No abstract available.
Vibrio vulnificus* ; Vibrio*

Injury of the ankle ligaments is one of the most common sports-related injuries. Although there are some debates as to the best initial treatment for an acute tear of a lateral ligament, persistent functional instability of the ankle develops in approximately 20% of patients regardless of the type of initial treatment. In these patients, late reconstruction of the lateral ankle ligaments may become necessary. Among 13 cases which have been operated with Larsen procedure using peroneus brevis tendon from March 1991 to February 1993, the 11 cases followed up over 1 year were examined clinically and radiologically. We introduced the clinical analysis and results with the brief review of the literatures. 1. The indication of surgical treatment was the ankle instability which had differences over 10° in talar tilting angle or over 3mm in anterior displacement compared wit the uninjured site. 2. The postoperative results were 5 cases in excellent and 4 in good. 3. The Larsen procedure was considered a good method to anatomically and simply stabilize both the ankle and subtalar joint and to fix tendon depending on the type of instability.
Ankle ; Collateral Ligaments ; Humans ; Ligaments ; Methods ; Subtalar Joint ; Tears ; Tendons

Anterior cervical discectomy and fusion (ACDF) has been performed for degenerative and traumatic cervical diseases to improve pain and neurologic symptoms including sensory change and motor weakness. Infection, however, is a rare complication of ACDF, and late infection is even much rarer. We present a case of late Infection from ACDF C4-5 using Biocompatible Osteoconductive Polymer (BOP) after twenty years in the absence of an esophageal perforation, Zenker's diverticulum, or recent surgery or bacteremia. Late infection from ACDF after 20 years is extremely rare in the literature. However, possibility of such a late complication should be appreciated during the follow-up period and surgical resection will be required for proper treatment.
Bacteremia ; Diskectomy* ; Esophageal Perforation ; Follow-Up Studies ; Neurologic Manifestations ; Polymers ; Zenker Diverticulum

OBJECTIVE: Vertebral artery dissecting aneurysms (VADAs) are rare and many debates are present about treatment options. We review types and efficacy of our endovascular treatments and establish a safe endovascular therapeutic strategy regard to the angio-architecture of VADAs. MATERIALS AND METHODS: Between July 2008 and October 2015, we treated 22 patients with symptomatic VADAs. Fifteen patients presented with subarachnoid hemorrhage from the ruptured VADAs, digital subtraction angiography and magnetic resonance image confirmed the diagnosis and endovascular treatments were followed as their angio-architecture. RESULTS: Clinical results were good in 13 patients (86.7%), and there were no technical problems during endovascular procedures. The other 2 patients with poor prognosis showed severe neurological deficits at the initial evaluation. Among the three different endovascular treatments, there were no radiologic cure in one patient with stent insertion alone, but the patient had no significant clinical symptoms either. CONCLUSION: Endovascular treatments are safe and effective treatment option for managing VADAs and can be the first treatment of choice for most patients. To select proper endovascular treatment according to the angio-architecture of VADAs can reduce the risk of the treatment.
Aneurysm, Dissecting* ; Angiography, Digital Subtraction ; Diagnosis ; Endovascular Procedures ; Humans ; Prognosis ; Stents ; Subarachnoid Hemorrhage ; Vertebral Artery*

Colorectal cancer(CRC) is the most common gastrointestinal malignancy in the Western world. The total number of CRC cases in Korea is increasing probably due to western-style diets. CRC is relatively uncommon in the young adult group. Nevertheless, these cases warrant special attention because they are often diagnosed in an advanced stage and are more likely to involve a family history of CRC. Controversies still exist over the determination of the age range and over the true value of age factor in the prognosis for the young adults. The aim of this study is to calculate the incidence, to evaluate the clinicopathologic characteristics and the outcome of management of young adult with CRC. A retrospective review of 864 patients with an adenocarcinoma of the colon or rectum, who were surgically treated and followed-up in our Department of the Kang Buk Samsung Hospital, Sung Kwun Kwan University College of Medicine, Seoul, Korea, between January 1970 and December 1995 was performed. Among these patients, 138 were in the young adult group, aged less than 40. All cases accompanied by familial adenomatous polyposis coli and ulcerative colitis were excluded. Young adults accounted for 16.0% of all patients with CRC, showing no significant sex difference compared with the control group. The rectum and sigmoid colon were the most frequent sites of the lesion (80.4%). The incidences of Dukes' stage C and poorly differenciated adenocarcinoma cases were significantly higher in the young adult group (p<0.05). The curative resection rate of tumors in young patients was 93.4%. Despite of the more advanced stage and poorly differenciation, the stage-related and overall 5-year survival rate was not significantly different between old and young patients (57.9% and 59.4% in young and old patients, respectively). CRC in young adults in Korea is increasing in number, but its proportion is decreasing. The results of our study indicate that the prognosis and the stage-related survival for CRC in young adults are not related to age.
Adenocarcinoma ; Adenomatous Polyposis Coli ; Age Factors ; Colitis, Ulcerative ; Colon ; Colon, Sigmoid ; Colorectal Neoplasms* ; Diet ; Humans ; Incidence ; Korea ; Prognosis ; Rectum ; Retrospective Studies ; Seoul ; Sex Characteristics ; Survival Rate ; Western World ; Young Adult*

OBJECTIVE: The goal of this study was to evaluate the biomechanical features of human cadaveric spines implanted with the Activ L prosthesis. METHODS: Five cadaveric human lumbosacral spines (L2-S2) were tested for different motion modes, i.e. extension and flexion, right and left lateral bending and rotation. Baseline measurements of the range of motion (ROM), disc pressure (DP), and facet strain (FS) were performed in six modes of motion by applying loads up to 8 Nm, with a loading rate of 0.3 Nm/second. A constant 400 N axial follower preload was applied throughout the loading. After the Activ L was implanted at the L4-L5 disc space, measurements were repeated in the same manner. RESULTS: The Activ L arthroplasty showed statistically significant decrease of ROM during rotation, increase of ROM during flexion and lateral bending at the operative segment and increase of ROM at the inferior segment during flexion. The DP of the superior disc of the operative site was comparable to those of intact spine and the DP of the inferior disc decreased in all motion modes, but these were not statistically significant. For FS, statistically significant decrease was detected at the operative facet during flexion and at the inferior facet during rotation. CONCLUSION: In vitro physiologic preload setting, the Activ L arthroplasty showed less restoration of ROM at the operative and adjacent levels as compared with intact spine. However, results of this study revealed that there are several possible theoretical useful results to reduce the incidence of adjacent segment disease.
Arthroplasty ; Biomechanics ; Cadaver ; Humans ; Incidence ; Prostheses and Implants ; Range of Motion, Articular ; Spine ; Sprains and Strains

Synovial chondromatosis is a rare lesion in the wrist, but some cases in the distal radioulnar joint have been reported and previous case reports emphasize joint calcifications, shown on preoperative plain radiographs. We report an extremely uncommon case of synovial chondromatosis in the pisotriquetral joint, in which radiographs and magnetic resonance imaging did not demonstrate apparent calcified bodies. In our case, for the accurate diagnosis and treatment, surgical exploration of the joint and synovectomy with removal of loose bodies was performed.
*Chondromatosis, Synovial/diagnosis/physiopathology/surgery ; Female ; Humans ; Middle Aged ; *Wrist Joint/physiopathology/surgery

A 29-year-old woman in her 8th week of pregnancy was referred to our hospital for swelling in the lower extremities, rapid onset of dyspnea (1 hr) and pre-syncope. Severe right ventricular dysfunction and moderate pulmonary hypertension were detected using 2-dimentional Doppler echocardiography. In addition, left calf vein and proximal thromboses were detected by venous compression ultrasound imaging. After successful thrombolytic treatment, the patient quickly recovered and was discharged from hospital on subcutaneous low-molecular-weight heparin. She delivered a normal, healthy infant at full-term (40 weeks).
Adult ; Dyspnea ; Echocardiography, Doppler ; Female ; Heparin, Low-Molecular-Weight ; Humans ; Hypertension, Pulmonary ; Infant ; Lower Extremity ; Pregnancy* ; Pulmonary Embolism* ; Thrombolytic Therapy ; Thrombosis ; Ultrasonography ; Veins ; Venous Thrombosis* ; Ventricular Dysfunction, Right

OBJECTIVE: The number of elderly patients with cerebral aneurysm has markedly increased. We investigated the clinical characteristics and the surgical outcomes of cerebral aneurysms among elderly patients more than 65 years of age compared to a control group including patients less than 65. MATERIALS AND METHODS: From March 2001 to May 2007, 590 patients with aneurysmal subarachnoid hemorrhage (SAH) were treated; among them, 88 patients (14.9%) more than 65 were candidates for this study. The variables included in the analysis were: age, gender, size and site of the aneurysm, the Hunt-Hess grade, size of the hematoma on the CT scan, and comorbidities. RESULTS: The mean age was 69 (range 65-84 years), 72 patients (81%) were female, 72 of the patients had a Hunt-Hess grade of I-III, 37 patients (42%) had anterior communicating artery bleeds, and 13 patients (16.7%) had multiple aneurysms. The treatments consisted of neck clipping for 77 aneurysms and endovascular therapy for 11 aneurysms. Fifty eight patients (65.9%) had a favorable outcome and the overall mortality was 11.4%. The main causes of unfavorable outcomes among the elderly patients included a poor Hunt-Hess grade on admission and a concurrent intracerebral hematoma. CONCLUSIONS: The results of this study showed that advanced age was not a contra-indication to aneurysm surgery and early craniotomy can lead to a better outcome in elderly patients.
Aged ; Aneurysm ; Arteries ; Comorbidity ; Craniotomy ; Female ; Hematoma ; Humans ; Intracranial Aneurysm ; Neck ; Subarachnoid Hemorrhage

OBJECTIVES: We sought to examine the diverse factors associated with aneurysms of the posterior circulation. In addition, the results of conventional craniotomy were compared with those of endovascular treatment. METHODS: One hundred and one patients with posterior circulation aneurysms were selected for study inclusion. The factors that might affect the clinical outcomes were studied , such as the initial Hunt-Hess (H-H) grade, aneurysm location, size of the aneurysm, and therapeutic modalities. In addition, the morbidity and mortality rates were analyzed. The treatment outcomes were evaluated using the Glasgow Outcome Scale (GOS) 6 months after the initial insult. RESULTS: The patient population consisted of 67 women and 34 men, with a mean age of 52 (range 28-81 years). The overall morbidity and mortality rates at 6 months were 13.9% (14/101) and 17.8% (18/101), respectively. Sixty-one operations (60.3%) were performed, and 32 patients were treated with endovascular therapy. Forty-two (85.7%) of the 49 patients that had initial H-H grades of I and II had a better prognosis (GOS more than 4) than those with poor H-H grades (P<0.001). Patients that underwent endovascular treatment had better outcomes than those that had clipping (P=0.032). There was no significant difference in outcome according to the size of the aneurysm, location of the aneurysm, or the age of the patients. CONCLUSIONS: The results of this study showed that the factors affecting the prognosis were the initial HH grade and treatment modality. Considering the very high mortality rate in patients with rebleeding, early management may help improve the prognosis of patients with posterior circulation aneurysms. Endovascular therapy should be considered the primary treatment modality in patients with posterior circulation aneurysms.
Aneurysm ; Craniotomy ; Female ; Glasgow Outcome Scale ; Humans ; Intracranial Aneurysm ; Male ; Prognosis