No abstract available.

STUDY DESIGN: This was designed as a retrospective study. PURPOSE: We assessed the radiographic and clinical outcome of patients who underwent percutaneous vertebroplasty (PVP) in osteoporotic compression fractures with a minimum of 5 years follow-up. OVERVIEW OF LITERATURE: Percutaneous vertebroplasty is effective surgical method for treating osteoporotic compression fracture. METHODS: Between January 2000 and August 2005, 159 patients were treated with PVP for osteoporotic compression fracture at our department; 43 patients died during follow-up, and 69 patients (121 vertebras) were available for follow-up for over 5 years. We analyzed the clinical and radiologic outcome including cement feature. RESULTS: The mean follow-up period was 5.7 years. Clinical outcome by mean visual analogue scale (VAS) score revealed a decreased 4.9 points perioperatively. A decreased score was maintained over 5 years in 46% of patients. A new adjacent vertebral fracture was documented by 33 vertebral bodies in 22 patients. During the follow-up period, 43 patients (38%) in 112 patients died. Anterior body heig ht in the last follow-up was improved about 0.3 mm compared with the preprocedural value, but was not statistically significant. Also, the focal kyphotic angle was reduced from 12.3degrees at the preprocedural state to 11.7degrees at the postprocedural state, but was not statistically significant (p > 0.05). CONCLUSIONS: PVP for osteoporotic compression fracture is an efficient procedure for pain relief by long term follow-up. The cement injected vertebrae showed stable radiologic progression without significant changes in vertebral height or kyphotic angle.
Follow-Up Studies ; Fractures, Compression ; Humans ; Retrospective Studies ; Spine ; Vertebroplasty

Acellular pertussis vaccine has been used widely in Korea since 1984. However, because many of the former generations were not inoculated with pertussis vaccine, they may infect infants with pertussis. With this background, we investigated the prevalence of pertussis antibodies in all age groups. Enzyme-linked immunosorbent assay (ELISA) to assess IgG antibodies to pertussis toxin (PT) and filamentous hemagglutinin (FHA) and bacterial agglutination (BA) to assess antibodies to agglutinogen were compared on 842 serum samples which were donated from 11 hospitals in Seoul area. In comparison with age groups under 20 years, antibodies of adults against PT and FHA were maintained. But antibodies against agglutinogen showed no pattem in all age groups. Antibodies to PT were correlated with antibodies to FHA. There was no significant difference in antibody levels between male and female (p<0.05).
Adult ; Agglutination ; Antibodies ; Bordetella pertussis ; Enzyme-Linked Immunosorbent Assay ; Family Characteristics ; Female ; Hemagglutinins ; Humans ; Immunoglobulin G ; Infant ; Korea* ; Male ; Pertussis Toxin ; Pertussis Vaccine ; Prevalence ; Seoul ; Whooping Cough*

PURPOSE: The purpose of this study was to analyze the results for clinical outcome and radiologic assessment of ceramic on ceramic cementless total hip arthroplasty using a 36 mm diameter femoral head. MATERIALS AND METHODS: This study included a group of 40 patients of 43 cases who underwent ceramic on ceramic cementless total hip arthroplasty using a 36 mm diameter femoral head. The age range of this group was 28 to 82(mean 56); we monitored them over a period of 5.3 years(3-7.5 years). This clinical evaluation process included monitoring the degree of pain, range of motion, and the Harris hip score after three years since the surgery was performed. Radiographic evaluation and complication were confirmed as well. RESULTS: The preoperative Harris hip score increased from 43.4(21-57) to 88.1(81-95) after the surgery. The average motion range of hip was 113degrees flexion, 30degrees abduction, 24degrees adduction, 36degrees external rotation, and 12degrees internal rotation. Subjective pain was zero or minimal in all cases. Among the complications, dislocation occurred in only one case by a fall from a height and was reduced by closed reduction. There was no occurrence of ceramic fracture, even though infection occurred in one hip. CONCLUSION: The clinical outcome and radiologic assessment of the ceramic on ceramic cementless total hip arthroplasty using a 36 mm diameter femoral head showed a satisfactory result at three-year follow-up. Longer-term follow up is needed for further assessment.
Arthroplasty ; Ceramics ; Dislocations ; Follow-Up Studies ; Head ; Hip ; Humans ; Range of Motion, Articular

Primary erythromelalgia is a rare condition that's characterized by erythema, an increased skin temperature and burning pain in the extremities. The pain is often very severe, and treating erythromelalgia is frustrating and difficult. We report here on the case of a 12-year old girl with primary erythromelalgia in both lower extremities. The pain was refractory to medical treatment, but a bilateral sympathetic block with lidocaine and triamcinolone resulted in relief from the pain. Our experience with this disease demonstrates that sympathetic blocks are effective in improving the symptoms and they may be attempted on erythromelalgia patients who do not respond to other treatments, including medication and epidural blocks.
Burns ; Erythema ; Erythromelalgia ; Extremities ; Humans ; Lidocaine ; Lower Extremity ; Skin Temperature ; Triamcinolone

PURPOSE: For fixation of the large posterior malleolar fracture fragment, indirect anterior fixation with cannulated screw has been widely used, but the anatomical reduction is not always obtained. The purpose of this article is to evaluate the clinical result of posterior malleolar fractures treated with anatomical reduction and internal fixation using posterior approach. MATERIALS AND METHODS: We have analyzed the 15 patients with posterior malleolar fractures, treated with posterior approach from August 2005 to August 2008. The mean follow up period was 17.6 months, We have reviewed the perioperative joint integrity, method of operation, postoperative care, bony union and complication. A clinical outcome was evaluated by AOFAS (American orthopedic foot and ankle society) scaling system and Olerud & Molander scoring system. RESULTS: Among 15 cases, posterolateral approach and posteromedial approach were chosen in 9 cases and 6 cases respectively. The radiologic unions were achieved at 12.4 (12~18) weeks. Mean AOFAS score was 90.3 (72~98), and Olerud & Molander score was "excellent" in 5 cases, "good" in 7 cases, "fair" in 1 case and "poor" in 2 cases. Postoperative complications in 2 cases revealed a posttraumatic arthritis and a scar band contracture respectively. CONCLUSION: In posterior malleolar fracture of ankle joint, the integrity of joint has closely affected clinical outcomes. We suggest that a posterior approach for posterior malleolar fracture with especially incarcerated fragments and comminuted fractures, can be a useful method for anatomical reduction and stable fixation, and satisfactory clinical results.
Animals ; Ankle ; Ankle Joint ; Arthritis ; Cicatrix ; Contracture ; Follow-Up Studies ; Foot ; Fractures, Comminuted ; Humans ; Joints ; Orthopedics ; Postoperative Care ; Postoperative Complications

BACKGROUND AND OBJECTIVES: Statin prevents atherosclerotic progression and helps to stabilize the plaque. According to a recent study, statin reduces inflammation in blood vessels. However, it has not been demonstrated to have any anti-inflammation reaction in patients who have been diagnosed as having a triple-vessel coronary artery disease (CAD). SUBJECTS AND METHODS: This study included a total of thirty (30) patients who had been diagnosed by coronary angiogram as having a triple-vessel CAD. Patients who already had been taking statin were given doubled dosage. An interview, physical examination and blood test were performed at the beginning of this study and three months later. RESULTS: After doubling the dose of statin, there was no statistically significant decrease in total cholesterol, low density lipoprotein-cholesterol, (increase in) high density lipoprotein-cholesterol and triglyceride in the blood test. C-reactive protein (CRP), an acute phase reactant, significantly decreased from 0.34 mg/dL at the beginning of the study to 0.12 mg/dL at the end of study (p<0.01). The interleukin-6 concentration also significantly decreased from 8.55 pg/dL to 4.81 pg/dL (p<0.001). No major cardiovascular events occurred and the dosage regimen was not modified during the close observation period. There was no difference in the symptoms of angina pectoris, established by World Health Organization Angina Questionnaires, before and after the dose increase. Liver enzymes remained within normal range with no significant increase before and after conducting this study. CONCLUSION: Doubling the dose of statin alone significantly lowers pro-inflammatory cytokine concentration, which is closely related to the potential acute coronary syndrome, and CRP, a marker of vascular inflammation.
Acute Coronary Syndrome ; Angina Pectoris ; Blood Vessels ; C-Reactive Protein ; Cholesterol ; Coronary Artery Disease ; Coronary Vessels ; Hematologic Tests ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Inflammation ; Interleukin-6 ; Liver ; Physical Examination ; Reference Values ; World Health Organization ; Surveys and Questionnaires

OBJECTIVE: Re-implantation of autologous skull bone has been known to be difficult because of its propensity for resorption. Moreover, the structural characteristics of the area of the defect cannot tolerate physiologic loading, which is an important factor for graft healing. This paper describes our experiences and results with cranioplasty following decompressive craniectomy using autologous bone flaps. METHODS: In an institutional review, the authors identified 18 patients (11 male and 7 female) in whom autologous cranioplasty was performed after decompressive craniectomy from January 2008 to December 2011. We examined the age, reasons for craniectomy, size of the skull defect, presence of bony resorption, and postoperative complications. RESULTS: Postoperative bone resorption occurred in eight cases (44.4%). Among them, two experienced symptomatic breakdown of the autologous bone graft that required a second operation to reconstruct the skull contour using porous polyethylene implant (Medpor(R)). The incidence of bone resorption was more common in the pediatric group and in those with large cranial defects (>120 cm2). No significant correlation was found with sex, reasons for craniectomy, and cryopreservation period. CONCLUSION: The use of autologous bone flap for reconstruction of a skull defect after decompressive craniectomy is a quick and cost-effective method. But, the resorption rate was greater in children and in patients with large skull defects. As a result, we suggest compressive force of the tightened scalp, young age, large skull defect, the gap between bone flap and bone edge and heat sterilization of autologous bone as risk factors for bone resorption.
Autografts ; Bone Resorption ; Child ; Cryopreservation ; Decompressive Craniectomy ; Hot Temperature ; Humans ; Incidence ; Male ; Polyethylene ; Postoperative Complications ; Risk Factors ; Scalp ; Skull ; Sterilization ; Transplants*

PURPOSE: The fracture of talus has critical complications and results in various clinical outcomes. The purpose of this study is to evaluate clinical outcome and influence on involvement of ankle and subtalar joint. MATERIALS AND METHODS: From December 1999 to December 2008, a total of 66 fractures and dislocations of talus was treated with minimal 9 months follow up period. Ankle-hindfoot scale of the American Orthopedic Foot& Ankle Society (AOFAS) was used to evaluate the clinical outcome. The complications and sequential radiologic findings were also analyzed. RESULTS: There were 28 neck fractures, 11 lateral process fractures, 10 body fractures, 7 osteochondral fractures, 4 posteromedial tubercle fractures and 4 medial process fractures. In 38 cases, there were concomitant injuries. Ipsilateral ankle fracture, which found in 19 cases, was most common. The surgical treatment was performed in 36 cases. Mean AOFAS score was 85.5 (range, 72 to 96). In 13 of 47 cases, one or more fracture lines involving weight bearing surface were confirmed. The involvement of ankle or subtalar joint had resulted in unsatisfied outcome. Complications were developed as follows, post-traumatic arthritis in 8 cases, avascular necrosis in 3 cases, and deep infection in 2 cases. CONCLUSION: The involvement of ankle or subtalar joint in fractures of talus seemed to be common and to impact the clinical outcome. Meticulous consideration about that will be positively necessary.
Animals ; Ankle ; Arthritis ; Dislocations ; Follow-Up Studies ; Neck ; Necrosis ; Orthopedics ; Subtalar Joint ; Talus ; Weight-Bearing

BACKGROUND AND AIMS: There was no single method satisfying accuracy, patient compliance and cost in preoperative staging of gastric cancer. A transabdominal ultrasonography of water-filled stomach (TUS) was compared with endoscopic ultrasonography (EUS) for TN staging in operated gastric cancer. METHODS: We performed EUS conventionally and TUS immediately after 600 mL deaerated water ingested in 40 patients with gastric cancer prior to operation. All the cases were operated and the histological findings were compared with the results of preoperative TN staging. RESULTS: The overall T-staging accuracy rate of TUS was 62.5% and 55.0% for EUS. Both TUS and EUS could differentiate EGC from AGC in 85.0%. There was no statistical difference in the accuracy for the depth of cancer invasion between EUS and TUS. Differentiation of the cancer defined within the gastric wall (T3) from the cancer invading adjacent organs (T4) was possible in 92.5% for TUS and 87.5% for EUS. The accuracy of determining the depth of invasion was tent to be lower in fundus than in antrum and body. Lymph node metastasis was correctly diagnosed in 67.5% for TUS and in 70.0% for EUS. CONCLUSIONS: TUS may be a considered to be a relatively accurate and simple method for preoperative staging of gastric cancer in the absence of available EUS.
Endosonography* ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Patient Compliance ; Stomach Neoplasms* ; Stomach* ; Ultrasonography* ; Water