STUDY DESIGN: This is a case report. OBJECTIVE: We present here a patient who had a discal cyst of the lumbar spine along with neurological symptoms. SUMMARY OF THE LITERATURE REVIEW: Discal cysts are intraspinal cysts that communicate with an adjacent intervertebral disc, and these are rare lesions that can cause lumbar radiculopathy. Because they are very rare, their natural history and the details of the therapeutic guidelines for the treatment of these cysts are still unknown. MATERIAL AND METHODS: The patient complained of moderate lumbar pain and right lower extremity radiculopathy and he was administered conservative treatment for 5 months. But the radiculopathy became aggravated and he then underwent a hemilaminectomy, cyst decompression and discectomy. RESULTS: The radiculopathy disappeared and any signs of recurrence were not found on the follow up performed at 1 year. CONCLUSION: Discal cyst is rare, but it can be treated successfully.
Decompression ; Diskectomy ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Lower Extremity ; Natural History ; Radiculopathy ; Recurrence ; Spine

PURPOSE: To evaluate correlations between vascular endothelial growth factor (VEGF) which is associated with tissue remodeling and bone repair and systemic and tissue inflammation in osteoarthritis. MATERIALS AND METHODS: Sixty patients who were above grade 2 in Kellgren-Lawrence radiologic classification of osteoarthritis were classified into group 1 (grade 2, 16 patients), group 2 (grade 3, 18 patients) and group 3 (grade 4, 26 patients). All patients were checked C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and total WBC count in the blood and VEGF and total WBC count in the synovial fluid by ELISA. RESULTS: The severe in osteoarthritic change in radiographs, the more VEGF in the synovial fluid (mean value; group 1 82.7 pg/ml, group 2 111.6 pg/ml, group 3 152.6 pg/ml). VEGF in the synovial fluid were related with total WBC count in the blood and in the synovial fluid (p=0.012, p=0.028 respectively), but not related with CRP and ESR in the blood. CONCLUSION: The severe in osteoarthritic change in radiographs, the more VEGF in the synovial fluid. This facts suggested that there were much neovascularization and bone repair in the synovium of advanced osteoarthritis. Therefore further study elucidating mechanisms of tissue remodeling and its associated factors will be needed.
Acute-Phase Proteins ; Blood Sedimentation ; C-Reactive Protein ; Humans ; Inflammation ; Osteoarthritis ; Synovial Fluid ; Synovial Membrane ; Vascular Endothelial Growth Factor A

PURPOSE: We wanted to evaluate the usefulness of arthroscopic repair using the modified Mason-Allen Massive Cuff Stitch for medium sized full thickness rotator cuff tear. We verified the clinical results and evaluated the repair integrity after short term follow up. MATERIALS AND METHODS: Twenty-three cases of arthroscopically repaired full thickness tear of the rotator cuff of an estimated medium size were evaluated between December 2004 to May 2005. The average patient age was 54 years old (range: 43-69 years old), and the mean follow-up was 14 months (range: 12-17 months). We analyzed the results by paired t-test. The follow up MRIs were checked in 11 cases. RESULTS: The VAS pain score was improved from a preoperative average of 7.0 to a postoperative average of 0.9, the ADL was improved from 11.1 to 26.0 and the UCLA score was improved from 13.6 to 32.5 (all p<0.05). 91.3% showed an excellent or good result at the final follow-up. The satisfied rate was 95.7% (22 cases). There was re-rupture of the repaired rotator cuff in one out of 11 cases (9.1%). CONCLUSION: Arthroscopic repairs using a modified Mason-Allen Massive Cuff Stitch for full thickness rotator cuff tear of an estimated medium size showed good clinical outcomes.
Activities of Daily Living ; Arthroscopy ; Follow-Up Studies ; Humans ; Rotator Cuff ; Shoulder

Patients with Crowned dens syndrome typically present with severe neck pain and have calcification around the axial odontoid process on radiographs. To our knowledge, Crowned dens syndrome is unreported in the Korean literature and the clinical features remain unclear. We present Crowned dens syndrome as a cause of acute cervical pain and review the literature.
Crowns ; Humans ; Neck Pain ; Odontoid Process

PURPOSE: To evaluate the 3 to 8 year follow-up clinical and radiological results after NexGen(R) total knee arthroplasty (TKA). MATERIALS AND METHODS: Ninety-six knees in 75 patients, who could be followed up more than 3 years after NexGen(R) TKA [cruciate retaining (CR) type:34, posterior cruciate substituting (PS) type:62] from March 1997 to May 2002, were evaluated retrospectively. The evaluations included the preoperative and postoperative range of motion (ROM), Knee Society Score (KSS), knee functional score, tibiofemoral angle and postoperative complications. RESULTS: The ROM increased from preoperative mean flexion contracture of 9.3 degrees and further flexion of 116.4 degrees to a postoperative mean flexion contracture of 2.1 degrees and further flexion of 126.3 degrees (ROM: 124.2 degrees). The ROM of CR type improved from 112.7 degrees to 123.1 degrees, and the PS type improved from 105.3 degrees to 124.9 degrees (p>0.05). The KSS and knee function score improved from 54 and 41 before surgery to 94 and 87 after surgery, respectively (p>0.05). The tibiofemoral angle changed from preoperative varus 5.7 degrees to postoperative valgus 5.2 degrees. The complications were two cases of infection and two cases of early loosening. CONCLUSION: The 3 to 8 year follow-up results after NexGen(R) TKA were satisfactory in both the CR and PS types. However, a longer term follow-up evaluation will be necessary.
Arthroplasty* ; Contracture ; Follow-Up Studies* ; Humans ; Knee* ; Postoperative Complications ; Range of Motion, Articular ; Retrospective Studies

PURPOSE: To compare the radiographic and early clinical results of mini-incision total knee arthroplasty(TKA) with those of conventional TKA. MATERIALS AND METHODS: A prospective study was made for 40 primary TKAs(20 mini-incision TKAs; group I and 20 conventional TKAs; group II) done by one surgeon between Dec. 2005 and Feb. 2006, followed up more than 1 year. There were no significant differences between the two groups in all the preoperative evaluations, including age, sex, body mass index, range of knee motion, knee society score(KSS) and radiographic alignments. Postoperative evaluations included length of skin incision, operative time, blood loss, immediate postoperative course, range of knee motion, KSS and radiographic results. RESULTS: Except for the shorter skin incision in mini-incision TKAs(group I), no significant difference was noted between the two groups in all the postoperative evaluations. There were no significant complications in both groups. CONCLUSION: Mini-incision TKA had the advantage of a shorter skin incision and could give us the similar early clinical and radiographic results as conventional TKA.
Arthroplasty* ; Body Mass Index ; Knee Joint ; Knee* ; Operative Time ; Prospective Studies ; Skin

The mechanism of the loosening after arthroplasty is considered that micromotion makes a gap between implant and bone, the subsidence of implant and osteolysis around the implant. The loosening of femoral component after total knee arthroplasty(TKA) might be related to the improper support of posterior condylar area, the causes of which may be inaccurate osteotomy, improper cementing technique and poor bone quality, etc. The authors found four cases of flexed displacement and osteolysis around the femoral component after TKA. The types of implant were one case of PS type and three cases of High Flex PS type. Revision arthroplasty was done in three patients who had severe clinical symptoms with diffuse bone loss around the distal femur. We evaluated the mechanism of the early loosening by clinical and radiologic assessment of four patients.
Arthroplasty* ; Femur ; Humans ; Knee* ; Osteolysis ; Osteotomy

Solitary juvenile polyps are the most common benign hamartomatous polyps in childhood presenting with painless rectal bleeding. It is rare in solitary juvenile polyps with adenomatous change which is associated with increased risk for gastrointestinal cancer. We report a rare case of a solitary juvenile polyp with adenomatous change and causing colonic intussussection in a 6 year old girl, who presented symptoms of lower abdominal pain, vomiting, and hematochezia. The colonic intussussception was reduced during the colon barium study and a polypoid round mass shadow at the splenic flexure was formed. On colonoscopy, it was seen as a single huge polyp impacted to the splenic flexure lumen. Endoscopic polypectomy was performed. The histologic evaluation revealed the characteristic features of a juvenile poloyps with adenomatous change.
Abdominal Pain ; Barium ; Child ; Colon* ; Colon, Transverse ; Colonoscopy ; Female ; Gastrointestinal Hemorrhage ; Gastrointestinal Neoplasms ; Hemorrhage ; Humans ; Intussusception* ; Polyps* ; Vomiting

PURPOSE: To evaluate prospectively the results of interventional radiologic placement of tunneled centralve-nous catheters, and subsequent complications. MATERIALS AND METHODS: Between April 1997 and April 1998, a totalof 557 tunneled central venous catheters were percutaneously placed in 517 consecutive patients in aninterventional radiology suite. The indications were chemotherapy in 533 cases, total parenteral nutrition in 23and transfusion in one. Complications were e-valuated prospectively by means of a chart review, chest radiography,central vein angiography and blood/catheter culture. RESULTS: The technical success rate for tunneled centralvenous catheter placement was 100% (557/557 cases). The duration of catheter placement ranged from 4 to 356 (mean,112 +/-4.6) days; Hickman catheters were re-moved in 252 cases during follow-up. Early complications included 3cases of pneumothorax(0.5%), 4 cases of local bleeding/hematoma(0.7%), 2 cases of primary malposition(0.4%), and 1case of catheter leakage(0.2%). Late complications included 42 cases of catheter-related infection(7.5%), 40 casesof venous thrombosis (7.2%), 18 cases of migration (3.2%), 5 cases of catheter / pericatheter of occlusion(0.8%),and 1 case of pseudoa-neurysm(0.2%) . The infection rate and thrombosis rate per 1000 days were 1.57 and 1.50,respectively. CONCLUSIONS: The technical success rate of interventional radiologic placement of tunneled centralvenous catheters was high. In comparison to conventional surgical placement , it is a more reliable method andleads to fewer complications.
Angiography ; Catheters ; Central Venous Catheters* ; Drug Therapy ; Follow-Up Studies ; Humans ; Parenteral Nutrition, Total ; Prospective Studies ; Thorax ; Thrombosis ; Veins ; Venous Thrombosis

BACKGROUND: Onychomycosis, especially toenail onychomycosis has become one of the common fungal infection and has historically been regarded as a cosmetic rather than medical problem by many patients, even by physicians. Recently, however, there are several reports that this is a refractory disease which may cause a deleterious effect on patients' quality of life (QOL). OBJECTIVE: The purpose of this study was to investigate the impact of toenail onychomycosis on QOL in Korea and to assess the changes of QOL after treatment. METHODS: Total 1004 patients with toenail onychomycosis which was confirmed by clinical findings and KOH preparation were enrolled at 47 dermatologic centers in Korea, and interviewed with standardized QOL questionnaire before and after systemic antifungal treatment. Responses to the questionnaire were scored by f-point scale (0~4) and averaged, and were analyzed for 5 dimensions of emotional impact, social impact, symptom and functional impact, patients' views concerning treatment, and relationship with doctor. RESULTS: 1. Before and after treatment, the most serious impact was emotional dimension showing 1.90 and 1.30 in average score (AS), and social (AS: 1.14 and 0.83) and symptom and functional impact (AS: 1.05 and 0.92) was also affected. 2. In female rather than male, statistically more significant impact on patients' QOL was observed in all dimensions. 3. After treatment, 3 of 5 dimensions were improved significantly - emotional dimension (AS: from 1.90 to 1.30), social dimension (AS: from 1.14 to 0.83), patients' view concerning treatment(AS: from 1.34 to 1.02) 4. The degree of patients' satisfaction at the therapeutic effect was very high - 62.4% (immediately after. treatment) and 65.8% (9 months after initiation of treatment) of patients answered excellent or good. CONCLUSION: This study confirms that toenail onychomycosis has significant Impact on the overall QOL of patients. Also the effect of antifungal therapy on patients' QOL were satisfactory. Therefore, both doctor and patient should pay more attention to the treatment of onychomycosis.
Female ; Humans ; Korea* ; Male ; Nails* ; Onychomycosis* ; Quality of Life* ; Social Change ; Surveys and Questionnaires