Reliability of Goldberg Scoring System in the Radiographic Evaluation of Bony Union after Bone Grafting

Background@#Evaluation of bony union after bone grafting is very important in orthopedic surgery. The aim of this study was to verify inter- and intraobserver reliability of the Goldberg scoring system for radiographic evaluation of bony union after bone grafting in various situations of animal models. @*Methods@#Twenty-seven male C57/BL6 mice, which lack the ability to synthesize galactose-alpha-1,3-galactose (GalT KO mice), and 9 C57/BL6 mice carrying a wild-type gene were used as animal models. We divided the mice into four groups. In group 1, syngenic bone grafting and intramedullary fixation were performed (9 wild type C57BL/6 mice). In group 2, allogenic bone grafting was performed (9 GalT KO mice). In group 3, an alpha-galactosidase-treated porcine xenograft was transplanted into the femur to reduce the antigenicity (9 GalT KO mice). In group 4, a non-treated porcine xenobone grafting was performed (9 GalT KO mice). The level of radiographic bony union (Goldberg method) was assessed by three orthopedic surgeons. Intra- and interobserver reliability for radiographic evaluation was assessed. @*Results@#In the Goldberg scoring system, most of the radiographic measurements showed substantial to almost perfect intraobserver reliability. The total score showed substantial intraobserver reliability. The kappa coefficient (κ) of the first examiner was 0.603, the κ of the second examiner was 0.790, and the κ of the third examiner was 0.758. The scoring system showed substantial interobserver reliability. The κ of the first session was 0.641 and the κ of the second session was 0.649. @*Conclusions@#The Goldberg scoring system is a reliable tool for radiographic evaluation of bony union after bone grafting.

A Report of Five Cases of Mixed Candida and Bacterial Keratitis

PURPOSE: To report the clinical manifestations and prognoses in 5 cases of mixed Candida and bacterial keratitis and present a literature review on mixed fungal and bacterial keratitis. CASE SUMMARY: Five eyes of 5 patients (1 male, 4 female) diagnosed as mixed Candida and bacterial keratitis by corneal smear and culture were included in the present study. Patient mean age was 62.80 years. All patients had preexisting ocular or systemic conditions as predisposing factors for mixed Candida and bacterial keratitis. The most common Candida species isolated was Candida albicans (3 eyes, 60%), while Staphylococcus (3 eyes, 60%) was the most common mixed bacterial species. The average size of ulceration was 7.02 mm2. In 2 eyes (40%), the lesions were located at the corneal center. The depth of the infiltration was significant in all cases, and hypopyon was present in 2 eyes (40%). On the initial visit, the visual acuity was counting fingers or worse in all cases. Four eyes (80%) unresponsive to the topical and systemic treatment underwent surgical intervention but only 1 eye (20%), which had responded to the topical and systemic treatment, showed acuity improvement of more than 1 line on the final visit. CONCLUSIONS: In managing chronically compromised cornea, the possibility of mixed infections with Candida and bacterial organisms should be considered as keratitis shows poor prognosis.

Outcomes of Autogenous Dermis Fat Grafting with Different Donor Sites in Exposed Porous Orbital Implants

PURPOSE: To compare the outcomes of autogenous dermis fat grafting with different donor sites in the treatment of exposed porous orbital implants. METHODS: The present study retrospectively evaluated the medical records of 17 patients (17 anophthalmic eyes) who had undergone autogenous dermis fat grafting based on the diagnosis of exposed porous orbital implants and were regularly followed up for at least 12 months since the surgery from January 2001 to December 2010. The patients were divided into 2 groups (thigh and abdomen) according to the site of the donor grafting. The treatment outcome and complications were compared between the 2 groups. RESULTS: The success rate of thigh dermis fat grafting was 88.9% (8/9) and 100.0% (8/8) in the abdominal dermis fat grafting, and there was no statistically significant difference between the 2 groups (p = 1.000). Regarding ocular complications, graft tissue infection (thigh 11.1%, abdomen 0%) and superior sulcus deformity (thigh 22.2%, abdomen 25.0%) were present. Regarding donor site complications, tenderness (thigh 55.6%, abdomen 25.0%), dehiscence (thigh 22.2%, abdomen 25.0%) and scar formation (thigh 33.3%, abdomen 25.0%) were observed. In the gait associated complications, pain (thigh 55.6%, abdomen 25.0%) and limping (thigh 22.2%, abdomen 12.5%) were observed. The rate of all complications showed no statistically significant difference between the thigh dermis fat grafting and the abdominal dermis fat grafting (all p > 0.05). CONCLUSIONS: Thigh and abdomen can both be considered as an effective donor site for the autogenous dermis fat grafting in the treatment of exposed porous orbital implants.

A Case of Bilateral Visual Loss due to an Olfactory Groove Meningioma

PURPOSE: To describe a case of severe bilateral visual loss in a patient with olfactory groove meningioma. CASE SUMMARY: A 64-year-old man presented with a 1-year history of anosmia, progressive loss of vision and visual field deficit. Presenting visual acuity was Counting fingers at 10 cm, and visual field exam showed total visual field defect in both eyes, but there was no remarkable finding to warrant an ophthalmologic examination except mild nucleosclerosis in both eyes and temporal pallor in the left optic nerve head. A brain MRI scan was performed and revealed an olfactory groove meningioma. Surgical resection was performed, and pathologic findings showed meningotheliomatous meningioma. Two months later, the patient was healthy, but no significant improvement of visual acuity or visual field was observed. CONCLUSIONS: In patients with unexplained visual loss with anosmia, olfactory groove meningioma should be considered.

Genetic Polymorphism of the Serum Proteins of Horses in Jeju

The study was carried out to investigate the genetic polymorphism of the serum proteins of horses in Cheju. They were assigned to three groups; 45 Cheju native horses(CNH), 60 Cheju racing horses(CRH) and 60 Thoroughbreds(TB). We analyzed the phenotypes and gene frequencies of serum proteins which were albumin (Alb), vitamin-D binding protein(GC), esterase (ES), A1B glycoprotein(A1B) and transferrin(TF) loci using horizontal polyacrylamide gel electrophoresis (HPAGE).All of the loci, except A1B in TB, showed polymorphisms and different allelic and phenotypic frequencies in all three groups. ESS and TFF1 were not observed in CNH. Allelic frequencies of AlbB, ESI, TFD and TFF1 were high in TB. All of the loci, except ES locus in CRH, appeared to be in a state of Hardy-Weinberg equilibrium from goodness-of-fit test in all three groups Heterozygosity estimates at Alb, ES and TF loci were high, but GC and A1B loci were low in all three groups. Average heterozygosities in CNH, CRH and TB were 0.3535, 0.3555 and 0.2726, respectively. Results showed differences in the frequencies of alleles and phenotypes of several serum protein loci between CNH and CRH, suggested that CRH might be crossed with other breeds of horses in some degree.