ABSTRACT
PURPOSE: To evaluate and compare the short-term clinical results of unicompartmental and total knee arthroplasty in the same patient. MATERIALS AND METHODS: Twenty patients who had primary TKA in their one knee and primary UKA in the other between August 2002 and July 2004, followed up more than 2 years, comprised the study population. The mean age at their first operation was 67.9 years. The clinical and radiologic outcomes were identified and analysed. The operating time, postoperative drainage, resultant transfusion and the subjective preference were evaluated. RESULTS: In the UKA knee, HSS score of 59.7 in average, the mean ROM of 120.2 degrees and tibiofemoral angle of 2.8 degrees in varus position were measured preoperatively. These values changed posteoperatively in 24 months follow-up into, 89.4, 131.7 degrees and 4.6 degrees in valgus position. In the TKA knee, the mean preoperative HSS score was 52.5, tibiofemoral angle was 5.4 degrees in varus position, ROM of 117.5 degrees. After 24 months posto- peratively, HSS score improved to 86.3, ROM of 125.9 degrees, tibiofemoral angle of 5.6 degrees in valgus position. And we found meaningful short operation time with UKA, conspicuous decrease of drained blood and low tendency of transfusion after UKA. In patient's preference, 8 out of 20 felt no difference between two knees and 8 out of 20 preferred UKA knee at 24 months follow-up. CONCLUSION: Satisfactory radiologic and clinical results were shown after UKA. Early clinical outcomes of UKA were not inferior to those of TKA.
Subject(s)
Humans , Arthroplasty , Drainage , Follow-Up Studies , Knee , OsteoarthritisABSTRACT
Moyamoya disease is a rare progressive cerebrovascular disorder caused by blocked arteries at the base of the brain in an area called the basal ganglia. The etiology and pathogenesis are unknown. Clinically, this disease is found with a higher incidence in young female, but there are few cases of moyamoya disease in pregnancy. The disease primarily affects children, but it can also occur in adults. in children. The first symptom of moyamoya disease is often stroke, or recurrent transient ischemic attack, frequently accompanied by muscular weakness or paralysis affecting one side of the body, or seizures. Adults most often experience a hemorrhagic stroke due to recurring blood clots in the affected brain vessels. The diagnosis of moyamoya disease is made on the basis of angiographic findings and threatment of Moyamoya disease is surgery, or conservative management. We report a case of moyamoya disease that presented as intracerebral hemorrhage and intraventricular hemorrhage during pregnancy complicating severe preeclampsia.
Subject(s)
Adult , Child , Female , Humans , Pregnancy , Arteries , Basal Ganglia , Brain , Cerebral Hemorrhage , Cerebrovascular Disorders , Diagnosis , Hemorrhage , Incidence , Ischemic Attack, Transient , Moyamoya Disease , Muscle Weakness , Paralysis , Pre-Eclampsia , Seizures , StrokeABSTRACT
Moyamoya disease is a rare progressive cerebrovascular disorder caused by blocked arteries at the base of the brain in an area called the basal ganglia. The etiology and pathogenesis are unknown. Clinically, this disease is found with a higher incidence in young female, but there are few cases of moyamoya disease in pregnancy. The disease primarily affects children, but it can also occur in adults. in children. The first symptom of moyamoya disease is often stroke, or recurrent transient ischemic attack, frequently accompanied by muscular weakness or paralysis affecting one side of the body, or seizures. Adults most often experience a hemorrhagic stroke due to recurring blood clots in the affected brain vessels. The diagnosis of moyamoya disease is made on the basis of angiographic findings and threatment of Moyamoya disease is surgery, or conservative management. We report a case of moyamoya disease that presented as intracerebral hemorrhage and intraventricular hemorrhage during pregnancy complicating severe preeclampsia.
Subject(s)
Adult , Child , Female , Humans , Pregnancy , Arteries , Basal Ganglia , Brain , Cerebral Hemorrhage , Cerebrovascular Disorders , Diagnosis , Hemorrhage , Incidence , Ischemic Attack, Transient , Moyamoya Disease , Muscle Weakness , Paralysis , Pre-Eclampsia , Seizures , StrokeABSTRACT
Separation of symphysis pubis during vaginal delivery is rare condition with incidence ranging from 1/500 to 1/30000 deliveries. The injury is caused by fetal head exerting pressure on pelvic ligaments that have been relaxed by progesterone and relaxin. The separation might be associated with considerable pain, swelling and tenderness over the pubic area. Diagnosis is based on clinical findings and X-ray findings. The condition is treated conservatively with bed rest, analgesics and physical therapy. Prognosis is exellent. We experienced 3cases of separation of symphysis pubis during vaginal delivery and report these cases with a brief review of literature.
Subject(s)
Analgesics , Bed Rest , Diagnosis , Head , Incidence , Ligaments , Progesterone , Prognosis , RelaxinABSTRACT
OBJECTIVE: It has been recognized that cold knife conization has higher incidence of postoperative hemorrhage and many techniques have been developed in an attempt to control hemorrhage. The aim of this study was to evaluate complications of Sturmdorf's suture in cold knife conization and to investigate various measures employed to reduce blood loss. METHODS: The results of 85 patients who had cold knife conization for diagnosis or treatment of cervical intraepithelial neoplasia (CIN) from August, 1997 to July, 2003 were reviewed. RESULTS: Among 85 patients, 83 patients (97.7%) had negative cut margins on conization specimen while 2 patients (2.3%) positive cut margins. 54 patients received no further treatment after cold knife conization and complications occurred in 9 patients (16.7%). Postoperative hemorrhage requiring additional hemostatic procedures occurred in 7 patients (13%), of which 6 patients were rehospitalized and 1 patient was managed at outpatient clinic with gauze packing only. Among 6 rehospitalized patients, hysterectomy was done in 2 patients and electrocoagulation in 1 patient. Packed red cell was transfused in 1 patient and 2 patients were managed with gauze packing only. Postoperative infection was found in 2 patients (3.7%). No other significant complications were noted. CONCLUSION: Cold knife conization using Sturmdorf's suture could be done to get much more accurate results of biopsy with relatively mild complication in magement of CIN, although several days? admission is needed and the other alternative methods seem to be more convenient.
Subject(s)
Humans , Ambulatory Care Facilities , Biopsy , Uterine Cervical Dysplasia , Conization , Diagnosis , Electrocoagulation , Hemorrhage , Hysterectomy , Incidence , Postoperative Hemorrhage , SuturesABSTRACT
OBJECTIVE: To evaluate the association of level of CA-125 and severity of dysmenorrhea with lesion depth in adenomyosis. METHODS: Sixty-eight women who had undergone hysterectomy and were found to have pure adenomyosis on histopathologic examination were reviewed retrospectively. Specimens were stratified according to the degree of adenomyosis penetration into 4 groups: group A consisted of specimens with adenomyosis penetration into myometrium of up to 25%; group B, 26-50%; group C, 51-75%, and group D, >75%. All women were submitted to serum determination of CA-125. Severity of dysmenorrhea was assessed by means of a modification of 10-point verbal rating scale. RESULTS: Each group was not correlated with severity of dysmenorrhea (p=0.7394 Fisher's exact test). The means of serum CA-125 levels was increased corresponding to depth of adenomyosis (p=0.0441 ANOVA test). CONCLUSION: In this study, serum CA-125 level is associated with the depth lesion and severity of dysmenorrhea is not. Therefore, the level of serum CA-125 might be useful indicator in management of adenomyosis before surgery.
Subject(s)
Animals , Female , Humans , Mice , Adenomyosis , Dysmenorrhea , Hysterectomy , Myometrium , Retrospective StudiesABSTRACT
Although arteriovenous malformation (AVM) of the uterus is a very rare cause of menometrorrhagia or postmenopausal vaginal bleeding, it is notable to think in the assessment of a woman with abnormal uterine bleeding because correct diagnosis can yield proper therapy to be designed and avoid hysterectomy in women who want to continue their reproductive capacity. AVM may be congenital or acquired. In times past, the diagnosis is usually made after hysterectomy, but currently it may be made before treatment by ultrasound, pelvic angiography, or magnetic resonance imaging. We have experienced one case of AVM of uterus, which is diagnosed after hysterectomy.
Subject(s)
Female , Humans , Angiography , Arteriovenous Malformations , Diagnosis , Hysterectomy , Magnetic Resonance Imaging , Ultrasonography , Uterine Hemorrhage , UterusABSTRACT
OBJECTIVE: To investigate the efficacy of PAP smear as a screening tool for cervical cancer by evaluating the result of a review of 34,970 cases of PAP smear at Pohang St. Mary's Hospital. METHODS: From January, 1992 to December, 2001 cytologic examination of 34,970 women were analysed and the results were reviewed. RESULTS: 1. The average of annual screening rate was 14.8%. 2. Abnormal cytology rate was 2.02% including 1.02% of ASCUS, 0.99% of class III, 0.20% of class IV and 0.30% of class V. 3. 8.28% of the women screened were aged less than 30 years, 31.8% or=70 years respectively. 4. Of the 188 patients who had a cytologic diagnosis of atypical squamous cells of undetermined significance (ASCUS), 127 (68%) were followed up, 99 (78%) were normal and 28 (22%) had squamous intraepithelial lesion. 5. The prevalence rate of cervical neoplasia confirmed by histopathology for the past 10 years was 1.53%. Of those the rate of invasive cervical cancer was 0.65%. 6. The false negative rate was 17.3% and false positive rate was 4.5%. 7. The sensitivity and specificity and positive predictive value of PAP smear were 82.7%, 95.5% and 90.2%. CONCLUSION: For PAP smear to be early detecting tool for cervical cancer, continuous effort is required to raise annual screening rate, to lower the false negative rate, and to raise the sensitivity of PAP smear.
Subject(s)
Female , Humans , Diagnosis , Mass Screening , Prevalence , Sensitivity and Specificity , Uterine Cervical NeoplasmsABSTRACT
OBJECTIVE: The purpose of this study is to evaluate the role of cold knife conization in the diagnosis and treatment of cervical neoplasia. METHODS: Sixty patients were divided into diagnostic and therapeutic conization group and then indication of conization, PAP smear, colposcopy directed biopsy, cone margin and residual lesion of each group were compared respectively. RESULTS: If the difference of PAP and colposcopy directed biopsy was 2 grades or more, upper limit of the lesion was invisible, squamocolumnar junction was not seen, PAP V or invasive cancer was suspected, diagnostic conization was performed in 22 patients. Six cases of follow-up group had cone margin (-) and no recurrence. Sixteen cases of immediate TAH (total abdominal hysterectomy) group had 2 cases of cone margin (+) with residual disease. There were 4 cases of cone margin (-) with residual lesion. If the difference of PAP and colposcopy directed biopsy was 1 grade or less, upper limit of the lesion was visible, squamocolumnar junction was seen and invasive cancer was ruled out, therapeutic conization was performed in 38 cases. All of therapeutic conization group had cone margin (-). Thirty two cases were follow up group and six cases were immediate TAH group. Three of follow up group had recurrences and delayed TAH was performed. There was no residual lesion in the specimen of immediate TAH group. CONCLUSION: The precise dignosis and treatment of cervical neoplasia was capable with cold knife conization. The more aggressive lesion or the more cases of cone margin (+) was diagnosed, the more residual lesion was found. Thorough follow up should be done after treatment of cervical neoplasia because of the possibility of residual disease even after documentation of cone margin (-).
Subject(s)
Humans , Biopsy , Colposcopy , Conization , Diagnosis , Follow-Up Studies , RecurrenceABSTRACT
PURPOSE: There is little information about the treatment of carpometacarpal (CMC) fracture-dislocations. The purpose of this study was to investigate treatment methods and times between diagnosis and surgery in CMC fracture-dislocations. MATERIALS AND METHODS: In 18 cases treated by surgery, the 4, 5th CMC joints were found to be the most frequently involved in 13 cases. Comminution of the carpal or metacarpal bone was present in 8 cases. The time to surgery was within 3 days in 10 patients, within 5 days in 6, within 9 days in one patient and more than 4 weeks in one. All the injuries were managed by closed reduction and K-wire fixation except for one which was detected after 4 weeks since initial trauma. RESULTS: A painless full hand function was restored in 13 cases. Intermittent pain was present in 5 cases in which there was comminution in 4. However, clinically full hand function was restored in 4 cases except for one in whom the treatment was delayed. CONCLUSION: If the treatment of CMC fracture-dislocation is not delayed a successful result can be gained using the closed method even though comminution occurs.
Subject(s)
Humans , Carpometacarpal Joints , Diagnosis , Hand , JointsABSTRACT
No abstract available.