Congenital kyphoscoliosis is an abnormal curvature of spine that is due to presence of vertebral anomalies which cause an imbalance in the longitudinal growth of the spine. Congenital kyphoscoliosis is often rigid and its correction can be difficult. It is often resistant to conservative treatment and more patients require surgical treatment than those with idiopathic curvature. The indication for the conservative treatment with Milwaukee brace is much limited. Largely Milwaukee brace is a delaying tactic to correct the spinal curvature until its growth is further advanced and it is more amenable for fusion. This paper was aimed to review our experience with 49 patients with congenital scoliosis, kyphosis and kyphoscoliosis who were treated surgically with various methods of preoperative correction, from Jan. 1968 to Dec. 1983, in special reference to new classification, proposed for common application to both kyphosis and scoliosis, and following results were obtained. 1.The average age when scoliosis was observed was 6.9 years, but the average age of surgery was deferred until 15.2 years. 2. The distribution of curve pattems were 1 cervicothoracic, 24 thoracic, 12 thoracolumbar, 7 lumbar and 1 lumbosacral curve in 45 scoliotic curves and 13 thoracic, 13 thoracolumbar and 4 lumbar curves in 30 kyphotic curves. The average degrees of deformity were most severe in thoracolumbar curves both in kyphosis and scoliosis. 3. The new morphological classification, which could be applicable to both kyphosis and scoliosis, was proposed. The type of unsegmented bar with contralateral hemivertebra was most common both in kyphosis and scoliosis. 4. Preoperative average degrees of scoliosis was 58.7 degrees and final correction was 20.6 degrees (35.1%) with loss of comection of 3.7 degrees (6.3%). Preoperative average degrees of kyphosis was 63.7 degrees and final correction was 20.1 degrees (42.5%) with loss of correction of 7.0 degrees (11.0%). 5. The surgical method with anterior and posterior fusion was the best treatment of severe kyphoscoliossis, in the aspect of final correction and loss of correction. 6. The lumbar curve was most amenable to treatment with the best final correction and the least loss of correction.
Braces ; Classification ; Congenital Abnormalities ; Humans ; Kyphosis ; Methods ; Scoliosis ; Spinal Curvatures ; Spine

BACKGROUND: The aim of this study was to assess the relationship between acute physiologic and chronic health examination (APACHE) II and sequential organ failure assessment (SOFA) scores and outcomes of post-cardiac arrest patients treated with therapeutic hypothermia (TH). METHODS: Out-of-hospital cardiac arrest (OHCA) survivors treated with TH between January 2010 and December 2012 were retrospectively evaluated. We captured all components of the APACHE II and SOFA scores over the first 48 hours after intensive care unit (ICU) admission (0 h). The primary outcome measure was in-hospital mortality and the secondary outcome measure was neurologic outcomes at the time of hospital discharge. Receiver-operating characteristic and logistic regression analysis were used to determine the predictability of outcomes with serial APACHE II and SOFA scores. RESULTS: A total of 138 patients were enrolled in this study. The area under the curve (AUC) for APACHE II scores at 0 h for predicting in-hospital mortality and poor neurologic outcomes (cerebral performance category: 3-5) was more than 0.7, and for SOFA scores from 0 h to 48 h the AUC was less than 0.7. Odds ratios used to determine associations between APACHE II scores from 0 h to 48 h and in-hospital mortality were 1.12 (95% confidence interval [CI], 1.03-1.23), 1.13 (95% CI, 1.04-1.23), and 1.18 (95% CI, 1.07-1.30). CONCLUSIONS: APACHE II, but not SOFA score, at the time of ICU admission is a modest predictor of in-hospital mortality and poor neurologic outcomes at the time of hospital discharge for patients who have undergone TH after return of spontaneous circulation following OHCA.
APACHE ; Area Under Curve ; Cardiopulmonary Resuscitation ; Hospital Mortality ; Humans ; Hypothermia* ; Hypothermia, Induced ; Intensive Care Units ; Logistic Models ; Odds Ratio ; Organ Dysfunction Scores* ; Out-of-Hospital Cardiac Arrest* ; Outcome Assessment (Health Care) ; Retrospective Studies ; Survivors

A 42-year-old man presented with severe pancytopenia and uncontrolled epistaxis. The diagnosis of SLE was made and the pancytopenia was found to be due to myelofibrosis. The pulse therapy with methylprednisolone and maintenance therapy with prednisolone reversed both pancytopenia and myelofibrosis. Although myelofibrosis has been described in SLE, this coexistence must be very rare since there has been only 19 cases showing this combination. We report a case of SLE with myelofibrosis which was reversed by the treatment with glucocorticoid.
Adult ; Diagnosis ; Epistaxis ; Humans ; Lupus Erythematosus, Systemic* ; Methylprednisolone ; Pancytopenia ; Prednisolone ; Primary Myelofibrosis*

Relapsing polychondritis, a rare multisystem disease, is characterized by wide spread potentially destructive inflammatory lesions, involving cartilaginous structures throughout the body. Auricular chondritis is the most frequent presenting sign of this disease, with arthritis being the second. Other clinical menifestations include nasal chondritis, scleritis, damage to tracheobroncheal cartilage, and cardiovascular and renal involvement. We experienced three cases of relapsiug polychondritis. One case is 66 year old male with bilateral auricular chondritis with histologic confirmation, episcleritis, polyarthritis, periarterial vasculitis, and sensorineural hearing loss. Another case is 42 year old male with respiratory, nasal, auricular chondritis and psoriasis with arthritis. The third case is 46 year old female with three year history of relapsing polychondritis, presenting bilateral auricular and nasal chondritis and severe respiratory tract involvement with histologic confirmation. We also reviewed the other case reports of relapsing polychondritis in Korea. The major presenting manifestations of relapsing polychondritis in Korea were respiratory tract symptoms of dyspnea, cough, and sputum. That is, auricular chondritis was less frequent thari laryngotracheal-bronchial involvement.
Adult ; Aged ; Arthritis ; Cartilage ; Cough ; Dyspnea ; Female ; Hearing Loss, Sensorineural ; Humans ; Korea ; Male ; Middle Aged ; Polychondritis, Relapsing* ; Psoriasis ; Respiratory System ; Scleritis ; Sputum ; Vasculitis

PURPOSE: In Korea, emergency department overcrowding in large hospitals have caused social concern. Moreover, patients with low socioeconomic status visit the emergency department more frequently. This kind of visitation also causes a burden on the national budget, but emergent patient should be treated in emergency department regardless of economic state. So, on establishment of policy about the patient with low socioeconomic status, the frequency of emergency visitation alone is difficult to obtain a sufficient basis for policy-making. METHODS: We retrospectively analyzed adult patients with a disease who visited the Pusan Wide-regional Emergency Center in 2015. Korean Triage and Acuity Scale level I, II or III were defined as emergency, and level IV or V was defined as non-emergency. The ratio of emergency and non-emergency was compared in the National Health Insurance and Medicaid database. RESULTS: The number of patients with National Health Insurance was 16,208 (90.3%) and with Medicaid was 1,737 (9.7%). Among those with National Health Insurance, there were 12,720 (78.5%) emergency cases and 3,488 (21.5%) non-emergency cases. Among those with Medicaid, 1,379 (79.4%) emergency cases and 358 (20.6%) non-emergency cases. Between National Health Insurance and Medicaid, there was no statistically significant difference in the ratio of emergency and non-emergency (p=0.380) CONCLUSION: Accessibility of emergency and non-emergency patients with National Health Insurance and Medicaid to Pusan Wide-regional Emergency Center was not different.
Adult ; Budgets ; Busan ; Emergencies* ; Emergency Service, Hospital ; Humans ; Insurance Coverage* ; Insurance* ; Korea ; Medicaid ; National Health Programs ; Retrospective Studies ; Social Class ; Triage

PURPOSE: This study aimed to evaluate the epidemiology of bicycle injuries in Korea. It analyzed the injury severity of bicycle accidents by making a comparison between accidents that originated from bicycle lanes and accidents that originated in other sites since the inception of the Korea Promoting Bicycle Usage Act in 2011. METHODS: We performed a retrospective study on 23,038 cases from January 2011 to December 2014, utilizing the data from the emergent department-based, in-depth injury surveillance system. The main analysis of death was conducted by a multivariate logistic regression, using SPSS statistics ver. 18.0. We also classified bicycle accidents in accordance with the sites of accident bicycle lane and other sites, accident year, age, gender, injury location, activity, helmet use, and alcohol consumption. RESULTS: The entire study population of 23,038 patients were divided into two groups depending on accident site: 4045 from bicycle lane and 18,993 from other accident sites. According to the analysis, the percentage of accidents involving female was significantly higher in bicycle lane than in other accident sites (75.8% vs. 79.3% p<0.001). The highest bicycle accident occurred alone (77.3%) in bicycle lane and 57% in other accident sites. However, motor vehicle crash was significantly higher in other accident sites than in bicycle lane (32.9% vs. 10.2%). The result from a multivariate logistic regression demonstrates that bicycle lanes significantly decreases the severity of mortality on average (odd ratio, 0.46; 95% confidence interval 0.24-0.91). CONCLUSION: We found that bicycle lanes have a significant impact on decreasing not only general accidents caused by bicycles, but also mortality.
Alcohol Drinking ; Bicycling ; Epidemiology ; Female ; Head Protective Devices ; Humans ; Korea* ; Logistic Models ; Mortality ; Motor Vehicles ; Retrospective Studies

PURPOSE: This study was performed to evaluate the usefulness of 99mTc-HMPAO-labelled leucocyte scintigraphy for diagnosing prosthetic infection after total knee replacement arthroplasty without the aid of following bone marrow scintigraphy. MATERIALS AND METHODS: The study subjects were 25 prostheses of 17 patients (one man and 16 women, mean age: 65 years) who had total knee replacement arthroplasty. After injection of 99mTc-HMPAO-labelled leucocyte, the whole body planar and knee SPECT images were obtained in all patients. The subjects were classified into three groups according to clinical suspicion of prosthetic infection: Group A (n=11) with high suspicion of infection; Group B (n=6) with equivocal suspicion of infection, and Group C (n=8) with asymptomatic contralateral prostheses. Final diagnosis of infection was based on surgical, histological and bacteriological data and clinical follow-up. RESULTS: Infection was confirmed in 13 prostheses (11 in Group A and 2 in Group B). All prostheses in Group A were true positive. There were two true positives, one false positive and three true negatives in Group B, and six true negatives and two false positives in Group C. Overall sensitivity, specificity, and accuracy for diagnosis of the infected knee prosthesis were 100%, 75% and 88%, respectively. CONCLUSION: 99mTc-HMPAO-labelled leucocyte scintigraphy is a sensitive method for the diagnosis of infected knee prosthesis. However, false positive uptakes even in asymptomatic prosthesis suggest that bone marrow scintigraphy may be needed to achieve improved specificity.
Arthroplasty* ; Arthroplasty, Replacement, Knee* ; Bone Marrow ; Diagnosis* ; Female ; Follow-Up Studies ; Humans ; Inflammation ; Knee ; Knee Prosthesis ; Prostheses and Implants ; Radionuclide Imaging* ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon

PURPOSE: To evaluate the effectiveness of polydeoxyribonucleotide (PDRN) material on murine subcutaneous laceration wounds. METHODS: Subcutaneous laceration wounds were made on the back of mice. The mice were divided into two groups according to method of PDRN applied: Group I (control, general dressing, and management) and Group II (PDRN injection). We evaluated gross findings and histological findings for the groups. RESULTS: A total of 18 mice (9 in the Suture group and 9 with Suture+PDRN) were enrolled. In the mean results of gross finding (5-point Likert scale), the mean gross findings for wounds in the PDRN group were significantly higher than the suture groups on post-operative day 4 and 7 (for day 4, Suture: 2, Suture+PDRN: 3.2; for day 7, Suture: 2.7, Suture+PDRN: 4.2; p<0.05). In the histological analysis of wounds in the Suture+PDRN group after 10 days, re-epithelization and granulation tissue formation were better than the Suture group. In terms of wound-healing grade, re-epithelization and inflammation were not different; however, in the Suture+PDRN group, more granulation tissue formation was noted compared to the Suture group (p<0.05). In addition, the expression of VEGF in the Suture+PDRN group significantly increased compared to the Suture group (Suture: 11170+/-2475, Suture + PDRN: 27243+/-6621, p<0.05). CONCLUSION: The Suture+PDRN group can be used for the early treatment and histological healing of subcutaneous laceration wounds.
Animals ; Bandages ; Granulation Tissue ; Inflammation ; Lacerations ; Mice ; Sutures ; Vascular Endothelial Growth Factor A

The purposes of this study were basic data collection and evaluation of the risk factors regarding rowing injuries through an epidemiologic study. We performed a questionnaire survey from rowers who participated in the 91th Annual Sports Festival in Jinju, Gyeongnam, in October 2010. 145 rowers (male: 84, female: 61) responded to the survey. The t-test was used for comparisons for the type of injury, age, and gender. The multiple linear regression analysis and the logistic regression analysis was used for the evaluation of risk factors. Overall, 100 (69.0%) rowers had a history of injury. The incidence of overuse injuries was significantly higher than the incidence of traumatic injuries (2.07+/-2.59/rower vs. 1.46+/-2.08/rower, p=0.027). The incidence of injuries for the adult group was significantly higher than those in the youth group (4.42+/-4.45/rower vs. 2.61+/-3.63/rower, p=0.008). There was no significant difference between males and females (3.85+/-4.33/rower vs. 3.08+/-3.87/rower, p=0.275). Also, the incidence of cross-training related injury was significantly higher in traumatic injuries rather than in overuse injuries (0.92+/-1.54/rower vs. 0.5+/-1.07/rower, p=0.008). In addition, rowing injuries were more related with overuse injuries. Risk factors regarding overall rowing injuries were training time, and training using stairs. Traumatic injuries were related with diverse cross-training and time spent cross-training. Therefore, in order to reduce the incidence of rowing injuries, time and the number of cross-training sessions should be reduced. Moreover, highly risky training such as using stairs should be replaced with other low risk training methods.
Adolescent ; Adult ; Athletes ; Cumulative Trauma Disorders ; Data Collection ; Epidemiologic Studies ; Female ; Holidays ; Humans ; Incidence ; Linear Models ; Logistic Models ; Male ; Surveys and Questionnaires ; Risk Factors ; Sports

PURPOSE: We evaluated the differences between radiologically measured size and pathologic size of renal tumors. MATERIALS AND METHODS: The data from 171 patients who underwent radical or partial nephrectomy for a renal tumor at Ajou University Hospital were reviewed. Radiologic tumor size, which was defined as the largest diameter on a computed tomographic scan, was compared with pathologic tumor size, which was defined as the largest diameter on gross pathologic examination. RESULTS: Mean radiologic size was significantly larger than mean pathologic size for all tumors (p=0.019). When stratified according to radiologic size range, mean radiologic size was significantly larger than mean pathologic size for tumors <4 cm (p=0.003), but there was no significant difference between the sizes for tumors 4-7 cm and >7 cm. When classified according to histologic subtype, mean radiologic size was significantly larger than mean pathologic size only in clear cell renal cell carcinomas (p=0.002). When classified according to tumor location, mean radiologic size was significantly larger than mean pathologic size in endophytic tumors (p=0.043) but not in exophytic tumors. When endophytic tumors were stratified according to radiologic size range, there was a significant difference between the mean radiologic and pathologic sizes for tumors <4 cm (p=0.001) but not for tumors 4-7 cm (p=0.073) and >7 cm (p=0.603). CONCLUSIONS: Our results suggest that in planning a nephron-sparing surgery for renal tumors, especially for endophytic tumors of less than 4 cm, the tumor size measured on a computed tomography scan should be readjusted to get a more precise estimate of the tumor size.
Carcinoma, Renal Cell ; Humans ; Kidney ; Nephrectomy