The Korean Version of the Cognitive Assessment Scale for Stroke Patients (K-CASP): A Reliability and Validity Study

OBJECTIVE: To develop the Korean version of the Cognitive Assessment Scale for Stroke Patients (K-CASP) and to evaluate the test reliability and validity of the K-CASP in stroke patients. METHODS: The original CASP was translated into Korean, back-translated into English, then reviewed and compared with the original version. Thirty-three stroke patients were assessed independently by two examiners using the K-CASP twice, with a one-day interval, for a total of four test results. To evaluate the reliability of the K-CASP, intra-class correlation coefficients were used. Pearson correlations were calculated and simple regression analyses performed with the Korean version of Mini-Mental State Examination (K-MMSE) and the aphasia quotient (AQ) to assess the validity. RESULTS: The mean score was 24.42±9.47 (total score 36) for the K-CASP and 21.50±7.01 (total score 30) for the K-MMSE. The inter-rater correlation coefficients of the K-CASP were 0.992 on the first day and 0.995 on the second day. The intra-rater correlation coefficients of the K-CASP were 0.997 for examiner 1 and 0.996 for examiner 2. In the Pearson correlation analysis, the K-CASP score significantly correlated with the K-MMSE score (r=0.825, p<0.001). The coefficients of determination (r²) of the AQ were 0.586 for the K-MMSE and 0.513 for the K-CASP in the simple regression analysis. CONCLUSION: The K-CASP is a reliable and valid instrument for cognitive dysfunction screening in post-stroke patients. It is more applicable than other cognitive assessment tools in stroke patients with aphasia.

The Efficacy and Safety of Postoperative Autologous Transfusion of Filtered Shed Blood and Anticoagulant Prophylaxis in Total Knee Arthroplasty Patients

PURPOSE: To assess the efficacy and safety of autologous transfusion of filtered shed blood in total knee arthroplasty (TKA). MATERIALS AND METHODS: A total of 42 patients with TKA (group A; without autologous transfusion in 15 patients, group B; with autologous transfusion in 27 patients) were evaluated retrospectively. The influence of autologous reinfusion of filtered blood, bleeding tendency, amount of blood drainage, rate of allogenic transfusion, and the postoperative changes of hemoglobin were analyzed. RESULTS: Allogenic transfusion was needed in 26.7% (4/15) of group A and none of group B till postoperative 48 hours. Till postoperative 14 days, 46.7% (7/15) of group A needed allogenic transfusion while 7.4% (2/27) in group B. The average drained blood volume was 1,197+/-400 mL in group A and 975+/-422 mL in group B. The average decrease of hemoglobin at postoperative 1, 7, and 14 days was 2.9+/-1.5, 2.9+/-1.6, and 2.3+/-1.5 g/dL respectively in group A and 2.7+/-0.8, 4.0+/-1.0, and 2.9+/-1.3 g/dL respectively in group B. CONCLUSIONS: An autotransfusion system lowered the allogenic transfusion rate, while anticoagulants did not increase the amount of drained blood. An autotransfusion system with anticoagulants was effective and safe to save the shed blood in TKA.

Hemiarthroplasty Using a Modular Hip Segment in a Patient with a Long Stem Total Knee Prosthesis

Femoral neck fractures frequently occur in elderly patients and the treatment strategies for this are well documented. Revision knee arthroplasty using a long intra-medullary stem has recently been increasingly used for treating complications such as infection, aseptic loosening or instability. The current case had a femoral neck fracture with a well-fixed, long stem knee prosthesis, which reached to near the lesser trochanter of the femur. The authors performed the surgery using impaction of the modular hip segment; its inner diameter was fit to the outer diameter of the femoral stem of the knee prosthesis. At two years postoperative follow-up, the result was excellent without loosening or osteolysis.

Lumbar Pyogenic Spondylodiscitis and Bilateral Psoas Abscesses Extending to the Gluteal Muscles and Intrapelvic Area Treated with CT-guided Percutaneous Drainage: A Case Report

Bilateral psoas abscesses extending to the gluteal muscle and intrapelvic area are uncommon. We present our experience with computed tomography (CT)-guided percutaneous catheter drainage for the treatment of multiple aggressive abscesses in a diabetic patient. The abscesses completely resolved after the procedures. Psoas abscess should be considered in the differential diagnosis of older diabetic patients with fever, flank or back pain, and flexion contracture of the hip joint. CT scanning is a useful method in diagnosing abscesses, and CT-guided percutaneous catheter drainage is an effective treatment method in selected patients.

LumbarWedgeResectionOsteotomyforCongenitalScoliosis duetoaSacralMalformation: A CaseReport / 대한정형외과학회잡지

Congenital scoliosis due to a sacral malformation is quite rare. To the best of our knowledge, most wedge resection osteotomies have been performed to correct a kyphotic deformity in ankylosing spondylitis. However, there is no report of a trapezoidal lumbar wedge resection osteotomy of the vertebral body in the surgical treatment of congenital scoliosis due to a sacral malformation. This paper reports a 41-year-old female with a 25-year history of lower back and buttock pain combined with radiating pain to the lower extremities. The coronal imbalance was 3.8 cm and the scoliosis angle using the Cobb method was 22 degrees. A trapezoidal wedge resection osteotomy of the L5 body was performed, and the scoliosis was corrected. We detail this modification of a vertebral osteotomy technique and show that a fixed coronal deformity could be corrected effectively using this technique.