ABSTRACT
Purpose@#Although proximal femoral nail antirotation (PFNA; Synthes, Switzerland) has demonstrated satisfactory results when used for the treatment of intertrochanteric fractures, mechanical complications may occur. To better quantify the risk of mechanical complications when proximal femoral nail antirotation is used to treat intertrochanteric fractures, this study aimed to: (1) characterize the frequency of mechanical complications and extent of blade sliding and their correlation with reduction quality and (2) identify factors associated with mechanical complications. @*Materials and Methods@#A review of medical records from 93 patients treated for intertrochanteric fractures with a minimum of 6-months of follow-up between February 2014 and February 2019 was conducted. Blade position was evaluated using Tip-apex distance (TAD) and Cleveland index. The extent of blade sliding was evaluated using the adjusted Doppelt’s method for intramedullary nailing. Individuals were classified as having or not having mechanical complications, and reduction quality and radiologic outcomes were compared between the two groups. @*Results@#Mechanical complications occurred in 12 of 94 hips (12.8%), with 11 out of 12 being from the intramedullary reduction group. There was no significant difference in TAD between groups; however, there were significant differences were noted in Cleveland index, AO/OTA classification, reduction quality and extent of blade sliding. The mean blade sliding distance was 1.17 mm (anatomical group), 3.28 mm (extramedullary group), and 6.11 mm (intramedullary group), respectively (P<0.001). Data revealed that blade sliding was an associated factor for mechanical complications (odds ratio 1.25, 95% confidence interval 1.03-1.51). @*Conclusion@#The extent of blade sliding determined using the adjusted Doppelt’s method was significantly associated with mechanical complications suggesting that prevention of excessive sliding through proper intraoperative reduction is important to help achieve satisfactory treatment outcomes.
ABSTRACT
Localized forms of giant cell tumor are known to arise commonly in the synovial membrane of the finger joints. Multinucleated giant cells are its characteristic pathology finding, giant cell tumor shows a low rate of recurrence after complete excision. When occurring at the knee joints, giant cell tumor manifests a wide form of symptoms, from no symptom at all, to intermittent locking. Complete excision is possible by arthroscopy, but if done incompletely, it is reported to recur in 45% of cases. We present here a case of giant cell tumor that has arisen from the anterior portion of the posterior cruciate ligament, excised by arthroscopy and followed by pathologic confirmation.
Subject(s)
Arthroscopy , Finger Joint , Giant Cell Tumors , Giant Cells , Knee Joint , Pathology , Posterior Cruciate Ligament , Recurrence , Synovial MembraneABSTRACT
BACKGROUND: Human T-cell lymphotropic virus type I (HTLV-I) is a retrovirus that has been identified as a cause of adult T-cell leukemia/lymphoma and tropical spastic paraparesis. HTLV-I infection is highly endemic in the southwestern islands of Japan, Caribbean basin, South America, and Africa. In 1993, we showed that the seroprevalence of antibodies to HTLV-I was 0.13% among blood donors in Korea, but surprisingly, 0.80% in Cheju-Do adjacent to endemic areas of Japan. So this study was designed to reevaluate the seroprevalence of antibodies to HTLV-I among residents in Cheju-Do. METHODS: Total 2,372 residents in Cheju-Do were tested from December 1995 to March 1996. Anti-HTLV-I antibodies were detected by the microtiter particle agglutination test. RESULTS: Among total 2,372 residents, 19 were anti-HTLV-I positive. So the overall positive rate of anti-HTLV-I antibodies was 0.80%. The positive rate in females was higher than in males (0.82% vs 0.78%). The positive rate was 1.45% in the age group of 20-29 years, 1.41% in 40-49 years, 0.91% in 0-9 years, 0.70% in 30-39 years, and 0.54% in 50-59 years. The mean age of seropositive cases is 35.2 in males and 35.4 in females, with a mean of 35.3. Geographically, high positive rate was observed in Sogwipo-City (1.37%) and Namcheju-Gun (0.83%) compared to those of Pukcheju-Gun (0.64%) and Cheju-City (0.61%), which showed high seroprevalence in districts adjacent to endemic areas of Japan. Any specific risk factors or associated disorders of HTLV-I infection could not be found among the seropositive cases. CONCLUSION: The seroprevalence of antibodies to HTLV-I in Cheju-Do was noted to be very high by the microtiter particle agglutination test. So henceforth serosurvey by confirmative laboratory tests is needed, and if high seroprevalence is showed from it, screening of blood donors for HTLV-I in Cheju-Do should be considered to prevent transfusion-associated HTLV-I infection.
Subject(s)
Adult , Female , Humans , Male , Africa , Agglutination Tests , Antibodies , Blood Donors , Caribbean Region , Epidemiology , HTLV-I Infections , Human T-lymphotropic virus 1 , Islands , Japan , Korea , Mass Screening , Paraparesis, Tropical Spastic , Retroviridae , Risk Factors , Seroepidemiologic Studies , South America , T-LymphocytesABSTRACT
BACKGROUND: Although we gain new knowledge, the problem of pneumonia will not be eliminated. We should understand who is at risk, why these people develop this problem, what causes the pneumonia, and how to manage and prevent respiratory infection. To clarify the alterations of the etiologies of bacterial pneumonia we analysed the recent causative organisms and evaluated the therapeutic implications. METHODS: A retrospective four-year study of bacterial pneumonia was conducted in Soon Chun Hyang University Hospital. 190 episodes of bacterial pneumonia was investigated. RESULTS: 1) The causative organisms were isolated in 173 cases on the sputum culture: 154 cases (89%) were gram negative bacilli and 19 cases(ll%) were gram positive cocci. The major organisms were Pseudomonas species 49 cases(28%), Klebsiella pneumoniae 29 cases(17%), Enterobacter species 25 cases(14%), and Acinetobacter species 20 cases(12%) in decreasing order. Pseudomonas species(13 cases, 34%) were frequently found in nosocomial pneumonia. 2) The causative organisms were isolated in 16 cases on the blood culture: 7 cases(43%) were gram negative bacilli and 9 cases(57%) were gram positive cocci. The major organisms were Staphylococcus aureus(6 cases, 38%), Pseudomonas species(3 cases, 19%) in decreasing order. 3) In the susceptibility test of causative organisms to antimicrobial drugs, Pseudomonas was susceptible to amikacin, ciprofloxacin, aztreonam, ceftazidime(more than 50%) and resistant to piperacillin, gentamicin, carbenicillin(more than 60%). Klebsiella was susceptible to chloramphenicol, gentamicin, cefotetan(more than 70%) and resistant to carbenicillin, ampicillin(more than 70%). Staphylococcus was susceptible to methiciilin(64%), and Streptococcus pneumoniae was susceptible to oxacillin(94%). 4) The response rate after antibiotics therapy was 81% and the mortality rate was 19%. CONCLUSION: As considering the changes of causative organisms and antibiotic resistance, it behooves us to exercise caution in dispending antibiotics in order to maximize their continued efficacy and to do appropiate antibiotics therapy based on cultures and susceptibility test.
Subject(s)
Acinetobacter , Amikacin , Anti-Bacterial Agents , Aztreonam , Carbenicillin , Chloramphenicol , Ciprofloxacin , Drug Resistance, Microbial , Enterobacter , Gentamicins , Gram-Positive Cocci , Klebsiella , Klebsiella pneumoniae , Mortality , Piperacillin , Pneumonia , Pneumonia, Bacterial , Pseudomonas , Retrospective Studies , Sputum , Staphylococcus , Streptococcus pneumoniaeABSTRACT
The role of limbal epithelial cells on the initial re-surfacing of the central epithelial defect was evaluated. Central or peripheral corneal wounds were produced by using n-heptanol in New Zealand white rabbit, and the epithelial healing rates were evaluated. Central corneal wounds made by applying a filter paper soaked in 0.2 N NaOH with vs without limbal damage were produced for the paralleled set of experiment. A 5.5 mm round filter paper for central wound and a 2 mm filter paper strip for limbal damage were used for the initial wounding. Epithelial defect areas were photodocumented after fluorescein stainmg at 0.6, 18, 30, 42, 48 hours following initial damage. Epithelial healing rates were measured by linear regression analysis, The epithelial healing rates of central and peripheral heptatlol wounds were 0.71 +/- 0.14 mm2/h, and 0.79 +/- 0.10 mm2/h(p>0.05), respectively, NaOH central wound without limbal damage and with limbal damage were 0.77 +/- 0.11 mm2/h, and 0.76 +/- 0.11 mm2/h, respectively(p>0.05). These data suggest that the limbal epithelium has no influence on the initial re-surfacing of the central epithelial defect.
Subject(s)
Rabbits , Epithelial Cells , Epithelium , Fluorescein , Heptanol , Linear Models , New Zealand , Wounds and InjuriesABSTRACT
Pilomatrixoma, a rare benign tumor which consists of basophils and shadow cells, has not been reported in Korea. It originates from a hair follicle and occurs commonly on eyelids and the eyebrow in children and young adults. We expoerienced a 7 year-old male who had a progressive growing palpable mass on the upper eyelid. The systemic steroid was administrated under the impression of hemangioma, but there was no effect. So, the mass was exploratorily excised and confirmed as pilomatrixoma by pathologic examinations. We present a case of pilomatrixoma on the upper eyelid in a child.