Impact of Familial Pseudohyperkalemia on Donated Blood and Clinical Outcomes from Transfusion / 대한수혈학회지

Familial pseudohyperkalemia (FP) is a dominantly inherited condition caused by variants in the gene ABCB6 resulting in red blood cell (RBC) membrane protein defects. FP is generally asymptomatic. However, FP RBCs have an increased permeability to monovalent cations when stored below 37°C. Transfusion of RBC components donated by FP individuals can induce hyperkalemia and may be causally related to transfusion-associated hyperkalemic cardiac arrest, particularly in neonates and infants. Therefore it is necessary to accurately evaluate the frequency of FP occurrence in the Korean population and assess whether FP RBCs have significantly higher supernatant potassium levels. Efforts should be made to recognize the effects of blood products collected from FP donors on blood transfusion recipients to reduce the risk of hyperkalemia, especially in fetuses, infants, and patients at risk of this condition.

Transfusion thresholds: the need for a patient-centered approach in hematologic disorders that require chronic transfusion therapy

Transfusion is an essential life-sustaining treatment for many patients. However, unnecessary transfusion has been reported to be related to worse patient outcomes. Further, owing to the recent pandemic, blood supply has been more challenging to maintain. Many studies have been conducted to elucidate the optimal transfusion threshold for many clinical conditions, and most suggested that a restrictive transfusion strategy has advantages over a liberal transfusion strategy. Hematologic disorders, which require chronic transfusion in many cases, have not been the main subjects of such studies, and only little evidence is available regarding the optimal transfusion threshold in these patients.According to several recent studies, a liberal transfusion strategy is preferable for patients with hematologic disorders due to their quality of life. A patient-centered approach is needed for proper management of hematologic disorders.

Practicality of thermography in evaluation of osteoarthritis of knee joint

BACKGROUND: About 80 percent of the Korean population over 55 years old show radiographic signs of osteoarthritis. Hence, osteoarthritis has become one of the most important public health problem among the old age. Despite the importance of this disease, proper methods for evaluation and diagnosis of osteoarthritis have not been developed. Authors have investigated the sensitivity and specificity of thermography in diagnosing osteoarthritis. METHODS: Twenty patients who had visited the department of family medicine, Korea University Hospital, with non-traumatic knee pain during the period from April 1 to May 30, 1999, were included in the study. Patients had gone through series of careful history taking, physical examination and laboratory evaluations for clinical evaluation of osteoarthritis of the knee joints. Furthermore, the radiographic and thermographic examination of both knee joints were assessed. RESULTS: Among the twenty patients who have been examined, 15 patients were to have shown radiographic abnormality; on the other hand, 14 patients showed thermographic abnormality. Seventeen patients showed clinical manifestations of osteoarthritis. Twelve patients, among those who had clinical osteoarthritis, were shown to have osteoarthritis in both image studies, i.e. radiographic and thermographic abnormalities. All patients who had not shown clinical osteoarthritis, were normal on both image studies. The sensitivity and specificity of thermography in diagnosing osteoarthritis were 80% and 80%, respectively (P<0.05). CONCLUSIONS: Hot spots or asymmetric distribution in the knee joint area of osteoarthritis patients were in thermographic examination. Thermography has shown efficacy in the evaluation of osteoarthritis.

Squamous Cell Carcinoma Arising from Chronic Osteomyelitic Sinus: A Report of Three Cases / 대한정형외과학회잡지

The developement of squamous cell carcinoma from the draining sinus of chronic osteomyelitis has long been recognized as a rare and late complication. The mode of developement of carcinoma at the site of chronic osteomyelitis is not well understood. This, however, is chiefly a disease of middle aged men, and tibia is the most common site. There are two types in this carcinoma; superficial and deep types. In the superficial type obvious presence of fungaiing growth makes diagnosis simple and easily confirmed by biopsy. In the deep type the diagnosis is difficult clinically, but the features most frequently described are an increase in pain and discharge with swelling and hemorrhage. Amputation at the adequate level is the treatment of choice. Three cases of the disease involving one left femur, and two left tibiae are reported with review of literature.

Vacuum Arthrography of the Hip Joint / 대한정형외과학회잡지

It is possible to create a diastasis in the hip by traction. The space thus created between articular surfaces can be visualized radiographically and is known as “a vacuum phenomenon”. Twenty one cases of unilateral hip joint disease were studied with vacuum arthrography from Oct. 1983 to July 1984 in Catholic Medical College and Center. The patients ages ranged from a month to 53 years of age but most of them(18 out of 21 patients) were below 10. There were 5 female patient's and 16 male patients in this series. The results were as follows: 1. In the absence of an effusion in all normal hip joints the vacuum phenomenon was demonstrated. 2. In the absence of an effusion in the hips of a transient synovitis, 4 Legg-Calve-Perthes disease and 3 sprain the size of vacuum was normal. 3. The size of vacuum of 3 transient synovitis and a pyohip of healing stage which had only mild effusion was smaller than those of normal hips. 4. In the presence of large amount of effusion in the hips of 5 transient synovitis, 2 pyogenic arthritis and 2 tuberculous arthritis it has not been possible to produce the vacuum phenomenon. 5. This study, in summary, shows that the size of vacuum represents the amount of effusion. 6. Non-ossified femoral head in the new born, articular surface of acetabulum and thickness & local changes in the cartilage of the femoral head could be demonstrated using the vacuum arthrography. 7. It has not been possible to demonstrate the articular surface lateral to the limbus, ligamentum teres and limbus in the vacuum arthrogram.

Melorheostosis: Report of 2 Cases / 대한정형외과학회잡지

Melorheostosis is a rare disease entity of bone with an etiology and pathogenesis. It cause pain and stiffness in an affected limb, and dense bone formation along the side of bone resembles the flow of candle dripping. Two cases of the disease involving left hand and wrist, and right lower leg are reported with the review of literature.

Malignant Schwannoma (A Case Report) / 대한정형외과학회잡지

No abstract available in English.

Treatment of Intertrochanteric Fracture with Multiple Flexible Intramedullary Nails / 대한정형외과학회잡지

Recently, morbidity and mortality are reduced in elderly trochanteric fracture patients, which is best accomplished with multiple flexible intramedullary nail fixation under image intensifier control. Condylocephalic nailing of the trochanteric fractures offers four advantages; Minimally traumatic, short operation time, little blood loss, and very early weight bearing on the injured limb after surgery. The authors treated 15 cases of intertrochanteric fractures from June 1981 to March 1983 with multiple flexible intramedullary nails (Ender or P.G.P.). The results obtained were as follows; l. Among 15 cases, two patients were ages between 41 and 50, there between 51 and 60, one between 61 and 70, seven between 71 and 80, and two patients above 81 years, Nine were men and six women. 2. The average operation time was 60 minutes (range, 30 to 150 minutes) and average blood loss was 140ml (range, 50 to 400ml). After operation, Bucks extension traction was applied for 3 weeks in three cases. 3. Partial weight bearing ambulation was recommended one day after operation in eleven cases, and at 21th days in the other three cases. Full weight bearing ambulation, using appropriate assistive devices, was recommended as early as possible. 4. The clinical union was obtained as early as 5 weeks after operation in 7 cases, 9 weeks in two cases and 12 weeks in one case. 5. Among the complications, downward migration of the nail occured in two patients. With early weight-bearing, varus deformity due to collapse of the reduced fracture resulting secondary leg shortening (less than 3 cm) occured in 8 cases and mild external rotation deformity of lower leg in 3 cases (less than 15), but did not present any clinical problem in elderly patients, Irritation by the nail tip caused pain around the knee and also developed the partial stiffness of the joints temporarily after surgery. No nails migrated into the oits. It was felt that most difficult thing to manage was the maintenance of reduced fracture till clinical union to prevent varus deformity and distal nail migration, and the method was technically simple and could be employed succesfully.

Reiter's Syndrome: Two Cases Report / 대한정형외과학회잡지

Reiter's syndrome is a clinical triad of urethritis, conjunctivitis, and arthritis, but the characteristic mucocutaneous lesion occurs very frequently. Therefore, Reiters syndrome in fact might better be considered a tetrad, consisting in its complete form of urethritis, arthritis, conjunctivitis, and mucocutaneous lesions. In initial stage of the disease, the arthritis usually appear after the urethritis and conjunctivitis have been made. The arthritis is usually of subacute onset, reaching its full intensity within a few weeks in most cases. Additionally a man with Reiters syndrome who developed aortic insufficiency with no evidence of syphilis or rheumatic heart disease has been reported. Two cases of Reiters syndrome are presented with the review of the literature: the first case was a 60 years old male who had non-gonococcal urethritis with mucous purulent discharge, conjunctivitis, polyarthritis, and aortic insufficiency; the second case was a young man aged 21 years who had the characteristic conjunctivitis and a past history of urethritis, and he also has had obvious keratodermia blenorrhagica and polyarthritic symptoms and signs.

The Study of Pinching Type and Power / 대한정형외과학회잡지

The pinching motion is thought to be one of fundamental hand functions, the power of which has been quantified by measuring it isometrically with variously devised pinch-meters. The present authors describe the investigations on the pinching power of 350 healthy persons, 200 male and 150 female Koreans, by the use of Preston Pinch Gauge. Six kinds of pinch were chosen: (1) thumb index finger tip pinch (1-2TP), (2) thumb-middle finger tip pinch (1-3TP), (3) thumb-index finger pulp pinch (1-2PP), (4) thumb-middle finger pulp pinch (1-3PP), (5) thumb-index-middle finger pulp pinch (3PP), (6) key pinch (KP), which were classified again into 19 kinds according to the shape of thumb, index, middle, or other fingers during each pinch. We describe those as principal type, hyperextension-flexion type, hyperextension type and other type into four. It should be justified to calculate the mean normal value of principal type pinching power in Korean. Principal type of pinch involves 1-2TP, 1-3TP, 1-2PP, 1-3PP, 3PP and KP, as to Hyperextension type of 1-2PP, 1-3PP, 3PP and KP. Other type of pinch involving 1-2TP, 1-3TP, 1-2PP, 1-3PP, 3PP and KP is different from Principal type simply because of the shape of nonjoining fingers during pinch. Generally, the pinching power of Principal type was clearly highest among the four types except for pulp pinches.

Congenital Synovial Sarcoma in Ankle: Report of A Case / 대한정형외과학회잡지

Synovial sarcoma is a highly malignant tumor which arises from synovial tissue derived from mesothelium and its occurrence is very rare. Furthermore, congenital synovial sarcoma which developed from aggressive deposition of tumor cells during intra-uterine fetal life is extremely rare. Authors present a case of congenital synovial sarcoma which is found in the right ankle of one month old boy, because of its rarity of occurrence.

Reconstruction of traumatic deficiency of forearm bone: report of Two Cases / 대한정형외과학회잡지

Two cases of acquired absence of forearm bone secondary to compound comminuted fractures were treated by reconstructive surgery, which consist of surgical construction of one-bone forearm. The results of treatment were referred and the review of the literature was done concerning about surgical reconstruction of one-bone forearm.

Clinical Study of Treatment and it's Results / 대한정형외과학회잡지

Calcaneal fractures of 82 feets in 68 patients which were treated at the Dept. of Orthopedic Surgery, St. Mary's Hospital since 1974 to 1978 were cllnically analysed, and the following results were obtained. 1. Of 68 patient 50 patients were male and 18 female. Their ages ranged from 9 to 58 years and averaged 33 years. 2. Fourteen patients had both calcaneal fractures, and the spine fractures were associated in 14 patients with calcaneal fractures. 3. Of 82 fractures 50 fractures were Rowe's type 5. Of these type 5 fracture 14 cases of tongue type were treated by axial pin flxation and favourable result were obtained. All the other types of fractures were treated conservatively. 4. After treatment, the most common complication after treatment was presistant foot pain. The commonest site of residual pain was beneath the lateral malleculus. Of 82 fractures 22 cases had this complaint. This residual pain occured in the seventeen cases type 5 fracture. 5. Residual flat foot deformity and weakness of triceps power were clinically not significant if the residual foot pain is nat associated with those two factors.