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Purpose@#To investigate the radiologic and clinical outcomes of direct internal fixation for unstable atlas fractures. @*Materials and Methods@#This retrospective study included 12 patients with unstable atlas fractures surgically treated using C1 lateral mass screws, rods, and transverse connector constructs. Nine lateral mass fractures with transverse atlantal ligament (TAL) avulsion injury and three 4-part fractures with TAL injury (two avulsion injuries, one TAL substance tear) were treated. Radiologic outcomes included the anterior atlantodental interval (AADI) in flexion and extension cervical spine lateral radiographs at 6 months and 1 year after treatment. CT was also performed to visualize bony healing of the atlas at 6 months and 1 year. Visual Analog Scale (VAS) scores for neck pain, Neck Disability Index (NDI) values, and cervical range of motion (flexion, extension, and rotation) were recorded at 6 months after surgery. @*Results@#The mean postoperative extension and flexion AADIs were 3.79±1.56 (mean±SD) and 3.13±1.01 mm, respectively. Then mean AADI was 3.42±1.34 and 3.33±1.24 mm at 6 months and 1 year after surgery, respectively. At 1 year after surgery, 11 patients showed bony healing of the atlas on CT images. Only one patient underwent revision surgery 8 months after primary surgery due to nonunion and instability findings. The mean VAS score for neck pain was 0.92±0.99, and the mean NDI value was 8.08±5.70. @*Conclusion@#C1 motion-preserving direct internal fixation technique results in good reduction and stabilization of unstable atlas fractures. This technique allows for the preservation of craniocervical and atlantoaxial motion.
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Purpose@#This study examined the characteristics based on the ultrasound findings of non-contact, gradual-onset shoulder pain in recreational-level surf beginners with a surf experience of one year or less and the treatment outcomes. @*Materials and Methods@#From January 2019 to May 2020, 34 patients with gradual-onset shoulder pain from recreational-level surfing activity who visited outpatient clinics were analyzed retrospectively with prospective data collection. All patients had a surf experience of one year or less as surf club members. The demographic data, including the surf-specific data and physical test, were reviewed. Simple radiographs and ultrasound of both shoulders were performed for an initial evaluation in all patients. If needed, magnetic resonance images were taken for an additional evaluation. Conservative treatments, including medication or injection, combined with trunk extension, periscapular, and core muscle training were performed in all cases. The clinical outcomes were evaluated using the visual analog scale for pain (PVAS), the Simple Shoulder Test (SST) score at the initial and final follow-up, and the patient’s level of satisfaction with treatment. @*Results@#Thirty-two patients (94.1%) showed minor symptoms. The clinical findings were predominantly divided into periscapular or pectoralis muscle strain (14.7%), proximal biceps tendinopathy (38.2%), subacromial impingement (44.1%), and shoulder instability (2.9%). The common findings in ultrasound were effusion around the biceps tendon, cuff tendinosis, and subacromial bursitis. The mean PVAS and SST score improved significantly at the last follow-up (p<0.001, p<0.001). The patient’s satisfaction with treatment ranged from ‘satisfied’ to ‘very satisfied’ in 31, ‘so so’ in two, and ‘dissatisfied’ in one patient. @*Conclusion@#This study showed that the common pathologic conditions of shoulder pain in recreational-level beginners with a surf experience of one year or less are tendinopathy around the long head of the biceps tendon and rotator cuff. Ultrasound was helpful in rapidly diagnosing and determining the treatment plans during the primary diagnostic approach at the outpatient visit. Most cases were associated with minor symptoms that did not interfere with work or surfing and showed relatively satisfactory results for conservative treatments combined with functional muscle training.
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Objectives@#To evaluate the effectiveness and safety of posterior interbody fusion with a new type of pedicle screws after posterior decompression for degenerative spinal disease.Summary of Literature Review: There are no reports of surgical treatment results using the new type of pedicle screw (LumFix™) analyzed herein. We report the results of posterior interbody fusion with this new type of pedicle screw. @*Materials and Methods@#Ten patients underwent surgical treatment for degenerative spinal disease and were followed up for at least 1 year. In all cases, fixation using pedicle screws and posterior interbody fusion were performed after posterior decompression. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores were measured before surgery, at 3 months postoperatively, and at 12 months postoperatively. Bone union was investigated through simple radiographs and computed tomography (CT) at 12 months postoperatively. In addition, blood inflammation levels and basic vital signs were investigated preoperatively and at the last follow-up. @*Results@#In all cases, preoperative symptoms improved, and the back pain VAS improved from 7.30±1.49 preoperatively to 2.70±1.64 at 3 months postoperatively and 1.80±1.40 at the final follow-up. Leg pain was 7.40±1.17 preoperatively and 2.60±2.17 at 3 months postoperatively. At the last follow-up, it improved to 2.40±1.96 (p<0.001). The ODI improved from 28.80±4.89 preoperatively to 15.60±5.04 at 3 months postoperatively and 16.90±6.61 (p=0.002) at the final follow-up. Bone union was achieved in all cases. Inflammation levels and vital signs were within the normal range both preoperatively and at 12 months postoperatively. @*Conclusions@#The LumFix™ pedicle screws used in this study were fused in 100% of patients with degenerative spinal diseases. No complications were observed, and the VAS of back and leg pain and ODI of the lumbar spine significantly improved. There were no abnormal findings in blood tests or vital signs, demonstrating biocompatibility. Therefore, the type of new pedicle screw analyzed in this study can be used in fusion surgery for degenerative spinal diseases.
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Objectives@#To evaluate the effectiveness and safety of posterior interbody fusion with a new type of pedicle screws after posterior decompression for degenerative spinal disease.Summary of Literature Review: There are no reports of surgical treatment results using the new type of pedicle screw (LumFix™) analyzed herein. We report the results of posterior interbody fusion with this new type of pedicle screw. @*Materials and Methods@#Ten patients underwent surgical treatment for degenerative spinal disease and were followed up for at least 1 year. In all cases, fixation using pedicle screws and posterior interbody fusion were performed after posterior decompression. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores were measured before surgery, at 3 months postoperatively, and at 12 months postoperatively. Bone union was investigated through simple radiographs and computed tomography (CT) at 12 months postoperatively. In addition, blood inflammation levels and basic vital signs were investigated preoperatively and at the last follow-up. @*Results@#In all cases, preoperative symptoms improved, and the back pain VAS improved from 7.30±1.49 preoperatively to 2.70±1.64 at 3 months postoperatively and 1.80±1.40 at the final follow-up. Leg pain was 7.40±1.17 preoperatively and 2.60±2.17 at 3 months postoperatively. At the last follow-up, it improved to 2.40±1.96 (p<0.001). The ODI improved from 28.80±4.89 preoperatively to 15.60±5.04 at 3 months postoperatively and 16.90±6.61 (p=0.002) at the final follow-up. Bone union was achieved in all cases. Inflammation levels and vital signs were within the normal range both preoperatively and at 12 months postoperatively. @*Conclusions@#The LumFix™ pedicle screws used in this study were fused in 100% of patients with degenerative spinal diseases. No complications were observed, and the VAS of back and leg pain and ODI of the lumbar spine significantly improved. There were no abnormal findings in blood tests or vital signs, demonstrating biocompatibility. Therefore, the type of new pedicle screw analyzed in this study can be used in fusion surgery for degenerative spinal diseases.
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PURPOSE: To compare clinical outcome of Sanders type IV intra-articular calcaneal fracture treated with open reduction and internal fixation (ORIF) versus ORIF and primary subtalar arthrodesis (PSTA). MATERIALS AND METHODS: Between March 2003 and November 2013, 22 patients with 22 Sanders type 4 intra-articular calcaneal fractures were included in this study. Of these, 11 were treated with ORIF (ORIF group), and 11 were treated with ORIF and PSTA (PSTA group). The mean follow-up period was 34.6 months (range, 18–72 months). Clinical outcomes were assessed along with the American Orthopedic Foot and Ankle Society's ankle-hindfoot scale (AOFAS score), and the visual analogue scale pain score (VAS score) at 6-month, 12-month, and last follow-up. Patient satisfaction, return to previous occupation and postoperative complications were also investigated. RESULTS: The results for ORIF did not differ from those for PSTA based on the last follow-up AOFAS scores or the VAS scores (p>0.05). However, patient satisfaction was significantly higher in the PSTA group (p=0.008). Secondary subtalar arthrodesis was conducted in five patients (45.5%) of the ORIF group within 2 years postoperatively. CONCLUSION: We were unable to demonstrate a significant difference in clinical outcomes between ORIF and PSTA; however, the patient satisfaction was higher in the PSTA group. PSTA may be a suitable choice for patients who need fast recovery to daily activity and to prevent the need for secondary subtalar arthrodesis.
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Humans , Ankle , Arthrodesis , Follow-Up Studies , Foot , Occupations , Orthopedics , Patient Satisfaction , Postoperative ComplicationsABSTRACT
Although talus fractures are uncommon, proper management is important because they are often associated with severe complications. Talar neck and body fractures occupy most of the talar fractures. It remains controversial whether talar neck fractures require emergent or elective treatment. Elective definitive fixation, however, may reduce risks of wound complications. Many surgeons recommend dual surgical approaches—anteromedial and anterolateral—to allow accurate visualization and anatomic reduction. Although there are various methods of fixation, the use of plates is necessary in comminuted talar fractures. Outcomes may vary and will be dependent on the degree of the initial fracture displacement. It is necessary to restore articular congruency and axial alignment for normalizing hindfoot function. Common complications include posttraumatic arthritis, avascular necrosis, malunion, and nonunion.
Subject(s)
Arthritis , Neck , Necrosis , Surgeons , Talus , Wounds and InjuriesABSTRACT
INTRODUCTION: Osteoporotic vertebral fractures, which account for the largest part of the disease has become important and common diseases. We studied persistence for osteoporosis medication and its related factor in patients with osteoporotic compression vertebral fracture. METHODS: A total of 458 patients that visited our outpatient clinic with osteoporotic vertebral fractures and were prescribed with osteoporosis medication at the Seoul Spine Center from January 2010 to February 2014 and were analyzed retrospectively. The male to female ratio was 403: 55 and the mean age was 75 years. Survival analysis was used with the Kaplan-Meier method. Related factor analysis was performed with the log rank test and Cox regression test. RESULTS: The survival rate at 6 months was 52%, 12 months was 40%, 24 months was 28%, and at 3 years it was 25%. There was no difference between the persistent rate according to age. Women demonstrated higher persistent rate than men in significantly. It showed a significant difference between some of the groups in accordance with the dose rate and duration of the drug dose interval. Especially, medication change group had significant higher persistence rate than not changing group. CONCLUSIONS: Persistence rate of osteoporosis drugs, decreased rapidly with the passage of time. The patients with changing medication during follow-up had significantly higher persistence ratio than those without it. The persistence rate of osteoporosis medication could be increased through actively solving the problems of the patients, which are associated with taking medication.
Subject(s)
Female , Humans , Male , Ambulatory Care Facilities , Follow-Up Studies , Medication Adherence , Osteoporosis , Retrospective Studies , Seoul , Spine , Survival RateABSTRACT
A 72-year-old female with 10% TBSA flame, mostly partial thickness, was treated topically with 10% mafenide acetate cream and 1% silver sulfadiazine cream. On day 28, burn wound was nearly healed but black colored, 3~5 mm sized maculopapular lesions developed in healed facial burn wound. Similar skin lesion progressed in both hand and both wrist. All skin lesions were peeled off. On day 30, biopsy was performed. An excisional biopsy of the lesion in the left cheek revealed benign papilloma. On day 44, we excised all skin lesions and performed STSG. All graft sites were healed 14th day after STSG.
Subject(s)
Aged , Female , Humans , Biopsy , Burns , Cheek , Hand , Mafenide , Papilloma , Silver Sulfadiazine , Skin , Transplants , WristABSTRACT
To investigate the neuroprotective effects of bovine colostrums (BC), we evaluate the ability of consuming BC after focal brain ischemia/reperfusion injury rat model to reduce serum cytokine levels and infarct volume, and improve neurological outcome. Sprague-Dawley rats were randomly divided into 4 groups; one sham operation and three experimental groups. In the experimental groups, MCA occlusion (2 h) and subsequent reperfusion (O/R) were induced with regional cerebral blood flow monitoring. One hour after MCAO/R and once daily during the experiment, the experimental group received BC while the other groups received 0.9% saline or low fat milk (LFM) orally. Seven days later, serum pro-inflammatory cytokine (IL-1beta, IL-6, and TNF-alpha) and anti-inflammatory cytokine (IL-10) levels were assessed. Also, the infarct volume was assessed by using a computerized image analysis system. Behavioral function was also assessed using a modified neurologic severity score and corner turn test during the experiment. Rats receiving BC after focal brain I/R showed a significant reduction (-26%/-22%) in infarct volume compared to LFM/saline rats, respectively (P < 0.05). Serum IL-1beta, IL-6, and TNF-alpha levels were decreased significantly in rats receiving BC compared to LFM/saline rats (P < 0.05). In behavioral tests, daily BC intake showed consistent and significant improvement of neurological deficits for 7 days after MCAO/R. BC ingestion after focal brain ischemia/reperfusion injury may prevent brain injury by reducing serum pro-inflammatory cytokine levels and brain infarct volume in a rat model.
Subject(s)
Animals , Rats , Brain , Brain Injuries , Colostrum , Cytokines , Eating , Interleukin-6 , Milk , Neuroprotective Agents , Rats, Sprague-Dawley , Reperfusion , Salicylamides , Tumor Necrosis Factor-alphaABSTRACT
The apoptotic effect of bacteria-derived beta-glucan was investigated in human colon cancer cells SNU-C4 using terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL) assay, reverse transcription-polymerase chain reaction (RT-PCR) expressions of Bcl-2, Bax, and Caspase-3 genes, and assay of caspase-3 enzyme activity. beta-Glucan of 10, 50, and 100 microg/mL decreased cell viability in a dose-dependent manner with typical apoptotic characteristics, such as morphological changes of chromatin condensation and apoptotic body formation from TUNEL assay. In addition, beta-glucan (100 microgram/mL) decreased the expression of Bcl-2 by 0.6 times, whereas the expression of Bax and Caspase-3 were increased by 3.1 and 2.3 times, respectively, compared to untreated control group. Furthermore, the caspase-3 activity in the beta-glucan-treated group was significantly increased compared to those in control group (P < 0.05). Bacterial derived beta-glucan could be used as an effective compound inducing apoptosis in human colon cancer.
Subject(s)
Humans , Apoptosis , Caspase 3 , Cell Survival , Chromatin , Colon , Colonic Neoplasms , DNA Nucleotidylexotransferase , In Situ Nick-End LabelingABSTRACT
BACKGROUND: Although glyphosate, organophosphorus herbicide, has been used extensively in agricultural area, no clinical data of acute poisoning have been reported in Korea. The current study evaluated clinical characteristics of acute intoxication by glyphosate. METHODS: We retrospectively collect and analysed the clinical data of 16 acute glyphosate poisoned patients admitted to the department of internal medicine, Soonchunhyang University Chunan hospital from January 1999 through June 2000. RESULTS: 1) Thirteen of sixteen poisoning were male and mean age was 44.2 year-old. 2) The main cause of glyphosate ingestion was suicide intent (12 cases, 75%), and clinical severity was divided into 3 categories : mild (14 cases), moderate (1 case) and severe (1 case). 3) Nausea and vomiting were the most frequent clinical features (each 6 cases) and dyspnea (4 cases), cough (3 cases), sputum (3 cases) and sore throat (3 cases) were followed. Leucocytosis, hepatotoxicity, anemia, hypoxia and renal toxicity were observed in 9,8,5,6 and 3 cases, respectively. 4) No fatal case and severe complication, except 1 aspiration pneumonia and 1 acute respiratory failure, were observed in acute glyphosate poisonings. CONCLUSION: Our data supported that acute glyphosate poisoning dose not result in fatal in humans even after intentional ingestion of glyphosate.
Subject(s)
Humans , Male , Anemia , Hypoxia , Cough , Dyspnea , Eating , Herbicides , Internal Medicine , Korea , Nausea , Organophosphorus Compounds , Pharyngitis , Pneumonia, Aspiration , Poisoning , Respiratory Insufficiency , Retrospective Studies , Sputum , Suicide , VomitingABSTRACT
Bone imagings have played important role in early detection of acute osteomyelitis. In acute osteomylitis, bone scan findings precede the appearance of bone change on radiograph. Also, recent studies have reported accuracies of bone scan in diagnosis of osteomyelitis ranging from 84% to 100%. But, in above datas, bone scan reading were only qualitative studies. So we have reviewed Technetium-99m labelled methylen dipho sphonate(99mTc-MDP) scan on 21 patients who had been diagnosed acute osteomyelitis by clinical symptoms, blood culture, pus culture and operative findings from January, 1984 to September, 1985. The purpose of this study is to establish the quantitative study of bone scan using computed pixel counting method. The 21 cases were classified into group I and group II according to initial radiographic findihgs. The group I showed normal radiographic finding or soft tissue swelling without osseous change. The group II showed osseous change. The results obtained were as follows: 1. We obtained positive bone scans in the all cases which were confirmed acute osteomyelitis. 2. We experienced diagnosis of acute osteomyelitis by bone scan which was confirmed as early as 48 hours after onset of clinical symptom. 3, In group I, the average uptake ratio of 99mTc-MDP was 3.22±0.82 ranging from 2.20 to 4.80. 4. In group II, the average uptake ratio of 99mTc-MDT was 6.20±2.27 ranging from 4.00 to 9.40. (p <0.001).