ABSTRACT
PURPOSE: The purpose of this review is to compare the clinical and radiological outcomes between open and closed wedge distal femoral varus osteotomy (DFO). METHODS: A literature search of online databases (MEDLINE, EMBASE, and Cochrane Library database) was made in addition to manual search of major orthopedic journals. Data were searched from the time period of January 1990 to October 2016. A modified Coleman Methodology Score system was used to assess the methodologic quality of the included studies. A total of 20 studies were included in the review. All studies were level IV evidence. RESULTS: Comparative analysis of open and closed wedge DFO did not demonstrate clinical and radiological differences. The survival rates were also similar. Five studies (56%) on open wedge DFO mentioned the need for either bone grafting or substitute for osteotomy gap filling and reported higher incidences of reoperation for plate removal than the closed wedge DFO studies. CONCLUSIONS: The present systematic review showed similar performance between open and closed wedge DFO. Outcomes including survival rates were not statistically significantly different. However, additional bone grafting or substitutes were often needed to prevent delayed union or nonunion for open wedge techniques. Additional operations for plate removal were commonly required due to plate irritation in both techniques.
Subject(s)
Arthritis , Bone Transplantation , Femur , Incidence , Knee , Orthopedics , Osteotomy , Reoperation , Survival RateABSTRACT
The role of atypical bacteria and the effect of antibiotic treatments in acute bronchitis are still not clear. This study was conducted at 22 hospitals (17 primary care clinics and 5 university hospitals) in Korea. Outpatients (aged > or = 18 yr) who had an acute illness with a new cough and sputum (< or = 30 days) were enrolled in 2013. Multiplex real-time polymerase chain reaction (RT-PCR) was used to detect five atypical bacteria. A total of 435 patients were diagnosed as having acute bronchitis (vs. probable pneumonia, n = 75), and 1.8% (n = 8) were positive for atypical pathogens (Bordetella pertussis, n = 3; B. parapertussis, n = 0; Mycoplasma pneumoniae, n = 1; Chlamydophila pneumoniae, n = 3; Legionella pneumophila, n = 1). Among clinical symptoms and signs, only post-tussive vomiting was more frequent in patients with atypical pathogens than those without (P = 0.024). In all, 72.2% of the enrolled patients received antibiotic treatment at their first visits, and beta-lactams (29.4%) and quinolones (20.5%) were the most commonly prescribed agents. In conclusion, our study demonstrates that the incidence of atypical pathogens is low in patients with acute bronchitis, and the rate of antibiotic prescriptions is high.
Subject(s)
Female , Humans , Male , Middle Aged , Anti-Bacterial Agents/therapeutic use , Bordetella parapertussis/genetics , Bordetella pertussis/genetics , Bronchitis/drug therapy , Chlamydophila pneumoniae/genetics , Community-Acquired Infections/microbiology , Hypertension/complications , Legionella pneumophila/genetics , Mycoplasma pneumoniae/genetics , Real-Time Polymerase Chain Reaction , Republic of Korea , Sputum/microbiologyABSTRACT
Malignant colonic obstruction can lead an emergency operation for decompression, and this can cause post-operative complications due to poor bowel preparation. Self-expandable metal stent (SEMS) insertion is useful for avoiding an emergency operation and unnecessary complications. However, SEMS insertion for dual malignant colonic obstructions is very rare. We report here on a case of two SEMS that were inserted in dual malignant colonic obstructions caused by synchronous colon cancer. A 66-year-old man visited our hospital due to abdominal distension. Sigmoidoscopy and an abdominopelvic computerized tomographic (CT) scan revealed synchronous colon cancer at the splenic flexure and distal descending colon with dual obstruction. The initial SEMS insertion on the descending colon was not effective for decompression due to the proximal obstruction. After the second SEMS insertion on the splenic flexure through the first stent, all the signs and symptoms due to obstruction disappeared. SEMS insertion is considered to be useful for treating dual malignant colonic obstruction caused synchronous colon cancer.
Subject(s)
Aged , Humans , Colon , Colon, Descending , Colon, Transverse , Colonic Neoplasms , Decompression , Emergencies , Sigmoidoscopy , StentsABSTRACT
OBJECTIVES: This study was conducted to compare between hallucination group and delusion group in patient with schizophrenia, using Brain (99m)Tc-ECD SPECT. METHODS: Among 16 patients with less than 3 schizophrenic episodes, 8 patients whose initial symptom was hallucination were assigned to the hallucination group, and other 8 patients with initial sumptom of delusion were assinged to the hallucination group. All of the patients clinically evaluated using the PANSS and BPRS. Both groups of patients and 8 healthy subjects underwent (99m)Tc-ECD SPECT. RESULTS: Score of thinking disturbance subscale of BPRS were significantly lower in the hallucination group than the delusion group. In SPECT analysis, the hallucination group showed significantly increased perfusion in some areas of the right temporal lobe, bilateral limbic lobes and left parietal lobe compared to delusion group. Both group had a reduced rCBF in some areas of the frontal lobe. CONCLUSION: The hallucniation group, compared with the delusion group, showed significantly increased regional cerebral blood flow in some regions. Therefore, this data suggests that different neural substrates may affect the process of auditory hallucination and delusion.
Subject(s)
Humans , Brain , Delusions , Frontal Lobe , Hallucinations , Parietal Lobe , Perfusion , Schizophrenia , Temporal Lobe , Thinking , Tomography, Emission-Computed, Single-PhotonABSTRACT
Bisphosphonates are widely used for the treatment of osteoporosis to prevent fractures. Although their safety and efficacy have been well documented, some recent reports have drawn attention to a possible correlation between long term bisphosphonate therapy and the occurrence of insufficiency fractures owing to prolonged bone turnover suppression. A 71-year-old woman presented to our emergency room with pain and deformity of the left thigh with low energy injury. Radiographs showed a left femur subtrochanteric fracture and a transverse sclerotic fracture line in the right femur subtrochanteric area with cortical thickening, which indicate insufficiency fractures. She had been treated with sodium alendronate 70 mg per week for 6 years and was suffering from prodromal symptoms in both thighs from 3 months ago. After surgery and intraoperative bone biopsy for a left subtrochanteric fracture, her osteoporosis medication was changed with a bone forming agent. We have analyzed the characteristics of insufficiency fractures related to long term bisphosphonate therapy. Physicians should keep in mind the possibility of insufficiency fracture in cases such as ours, especially with prodromal thigh pain.
Subject(s)
Aged , Female , Humans , Alendronate , Biopsy , Congenital Abnormalities , Diphosphonates , Emergencies , Femur , Fractures, Stress , Osteoporosis , Prodromal Symptoms , Sodium , Stress, Psychological , ThighABSTRACT
BACKGROUND/AIMS: Obesity is associated with the risk of colorectal cancer. However, there is a lack of information about the relationship between obesity and colorectal adenoma. We investigated whether general and abdominal obesity are risk factors for colorectal adenoma. METHODS: Subjects who received health check-ups, including colonoscopy, from April 2006 to September 2007 in Chung-Ang University Hospital were included (n=1,316). The frequency and characteristics of colorectal adenomas were analyzed according to demographic features, past history, blood tests, body mass index, and components of metabolic syndrome. Abdominal obesity was defined as a waist circumference of > or =80 cm in women and > or =90 cm in men. RESULTS: The sex ratio of the subjects was 1.9:1 (male:female) and their age was 47.7+/-10.0 years (mean+/-SD). In univariate analysis, abdominal obesity was significantly associated with the frequency of colorectal adenoma (26.5% "yes" vs 16.9% "no"; p or =100 mg/dL) or fatty liver (p or =60 years; OR, 6.7; 95% CI, 3.5-12.5), and abdominal obesity (OR, 1.5; 95% CI, 1.0-2.2) were independent risk factors for colorectal adenoma (p<0.05). The frequency of multiple adenomas (more than two sites) was also significantly higher in subjects with abdominal obesity. However, the effect of abdominal obesity on the development of colorectal adenoma decreased in elderly people. CONCLUSIONS: Abdominal obesity is an independent risk factor for colorectal adenoma and its multiplicity, especially in younger people in South Korea.
Subject(s)
Aged , Female , Humans , Male , Adenoma , Body Mass Index , Colonoscopy , Colorectal Neoplasms , Fasting , Fatty Liver , Hematologic Tests , Hyperglycemia , Multivariate Analysis , Obesity , Obesity, Abdominal , Republic of Korea , Risk Factors , Sex Ratio , Waist CircumferenceABSTRACT
STUDY DESIGN: A prospective, non-randomized study OBJECTIVES: To evaluate the early clinical results of percutaneous endoscopic lumbar discectomy (PELD) and microdiscectomy (MD) using a tubular retractor. SUMMARY OF THE LITERATURE REVIEW: There are few reports comparing the clinical results of different minimal invasive surgical procedures for disc herniation. MATERIALS AND METHODS: Out of 41 patients who underwent a discectomy at the L4-5 level, 16 patients (Group I) underwent PELD and 25 patients (Group II) underwent MD. The surgical techniques were based on the patient's selection. The characteristics of the operation(operation time, time for C-arm, amount of removed disc) were compared with the clinical outcomes by evaluating the SLR (straight leg raising test), leg VAS (visual analogue scale), ODI (Oswestry Disability Index), hospital day, changes in disc height. RESULTS: Group I showed a larger amount of disc removed and exposure time for the C-arm than group II (p<0.05). However, the hospital day was shorter in group I than in group II (p<0.05). There were no differences in the leg VAS, ODI, the change in disc height and surgery time between the two groups at the last follow up. One case in group I had a neuropraxia of the L5 root that had recovered fully at postoperative 3months. In group II, there was one case of a postoperative hematoma and 2 cases of a dural tear. CONCLUSION: Although the early clinical outcomes were similar in both groups, group I showed a larger amount of disc removed and more exposure time to radiation but a shorter hospital stay.
Subject(s)
Humans , Diskectomy , Follow-Up Studies , Hematoma , Leg , Length of Stay , Prospective Studies , TearsABSTRACT
PURPOSE: Aim of this study was to compare the effects of the Valsalva maneuver (VM), carotid sinus massage (CSM) and cold water facial immersion (CWFI) on the automomic nervous system of the heart by measuring heart rate variability. METHODS: Maximal endurance VM, CSM for 10 seconds, and CWFI for 30 seconds were done on healthy subjects. Prolongation of the R-R interval (RRI), vagal ratio (ratio of maximal RRI after vagal stimulation to mean RRI before stimulation), duration of maximal RRI, and variables from a power spectrum analysis and time domain analysis were compared. RESULTS: RRIs were significantly prolonged in the CSM and CWFI groups compared to the VM group. Vagal ratio was greatest with the CWFI group. The CSM group had the fastest reaction, with no right and left difference, and the VM group was the slowest. Increase in the high frequency (HF) power of RRI variability was greater with CWFI than with VM. LF/HF ratio showed meaningful decrease with CWFI and CSM as compared to VM. Standard deviation of all normal-to-normal intervals (SDNN) and Square root of the mean of the sum of the squares of differences between adjacent normal-to-normal intervals (RMSSD) was significantly greater with CWFI and with VM than with both CSMs. CONCLUSION: CWFI could prolongate RRI more than other procedures and could also increase vagal activity of the heart more than other methods. VM is difficult to perform properly, and CSM is prone to complication when done by non-medical personnels. CWFI, however, is a relatively safe technique for primary treatment that can be done with paroxysmal supraventricular tachycardia.
Subject(s)
Carotid Sinus , Cold Temperature , Diving , Heart , Heart Rate , Immersion , Massage , Nervous System , Spectrum Analysis , Valsalva Maneuver , WaterABSTRACT
The most serious problem after splenectomy is the increased risk of life-threatening infections caused by encapsulated bacteria such as Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis. Purpura fulminans, which is commonly associated with meningococcal sepsis, is characterized by disseminated intravascular coagulation and rapidly progressive purpuric skin lesions. Purpura fulminans can also develop in invasive pneumococcal infection especially after splenectomy, however, there has been no report in Korea. We report a case of overwhelming pneumococcal sepsis manifested as purpura fulminans in a splenectomized patient.
Subject(s)
Humans , Bacteria , Disseminated Intravascular Coagulation , Haemophilus influenzae , Korea , Neisseria meningitidis , Pneumococcal Infections , Purpura Fulminans , Purpura , Sepsis , Skin , Splenectomy , Streptococcus pneumoniae , StreptococcusABSTRACT
Emphysematous cystitis is an uncommon life-threatening disease, which often occurs in patients with diabetes mellitus or neurogenic bladder. Bacterial etiologies are common, while cases by Candida species have been very rarely reported. To date, only six cases of Candida albicans related emphysematous cystitis have been reported; two cases resulted in bladder repture and the causative organisms were non-albicans Candida species. We report the first case of emphysematous cystitis caused by Candida albicans accompanying a spontaneous bladder rupture with the review of literatures.
Subject(s)
Humans , Candida albicans , Candida , Cystitis , Diabetes Mellitus , Rupture , Rupture, Spontaneous , Urinary Bladder , Urinary Bladder, NeurogenicABSTRACT
Emphysematous cystitis is an uncommon life-threatening disease, which often occurs in patients with diabetes mellitus or neurogenic bladder. Bacterial etiologies are common, while cases by Candida species have been very rarely reported. To date, only six cases of Candida albicans related emphysematous cystitis have been reported; two cases resulted in bladder repture and the causative organisms were non-albicans Candida species. We report the first case of emphysematous cystitis caused by Candida albicans accompanying a spontaneous bladder rupture with the review of literatures.
Subject(s)
Humans , Candida albicans , Candida , Cystitis , Diabetes Mellitus , Rupture , Rupture, Spontaneous , Urinary Bladder , Urinary Bladder, NeurogenicABSTRACT
BACKGROUND AND OBJECTIVES: Deep vein thrombosis and pulmonary embolism are both associated with a high mortality. However, in Korea, they are known as relatively rare diseases and are not sufficiently evaluated, so there is limitations in the proper approach toward their diagnosis and management. SUBJECTS AND METHODS: The risk factors, accompanying illness and family history of patients with deep vein thrombosis and pulmonary embolism, treated at Hallym University Sacred Heart Hospital, between January 1999 and July 2002, were analyzed. RESULTS: There were 113 patients with deep vein thrombosis and pulmonary embolism, comprised of 45 men and 68 women, 31 being older than 70 years of age (the largest portion). Of the 113 patients, 101 had identified causal illness causative diseases, but the other was no obvious risk factors. Overweight and obese turned out to be the most frequent risk factor. While there were 35% with one risk factor, 51.3, 10 and 3.7% had two, three or four risk factors, respectably. The recurrence rate was 20.3%, and that of women was 1.2 fold that of men, irrespectively of the risk factor. There were also two patients with a positive family history. CONCLUSION: The freguent risk factors and underlying diseases for deep vein thrombosis and pulmonary embolism were over-weight/obesity, antiphospholipid syndrome, cancer and a bed ridden state, in that order of frequency. As the individual risk factors of the patients overlapped in 61.5% cases, attention should be paid to overlapping risk factors. In order to reduce the complications of these diseases, each patient's risk factors should be carefully evaluated, and some patients should be advised to take life-long care.
Subject(s)
Female , Humans , Male , Antiphospholipid Syndrome , Diagnosis , Heart , Korea , Mortality , Overweight , Pulmonary Embolism , Rare Diseases , Recurrence , Risk Factors , Venous ThrombosisABSTRACT
PURPOSE: This study was undertaken to elucidate the natural healing potential in posterior cruciate ligament (PCL) injury using histological and biomechanical methods. MATERIALS AND METHODS: PCLs of 92 rabbits were cut partially or completely cut on one side. In Group I, 75% of the PCL was cut preserving the synovium partially. In Group II, the PCL and synovium were completely severed. Investigations were performed by gross inspection, histological examination after Hematoxylin-Eosin (HE) staining and tensile stress testing using an Instron. RESULTS: Continuity of the ligaments began to appear at 2 weeks in group I and at 12weeks in group II. Proliferation of fibroblasts and vessels were observed in HE stained ligaments at 6 and 12 weeks in both groups. The ultimate tensile strength in group I was .3% and in group II 33.1% at 12 weeks. CONCLUSION: Although the mechanical properties of the regenerated ligaments were poor, this study demonstrats that the rabbit PCL has healing potential irrespective of the degree of injury.
Subject(s)
Rabbits , Exercise Test , Fibroblasts , Ligaments , Posterior Cruciate Ligament , Synovial Membrane , Tensile StrengthABSTRACT
Prediction of acetabular development after reduction in treatment of developmental dysplasia of thc hip (DDH) is earlier, the hetter results because it would help ensure optimal timing of additional procedure if necessary. In this respect, authors reviewed retrospectively the radiographs of the hips of 35 children with DDH who had unilateral involvement and treated hy senior author (S.H.Lee) from the heginning with single successful attempt of reduction. The radiographs which were made at the time of initial diagnosis, one, two year nfter reduction und final follow up were assessed of teardrop figures. The results of treatment were classified as satisfactory group(CE > 10degrees ) and unsatisfactory group(CE < 10degrees) judged hy center-edge angle(CE degrees) at final follow-ups. 1. The teardrop figures were classifiable into 4 distinct groups as i)absent. ii)V-shaped, iii)Ushaped, iv) inverted D-shaped. 2. The teardrop figures in normal sides of hip were all U-shaped. 3. In dislocated but with satisfactory result group(24 cases), absent at 2 cases(8%), U-shaped teardrop was seen at 13 cases(54%), V-shaped in 9 cases(38%), and inverted 2-shaped in 0 case at I year after reduction. 4. In dislocated but with unsatisfactory result group( 11 cases), they were mostly of V-shaped(7 cases, 64%). The rest were of ahsent in 4 cases(36%) . hut none of U-shaped and inverted 2-shaped. In conclusions, teardrop figures appeared as significant predictor of future development of hip joint. Teardrop figure which stay as V-shaped at one year after reduction seems suggestive of insufficient reduction of DDH, therehy calls for early additional procedure.
Subject(s)
Child , Humans , Acetabulum , Diagnosis , Joint Dislocations , Dronabinol , Follow-Up Studies , Hip Joint , Hip , Retrospective StudiesABSTRACT
No abstract available.