An Intratendinous Tophaceous Gout Mistaken for Cellulitis in the Patellar Tendon / 대한정형외과학회잡지

Gout is characterized by recurrent attacks of arthralgia, and deposition of monosodium urate crystals in and around the joints of the extremities and soft tissues. Monosodium urate crystals are observed most frequently at the 1st metatarsophalangeal joint and usually presented in the ankle and wrist joint. However, no case of an intratendinous tophus in the patellar tendon has been reported in Korean literature. In this report, we found monosodium urate crystals in the patellar tendon on magnetic resonance imaging images and intratendinous tophus were visible to the naked eye by excision. We reported on the case of a patient who experienced an unusual intratendinous tophus in the patellar tendon.

Acute Brachialis Tear and Hematoma Caused by Closed Acute Elbow Posterior Dislocation / 대한스포츠의학회지

This report was designed to investigate a rare case that brachialis tear and hematoma caused by acute elbow posterior dislocation. We studied a 20-year-old male patient with right elbow joint pain after outstretched injury. Physical examination showed instability of hright elbow joint and simple radiography indicated a posterolateral dislocation of right elbow joint. Computed tomography taken after closed reduction using Parvin technique revealed a few small bone fragment located on posterior humerus capitulum. Magnetic resonance imaging showed complete tear of brachialis and anterior articular capsule with hematoma. The patient was managed with long arm splint and hinge brace for an elbow dislocation with brachialis rupture and hematoma. The elbow joint range of motion was recovered to be in a normal range, and pain was diminished. There are few reported cases of acute elbow posterior dislocation combined with brachialis rupture and hematoma. The patient showed good clinical outcome after conservative treatment.

Cement Leakage after Vertebroplasty; Correlation with Patterns of Compression Fractures and Bone Mineral Density (BMD)

STUDY DESIGN: Retrospective study. OBJECTIVES: To analyze the influence of fracture patterns and the result of bone mineral density on cement leakage after percutaneous vertebroplasty for osteoporotic vertebral compression fractures. SUMMARY OF LITERATURE REVIEW: Leakage of bone cement after vertebroplasty has known to be related with the direction of cortical disruption of fractured vertebral body and low bone mineral density (BMD). MATERIALS AND METHODS: One hundred eighty-two patients with osteoporotic vertebral compressions were studied from January 2009 to August 2013. The patients' fracture levels and patterns were compared. Among them, the cement leakage patterns were analyzed in 105 patients who had undergone vertebroplasty. The findings were compared with fracture patterns including cortical disruption and BMD. RESULTS: Seventy-five cases of cement leakage were observed. Among them, intradiscal leakage was the most common type of leakage. In the patient group with low BMD, there was a high incidence of lower and posterior cortical disruption in the fractures. Patients with posterior cortical disruption demonstrated a higher incidence of leakage into the spinal canal and anterior cortex. No significant correlation was observed between fracture patterns and leakage. CONCLUSIONS: A surgeon should use caution in performing vertebroplasty in patients with low BMD and posterior disruption of the vertebral cortex.

Bilateral Necrotizing Fasciitis around the Hips Differentiated from Fournier Gangrene: A Case Report / 대한고관절학회지

As an emergency encountered in orthopedic practice requiring prompt diagnosis and aggressive treatment, necrotizing fasciitis around the hip must be discriminated from Fournier gangrene. The current case report describes a patient who suffered from bilateral type I necrotizing fasciitis around the hips, which was alleviated by prompt surgical debridement and intensive postoperative care.

Atraumatic Spinal Interdural Hamatoma: A Case Report

STUDY DESIGN: A case report. OBJECTIVES: To investigate the outcomes of recapping laminoplasty for the treatment of atraumatic spinal interdural hematoma. SUMMARY OF LITERATURE REVIEW: There are several causes for a spinal hematoma. The occurrence of spinal hematoma is rare; in particular, the ones arising atraumaticaly are considered extremely rare. MATERIALS AND METHODS: We studied a 33 year old male patient without any known risk factor. Magnetic resonance image has revealed an intraspinal epidural cyst compressing on the spinal nerve. After performing recapping laminoplasty, followed by partial excision of dura mater and resection of hematoma, we were able to observe another layer of dura mater, confirming the location of hematoma within two epidural layers, i.e., an interdural hematoma. RESULTS: Performing recapping laminoplasty is a more effective and less invasive procedure for removing cyst than conventionally used laminectomy. Patients were found to have synostosis after three months post-op, and they have exhibited neither lumbosacral pain nor lower limb motor weakness after six months follow-up. There were no recurrences or complications reported on our study. CONCLUSION: There are a few reported cases of atraumatic spinal interdural hematoma. Our study shows that performing pars osteotomy with recapping laminoplasty yield good clinical outcome for the treatment of atraumatic spinal interdural hematoma.

Antimicrobial Activities of Root Surfaces Treated with Tetracycline-containing gel and a Mixture of tetracycline and citric acid-containing gel: in vivo study / 대한치주과학회지

The purpose of this study was to evaluate the substantivity of experimentally developed gel type tetracycline HCl and a mixture of tetracycline-citric acid gel, and compare to those of solution type tetracycline HCl. 11 extracted anterior teeth were subjected to this study. After scaling and root planing teeth were randomly divided into 3 treatments groups : group 1; 3 teeth were irrigated with tetracycline HCl(50mg/ml) solution , group 2; tetracycline gel (5%) was inserted in the periodontal pockets of 3 teeth, group 3; a mixture of tetracycline and citric acid gel was inserted in the pockets of 3 teeth. And 2 teeth treated in 0.9 % sterile saline served as controls. After 5-minute exposure, each tooth immediately extracted and incubated at room temperature for 22 days in tris-buffered saline as a desorption media. The total volume of TBS was removed and replaced with fresh TBS, at 24-h intervals. Removed desorption media transferred to a sterile vial and stored at -70 oC. This procedure was repeated every 24 h throughout the 22-day desorption period. Using Porphyromonas gingivalis as an indicator organism, a microtiter assay was used to evaluate antimicrobial activity desorbed from the teeth. 1. 50mg/ml tetracycline HCl solution exhibited the longest antimicrobial activity. Compared to saline treated group, it showed significant difference on the day 1 and day 2 desorption period. 2. The ODs of 5% tetracycline gel and a mixture of tetracycline-citric acid gel were significantly different during the first 24 hour only. 3. There was no statistically significant difference after the day 3 between the groups.(p<0.05). Despite our expectation a mixture of tetracycline-citric acid gel did not show longer antimicrobial activities than those of tetracycline gel, and the solution type exhibited the longest activities. Because the gel type agents may stay in the subgingival environment longer than the solution, if the teeth were not extracted immediately after the delivery of the agent, the result could be different. hus this result suggests the possibilities of practical use of these kind of gel type agents.