No abstract available.
Child* ; Humans ; Leukemia*

No abstract available.

BACKGROUND/AIMS: Computed tomography during arterial portography and computed tomography during hepatic arteriography (CTAP and CTHA), one of the most sensitive method in detection of hepatocellular carcinoma (HCC) nodules , is reported to reduce unnecessary operation of HCC. However, it is not clear whet her CT AP and CT HA can reduce early post operative recurrence rate of HCC. We performed this study to find any differences in early postoperative recurrence rate of HCC according to the imaging modalities used for preoperativest aging. METHODS: Ninety-seven patients with HCC who had underg one curative hepat icres ection from Dec.1994 to Mar. 1998 were included (median age = 52 years (26-78), M:F = 85:12). They were classified into 3 groups according to the imaging methods used for preoper ative staging: CTAP & CTHA group (n=56), Lipiodol CT group (n=24), and three phase helical CT group (n=16). No significant inter-group difference was found in preoperative status of the patients or characteristics of HCC. One-year recurrence rates were compared by log-rank test. RESULTS: HCC recurred in 17 of 97 patients (18.7%) within 12 months. A significant difference in 1- year recurrence rate was observed between the groups: helical CT , may be a superior imaging modality for preoperative staging of HCC that can reduce early postoperative recurrence rate.
Aging ; Angiography ; Carcinoma, Hepatocellular* ; Ethiodized Oil* ; Humans ; Portography ; Recurrence* ; Tomography, Spiral Computed*

Although there have been several reported cases of enterocolitis caused by Yersinia enterocolitica, its colonoscopic findings have not been reported in Korea. We recently experienced two cases of Y. enterocolitica enterocolitis, where the colonoscopic examinations were performed. Two patients visited our hospital due to right lower quadrant pain. The thickened terminal ileum and right side colon with enlarged mesenteric nodes were observed on ultrasonography using graded compression method. Y. enterocolitica was isolated from stool in both cases, The colonascopy revealed nodular elevations, erosion., hyperemia, and edema on the terminal ileum and small hyperemic erosions or aphthoid ulcers on the colon, especially on the right side of the colon. In one of the cases, the aphthoid ulcers could be also seen on the sigmoid colon. Their clinical symptoms and signs improved 3-5 days after their visit without using antibiotics. We report these cases with a review of the relevant literature.
Anti-Bacterial Agents ; Colon ; Colon, Sigmoid ; Colonoscopy ; Edema ; Enterocolitis* ; Esophagus* ; Humans ; Hyperemia ; Ileum ; Intestines* ; Korea ; Lymphadenitis* ; Stomach* ; Ulcer ; Ultrasonography ; Yemen* ; Yersinia enterocolitica* ; Yersinia*

PURPOSE: Since the existence of an extra-articular deformity seriously alters the normal geometry and kinetics around the knee joint, difficulties are often encountered in total knee arthroplasty (TKA) using a standard surgical technique. The purpose of this study was to evaluate the usefulness of surgical navigation system as a treatment option for osteoarthritic knees with extra-articular deformity. MATERIALS AND METHODS: The authors retrospectively reviewed medical records of the patients who underwent primary TKA between 2007 and 2012. Knees with preoperative radiography showing an angular deformity within the region from the middle third of the femur to the middle third of the tibia in the ipsilateral limb of the arthritic knees were considered as cases having extra-articular deformity. Thirteen knees of the 13 patients were found to have undergone TKA using a navigation system for osteoarthritis with ipsilateral extra-articular deformity. The hip-knee-ankle angle, Knee Society score (KSS), and range of motion were measured before and after the operation to evaluate the improvement. RESULTS: The mean hip-knee-ankle angle in the coronal plane was improved to 0.2degrees+/-4.5degrees in valgus alignment postoperatively. The KSS was improved to 89.6+/-4.6 points postoperatively at the last follow-up, with over 90% of good and excellent results. The range of motion was improved to 118.5degrees+/-10.5degrees postoperatively. CONCLUSIONS: Navigation-assisted TKA is a good treatment option of osteoarthritic knees with extra-articular deformity.
Arthroplasty ; Congenital Abnormalities ; Extremities ; Femur ; Follow-Up Studies ; Humans ; Kinetics ; Knee Joint ; Knee ; Medical Records ; Osteoarthritis ; Radiography ; Range of Motion, Articular ; Retrospective Studies ; Tibia

Patellar tendon rupture is a catastrophic complication following total knee arthroplasty (TKA). Though revision TKA has been suspected of being a predisposing factor for the occurrence of patellar tendon rupture, there are few reports on patellar tendon rupture after revision TKA. Here, we present a case of acute patellar tendon rupture that occurred after TKA revision. In the patient, the patellar tendon was so thin and could not be repaired, and accordingly was sutured end to end. We used the anterior tibialis tendon allograft to augment the poor quality patellar tendon tissue. Fixation of the allograft was done by using the bone tunnel created through tibial tuberosity and suturing the allograft to the patellar tendon and quadriceps tendon. The patient was instructed to wear a full extension knee splint and was kept non-weight bearing for 6 weeks after operation. Full knee extension could be achieved 6 weeks postoperatively.
Allografts ; Arthroplasty ; Causality ; Humans ; Knee ; Patella ; Patellar Ligament ; Rupture ; Splints ; Tendons

PURPOSE: This study is to report clinical and radiological results of high-flexion total knee arthroplasty (TKA) using NexGen LPS-flex system at a minimum 5-year follow-up, and to analyze the implant survivorship based on the results. MATERIALS AND METHODS: A total of 80 patients (118 knees) who underwent patellar preserving TKA using NexGen LPS-flex implant between February 2007 and February 2008 and could be followed for minimum 5 years were reviewed. The range of motion (ROM), hip-knee-ankle angle, Knee Society Knee score (KSKS), and Knee Society Function score (KSFS) were assessed preoperatively and at the last follow-up and analyzed. Implant position of the femoral and tibial components on the immediate postoperative and last follow-up X-rays were compared. RESULTS: The mean ROM was 110.2degrees+/-14.5degrees (range, 60degrees to 140degrees) preoperatively and 132.4degrees+/-5.2degrees (range, 90degrees to 145degrees) at the last follow-up. KSKS was 36.9degrees+/-6.4degrees preoperatively and 94.2degrees+/-3.2degrees at the last follow-up. KSFS was 30.5degrees+/-5.7degrees preoperatively and 93.7degrees+/-4.1degrees at the last follow-up. There was no statistically significant change in the implant position measured as alpha, beta, gamma, and delta angles at the last follow-up compared to the immediate postoperative values. Radiolucent lines were observed in 13 knees (11%) on the last follow-up X-rays. Revision TKA was performed due to aseptic implant loosening in 1 knee (0.84%), and the survival rate at the 5th postoperative year was 99.2%. CONCLUSIONS: The clinical and radiological outcomes of high-flexion TKA using NexGen LPS-Flex implant design were satisfactory with 99.2% implant survival rate after 5 years of protected activities of daily living.
Activities of Daily Living ; Arthroplasty ; Follow-Up Studies ; Humans ; Knee ; Prosthesis Design ; Range of Motion, Articular ; Survival Rate

PURPOSE: To investigate the efficacy and advantages of the lateral approach for internal fixation of the distal humeral shaft fractures. MATERIALS AND METHODS: Twelve patients with distal humeral shaft fractures who underwent open reduction and internal fixation using plate and screws by lateral approach from January, 1997 to May, 2002 were investigated. Postoperative results after a minimum 1 year follow-up were assessed using union rate, elapsed time to union, postoperative complications such as iatrogenic radial nerve palsy, range of motion of the elbow joint. Clinical outcomes were evaluated with Mayo elbow performance scoring system. RESULTS: Union was achieved in all cases. The average time to union was 9 weeks (range, 7~12 weeks). Four cases of preoperative radial nerve palsy were revealed as contusion of the intact nerve and resolved completely by three months. The mean elbow range of motion was from 5 to 138 degrees. The average Mayo elbow performance score was 91 points; 9 cases ranked as excellent and 3 as good. CONCLUSION: Distal humeral shaft fractures can be treated successfully through open reduction and internal fixation using plate and screws. Lateral approach is recommended to stabilize distal humeral shaft fractures without compromising the range of motion of the elbow, and to protect or explore the injured radial nerves easily
Contusions ; Elbow ; Elbow Joint ; Follow-Up Studies ; Humans ; Paralysis ; Postoperative Complications ; Radial Nerve ; Range of Motion, Articular

Multiple rice bodies are commonly observed in various rheumatologic disorders and tuberculous arthritis, but rice bodies are rarely observed in nonspecific synovitis without any underlying disease. We performed arthroscopic rice body removal and synovectomy for nonspecific synovitis with multiple rice bodies in a 31-year-old male patient, and the results were satisfactory. No evidence of underlying disease, including rheumatoid arthritis or tuberculous arthritis, was observed during 2 years on the follow-up evaluations after the arthroscopic procedure. There have been very few confirmed rice bodies cases without underlying disease, so making a careful differential diagnosis to rule out rheumatologic and infectious disorders is required to avoid possible aggravation of disease, which may result in persistent articular cartilage destruction.
Adult ; Arthritis ; Arthritis, Rheumatoid ; Cartilage, Articular ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Male ; Synovitis

BACKGROUND/AIMS: Perioperative endoscopic retrograde cholangiopancreatography (ERCP) and en copic sphincterotomy (EST) offer the ability to remove common bile duct (CBD) stones and it ean make laparoscopic cholecystectcqny possible instead of open cholecystectomy. Although ERCP accurately detects CBD stones, the associated financial costs and potential morbidity argue against its indiscriminate use. Thus, we undertook the current retrospective study to analyze our own experience in the identification of preoperative indicators of CBD stones in patients managed by laparoscopic cholecystectomy. METHODS: Between October 1994 and October 1996, 503 laparoscopic cholecystectomy were performed at Samsung Medical Center. We analyzed the value of serum biochemical tests and findings of ultrasonography in patients ted by laparoscopic cholecystectomy. RESULTS: A total of 117 patients underwent perigperative ERCP; 113 patients underwent preoperative ERCP with 2/113 (1.8%) failing to cannulate the ampulla; 21 patients (18.0%) had choledocholithiasis; and all patients with CBD stones were cleared by EST without major complications. The indication of ERCP for prediction of CBD stones were categorized as 4 groups; abnormal liver function tests (LFT) and duct dilatation in ultrasonography 61.9% (13/22), only abnormal liver function tests 13.6% (6/44), only duct dilatation in ultrasonography 5,9% (1/17), and normal liver function tests with normal findings in ultrasonopaphy 2.9% (1/35) in this study. In patients with CBD stones, there was no significant difference to predict CBD stones in total bilirubin, alkaline phosphatase, and alanine aminotransferase. Gallstone pancreatitis patients who had hyperamylasemia and abnornal LFT that were resolved or resolving before ERCP revealed no CBD stones (0/10, 0%). CONCLUSIONS: ERCP before laparoscopic cholecystectomy is needed in selected patients who have abnormal liver function and/or CBD dilatation on ultrasonography. Gallstone pancreatitis that is resalving or resolved clinically may not require preoperative ERCP. ERCP with EST and laparoscopic cholecystectomy is a safe and effective method for the management of symptomatic eholelithiasis and choledocholithiasis.
Alanine Transaminase ; Alkaline Phosphatase ; Biliary Tract* ; Bilirubin ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Choledocholithiasis ; Common Bile Duct ; Dilatation ; Gallstones ; Humans ; Hyperamylasemia ; Liver ; Liver Function Tests ; Pancreas* ; Pancreatitis ; Retrospective Studies ; Ultrasonography