Clinical implications in laboratory parameter values in acute Kawasaki disease for early diagnosis and proper treatment / 소아과

PURPOSE: This study aimed to analyse laboratory values according to fever duration, and evaluate the relationship across these values during the acute phase of Kawasaki disease (KD) to aid in the early diagnosis for early-presenting KD and incomplete KD patients. METHODS: Clinical and laboratory data of patients with KD (n=615) were evaluated according to duration of fever at presentation, and were compared between patients with and without coronary artery lesions (CALs). For evaluation of the relationships across laboratory indices, patients with a fever duration of 5 days or 6 days were used (n=204). RESULTS: The mean fever duration was 6.6±2.3 days, and the proportions of patients with CALs was 19.3% (n=114). C-reactive proteins (CRPs) and neutrophil differential values were highest and hemoglobin, albumin, and lymphocyte differential values were lowest in the 6-day group. Patients with CALs had longer total fever duration, higher CRP and neutrophil differential values and lower hemoglobin and albumin values compared to patients without CALs. CRP, albumin, neutrophil differential, and hemoglobin values at the peak inflammation stage of KD showed positive or negative correlations each other. CONCLUSION: The severity of systemic inflammation in KD was reflected in the laboratory values including CRP, neutrophil differential, albumin, and hemoglobin. Observing changes in these laboratory parameters by repeated examinations prior to the peak of inflammation in acute KD may aid in diagnosis of early-presenting KD patients.

Early Additional Immune-Modulators for Mycoplasma pneumoniae Pneumonia in Children: An Observation Study / 감염과화학요법

BACKGROUND: Mycoplasma pneumoniae (MP) pneumonia is a self-limiting disease, but some patients complain of progressive pneumonia, despite of appropriate antibiotic treatment. We aimed to introduce the role of immune-modulators (corticosteroid and/or intravenous immunoglobulin, IVIG) treatment for childhood MP pneumonia based on previous our experiences. MATERIALS AND METHODS: A retrospective case series analysis for 183 children with MP pneumonia was performed. MP pneumonia patients were diagnosed by two Immunoglobulin M (IgM) tests: the micro-particle agglutination method (> or =1:40) and the cold agglutination test (> or =1:4), and were examined twice at the initial admission and at discharge. Among 183 MP pneumonia patients, 90 patients with persistent fever for over 48 hours after admission or those with severe respiratory symptoms and signs received additional prednisolone (82 patients, 1 mg/kg/day) or intravenous methylprednisolone (8 patients, 5-10 mg/kg/day) with antibiotics. Four patients with aggravated clinical symptoms and chest radiographic findings after corticosteroid treatment received IVIG (1 g/kg/day, 1-2 doses). RESULTS: Mean age of 183 patients was 5.5 +/- 3.2 years (6 months-15 years), and the male: female ratio was 1.1:1 (96:87). Fifty-seven patients (31%) were seroconverters and 126 seropositive patients showed increased diagnostic IgM antibody titres during admission (over 4 folds). The majority of the patients who received corticosteroids (86/90 cases) showed rapid defervescence within 48 hours with improved clinical symptoms, regardless of the used antibiotics. Also, 4 patients who received additional IVIG improved both clinically and radiographically within 2 days without adverse reaction. CONCLUSIONS: In the era of macrolide-resistant MP strains, early additional immune-modulator therapy with antibiotics might prevent from the disease progression and reduce the disease morbidity without adverse reaction.

The Effect of Vertebral Wedge Angle to the Change of Kyphotic Angle by the Posterior Instrumentation Method in Thoracolumbar Spine Fracture / 대한척추외과학회지

STUDY DESIGN: Retrospective study OBJECTIVES: To examine the effect of transpedicular screw fixation on fractured vertebrae about the vertebral wedge angle (VWA) after posterior instrumentation of the thoracolumbar fracture, determine the effect of reduced VWA on the change in the Kyphotic angle (KA), and minimize loss of reduction of KA. SUMMARY OF THE LITERATURE REVIEW: Maintenance of the KA of a thoracolumbar fracture after surgery is important for the radiologic and functional outcome. MATERIALS AND METHODS: Forty patients, who had undergone posterior instrumentation in a thoracolumbar fracture between February 2006 and February 2008 and followed-up for more than one year, were enrolled in this study. The patients were divided into two groups according to transpedicular screw fixation (Group A) or not (Group B) including fractured vertebrae. The evaluation was performed by measuring the changes in the KA and VWA taken after the injury, immediate after surgery and 1 year after surgery. RESULTS: There was correlation between groups A (transpedicular screw fixation on fractured vertebrae) and B (no transpedicular screw fixation on the fractured vertebrae) regarding the correction of the VWA and the loss of correction KA, (p<0.05). CONCLUSIONS: Reduction of the VWA is an important factor for preventing reduction loss of the KA, and transpedicular screw fixation including fractured vertebrae would help reduce the VWA. Therefore, the operator must pay attention to the increase in VWA to maintain the KA through short segment transpedicular screw fixation including fractured vertebrae.

The Measurement of Strain of the Anterior Cruciate Ligament in vivo / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to measure the strains of normal and lax anterior cruciate ligament (ACL) under serial loading using specially designed ACL strain analyzer (ASA) during arthroscopic examination. MATERIALS AND METHODS: The study is based on sixty-eight patients. Before the arthroscopic examination, all cases were divided into three groups according to their laxity based on Lachman test, KT2000 arthrometer, and magnetic resonance imaging. During arthroscopic examination, the ASA was connected with ACL using anteromedial portal with the knee flexed in 90. Under serial loading to ACL, the strains were illustrated and calculated. RESULTS: A statistically significant differences had been shown in strains between normal and lax ACL. Using ANOVA test, the ASA results according to preoperatively divided groups showed no significant differences between all groups and each loads. CONCLUSION: We had designed newly diagnostic method for estimate of ACL laxity, and measured the strains of lax ACL compared with normal ACL. This diagnostic method will be helpful to establish treatment plan for injuried ACL during arthroscopic examination.

Musculoskeletal Tissue Banking

No abstract available.

Bone Mineral Densities in Ballerinas, Korean Traditional Dancers and Athletes / 대한정형외과학회잡지

Evidence in human studies of the association of long term habitual exercise with bone mineral content (BMC) and bone mineral density (BMD) mostly come from studies done on athletes. The highest BMC and BMD values in young adults have been found in strength and power-training athletes, while endurance activities such as long distance running and swimming seem to be less effective in obtaining peak bone mineral density. To compare the differences in BMD among ballet, Korean traditional dancing and athletics, we examined the BMD of 10 ballerinas, 10 Korean traditional dancers, 12 athletes and 12 volunteers as the control group. All participants were female. The average age were 20.6 years for the ballerinas, 21.2 for the Korean traditional dancers, 20.4 for the athletes and 21.3 for the control group. Average weights were 50.6 kg for the ballerina, 53.7 kg for the Korean traditional dancer, 59.2 kg for the athletes and 53.8 kg for the control group. Average heights were 162.0 cm for the ballerinas, 160.4 cm for the Korean traditional dancers, 162.3 cm for the athletes and 160.5 cm for the control group. There were no significant differences in the BMD values of the proximal femur and the lumbar spine between ballerinas and control group and between Korean traditional dancers and control group (p>0.05). There was, however, a significant increase of BMD in the proximal femur and lumbar spine of the athletes when compared with the control group (p0.05). Differences of BMD values between the ballerinas and control group was statistically significant only in femoral neck (p<0.05).

A Study on the Shape of the Proximal Femur for Designing Korean-type of the Femoral Stem / 대한정형외과학회잡지

Avascular necrosis of the femoral head is the most common disease for which total hip arthroplasty is being performed in Korea. In order to develop a femoral stem having a proper fit to Korean femur, it is essential to study the change in the shape of the proximal endosteal canal of the femur resulting from disuse caused by pain avascular necrosis of the femoral head. The size and shape of the proximal femur were measured with 3-dimensional images reconstructed from the CT data of 116 femurs in 58 patients who had suffered from avascular necrosis of the femoral head. Among them, there were 30 patients who had suffered from unilateral involvement of avascular necrosis of the femoral head. The comparative study was made on the shape of the proximal endosteal canal of the femur between the normal and the diseased femurs. The shape of proximal endosteal canal of femur in avascular necrosis didn't show statistically significant difference from that of the normal femur. Therefore, the femoral stem designed from the data of normal femurs can be usually applied to the avascular necrosis without problem in obtaining the maximal fit between the stem and the endosteal canal. The canal flare index was greater and the proportion of champagne-flute type was higher in Korean than in Westerner. The shape of the endosteal canal of isthmus was nearly circular in Korean in contrast to anteroposteriorly ovoid in Westerner. The distribution of sagittal canal flare index which was newly defined in this study was entirely different from that of preexisting canal flare index in coronal plane. It will be necessary to study further in the future.

Acromial Downslping and Subacromial Interval in Shoulder Impingement Syndrome / 대한정형외과학회잡지

INTRODUCTION: There are three anatomic findings that correlate with a patient risk for developing anterior acromial impingement : acromial shape, anterior downsloping of the acromion. To analyze the effect of anterior and lateral downslopings and subacromial interval to the impingement syndrome retrospectively, the authors reviewed 32 patients who performed MRI of the shoulder joint in the Dankook university hoipital. MATERIALS AND METHODS: Eighteen males & fourteen females were reviewed and the average age was 46.6 years old. There were 23 cases of impingement syndrome and 9 cases of control group. The authors analyzed oblique coronal images and oblique sagittal images in shoulder MRI.

Total Hip Arthroplasty in Ankylotic Hips / 대한정형외과학회잡지

Total hip arthroplasty(THA) is applied to various hip diseases, and the results are different according to the disease entities. We have made the functional evaluation of three groups of the patients who had undergone THA in Seoul National University Hospital from 1981 to 1990: the first group-fused hips (28 hips of 27 patients), the second group partially ankylotic hips whose total range of motion were less than 60°(46 hips of 46 patients), and the third group-hips of ankylosing spondylitis (22 hips of 14 patients). The results were summerized as follows: No statistically significant difference was seen in the postoperative average Harris hip score between three groups. In the postoperative average range of motion, statistically significant difference was seen only between the first and second groups. Therefore, similar clinical results can be obtained from the THA in the fused hips to those of the partially ankylotic hips such as tuberculous or septic hip sequelae.

Analysis about the kinetics of the wrist motion using 3-dimensional reconstruction imaging of C.T / 대한정형외과학회잡지

No abstract available.

The value of the transverse histogram of the peri-prosthetic bone mineral density in the detection of the femoral stem loosening / 대한정형외과학회잡지

No abstract available.

Opertive treatment of nonunion of the surgical neck fracture of the humerus / 대한정형외과학회잡지

No abstract available.

A study on the serial changes of the bone mineral density around the femoral stem after cementless hip replacement arthroplasty: Changes during the first 6 months after operation / 대한정형외과학회잡지

No abstract available.

Screening tests in early detection of proximal deep venous thrombosis(DVT): prospective study / 대한정형외과학회잡지

No abstract available.

Observations on the postmortem ethanol production of rats / 대한법의학회지

No abstract available.

Opponensplasty / 대한정형외과학회잡지

Opposition of the thumb is necessary for pinch-one of the three most important functions of the hand. Frequently, opposition is either partially or totally lost in poliomyelitis or median nerve palsy. Several types of operations have been devised for restoration of opposition, and in 1973, Burkhalter et al. announced extensor indicis proprius opponensplasty: the tendon of extensor indicis proprius is brought out in the area of the pisiform and then passed against subcutaneously across the palm to the thumb, being attached to the abductor pollicis brevis and extensor pollicis longus tendon. It is useful in the case of loss of opposition without available finger flexor or wrist motors. Of nine patients who underwent operation-one with Riordan and eight with Burkhalter type of opponensplasty-at National Medical Center, seven had excellent results: one had a fair, and another one had a poor result. Six patients were with low combined median and ulnar nerve injury: one with high combined median and ulnar nerve injury: one with brachial plexus injury: and one with myotmesis of the thenar muscles. From the results, we conclude that Burkhalter type of opponensplasty makes satisfactory result for the hand without opposition movement; it is indicated in high median nerve injury and any combined median and ulnar nerve injury6; early restoration of opposition to the thumb in median nerve injury and in those limbs with multiple tissue trauma adds immeasurably to the over-all early rehabilitative effort.

Tendon Graft in Old Flexor Tendon Injury / 대한정형외과학회잡지

The flexor tendon injuries of the finger are very difficult to treat satisfactorily. Early treatment is desirable, but not always posaible. In addition, joint stiffness and limitation in gliding of the tendon caused by adhesion, make the problem more complex. From 1978 until 1988, 13 patients (14 eases) underwent operations for free tendon graft, and 10 patients (13 eases) for staged tendon graft at the Department of Orthopaedic Surgery, National Medieal Center. They have been followed up for clinical study, and the result was summarized as follows:1. Old flexor tendon injuries were common in the teen and twenties, especially in male. 2. They occurred in the index (10 Cases, 37.0%) and middle (8 cases, 29.6%) fingers most commony, especially zone II (62.9%). 3. The result was evalusted according to the method designed by Strickland and Glovac. In 19 out of 27 cases, satisfactory result (excellent and good) was yielded. 4. In cause, deep laceration by sharp object was better in the result than crushing injury. 5. The interval between the injury and the operation ranged from 1 month through 11 years, averaging 16 months, and is supposed to have little relation to the result. 6. The preoperative state is supposed to have much relation to postoperative result, judging from 100% of satisfactory result in Grade I compared with 40% in Grade V according to Boyes preoperative classification. 7. Little difference is seen in the result between free tendon graft and staged tendon graft. And 5 cases complicated by adhesion, rupture of grafted tendon and wound infection yielded poor result.