ABSTRACT
PURPOSE: Mycoplasma pneumoniae (MP) is a common cause of community-acquired pneumonia (CAP) in children. MP serum IgM and polymerase chain reaction (PCR) are the methods that enable early diagnosis in patients with MP pneumonia. The objective of this study was to investigate the clinical value of serum MP-specific IgM antibodies in PCR-positive MP pneumonia for the early diagnosis of MP pneumonia in children with CAP. METHODS: Out of 129 patients with lower respiratory tract infection aged over 3 years, 90 CAP children were enrolled in the study. Throat swab MP real-time PCR and serum enzyme-linked immunosorbent assays (ELISA) IgM antibodies were performed. A positive rate of MP PCR and serum IgM, the level of IgM index, clinical features, and laboratory findings were analyzed. RESULTS: PCR was positive in 57 cases. Longer fever duration before admission (P < 0.001), higher rates of lobar or segmental pneumonia (P=0.048), unilateral infiltration (P=0.038), and extrapulmonary symptoms (P=0.049) were associated with MP PCR-positive pneumonia. Serum IgM index was significantly higher in MP PCR-positive pneumonia them in MP PCR-negative pneumonia (3.9±3.0 vs. 0.8±1.3, P < 0.001). Using MP PCR as a gold standard, the sensitivity, specificity, positive predictive value and negative predictive value of serum IgM were 85.5%, 82.1%, 91.4%, and 71.9%, respectively. The area under the curves for serum IgM index was 0.892, and the ROC analysis indicated that an optimal cutoff value of 1.05 for serum IgM provided the highest sensitivity and specificity interestingly (83.9% vs. 85.7%, P < 0.001). CONCLUSION: Serum IgM ELISA has useful diagnostic value in PCR-positive MP pneumonia. Applying an IgM index cutoff of 1.05 improves diagnostic accuracy.
Subject(s)
Child , Humans , Antibodies , Diagnosis , Early Diagnosis , Enzyme-Linked Immunosorbent Assay , Fever , Immunoglobulin M , Mycoplasma pneumoniae , Mycoplasma , Pediatrics , Pharynx , Pneumonia , Pneumonia, Mycoplasma , Polymerase Chain Reaction , Real-Time Polymerase Chain Reaction , Respiratory Tract Infections , ROC Curve , Sensitivity and SpecificityABSTRACT
PURPOSE: The purpose of this study was to retrospectively analyze the clinical and radiologic results of the proximal crescentic osteotomy for moderate to severe hallux valgus deformity. MATERIALS AND METHODS: Between March 2001 and March 2008, 55 patients (71 feet) who had undergone crescentic osteotomy and distal soft tissue procedure for hallux valgus were followed up for more than one year. The average follow-up period was 15.8 months (12~28 months) and the average age at the time of surgery was 49.8 years (20~69 years). We analyzed the hallux valgus angle (HVA), the first-second intermetatarsal angle (IMA), the length of 1st metatarsal bone and the position of medial sesamoid in preoperative and the last follow-up radiographs. The American Othopeaedic Foot and Ankle Society (AOFAS) score and patient satisfaction were measured by modifying Johnson's method which were used for clinical outcome assessments. RESULTS: The HVA and the IMA were 36.2 and 15.8 degrees preoperatively, and 10.8 and 3.9 degrees at the last follow-up, respectively. The amount of shortening of 1st metatarsal bone averaged 2.3+/-1.1 mm postoperatively. The medial sesamoid position improved from a preoperative average of grade 6.6 to the last follow-up average of grade 1.9. The AOFAS score improved from a preoperative average of 45.3 points to an average 90.6 points at the last follow-up. The patient's satisfaction was completely satisfied in 61 cases (85.9%), satisfied with minor reservations in 6 cases (8.5%), satisfied with major reservations in 2 cases (2.8%), and dissatisfied in 2 cases (2.8%). CONCLUSION: Proximal crescentic osteotomy produced satisfactory results for moderate to severe hallux valgus deformity.
Subject(s)
Animals , Humans , Ankle , Congenital Abnormalities , Follow-Up Studies , Foot , Hallux , Hallux Valgus , Metatarsal Bones , Osteotomy , Patient Satisfaction , Retrospective StudiesABSTRACT
PURPOSE: The purpose of this study was to retrospectively analyze the clinical and radiologic results of the proximal crescentic osteotomy for moderate to severe hallux valgus deformity. MATERIALS AND METHODS: Between March 2001 and March 2008, 55 patients (71 feet) who had undergone crescentic osteotomy and distal soft tissue procedure for hallux valgus were followed up for more than one year. The average follow-up period was 15.8 months (12~28 months) and the average age at the time of surgery was 49.8 years (20~69 years). We analyzed the hallux valgus angle (HVA), the first-second intermetatarsal angle (IMA), the length of 1st metatarsal bone and the position of medial sesamoid in preoperative and the last follow-up radiographs. The American Othopeaedic Foot and Ankle Society (AOFAS) score and patient satisfaction were measured by modifying Johnson's method which were used for clinical outcome assessments. RESULTS: The HVA and the IMA were 36.2 and 15.8 degrees preoperatively, and 10.8 and 3.9 degrees at the last follow-up, respectively. The amount of shortening of 1st metatarsal bone averaged 2.3+/-1.1 mm postoperatively. The medial sesamoid position improved from a preoperative average of grade 6.6 to the last follow-up average of grade 1.9. The AOFAS score improved from a preoperative average of 45.3 points to an average 90.6 points at the last follow-up. The patient's satisfaction was completely satisfied in 61 cases (85.9%), satisfied with minor reservations in 6 cases (8.5%), satisfied with major reservations in 2 cases (2.8%), and dissatisfied in 2 cases (2.8%). CONCLUSION: Proximal crescentic osteotomy produced satisfactory results for moderate to severe hallux valgus deformity.
Subject(s)
Animals , Humans , Ankle , Congenital Abnormalities , Follow-Up Studies , Foot , Hallux , Hallux Valgus , Metatarsal Bones , Osteotomy , Patient Satisfaction , Retrospective StudiesABSTRACT
PURPOSE: To compare the short-term clinical results of mini-midvatus minimally invasive total knee arthroplasty(TKA) with quadriceps-sparing minimally invasive TKA. MATERIALS AND METHODS: Between August 2005 and February 2006, 23 bilateral (46 knees) minimally invasive total knee arthroplasties were performed simultaneously using quadriceps-sparing surgical technique at one side and mini- midvastus minimally invasive technique at the contralateral side. The same surgeon performed all the operations with the same type of prosthesis(Nexgen LPS-flex Total Knee System) using MIS quadriceps-sparing instrument. The pos- toperative clinical and radiological results were analyzed in each group. RESULTS: There were no significant differences between the two groups in the operating time, total blood loss, length of skin incision, radiological results and postoperative HSS scores at 8 weeks and 1 year follow-up(p>0.05). Also, there were no differences in the postoperative range of motion and pain score assessed by visual analog scale at 1 day, 3 days, 7 days, 14 days, 8 weeks and 1 year follow-up(p>0.05). Conclusions: Compared to quadriceps-sparing TKA, mini-midvastus minimally invasive TKA revealed no significant differences in the short-term clinical and radiological results. Therefore, it can be considered as an effective, alternative minimally invasive technique.
Subject(s)
Arthroplasty , Knee Joint , Knee , Range of Motion, Articular , Skin , Visual Analog ScaleABSTRACT
PURPOSE: The main purpose of this study is to develop new payment rates for services of Radiation Oncology, considering costs of treating patients. MATERIAL AND METHODS: A survey of forty hospitals has been conducted in order to analyze the costs of treating patients. Before conducting the survey, we evaluated and reclassified the individual service items currently using as payments units on the fee-for-service reimbursement system. This study embodies the analysis of replies received from the twenty four hospitals. The survey contains informations about the hospitals' costs of 1995 for the reclassified service items on Radiation Oncology. After we adjust the hospital costs by the operating rate of medical equipment, we compare the adjusted costs with the current payment rates of individual services. RESULTS: The current payment rates were 5.05-6.58 times lower than the adjusted costs in treatment planning services, 2.22 times lower in block making service, 1.57-2.86 times lower in external beam irradiation services, 3.82-5.01 times lower in intracavitary and interstitial irradiation and 1.12- 2.55 times lower in total body irradiation. CONCLUSION: We could conclude that the current payment system on Radiation Oncology does not only reflect the costs of treating patients appropriately but also classify the service items correctly. For an example, when the appropriate costs and classification are applied to TBI, the payment rates of TBI should be increased five times more than current level.
Subject(s)
Humans , Classification , Fee-for-Service Plans , Hospital Costs , Radiation Oncology , Whole-Body IrradiationABSTRACT
No abstract available.
Subject(s)
Female , Pregnancy , Pregnancy , Arteries , Pregnancy Outcome , Umbilical ArteriesABSTRACT
No abstract available.
Subject(s)
Female , Humans , Antigen-Antibody Complex , Cervix UteriABSTRACT
No abstract available.
ABSTRACT
No abstract available.