PURPOSE: When medial protrusion in the base of proximal phalanx is severe from removing metatarsal bunion during the hallux valgus surgery, it could lead to skin irritation and medial pain after the surgery. The purpose of this paper was to report our clinical and radiographic results with transarticular fixation of Akin osteotomy for the treatment of patients with hallux valgus after resection of the medial protrusion of base of the proximal phalanx. MATERIALS AND METHODS: Our study is subject to 34 cases of 30 patients who went through proximal phalanx medial corticectomy among patients undergone both hallux valgus surgery and Akin osteotomy at our institution from March 2006 to March 2012. In all cases, we used absorbable suture material through the articular surface for Akin osteotomy after resection of the medial protrusion in proximal phalanx. Radiographs were reviewed to assess the union and displacement of osteotomy site at the time of postoperative 6 months. The clinical results were assessed by using AOFAS score and complication such as skin irritation and pain. RESULTS: AOFAS score was improved from average 44 points(36-58), before operation and average 87 points(74-96), 12 months after operation. In two cases, partial union was suspected in radiological perspective, however, complete union on the osteotomy site was observed in all cases, 12 months after the operation. No patients was dissatisfied with pain, joint discomfort, skin irritation and inflammation from the knot. CONCLUSION: When medial protrusion in the base of proximal phalanx is severe from removing metatarsal bunion during the hallux valgus surgery, We have good results by transarticular fixation of Akin osteotomy using absorbable suture material.
Arthralgia ; Displacement (Psychology) ; Hallux ; Hallux Valgus ; Humans ; Inflammation ; Metatarsal Bones ; Osteotomy ; Skin ; Sutures

Immunoadjuvant activities of the extract (KM-110) from Korean mistletoe ( Viscum album coloratum) on the induction of humoral and cellular responses against Keyhole limpet hemocyanim (KLH) as an antigen and allogenic tumor cells were examined. When mice were immunized subcataneously (s.c.) with KLH admixed with KM-110, more than 1000-times higher antibody titers to KLH than those immunized with KLH alone was observed. KM-110 induced high level of KLH- specific IgG1, IgG2a and IgG2b antibodies. In an in vitro analysis of lymphocytes proliferation to KLH on week 4, the splenocytes of mice treated with KLH and KM- 110 exhibited significantly higher proliferating activity than those treated with KLH alone. In addition, the culture supernatnats obtained from the splenocytes of mice treated with both KLH and KM-110 showed high level of IL-2 and IL-4. In the test of cellular immune responses, KM-110 enhanced the DTH reaction to KLH in mice. Furthemore, cytotoxic T-lymphocyte (CTL) activity using an allogenic CTL induction model where C57BL/6 (H-2b) mice were injected with allogenic P815 (H-2d) mastocytoma cells admixed with or without KM-110, mice treated with P815 cells and KM-110 showed higher cytatoxic activity against allogenic tumor cells than those treated without KM-110. This results suggest that KM-110 may possess adjuvant activities to potentially enhance humoral as well as cellular immune responses against antigens.
Animals ; Antibodies ; B-Lymphocytes ; Immunity, Cellular* ; Immunoglobulin G ; Interleukin-2 ; Interleukin-4 ; Lymphocytes ; Mastocytoma ; Mice ; Mistletoe* ; T-Lymphocytes ; T-Lymphocytes, Cytotoxic ; Viscum album* ; Viscum*

PURPOSE: To evaluate the efficacy of surgical treatment through retrospective comparison of minimally invasive percutaneous plate osteosynthesis (MIPPO) vs open plate fixation in the treatment of the distal femur fractures. MATERIALS AND METHODS: Thirty-one patients with distal femur fractures from January 2002 to December 2010 were divided into two groups depending on the surgical method. Minimum follow up was 12 months. Group A consisted of 17 patients treated with MIPPO, and group B was comprised of 14 patients treated with open plate fixation. Clinical outcomes including operation time, transfusion rate, rehabilitation, range of motion, and interval change of postoperative C-reactive protein (CRP) were evaluated to assess postoperative inflammatory reaction, postoperative complications and clinical results with the use of Sanders criteria. RESULTS: The operative time was 86/135 min and transfusion volume was 0.8/1.9 unit respectively. The postoperative 3-day and 7-day CRP were 7.4/1.5 mg% in group A and 10.3/2.4 mg% in group B, showing more minimal tissue injury and early recovery in group A. There were no significant differences in clinical results by Sanders criteria in both groups. CONCLUSION: Both MIPPO and open plate fixation for the treatment of distal femur fractures showed comparably good results. However, the MIPPO technique is superior to group B in view of minimal tissue injury and operation time and was proven to lessen the transfusion rate.
C-Reactive Protein ; Femur* ; Follow-Up Studies ; Humans ; Operative Time ; Postoperative Complications ; Range of Motion, Articular ; Retrospective Studies

OBJECTIVE: The aim of this study was to evaluate the microanatomy and histological features of the central myelin in the root exit zone of facial nerve. METHODS: Forty facial nerves with brain stem were obtained from 20 formalin fixed cadavers. Among them 17 facial nerves were ruined during preparation and 23 root entry zone (REZ) of facial nerves could be examined. The length of medial REZ, from detach point of facial nerve at the brain stem to transitional area, and the thickness of glial membrane of central myelin was measured. We cut brain stem along the facial nerve and made a tissue block of facial nerve REZ. Each tissue block was embedded with paraffin and serially sectioned. Slices were stained with hematoxylin and eosin (H&E), periodic acid-Schiff, and glial fibrillary acid protein. Microscopy was used to measure the extent of central myelin and thickness of outer glial membrane of central myelin. Thickness of glial membrane was examined at two different points, the thickest area of proximal and distal REZ. RESULTS: Special stain with PAS and GFAP could be differentiated the central and peripheral myelin of facial nerve. The length of medial REZ was mean 2.6 mm (1.6-3.5 mm). The glial limiting membrane of brain stem is continued to the end of central myelin. We called it glial sheath of REZ. The thickness of glial sheath was mean 66.5 microm (40-110 microm) at proximal REZ and 7.4 microm (5-10 microm) at distal REZ. CONCLUSION: Medial REZ of facial nerve is mean 2.6 mm in length and covered by glial sheath continued from glial limiting membrane of brain stem. Glial sheath of central myelin tends to become thin toward transitional zone.
Brain Stem ; Cadaver ; Eosine Yellowish-(YS) ; Facial Nerve* ; Formaldehyde ; Glial Fibrillary Acidic Protein ; Hematoxylin ; Membranes ; Microscopy ; Myelin Sheath* ; Paraffin

PURPOSE: In total knee arthroplasty (TKA), it is important to restore neutral mechanical alignment. The purpose of this study was to assess whether the lower limb alignment is neutral in healthy Korean females and investigate the incidence of constitutional varus knees among them. MATERIALS AND METHODS: Weight-bearing full-leg standing radiographs were obtained from 118 healthy females between the ages of 20 to 39 years. One radiologist and two orthopaedic surgeons measured the hip-knee-ankle angle (HKAA), medial proximal tibial angle (MPTA), and femoral anatomic mechanical angle (FAMA) on the radiographs and compared with the traditional gold standard HKAA of 0degrees, MPTA of 3degrees varus, and FAMA of 6degrees. RESULTS: The interobserver reliability of the three independent observers was high (p<0.001). The HKAA of the study subjects (1.35degrees+/-2.04degrees) was significantly different from the standard HKAA of 0degrees (p<0.001), but no statistically significant difference was observed in the MPTA (-3.18degrees+/-1.61degrees) and FAMA (5.99degrees+/-0.70degrees) from the standard values (p=0.083 and p=0.887, respectively). The incidence of constitutional varus alignment was 20.34%. CONCLUSIONS: In Korean females, the mechanical axis of the lower limb was not neutral and the incidence of constitutional varus alignment was slightly higher than that in Western females. We believe that these findings should be taken into consideration in planning reconstructive surgery of the knee, such as TKA, unicompartmental knee arthroplasty, and high tibial osteotomy.
Arthroplasty ; Axis, Cervical Vertebra ; Female ; Humans ; Incidence ; Knee ; Lower Extremity ; Osteotomy ; Weight-Bearing

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Severe fever with thrombocytopenia syndrome (SFTS) caused by the SFTS virus (SFTSV), a novel Phlebovirus, is endemic to South Korea, central and northeastern China, and western Japan. SFTS poses a threat to public health because of its high mortality and secondary transmission. Ticks and domestic animals are hosts for SFTSV in endemic areas. There is no specific treatment for SFTS, and avoiding tick bites is the best way to prevent infection. Early therapeutic plasma exchange (TPE) is a rescue therapy in patients with rapidly progressive SFTS. Here, we present a patient with SFTS who was improving on TPE but died suddenly due to acute lung injury after TPE.

PURPOSE: There have been no studies employing a specific questionnaire relating to patient satisfaction following ambulatory hernioplasty. Via the production of a novel specific questionnaire, attempts were made to determine the factors associated with patient satisfaction following hernioplasty on an ambulatory basis. METHODS: Patient satisfaction was evaluated via cross-sectional telephone surveys administered 10.5 (range of 2~23) months after their operations, consisting of six questions, regarding; anesthetic technique, surgical method, necessity for admission, necessity for follow-up, intraoperative pain, and postoperative pain. Each of the questions was then scored using a 4-point scoring system, with global satisfaction determined via the addition of each score. Factors related to global satisfaction were determined among preoperative, intraoperative and postoperative factors. RESULTS: Telephone questionnaire interviews were conducted on all 131 consecutive patients. Four respondents (3.1%) expressed dissatisfaction with the ambulatory surgery. Twelve (9.2%) had been admitted overnight after the operation. Thirteen (9.9%) required analgesics for over 3 days. No patients required a re-operation, although 20 (15.3%) experienced minor postoperative complications. Significant factors for global dissatisfaction were analgesic requirement for over 3 days and the presence of surgical complication (P value <0.05). Time until return to work and required overnight admission were important factors for patient satisfaction, but these were not significant. CONCLUSION: Patient satisfaction was associated with postoperative pain and surgical complications. Therefore, a more appropriate method for pain control and prevention of minor surgical complication are suggested might serve to enhance patient satisfaction after hernioplasty on an ambulatory basis.
Ambulatory Surgical Procedures ; Analgesics ; Follow-Up Studies ; Hernia, Inguinal ; Herniorrhaphy* ; Humans ; Pain, Postoperative ; Patient Satisfaction* ; Postoperative Complications ; Surveys and Questionnaires ; Return to Work ; Surveys and Questionnaires ; Telephone