patelloplasty, not resurfacing the patella, provided satisfactory results without significant problems regardless of the preoperative degree of patello-femoral arthritis.
Arthritis ; Arthritis, Rheumatoid ; Arthroplasty* ; Follow-Up Studies ; Humans ; Knee* ; Osteoarthritis ; Osteophyte ; Patella ; Range of Motion, Articular ; Retrospective Studies

PURPOSE: To evaluate the factors influencing periosteal interposition in distal tibial physeal fractures of children. MATERIALS AND METHODS: 34 cases of distal tibial physeal fractures were analysed. We confirmed the presence of periosteal interposition with MRI in all cases and accessed the relationship between periosteal interposition and gender, age, cause of injury, type of fracture, degree of initial displacement and after closed reduction. RESULTS: 9 (26.5%) of 34 fractures had interposed periosteum. There was no statistically significant correlation between periosteal interposition and gender, age, cause of injury (p>0.05). 5 (83.3%) of 6 pronation-eversion-external rotation type of fractures according to Dias-Tachjian classification had interposed periosteum and that was a statistically significant correlation (p=0.006). As Salter-Harris type was toward to high degree, there were decreasing tendency of periosteal interposition (p=0.026). There was high rate of periosteal interposition in case of displacement more than 2 mm in each initial and after closed reduction (p<0.05). CONCLUSION: There was high incidence of periosteal interposition in pronation-eversion-external rotation type with displacement more than 2 mm in distal tibial physeal fractures of children. But, periosteal interposition could occur in fractures with mild displacement less than 2 mm, if initial fracture displacement was more than 2 mm, the methods of treatment should be decided after confirm the presence of periosteal interposition with MRI after closed reduction.
Child ; Displacement (Psychology) ; Humans ; Incidence ; Periosteum

PURPOSE: The aim of this study was to validate the Glasgow-Blatchford score and the pre-endoscopic Rockall score to assess their ability to predict the presence of active bleeding in emergency department patients with suspected upper gastrointestinal bleeding. METHODS: We reviewed and extracted data from electronic medical records on patients presenting with a suspicion of acute upper gastrointestinal bleeding at our emergency department from January 1, 2012 to December 31, 2012. For each patient we calculated the Glasgow-Blatchford score and the pre-endoscopic Rockall score. Discriminative ability of the scoring systems for predicting active bleeding was evaluated by receiver operator characteristic (ROC) curve analysis. RESULTS: We identified 636 patients with upper gastrointestinal bleeding. There were 118 (18.6%) patients with active bleeding and 520 (81.8%) patients with need for intervention. The ROC curve analysis showed poor discriminative ability of the Glasgow-Blatchford score and the pre-endoscopic Rockall score for determining the presence of active bleeding (area under the curve (AUC)=0.546, 95% confidence interval (CI) 0.490-0.602 vs. 0.576, 95% CI 0.523-0.630; p=0.34). The sensitivity and the specificity of the two scoring systems were suboptimal. However, the Glasgow-Blatchford score outperformed the pre-endoscopic Rockall score in predicting the need for clinical intervention (AUC=0.867, 95% CI 0.831-0.903 vs. 0.698, 95% CI 0.643-0.754; p<0.001). CONCLUSION: The Glasgow-Blatchford score was superior in predicting the need for intervention in emergency department patients with suspected gastrointestinal hemorrhage. However, these clinical decision rules may be insufficient to predict the presence of active bleeding.
Electronic Health Records ; Emergency Service, Hospital* ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Hemostasis ; Humans ; ROC Curve ; Sensitivity and Specificity ; Upper Gastrointestinal Tract

Encephalitis associated with antibodies to the N-methyl-D-aspartate (NMDA) receptor has variable clinical manifestations and treatment responses. Anti-NMDAR encephalitis is often associated with ovarian teratoma, but some cases without tumor have been reported. Here, we describe a patient who has shown psychiatric symptoms, memory impairment and been diagnosed as schizophrenia for one year and had anti-NMDA receptor antibody. The patient showed atypical clinical course compared to previous cases with anti-NMDA receptor encephalitis.
Anti-N-Methyl-D-Aspartate Receptor Encephalitis ; Antibodies ; Encephalitis ; Humans ; Memory ; N-Methylaspartate ; Schizophrenia ; Teratoma

PURPOSE: To compare the various imaging techniques including application of magnetization transfer(MT), administration of IV contrast materials, and imaging time after injection of contrast materials in 3D time-of-flight(TOF) cerebral magnetic resonance angiography(MRA) in normal volunteers. MATERIALS AND METHODS: Each of 11 healthy volunteers was prospectively studied with 3D TOF cerebral MRA using various imaging parameters. Various parameters of 3D TOF MRA were 1) pre-enhanced magnetization transfer(MT), 2) postenhanced MT, immediate phase, 3) postenhanced MT, 10-minutes delayed phase, 4) postenhanced MT, 20-minutes delayed phase, 5) pre-enhanced non-MT, 6) postenhanced non-MT, immediate phase, 7) postenhanced non-MT, 10-minutes delayed phase, 8) postenhanced non-MT, 20-minutes delayed phase. Image qualities of various parameters were compared with regard to depiction of cerebral arteries and veins by visual assessment For statistical analysis paired t-test was used. RESULTS: In pre-enhanced MRA, images with MT mode were better in arterial visualization than those with :n0n-MT mode(p<0.01). Postenhanced MT and non-MT images were better in arterial and venous visualization !than pre-enhanced MT and non-MT images(p<0.01), respectively. Images obtained immediately after injection of contrast material were better in both arterial and venous visualization than delayed images(p<0.01). CONCLUSION: Postenhanced cerebral 3D TOF MRA with MT obtained immediately after injection of contrast materal is the best to increase visualization of both cerebral arteries and veins, and may be indicated in some cranial vascular diseases.
Angiography* ; Brain* ; Cerebral Arteries ; Contrast Media ; Healthy Volunteers* ; Prospective Studies ; Vascular Diseases ; Veins

PURPOSE: To overcome the potential disadvantages of the use of foreign materials and autologous fat or collagen, we introduce here an autologous plasma gel for injection laryngoplasty. The purpose of this study was to present a new injection material, a plasma gel, and to discuss its clinical effectiveness. MATERIALS AND METHODS: From 2 mL of blood, the platelet poor serum layer was collected and heated at 100degrees C for 12 min to form a plasma gel. The plasma gel was then injected into a targeted site; the safety and efficacy thereof were evaluated in 30 rats. We also conducted a phase I/II clinical study of plasma gel injection laryngoplasty in 11 unilateral vocal fold paralysis patients. RESULTS: The plasma gel was semi-solid and an easily injectable material. Of note, plasma gel maintains the same consistency for up to 1 year in a sealed bottle. However, exposure to room air causes the plasma gel to disappear within 1 month. In our animal study, the autologous plasma gel remained in situ for 6 months in animals with minimal inflammation. Clinical study showed that vocal cord palsy was well compensated for with the plasma gel in all patients at two months after injection with no significant complications. Jitter, shimmer, maximum, maximum phonation time (MPT) and mean voice handicap index (VHI) also improved significantly after plasma gel injection. However, because the injected plasma gel was gradually absorbed, 6 patients needed another injection, while the gel remained in place in 2 patients. CONCLUSION: Injection laryngoplasty with autologous plasma gel may be a useful and safe treatment option for temporary vocal cord palsy.
Adult ; Aged ; Aged, 80 and over ; Animals ; *Blood Platelets ; Female ; Humans ; Laryngoplasty/*methods ; Male ; Middle Aged ; Plasma/*physiology ; Rats

PURPOSE: Interleukin 1 receptor antagonist(IL-1ra) is an endogenous antiinflammatory agent that binds to IL-1 receptor and thus competitively inhibits the binding of IL-1alpha and IL-1beta. Allele 2 in association with various autoimmune diseases has been reported. In order to evaluate the influence of IL-1ra gene VNTR polymorphism on the susceptibility to HSP and its possible association with disease severity, manifested by severe renal involvement and renal sequelae, we studied the incidence of carriage rate and allele frequency of the 2 repeats of IL-1ra allele 2(IL1RN*2) of the IL-1ra gene in children with HSP with and without renal involvement. METHODS: The IL-1ra gene polymorphisms were determined in children with HSP with(n= 40) or without nephritis(n=34) who had been diagnosed at Busan Paik Hospital and the control groups(n=163). Gene polymorphism was identified by PCR amplification of the genomic DNA. RESULTS: The allelic frequency and carriage rate of IL1RN*1 were found most frequently in patients with HSP and in controls. The allelic frequency of IL1RN*2 was higher in patients with HSP compared to that of controls(4.7% vs. 2.5%, P=0.794). The carriage rate of IL1RN*2 was higher in patients with HSP compared to that of controls(8.1% vs. 6.8%, P= 0.916). The allelic frequency of IL1RN*2 was higher in patients with HSP nephritis compared to that of HSP(6.3% vs.2.9%, P=0.356). The carriage rate of IL1RN*2 was higher in patients with HSP nephritis compared to that of HSP(10.0% vs. 5.9%, P=0.523). Among 13 patients with heavy proteinuria(>1.0 g), 11 had IL1RN*1, 1 had IL1RN*2 and the others had IL1RN*4. At the time of last follow up 4 patients had sustained proteinuria and their genotype was IL1RN*1. CONCLUSION: The allelic frequency and carriage rate of IL1RN*1 were found most frequently in patients with HSP and in controls. Our study suggests that the carriage rate and allele frequency of the 2-repeats of IL-1ra allele 2(IL1RN*2) of the IL-1ra gene may not be associated with susceptibility and severity of renal involvement in children with HSP.
Alleles ; Autoimmune Diseases ; Busan ; Child* ; DNA ; Follow-Up Studies ; Gene Frequency ; Genotype ; Humans ; Incidence ; Interleukin 1 Receptor Antagonist Protein ; Interleukin-1* ; Interleukins* ; Nephritis* ; Polymerase Chain Reaction ; Proteinuria ; Purpura, Schoenlein-Henoch* ; Receptors, Interleukin-1*

Malignant lymphoma is an uncommon non-squamous cell tumor of the larynx. Clinical suspicion and deep structural pathologic biopsy is very important in diagnosis. Chemotherapy or combined chemoradiotherpy is the routine treatment method. We experienced a case of recurred malignant lymphoma originating from a non-head and neck area during chemotherapy in a 35-year-old man who complained of dysphagia and hoarseness. This laryngeal lymphoma was excised by CO2 laser and chemotherpy.
Adult ; Biopsy ; Deglutition Disorders ; Diagnosis ; Drug Therapy* ; Hoarseness ; Humans ; Larynx ; Lasers, Gas ; Lymphoma* ; Neck*

BACKGROUND AND OBJECTIVES: The objective of this study is to investigate the incidence and clinical implication of osteitis in patients with chronic paranasal sinusitis. MATERIALS AND METHODS: Forty three patients diagnosed as chronic paranasal sinusitis were examined with 99mTc-MDP bone SPECT preoperatively and underwent endoscopic operation, and 6 volunteers were recruited and examined as a control group. Each SPECT image was semiquantitatively assigned one of three grades of 0, 1, 2 according to intensities of isotope uptake. Quantitative analysis of the uptake of the isotope was performed by computer. The incidence of osteitis was analyzed. The correlation between semiquantitative grades and quantitative uptake indices was evaluated, and degree of isotope uptake and the severity of mucosal pathology on CT was correlated. The degree of isotope uptake between the patients who had recurrence and had not was compared. RESULTS: Quantitative evaluation of uptake indices were significantly higher in the patient group than in the control group. Marked uptakes of isotope on the sinus areas, suggesting the presence of osteitis, were shown in the patient group by 53.5%. The semiquantitative grades and quantitative indices showed positive correlation, and SPECT and CT scan findings also showed significant correlation. The uptake indices of patients who had recurrence were significantly higher than those of patients who showed no recurrence in both ethmoid sinus areas. CONCLUSIONS: The results of this study showed that significant proportion of patients with chronic paranasal sinusitis have osteitis, and patients with more severe osteitis represent poorer postoperative courses.
Ethmoid Sinus ; Evaluation Studies as Topic ; Humans ; Incidence ; Osteitis* ; Pathology ; Recurrence ; Sinusitis* ; Technetium Tc 99m Medronate* ; Tomography, Emission-Computed, Single-Photon* ; Tomography, X-Ray Computed ; Volunteers