STUDY DESIGN: A retrospective study. OBJECTIVES: We examined union rates and clinical outcomes to evaluate the efficacy of using autologous bone marrow along with a local autobone and biphasic calcium phosphate mixed graft with posterolateral fusion in spinal stenosis and spondylolisthesis. SUMMARY OF LITERATURE REVIEW: In lumbar posterolateral fusion, union rates of biphasic calcium phosphate and local autobone mixed graft are low compared to union rates of autogenous iliac bone graft. MATERIALS AND METHODS: Among the patients who had lumbar posterolateral fusion with autologous bone marrow along with local autobone and biphasic calcium phosphate mixed graft between February 2013 and January 2014, we analyzed 40 patients who were available for at least one year of follow-up. There were 22 cases with spinal stenosis and 18 cases with spondylolisthesis. Bone fusion was determined along with the fusion rates based on Lenke's criteria (citation). All patients were evaluated postoperatively at one year, using 3D CT. and the clinical outcomes were assessed using Kim's method (citation). RESULTS: In spinal stenosis, bone union was observed in 19 cases out of 22 (86.4%), and in case of spondylolisthesis, bone union was observed in 16 cases out of 18 (88.9%). In spinal stenosis, the clinical outcomes were: 2 excellent, 16 good, 3 fair, and 1 poor; in other words 18 cases (81.8%) displayed good or excellent outcomes. In spondylolisthesis, 2 excellent, 12 good, 4 fair and 0 poor; in other words, 14 cases (77.8%) showed good or superior outcomes. CONCLUSIONS: Posterolateral fusion using autologous bone marrow along with a local autobone and biphasic calcium phosphate mixed graft showed similar bone fusion rates to using autogenous iliac bone graft. Therefore, this method could serve as an alternative to using autogenous iliac bone graft in posterior lumbar fusion.
Bone Marrow* ; Calcium* ; Follow-Up Studies ; Humans ; Retrospective Studies ; Spinal Stenosis ; Spondylolisthesis ; Transplants*

This correction is being published to correct the corresponding author's name and e-mail information.

STUDY DESIGN: Retroprospective study. OBJECTIVES: To evaluate the efficacy of biphasic calcium phosphate and local autobone mixed graft in cases of spinal stenosis and spondylolisthesis in posterolateral fusion by examining radiologic union rates and clinical outcomes. SUMMARY OF LITERATURE REVIEW: It can be a practical alternative to the use of tricalcium phosphate in hydroxyapatite as a graft aid since using hydroxyapatite mixture in lumbar spine fusion has been reported to lead to a high rate of bone union. MATERIALS AND METHODS: From July 2011 to February 2013, we followed up 107 patients who had lumbar posterolateral fusion using biphasic calcium phosphate composed of HA/TCP (60:40) and local autobone mixed graft. Of these patients, 64 had spinal stenosis and 43 had spondylolisthesis. The bone fusion rate was determined using Lenke's criteria and clinical outcomes were evaluated using Kim's method. RESULTS: In spinal stenosis, bone union was presented in 53 patients (of 64; 82.8%) and in spondylolisthesis, 35 patients (of 43; 81.4%). In spinal stenosis, the clinical outcomes resulted in 20 excellent, 34 good, 9 fair and 1 poor. (84.4%, excellent or good) In spondylolisthesis, the clinical outcomes resulted in 10 excellent, 25 good, 7 fair and 1 poor. (81.4%, excellent or good). CONCLUSION: Posterolateral fusion using biphasic calcium phosphate and local autobone mixed graft showed high rates of bone union and acceptable clinical outcomes, and is considered a satisfactory bone graft aid.
Calcium* ; Durapatite ; Humans ; Spinal Stenosis ; Spine ; Spondylolisthesis ; Transplants*

In treatment of failure in ankle joint replacement therapy, talar avascular necrosis with massive bone defect, talus fracture with severe comminution and bone defect and ankle dislocation, treatment of large bone defects is considerably important for ankle joint stability and union, therefore, the choice of treatment for large bone defects is use of femoral head or iliac crest bone graft and rigid internal fixation. Because first generation total ankle arthroplasty performed for the first time using a cemented fixation technique requires a large amount of bone resection during re-surgery and there is some possibility of a larger bone defect after removal of implants, in cases where prosthesis for the defect is needed, performance of palliative femoral head or iliac crest bone graft and rigid internal fixation can be difficult. We report on a case of a 48-year-old woman who had experienced ankle pain for 25 years since undergoing total ankle arthroplasty. Because the patient had little ankle motion and rigid soft tissue despite a large bone defect caused by aseptic loosening, a good outcome was obtained only for the femoral cancellous bone graft using allo femoral head without internal fixation.
Ankle Joint ; Ankle* ; Arthroplasty* ; Arthroplasty, Replacement, Ankle ; Dislocations ; Female ; Head ; Humans ; Limb Salvage ; Middle Aged ; Necrosis ; Prostheses and Implants ; Talus ; Transplants

STUDY DESIGN: A retroprospective study. OBJECTIVES: We used a local autobone and beta-tricalcium phosphate mixed graft with posterolateral fusion in spinal stenosis and spondylolisthesis and evaluated union rates to verify the efficacy. SUMMARY OF LITERATURE REVIEW: Several reports have shown high union rates of posterolateral fusion using beta-tricalcium phosphate. However, in Korea, only one study reported a low union rate. MATERIALS AND METHODS: Forty-two patients who underwent lumbar posterolateral fusion with a local autobone and beta-tricalcium phosphate mixed graft from September 2010 to July 2011 were followed up. There were 32 cases with spinal stenosis and 10 cases with spondylolisthesis. Bone fusion was determined along with the fusion rates based on Lenke's criteria. Clinical outcomes were determined using Kim's method. RESULTS: In spinal stenosis, bone union was presented in 19 cases(59.4%) out of 32 cases and in spondylolisthesis, bone union was presented in 7 (70.0%) out of 10. In spinal stenosis, 12 cases showed excellent outcome, 16 good, 3 fair and 1 poor, 27 cases(87.5%) were superior to the good. In spondylolisthesis, 2 cases showed excellent outcome, 5 good, 3 fair and 0 poor, 8 cases(70.0%) were superior to the good. CONCLUSIONS: Posterolateral fusion using a local autobone and beta-tricalcium phosphate mixed graft showed lower bone fusion rates. We need further studies to enhance the fusion rate when using local autobone and beta-tricalcium phosphate mixed grafts.
Calcium Phosphates ; Humans ; Korea ; Spinal Stenosis ; Spondylolisthesis ; Transplants

Septic arthritis caused by Klebsiella pneumonia in adults is rare and is rarely observed after total knee arthroplasty. Acute or early onset of septic arthritis caused by K. pneumoniae has been reported after total knee arthroplasty. However, to date the only one overseas case of late K. pneumoniae infection after total knee arthroplasty has been reported, with no such case in Korea. In addition, monomicrobial infections by K. pneumoniae are not frequently found but are found primarily in the form of polymicrobial infections. The purpose of this paper is to report on a case in which an 85-year-old female patient, who had undergone a total joint arthroplasty 11 years ago, developed the late onset of septic arthritis caused by monomicrobial K. pneumonia infection with a periprosthetic fracture through literature reviews.
Adult ; Aged, 80 and over ; Arthritis, Infectious ; Arthroplasty* ; Arthroplasty, Replacement, Knee ; Coinfection ; Female ; Humans ; Joints ; Klebsiella pneumoniae* ; Klebsiella* ; Knee* ; Korea ; Periprosthetic Fractures* ; Pneumonia

BACKGROUND AND OBJECTIVES: Recent studies have implicated inflammation as playing an important role in the occurrence, persistence and recurrence of atrial fibrillation and that C-reactive protein is a useful marker of the inflammation. The purpose of this study is to evaluate the association between serum CRP levels and the risk of atrial fibrillation. SUBJECTS AND METHODS: This study was performed on 9,487 subjects (5,263 men and 4,224 women; mean age: 58.8+/-6.6 years) who underwent medical check-ups at the Health Promotion Center in Kanbuk Samsung Hospital. 9,438 normal control subjects and 49 atrial fibrillation patients were included in the study. The CRP was measured using a highly sensitive Behring Nephelometer II. RESULTS: When comparing the two groups, there were significant differences in age, gender and the presence of hypertension and cerebrovascular accident, and these are the previously known risk factors for atrial fibrillation. After adjustment was made for the clinical significant variables of atrial fibrillation, multiple regression analysis revealed that the hsCRP levels were not associated with the risk for atrial fibrillation (p=0.52). CONCLUSION: The inflammatory markers (CRP, WBC count) were not predictive of a higher risk for atrial fibrillation in the Korean population.
Adult* ; Atrial Fibrillation* ; C-Reactive Protein* ; Female ; Health Promotion ; Humans ; Hypertension ; Inflammation ; Male ; Recurrence ; Risk Factors ; Stroke

BACKGROUND AND OBJECTIVES: There is a seasonal variation in the incidence of diabetes mellitus and cardiovascular disease. Insulin resistance is important in the development of both non-insulin dependent diabetes mellitus (Type II DM) and cardiovascular disease. Hyperinsulinemia, induced by an insulin resistant state, causes the development of a chronic inflammatory response in vascular structures, which is one of the main causes of cardiovascular disease. There have been several studies on seasonal variation in insulin resistance. Therefore, seasonal variation in insulin resistance were investigated to discover if any relationship existed. SUBJECTS AND METHODS: Korean people examined at a health care center were included. The subjects were divided into four groups, according to the season, and a homeostasis model assessment index (HOMA) calculated, as an indicator of insulin resistance, and compared between the groups. RESULTS: Using the homeostasis model assessment, the highest insulin resistance was observed during winter. Also, the body mass index and waist-hip ratio were highest during winter. CONCLUSION: Compensating for other metabolic factors (age, gender, body mass index, waist-hip ratio and season), insulin resistance was still found to be higher during winter. Seasonal variation in insulin resistance can be associated with the incidence of DM or cardiovascular disease. Therefore, a prospective study will be needed.
Body Mass Index ; Cardiovascular Diseases ; Delivery of Health Care ; Diabetes Mellitus ; Homeostasis ; Hyperinsulinism ; Incidence ; Insulin Resistance* ; Insulin* ; Seasons* ; Waist-Hip Ratio

BACKGROUND AND OBJECTIVES: It is well known that, regardless of whether a person has cardiovascular diseases, the reduction of heart rate after exercise reflects the impairment of the autonomic nervous system. It is also a predictive factor of death rate and it correlates to insulin resistance. Therefore, we assessed these correlations in normoglycemic subjects. SUBJECTS AND METHODS: Exercise stress testing was performed according to the Bruce protocol. Anthropometric indices of adiposity, metabolic variables, blood pressure (BP) and several cardiovascular risk factors were measured. The HOMA index was used as the insulin resistance, and the impairment of the autonomic nervous system was assessed by measuring the reduction of heart rate for 2 minutes after the cessation of exercise. RESULTS: The reduction of heart rate during 2 minutes after the cessation of exercise statistically correlated with the HOMA index, gender, age, body mass index, the waist circumference, heart rate during rest, the maximum heart rate, serum total cholesterol concentration, serum high density lipoprotein cholesterol concentration and serum low density lipoprotein cholesterol concentration, (p<0.05). However, on multiple regression analysis, the HOMA index, gender, heart rate during rest, and the maximum heart rate significantly correlated to the reduction of heart rate during 2 minutes after the cessation of exercise. CONCLUSION: In individuals with normal serum glucose levels, even after adjustment was made for other factors, the reduction of heart rate after the cessation of exercise correlated to insulin resistance. Hence, in individuals with normal serum glucose levels, efforts to improve insulin resistance have to be made, and prospective study on this subject is required.
Adiposity ; Autonomic Nervous System ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Exercise Test ; Heart Rate* ; Heart* ; Humans ; Insulin Resistance* ; Insulin* ; Mortality ; Risk Factors ; Waist Circumference

BACKGROUND AND OBJECTIVE: The relationship between serum uric acid and metabolic syndrome variables has not been reported in Korea. Therefore, whether the circulating levels of serum uric acid are independently related to hypertension, insulin resistance and the variables of metabolic syndrome were assessed. SUCJECTS AND METHODS: A total of 53,477 health screen examinees were enrolled and divided into four groups (Quartile 1:<4.2 mg/dL, Quartile 2:4.2-5.29 mg/dL, Quartile 3:5.3-6.29 mg/dL, Quartile 4:>6.29 mg/dL) according to their serum uric acid level. The blood pressure, lipid profiles, fasting plasma glucose, waist circumference, HOMA, high sensitivity CRP and apolipoprotein were compared between the four groups. RESULTS: There was a positive association between blood pressure and the serum uric acid level (p<0.001). After adjustment for covariates the prevalence of hypertension due to uric acid was 1.192 (95% CI, 1.038-1.368 p=0.013), and 1.408 (95% CI, 1.221-1.623 p<0.001) times higher in subjects in the third and fourth uric acid level quartiles, respectively, compared to the subjects in the first quartile. Insulin resistance and metabolic syndrome variables were positively correlated with the serum uric acid level. The number of metabolic syndrome variables was also increased with an elevated serum uric acid level. CONCLUSION: Our study suggests that serum uric acid levels were independently associated with hypertension, insulin resistance and the variables of metabolic syndrome in the Korean population. Although the serum uric acid level was normal value, the risk of metabolic syndrome was increased with an elevated serum uric acid level. However, because of the cross-sectional nature of our study, these findings should be confirmed in prospective cohort studies.
Apolipoproteins ; Blood Glucose ; Blood Pressure ; Cohort Studies ; Fasting ; Hypertension* ; Insulin Resistance* ; Insulin* ; Korea ; Prevalence ; Reference Values ; Uric Acid* ; Waist Circumference