Fabella impingement syndrome after total knee arthroplasty (TKA) is a rare condition. However, the location of the inserted prosthesis and the size of the fabella are considered major causative factors. Thus far, a conventional surgical excision of the impinged fabella is recommended treatment for the impingement. A 72-year-old woman was diagnosed with degenerative arthritis of the knee. She complained of fabella impingement due to an incompletely excised bony spur behind the posterolateral femoral prosthesis after TKA. The fabella and remaining bony spur were removed using an arthroscopic procedure. The impingement has not recurred and the range of motion (ROM) of the knee was improved after a 12 months follow-up. Arthroscopic surgery might be an alternative treatment for fabella impingement after TKA.
Aged ; Arthroplasty* ; Arthroscopy ; Female ; Follow-Up Studies ; Humans ; Knee* ; Osteoarthritis ; Prostheses and Implants ; Range of Motion, Articular

OBJECTIVE: Evaluation of how much the presence of dementia is underdiagnosed or misdiagnosed in the elderly population by themselves. METHOD: The number of self-professed dementia cases was compared to the estimated number of cases with cognitive impairment based on the Korean version of the Mini-Mental State Examination (MMSEK) employed in a nationwide survey "Need assessment of the long-term care in the elderly" in three representative areas of Korea. The would-be dementia cases were analyzed. RESULTS: Only eighteen (0.7%) of 2,638 reported the presence of dementia while 414 (15.7%) were diagnosed as having questionable cognitive impairment and 385 (14.6%) as having definite cognitive impairment on the MMSEK. On the other hand, some of the self-professed "dementia" cases were not impaired on the MMSEK. CONCLUSION: The public should be educated on clinical manifestations of dementia for its early diagnosis and appropriate treatment because they are mostly without understanding about dementia.
Aged* ; Dementia* ; Diagnosis ; Early Diagnosis ; Epidemiology ; Hand ; Humans ; Korea ; Long-Term Care

OBJECTIVE: The prognosis of systemic lupus erythematosus (SLE) patients with pulmonary hypertension (PH) was reported to be very poor and the median duration of survival estimated to be within 2 years. This study was designed to assess the clinical outcome and risk factors for poor prognosis of patients with SLE combined with PH. MEHTODS: Two hundred ninety-two patients with SLE in whom echocardiography was performed were studied. The diagnosis of PH was made when the right ventricular systolic pressure (RVSP), measured by 2-dimensional echocardiography, was >30 mmHg. Demographic data, clinical manifestations, laboratory findings, and outcome of those with PH were evaluated. RESULTS: Twenty-one of 292 patients had PH. The mean age at diagnosis of PH was 33.8+/-12.5 years. The most frequent presenting symptoms were dyspnea on exertion and dyspnea. Eight of 21 patients died after 1.3+/-1.1 years from diagnosis of PH. Survival rate at first and third year were 86% and 66%, respectively, and the median duration of survival estimated 3.0 years. SLE disease activity index (SLEDAI) and damage index at diagnosis of PH were significantly higher in the deceased. Among the patients in whom sequential echocardiography was performed, RVSP were significantly lowered in the survivors. High SLEDAI and high damage index were independent risk factors for poor prognosis. CONCLUSION: The survival rates and the median duration of survival were slightly better than those of previous reports. The high SLEDAI and high damage index were risk factors for poor prognosis of patients with SLE combined with PH.
Blood Pressure ; Diagnosis ; Dyspnea ; Echocardiography ; Humans ; Hydrogen-Ion Concentration ; Hypertension, Pulmonary* ; Lupus Erythematosus, Systemic* ; Prognosis* ; Risk Factors* ; Survival Rate ; Survivors

BACKGROUND: The efficacy of bisphosphonates for osteoporotic fracture has been consistently reported in recent randomized controlled trials (RCTs) enrolling hundreds of patients. The objective of this study was to update knowledge on the efficacy of available bisphosphonates in the prevention of vertebral and non-vertebral fractures. METHODS: An approach “using systematic reviews” on PubMed and Cochrane Library was taken. Twenty-four RCTs investigating the effects of bisphosphonates for the prevention of osteoporotic fracture were included in final analysis. A pairwise meta-analysis was conducted with a random effects model. Subgroup analysis was performed according to the type of bisphosphonate. RESULTS: The use of bisphosphonate decrease the risk of overall osteoporotic fracture (odds ratio [OR] 0.62; P<0.001), vertebral fracture (OR 0.55; P<0.001) and non-vertebral fracture (OR 0.73; P<0.001). Subgroup analysis indicated that zoledronic acid showed the lowest risk reduction (OR 0.61; P<0.001) for overall osteoporotic fractures but no significance was observed for etidronate (OR 0.34; P=0.127). CONCLUSIONS: This update meta-analysis re-confirmed that bisphosphonate use can effectively reduce the risk of osteoporotic fracture. However, there is a lack of evidence regarding etidronate for the prevention of osteoporotic fracture.
Diphosphonates* ; Etidronic Acid ; Humans ; Meta-Analysis as Topic ; Osteoporosis ; Osteoporotic Fractures* ; Risk Reduction Behavior

No abstract available.
Intussusception* ; Peutz-Jeghers Syndrome*

The purpose of the study is to develop a Web-based health information service system for the disabled. To identify users' information needs, we conducted an online and offline survey of the disabled and their caregivers as well as welfare institutes' staff. Based on the user's information needs, a Web-site was developed. The Web-site was evaluated by users for their satisfaction with the Web-site and by experts for the quality of the site. Content of the Web-site includes information on rehabilitation, welfare, and diseases causing the disability, definition and classification of disability, prevention from disability, management of the disabled, and disability related policies. Besides this information, FAQ on the disabled, statistics, links to the disabled institutes and Web sites, risk factor appraisal tool, and aiding tools for the disabled are added. The Web site is a subsystem of the Healthguide. Users rated efficiency, convenience, and design of the site highly in their satisfaction rating. Staff at welfare institutes rated design, efficiency, and relevance of the site highly in their satisfaction rating. Experts rated easiness, reliability, clearness and appropriateness of the site highly in their site evaluation. It is expected that this Web-based health information service system for the disabled will contribute to the disabled's health promotion as well as provide a community for the disabled related researchers, professionals and experts to share information on the disabled's health.
Academies and Institutes ; Caregivers ; Classification ; Health Promotion ; Humans ; Information Services ; Information Systems ; Internet ; Rehabilitation ; Risk Factors

BACKGROUND AND OBJECTIVES: Hearing aids are commonly used to alleviate the effects of tinnitus. But the investigations for effectiveness of hearing aids on tinnitus gave variable results according to survey methods. We will determine the effects of the hearing aid on the perception of tinnitus using the THI (Tinnitus Handicap Inventory) and investigate the relationships between THI & SADL (Satisfaction with Amplification in Daily Life) scale. SUBJECTS AND METHOD: THI score was assessed at pre-aid time and 4 weeks after fitting with the same inventory prospectively by 36 hearing impaired patients who reported tinnitus. Also, the SADL scale was completed at 4 weeks after fitting. The relationship between SADL score and THI benefit was evaluated. RESULTS: Twenty-two of thirty six patients (61.1%) showed subjective beneficial effect of hearing aid on tinnitus. The use of hearing aid significantly reduced the tinnitus handicap score in all subclasses and total THI. The only positive effect in the subscale of SADL was related to the THI benefit statistically. CONCLUSION: The hearing aid can provide relief from tinnitus associated with hearing loss and improve the subjective satisfaction of fitting.
Surveys and Questionnaires ; Hearing ; Hearing Aids ; Hearing Loss ; Humans ; Prospective Studies ; Tinnitus

We report a rare case of meningioma with extracranial extensions into the temporal bone and infratemporal fossa in a 66 years old woman. Clinical symptoms were mainly otologic, including progressive hearing loss, tinnitus and an external auditory canal mass that mimicked an aural polyp. Computed tomography (CT) scan showed destruction of the tegmen tympani and petrous apex. Magnetic resonance imaging (MRI) revealed extensive intracranial tumor with extracranial extensions into the temporal bone and infratemporal fossa. This case showed an infiltrative nature of extracranial meningioma and its otologic manifestations of temopral bone involvement.
Aged ; Ear Canal ; Female ; Hearing Loss ; Humans ; Magnetic Resonance Imaging ; Meningioma* ; Polyps* ; Temporal Bone ; Tinnitus

Background: Patient perception is a key element in improving compliance with medications for osteoporosis. This study evaluated the awareness, perception, sources of information, and knowledge of osteoporosis among Korean women with osteoporosis. Methods: A questionnaire survey was conducted from July 22, 2021 to 13 August 2021. Patients who were followed up in endocrinology (Endo), orthopedic surgery (OS), and gynecology (GY) were recruited (N=40, 40, and 20 in each group). Patients were allocated according to their age, as follows: 15, 15, and 10 patients in their 60s, 70s, and 80s for Endo and OS, and 10 and 10 patients in their 60s and 70s for GY. The questionnaire was composed of the following topics: patient journey to the hospital, drug-related issues, communication with medical doctors, patient knowledge, and sources of information about osteoporosis. Results: The results of medical check-ups were the most common reason for patient visits to the hospital for an initial diagnosis of osteoporosis (61%). A knowledge gap regarding mortality, refracture, and drug-induced osteoporosis was observed. Doctors were the most preferred and trustful source of information, while health-related TV shows were the second most common source of information. Patients with OS reported lower perceived severity and higher drug discontinuation, along with a higher proportion of fractures, as the initial reasons for hospital visits for osteoporosis. Conclusions Variations in perceptions according to the issue and group were identified. These should be considered during patient consultations to improve compliance with osteoporosis treatment.

There are still some controversies in treatment strategy for the very low-birth-weight baby with esophageal atresia even though the result of primary repair has been improving. We report a successful end to end anastomosis with staged approach in one of twin weighing 1,270 g at birth.
Esophageal Atresia ; Humans ; Parturition ; Tracheoesophageal Fistula ; Twins