The Efficacy of Nerve Conduction Study on Tarsal Tunnel Syndrome / 대한족부족관절학회지

PURPOSE: Nerve conduction study (NCS) test is a standard diagnostic study of the tarsal tunnel syndrome. The purpose of this study was to determine the relation between the results of the NCS and postoperative clinical results. MATERIALS AND METHODS: From June 2004 to July 2015, 104 patients were diagnosed with tarsal tunnel syndrome and treated surgically. Of 104 patients diagnosed through NCS preoperatively and postoperatively, 41 patients were included in this study. There were 23 male and 18 female patients with mean age of 49.2 years old and the average follow-up period was 15.5 months. NCS, pain visual analogue scale (VAS) score, and subjective satisfaction were examined preoperatively and postoperatively. RESULTS: On the preoperative NCS, 32 patients (78.0%) were positive and 9 patients (22.0%) were negative, and 32 positive NCS patients consisted of 9 positive (28.1%), 16 improved (50.0%), and 7 negative (21.9%) postoperatively. VAS score was 7.4 preoperatively and 4.4 postoperatively. According to satisfaction, there were 8 excellent (19.5%), 21 good (51.2%), 6 fair (14.6%), and 6 poor (14.6%) patients. For 32 patients who were positive on the preoperative NCS, the postoperative VAS score was 4.87 and there were 7 excellent (21.9%), 16 good (50.0%), 4 fair (12.5%), and 5 poor (15.6%) patients. Sixteen patients were negative on the postoperative NCS, with a VAS score of 3.75, 1 excellent (6.3%), 11 good (68.8%), 2 fair (12.5%), and 2 poor (12.5%). There was no statistical correlation between the preoperative NCS and postoperative VAS score (p=0.10), between preoperative NCS and postoperative satisfaction (p=0.799), between preoperative NCS and postoperative VAS score (p=0.487), and between postoperative NCS and postoperative satisfaction (p=0.251). CONCLUSION: For patients diagnosed with tarsal tunnel syndrome and treated surgically, NCS showed little correlation with postoperative result.

Recurred Intraneural Ganglion on Superficial Peroneal Nerve (A Case Report) / 대한족부족관절학회지

Intraneural ganglilon of superficial peroneal nerve was rare condition around foot and ankle. we experienced a case of recurred intraneural ganglion of superficial peroneal nerve on foot. We treated the case with idendify of intraarticular branch of ganglion. We report the case with a review of literature.

Treatment of Superficial Peroneal Nerve Entrapment Syndrome under Local Anesthesia using Ultrasonogram / 대한족부족관절학회지

PURPOSE: To review the outcomes of surgical treatment for superficial peroneal nerve entrapment. MATERIALS AND METHODS: Ultrasonogram was used for diagnosis and surgical treatment. Seven superficial peroneal nerve entrapment were surgically treated with follow up of average 16 months (range, 6~29 months). Three patients were male and four patients were female with mean age 36.7 years (range, 19~51 years). Four cases developed after repetitive ankle sprain and three cases had no etiology. RESULTS: Operation was performed mini-open and subcutaneous fasciotomy under local anesthesia. The results were excellent in two cases, good in four cases, fair in one case. CONCLUSION: Ultrasonogram was useful for diagnosis and surgical treatment of superficial peroneal nerve entrapment syndrome.

A Rapid Diagnostic Test for Toxoplasmosis using Recombinant Antigenic N-terminal Half of SAG1 Linked with Intrinsically Unstructured Domain of GRA2 Protein

Toxoplasma gondii is an apicomplexan parasite with a broad host range of most warm-blooded mammals including humans, of which one-thirds of the human population has been infected worldwide which can cause congenital defects, abortion, and neonatal complications. Here, we developed a rapid diagnostic test (RDT) for T. gondii infection. Antigenic N-terminal half of the major surface antigen (SAG1) was linked with intrinsically unstructured domain (IUD) of dense granule protein 2 (GRA2). The recombinant GST-GRA2-SAG1A protein was successfully expressed and purified as 51 kDa of molecular weight. Furthermore, antigenicity and solubility of the rGST-GRA2-SAG1A protein were significantly increased. The overall specificity and sensitivity of GST-GRA2-SAG1A loaded RDT (TgRDT) were estimated as 100% and 97.1% by comparing with ELISA result which uses T. gondii whole cell lysates as the antigen. The TgRDT tested with Uganda people sera for field trial and showed 31.9% of seroprevalence against T. gondii antibody. The TgRDT is proved to be a kit for rapid and easy to use with high accuracy, which would be a suitable serodiagnostic tool for toxoplasmosis.

Radiological and Clinical Comparison of 1 Cage versus 2 Cages for Posterior Lumbar Interbody Fusion with PEEK Cage and Local Bone Graft / 대한척추외과학회지

STUDY DESIGN: This is a retrospective study. OBJECTIVES: We wanted to compare and evaluate the results of using one cage and two cages with local bone grafting for each segment when performing posterior lumbar interbody fusion (PLIF). Summary of Literature Review: Some authors have reported that unilateral one-caged PLIF with local bone grafting and posterior instrumentation was no difference from bilateral two-caged PLIF regard to the fusion rates and the radiologic or clinical results. MATERIALS AND METHODS: From March 2005 to February 2006, PLIF was performed on 36 patients who had lumbar degenerative disease. They were categorized as the cases for which one cage was used for a segment and the cases for which 2 cages were used for a segment. The clinical and radiological results in each group were compared. RESULTS: There was complete union in 11 segments with using one cage (55%), complete union in 12 segments using two cages (77%) and incomplete unions in 9 segments with using one cage (45%) and incomplete union in 4 segments with using 2 cages (25%), and there wasn't any case of nonunion (p>0.05). The postoperative changes of the intervertebral disc space were a 2.0 mm increase with using one cage and a 2.2 mm increase with using two cages, yet these values decreased by 0.4 mm and 0.3 mm, respectively, on the last follow-up. The mean operation time was 89 minutes for one segment with one cage and 105 minutes for one segment with two cages. The blood loss was a mean of 602 ml with one cage and 802 ml with two cages (p<0.05). There was no significant difference between the one cage group and the two cages group for the Kirkadly-Willis criteria. CONCLUSION: Posterior decompression and PLIF with one PEEK cage for treating degenerative lumbar disease was more effective for the operation time and the amount of blood loss than that with two cages, but the fusion rate, the alteration of the intervertebral disc space, the improvement of pain and the clinical results were no different. However, these results are from short term follow up, so continuous follow up will be necessary in the future for assessing the long term prognosis.

A Short Term Follow-up of Anterior Cruciate Ligament Reconstruction using Hamstring Tendon Grafts fixed with Ligament Plate(R)

PURPOSE: To evaluate the clinical outcomes at a minimum of 1 year following the ACL reconstruction with use of Liga- ment Plate(R) which was invented for secure fixation of hamstring tendon graft into femoral tunnel. MATERIALS AND METHODS: Seventy-six patients who could followed up for minimum 12 months were treated with the ACL reconstruction fixed with Ligament Plate(R) using a four-stranded autologous hamstring tendon graft. For femoral fixation, we used Ligament Plate(R), and for tibial fixation, we used suture-post strengthened with cortical screw. Average follow up period was 18.6 months. Prior to surgery and at the follow-up examination, we evaluated the clinical results with Lachmann test, pivot shift test, Lysholm score and the difference of mid-thigh circumference, and KT 2000 arth- rometer was perfomed. For radiographic evaluation, we analyzed knee radiographs including anterior drawer radiographs and evaluated the degree of tunnel enlargement. RESULTS: Lysholm score improved from 61.6 points to 93.8 points. Lachman test revealed negative findings for sixty- three cases, and ten cases with grade 1 laxity and another three cases with grade 2 at last follow-up. Pivot shift test showed negative findings except six cases with grade 1 laxity at last follow-up. The results of KT 2000 arthrometer improved from 5.4mm difference compared with normal limb to 2.1mm respectively. The difference of mid-thigh circumference compared with normal limb showed 1.7cm. Radiographic analysis of anterior drawer view revealed 6.5 mm difference compared with normal limb preoperatively and 1.1 mm difference at last follow-up. Femoral and tibial tunnel enlarged to 2.7mm and 1.8 mm compared with immediate postoperative radiographs. CONCLUSION: ACL reconstruction using hamstring tendon grafts fixed with Ligament Plate(R) could provide sufficient strength of early fixation, and then could show good clinical results. However, long term follow-up was necessary.

Staphylococcal Infection in the Neonatal Intensive Care Unit

PURPOSE: Staphylococcal bacteremia is a major problem in the neonatal intensive care unit. But, there is little data on staphylococcal bacteremia in the neonatal intensive care unit in Korea. We searched for patterns of staphylococcal infection in neonatal intensive care units. METHODS: A retrospective study was conducted on infants who had staphylococcal bacteremia and were in the neonatal intensive care unit between 2001, February and 2007, May. RESULTS: A total of 48 cases were reviewed (mean gestational age 31 wks [23-40], mean birth weight 1689 g [510-3,920]). The vast majority of cases were coagulase-negative staphylococcus (CoNS) (30 cases, 62.5%). Staphylococcus aureus caused 36.1% of staphylococcal bacteremia (17 cases). Methicillin-resistant staphylococcal aureus (MRSA) (14 cases) caused 77.7% of staphylococcal aureus bacteremia. Peripherally inserted central venous catheters were placed in situ in most patients (MSSA: 75%, MRSA: 88.2%, CoNS: 62.1%). Most of the staphylococcal bacteremia in patients were hospital-acquired (81%). Fifteen cases increased levels of C-reactive protein (CRP) (31%). (Mean CRP : MSSA 1.07 mg/dL, MRSA 3.64 mg/dL, CoNS 0.54 mg/dL). Exclusively MRSA had focal complications (osteomyelitis/arthritis: 3 cases). Vancomycin was used in 47.4% in MRSA and 52.6% in CoNS. Four patients (8.3%) died, but all were not directly attributable. CONCLUSION: The staphylococcal bacteremia was generally observed to be a hospital- acquired infection in the neonatal intensive care unit. MRSA caused more elevation of CRP levels and focal complication. To know exactly that what the pattern of staphylococcal bacteremia in Korea is, more research is needed in other neonatal intensive care unit.

Meconium Obstruction Syndrome in Two Extremely Low Birth Weight Infants

Ileal obstruction by meconium in premature and low birth weight infants is an unique clinical entity, and it is differentiated from other types of meconium obstruction not associated with cystic fibrosis. Markedly premature infants may present with intestinal obstruction symptoms resembling those of necrotizing enterocolitis, and perforation secondary to inspissated meconium. Between 2001 and 2006, two extremely low birth weight infants were treated for intestinal obstruction secondary to inspissated meconium. They were successfully treated with gastrografin enemas. Prompt diagnosis and appropriate management resulted in a beneficial patient outcome.

Nonunion in Bilateral Ball and Socket Ankle Joint / 대한족부족관절학회지

Ball-and-socket deformity of the ankle joint is a rare entity that is usually associated with inequality of leg length, fibular hyperplasia, coalition of the ankle, and ray deficiency. Etiology is unknown, congenital itself or secondary to congenital conditions in the ankle. Nonunion of medial malleolar is rare in bilateral ball and socket ankle joint without lower leg deformity. We report upon this case, and include brief reviwe of the literature.

Fat Embolism / 대한정형외과학회잡지

Fat Embolism is a rare complication of multiple long bone fracture or extensive soft tissue injury. The pathogenesis of fat embolism has been poorly understood and still its definite pathogenesis, diagnosis and treatment were not fully established. Recently fat embolism considered as a post traumatic respiratory failure. Monitoring of blood gas is required for early diagnosis and respiratory supportive treatment with continued minitoring is necessary until resolution. Fifteen cases of fat embolism treated at from September 1979 to October 1981 Eul Ji General Hospital were clinically analized. Among the fifteen cases, fourteen were recovered without sequalae and one was expired ten days after trauma.

Giant Extra-Capsular Synovial Chondroma of the knee joint: A Case Report / 대한정형외과학회잡지

Extra-capsular synovial chondroma is a rare condition in which metaplastic cartilaginous mass is formed by the cartilage nodule within the synovial connective tissue break through the joint capsule and continue to proliferate. The authors have experienced a case of giant extracapsular synovial chondroma, affecting the knee joint of 54 years old woman. A case of giant extra-capsular synovial chondroma is reported with brief review of literature.

Open Reduction and Internal Fixation in a Displaced, Comminuted Acetabular Fracture: Report of a Case / 대한정형외과학회잡지

An anatomical reduction and maintainance of articular fracture is on of the basic principles In Orthopedic Surgery if good function is to ensue, especially in a major welght bearing joint such as hip knee ankle. In displaced articular fractures, excellent results can be achieved mainly by an open anatomical reduction and firm internal fixation. We performed an open reduction and internal flxation with plates and screws in a patient with the severely comminuted acetabular fracture, and a satisfactory result is obtained.