Although joint infection with severe destruction remains a serious problem and severe bone loss is relative contraindication of arthrodesis, knee arthrodesis is most commonly a salvage procedure. Its goals are to relieve pain and restore the patient to functional level of activity. The purpose of this study is to evaluate the results and complications of Ilizarov method for knee arthrodesis in the presence of infection. We retrospectively reviewed the records of twelve patients who had managed with knee arthrodesis with Ilizarov method. Indications for the operation included a infected skeletal defect secondary severe open trauma in four patients, an infection at the site of an arthroplasty in three (with failure of previous arthrodesis with monofixator in one), an infected charcot joint in four and one pyogenic arthritis spreading from osteomyelitis of proximal tibia. The average age of the patients at the time of operation was fifty-three years (range twenty-two to eighty years). Follow-up averaged 17 months. The minimum follow up periods was 9 months. Average duration of Ilizarov fixator application was 7.2 months. In 3 cases we performed corticotomy and internal bone transport to treat large bone defect (17cm, 8cm, 6.5cm). Autoiliac bone graft was done in fusion site in two cases, and in three cases we performed bone graft at the docking site. Solid osseous union occured in each patient. There was no reinfection and nonunion. Average shortening was 3.4 cm. Complications were related to pin tract. When last seen, all patients were free of pain and could walk without cruthes or cane. Despite its pin tract problems, bulky cumbersome and expensive apparatus, the Ilizarov method is one of effective method for knee arthrodesis in the presence of infection and large bone loss especially.
Arthritis ; Arthrodesis* ; Arthropathy, Neurogenic ; Arthroplasty ; Canes ; Follow-Up Studies ; Humans ; Ilizarov Technique* ; Joints ; Knee Joint* ; Knee* ; Osteomyelitis ; Retrospective Studies ; Tibia ; Transplants

Today, CTDs (Cumulative Trauma Disorders) are one of major hazards in the US and European Industries disrupting work schedules, productivity and increasing workers compensation costs. The increase in injuries and their associated costs has led companies to form committees and implement programs to address this problem. Therefore, it is important that quantitative analysis tools help identify and assess industrial tasks that pose risk to workers. However, the process of quantifying risk in upper limb tasks is still in its infancy stage and calls for better measurement techniques are not going unheard. As the first work of quantification, baseline CTD checklist for risk assessment was developed in this study. It was mainly based on previous literature regarding CTDs. The checklist was unique in that its expected user was industrial hygienist who did not have much ergonomic background and in that it was targeted to Korean workers in various types of industries. As the first application of the checklist, some jobs in two industries (VDT, heavy Industry) were evaluated, and compared with the medical data. Eighteen out of thirty items in the checklist was univariately significant (p<0.05) on the results of medical examinations. The correlation between medical data and total risk score from the checklist was 0.62. The feasibility of its use by an industrial hygienist was also checked by comparing with the results by an ergonomist. Their correlation (on the basis of Kendall's tau-b) in terms of total risk score was 0.74. The checklist in this study shows reasonably good performance for the first trial. Further research will have to include continuous refinement and validation for many more industries and many more jobs.
Appointments and Schedules ; Checklist* ; Efficiency ; Risk Assessment* ; Upper Extremity ; Workers' Compensation

PURPOSE: To evaluate the therapeutic efficacy of intravitreal bevacizumab (IVB) in the treatment of branch retinal vein occlusion (BRVO) in eyes with normal tension glaucoma (NTG). METHODS: We included 16 NTG eyes and 48 age- and sex-matched eyes without NTG that had received IVB for BRVO with more than 6 months of follow-up. The main outcome measures were log MAR best-corrected visual acuity (BCVA) and central macular thickness (CMT) at baseline and 1, 3, and 6 months after IVB. We compared the results according to the comorbidity associated with NTG. RESULTS: The obstruction site of BRVO was significantly closer to the optic disc in eyes with NTG than in eyes without NTG. Baseline log MAR BCVA and CMT were similar between the two groups. After IVB, postoperative BCVA was significantly improved and CMT was significantly reduced, irrespective of the comorbidity associated with NTG. However, vision improvement was more limited in eyes with NTG, while CMT was similarly reduced compared with that in eyes without NTG. The mean numbers of injections were similar between the two groups, and there were no injection-related complications. CONCLUSIONS: IVB may have therapeutic efficacy in the treatment of BRVO associated with NTG. However, the comorbidity associated with NTG may limit vision improvement, although anatomic recovery of CMT is achieved.
Antibodies, Monoclonal, Humanized ; Comorbidity ; Eye ; Follow-Up Studies ; Low Tension Glaucoma ; Macular Edema ; Outcome Assessment (Health Care) ; Retinal Vein ; Retinal Vein Occlusion ; Retinaldehyde ; Vision, Ocular ; Visual Acuity ; Bevacizumab

The Foster Kennedy syndrome is ipsilateral optic disc atrophy and contralateral optic disc edema that is caused not only frontal lobe tumor but also another intracranial tumors and non tumorous conditions. In this case, suspected neurofibromatosis by the skin and ocular manifestations, there are glioblastoma multiforme in left temporoparietal lobe and undefined mass with bony destruction of the ipsilateral sphenoidal wing ridge. Authors asserted that ipsilateral optic atrophy was caused by direct compression of the undefined mass on sphenoidal wing ridge to the optic nerve and the contralateral disc edema was result from high intracranial pressure caused by glioblastoma multiforme.
Adult ; Anterior Chamber ; Atrophy ; Edema ; Female ; Filtering Surgery ; Frontal Lobe ; Glaucoma* ; Glioblastoma ; Humans ; Intracranial Pressure ; Iris ; Neurofibromatoses ; Optic Atrophy ; Optic Nerve ; Optic Nerve Diseases* ; Parturition ; Skin

No abstract available.
Adult* ; Humans ; Still's Disease, Adult-Onset*

No abstract available.
Intervertebral Disc* ; Zygapophyseal Joint*

BACKGROUND: Exercise-induced coronary spasm is occasionally recognized in patients with variant angina, but the patterns of exercise-induced coronary spasm and its relation to clinical features are still not clear. METHODS: Eight consecutive patients with variant angina without significant stenosis of the coronary artery performed serial treadmill exercise tests during early morning, late morning, and in the afternoon. The subjects repeated the tests after administration of atropine and doxazosin or phentolamine. RESULTS: (Upon drug administration), anginal episodes with ST-segment changes (elevation 5, depression 1) Occurred repeatedly in 6 of the 8 patients during early morning; the episodes occurred in only 2 patients during the afternoon exercise test. Four patients showed exercise-induced angina and ST-segment changes during early morning but not in the afternoon, and 2 of them showed mild episodes of exercise-induced angina and ST-segment changes during late morning. Three of the four patients had the characteristic clinical history of angina in early morning during usual activities but not during daytime activities despite the activities being more strenuous. Another 2 patients showed both exercise-induced ST-segment elevation and angina in early morning and afternoon, and they had the characteristic history of more episodes at night and in early morning but only occasionally in the daytime with or without relation to activity. One of the two patients showed intermittent ST-segment elevation during the exercise test. The other two patients had exercise-induced episodes neither in the early morning nor in the afternoon; they had a characteristic history of episodes only at night during sleep but never in the early morning nor in the daytime. Atropine did not suppress the exercise-induced angina in 4 of 5 patients studied. Doxazosin or phentolamine suppressed the exercise-induced episodes in 3 of 5 patients studied but aggravated spontaneous episodes in 3 patients. CONCLUSION: These data suggest that there's possibility of presence of different patterns of exercise-induced coronary spasm, which may be induced by different mechanisms from those in spontaneous episodes in patients with variant angina.
Atropine ; Constriction, Pathologic ; Coronary Vessels ; Depression ; Doxazosin ; Exercise Test ; Humans ; Phentolamine ; Spasm*

No abstract available.
Leukemia, Myeloid, Acute*

PURPOSE: To report a case of bilateral serous retinal detachment associated with Alport's syndrome that resolved following intensive blood pressure control and electrolyte imbalance correction. CASE SUMMARY: A 50-year-old male patient presented with bilateral lenticonus and bilateral serous retinal detachment. Bilateral serous retinal detachment with retinal flecks characteristic of Alport's syndrome appeared along with the development of chronic renal failure and hypertension. The following kidney biopsy revealed Alport's syndrome. After 14 days, the serous detachment resolved and vision recovered following intensive blood pressure control and electrolyte imbalance correction fundus and FA results were nearly normal. CONCLUSIONS: In this case, bilateral serous retinal detachment in Alport's syndrome resolved with intensive blood pressure control and electrolyte imbalance correction. To the author's knowledge, this is the first case in South Korea with documentation of the onset and resolution of bilateral serous retinal detachment in Alport's syndrome.
Biopsy ; Blood Pressure ; Humans ; Hypertension ; Kidney ; Kidney Failure, Chronic ; Male ; Middle Aged ; Nephritis, Hereditary ; Republic of Korea ; Retinal Detachment ; Retinaldehyde ; Vision, Ocular ; Zinc Phosphate Cement

We report the CT findings of diffuse esophageal spasm (DES) in a patient with dysphagia. Although an uncommon condition, DES should be included in the differential diagnosis if relatively long and symmetric segmental esophageal wall thickening and an epiphrenic esophageal diverticulum are noted at CT.
Deglutition Disorders ; Diagnosis, Differential ; Diverticulum, Esophageal ; Esophageal Spasm, Diffuse* ; Humans