Dislocation of Tibial Insert after Fixed Bearing TKA using Minimal Invasive Surgery: A Case Report

Posterior instability after mobile bearing total knee replacement may be caused by gap imbalance, component malpo- sition, and delayed rupture of posterior cruciate ligament, but could not be easily considered other cause except component breakage in fixed bearing posterior cruciate substituted total knee replacement. The dislocation of tibial polyethylene insert was reported after mobile bearing total knee replacement but rare after fixed bearing total knee replacement. We report a case of dislocation of tibial polyethylene insert that have been found at a patient who had continuing posterior instability after fixed bearing posterior cruciate ligament substituted total knee replacement with a review of article.

Operative Treatment for Hallux Valgus with Proximal Metatarsal Osteotomy in Patients over 55 Years Old / 대한족부족관절학회지

PURPOSE: The purpose of our report was to evaluate the result of operative treatment of hallux valgus in old age patients. MATERIALS AND METHODS: We studied about the clinical & radiologic results of the 31 patients over 55 years old, who had operative treatment of hallux valgus. Clinical evaluation, such as pain, activity limitation, footwear requirement, 1st metatarsophalangeal joint motion, and callosity, was done using AOFAS scale and preoperative and postoperative radiologic parameters, such as hallux valgus angle, intermetatarsal angle, tibial sesamoid position, 1st metatarsal shortening, were evaluated by conventional methods. RESULTS: Objectively, according to AOFAS, the score improved from average of 57.8 to 71.5 postoperatively. The range of motion of first metatarsophalangeal joint was decreased from average of 60.7 to 56.8 degrees. Radiologically, the hallux valgus angle improved from average of 35 to 6.5 degrees and the first intermetatarsal angle improved from average of 14.2 to 4.4 degrees. The position of sesamoid was collected from an average of grade 3.6 to grade 2.2. CONCLUSION: The combination of proximal metatarsal osteotomy, distal soft tissue procedure and Akin osteotomy may yield rather satisfactory clinacal result in severe elderly hallux valgus patients with massive degenerative change and poor soft tissue condition.

Operative Treatment for Hallux Valgus with Proximal Metatarsal Osteotomy in Patients over 55 Years Old / 대한족부족관절학회지

PURPOSE: The purpose of our report was to evaluate the result of operative treatment of hallux valgus in old age patients. MATERIALS AND METHODS: We studied about the clinical & radiologic results of the 31 patients over 55 years old, who had operative treatment of hallux valgus. Clinical evaluation, such as pain, activity limitation, footwear requirement, 1st metatarsophalangeal joint motion, and callosity, was done using AOFAS scale and preoperative and postoperative radiologic parameters, such as hallux valgus angle, intermetatarsal angle, tibial sesamoid position, 1st metatarsal shortening, were evaluated by conventional methods. RESULTS: Objectively, according to AOFAS, the score improved from average of 57.8 to 71.5 postoperatively. The range of motion of first metatarsophalangeal joint was decreased from average of 60.7 to 56.8 degrees. Radiologically, the hallux valgus angle improved from average of 35 to 6.5 degrees and the first intermetatarsal angle improved from average of 14.2 to 4.4 degrees. The position of sesamoid was collected from an average of grade 3.6 to grade 2.2. CONCLUSION: The combination of proximal metatarsal osteotomy, distal soft tissue procedure and Akin osteotomy may yield rather satisfactory clinacal result in severe elderly hallux valgus patients with massive degenerative change and poor soft tissue condition.

Multicenter Prospective Clinico-Epidemiologic Study on the Abuse, Misuse and Adverse Effects of Drugs in Dermatological Field / 대한피부과학회지

BACKGROUND: The abuse, misuse, and resultant adverse reactions of various drugs have been widespread due to lack of division of work of medicine and pharmacy in Korea. OBJECTIVE: This study was conducted to bring people to an awareness of the seriousness of drug abuse and misuse. METHODS: A multicenter, prospective, clinico-epidemiologic evaluation was made from patients with adverse drug reactions who visited 126 dermatologic departments in university hospitals(21) or private clinics(105) nationwide from July 1st to July 31st, 1999. RESULTS: The prevalence of adverse drug reaction was 10.4%, among them 47.9% of the patients had adverse cutaneous effects from external use of topical steroids and 24.1% of the patients had contact dermatitis from external use of various topical agents. The rate(66.3%) of misuse of topical steroids was higher than that(33.7%) of abuse of the drugs. 79.8% of patients had obtained drugs without an accurate diagnosis and prescription from their doctors. Regarding the potency of topical steroids, it was revealed that the lowest potency drugs also caused adverse effects. CONCLUSION: The strict grouping of drugs as prescription drugs or over-the-counter drugs based on drug safety is the key factor to avoid the abuse and misuse of drugs, and to protect the public health from harmful drug effects.

Bipolar Endoprosthesis between Femoral Neck Fracture and Avascular Necrosis of Femoral Head: Comparison of the Acetabular Migration and Function / 대한정형외과학회잡지

In 1974, bipolar hip prosthesis was developed by Giliberty and Bateman to reduce the problems of unipolar prosthesis, including acetabular wear and acetabular protrusion, but the indications for it are still controversial. From July, 1988, to February, 1991, at Pusan maryknoll hospital, 37 hips in 33 patients of femoral neck fracture (25 hips) and avascular necrosis (12 hips) with relatively normal acetabular articular cartilage were treated with bipolar hip prosthetic replacement. The thirty-seven cases were reviewed for more than 3 years(range, 3 years to 4 years 8 months: average, 3 years 10 months), and assessed in terms of acetabular migration and function. The authors compared the datas of the femoral neck fracture with those of the avascular necrosis of femoral head. There was no statistical difference between two groups in function. But the acetabular migration of bipolar hip prosthesis used in femoral neck fracture was lesser than that of avascular necrosis of femoral head, and the serial acetabular migration disclosed gradual decrease. The authors concluded that the results of bipolar endoprosthesis used in femoral neck fracture was superior than those of avascular necrosis of femoral head with relatively normal acetabular articular cartilage.

The Effect of Combination Treatment with Oral Etretinate (Ro 10 - 9359) and Vitamin E on Psoriasis Vulgaris / 대한피부과학회지

Etretinate(Ro 10-9359), an aromatic analogue of vitamin A acid, has been known to be effective in the treatment of psoriasis, Darier's disease, pityriasis rubra pilaris, ichthyosis, and palmoplantar keratoderma when administered orally. In this experiment, we compared the therapeutic and side effects between a group with high dose therapy(initially 75mg of etretinate a day) and an another group with low dose therapy(initially 40mg of etretinate a day). We also observed whether the pretreatment followed by combined treatment with vitamin E could potentiate the therapeutic effect as well as reduce the side effects of oral etretinate. This experiment comprised 102 moderate to severe psoriatic patients. The following results were obtained from this experiment. 1. Fifty-six among 92 patients(61%) who were treated with etretinate for more than 4 weeks showed good to excellent therapeutic effect. 2 The high dose therapy was more effective, but showed more side effects than low dose therapy. 3 Vitamin E did not potentiate the effect of etretinate. In low dose therapy, the pretreatment followed by combined treatment with vitamin E showed a tendency to reduce the side effects of etretinate.

Monilethrix with Keratosis Pilaris / 대한피부과학회지

Monilethrix is a rare hereditary disorder of hair which was described by smith in 1879. The scalp hair is most frequently affected but the body or sexual hair are rarely affected. The affected hair shows periodic constrictions that break easily, so the hair could not grow more than a few millimetere long. It is thought that the node of the affected hair is normal and the thin internodal segment is deficient in hair matrix. Keratosis pilaris is generally an associated feature. We experienced a case of monilethrix with keratosis pilaris. The 4 years old male patient with monilethrix affected only scalp hair with keratosis. The family history was non-contributory.

A Clinical Study of Urticaria / 대한피부과학회지

Urticaria is a common disease and a well known reaction pattern of the skin eharacterized by erythema or wheals and edema, that is the results of a local leakage ef plasma, from minute vessels into the connective tissue of the dermis. Seven hundred and sixty cases of urticaria visited to this department from January 1973 to December 1974 were studied clinically in various ways. Patients were classified as acute and chronic urticaria-acute form when the hives have been present for less than 8 weeks and chronic form when the hives lasted longer. In all patients, a detailed history, a complete physical examination, a total and differential leukocyte count, erythrocyte sedimentation rate and routine stool examination were performed. Foods were incriminated as the exciting causes of urticaria by history, diet elimination test and ingestion test. An ice cube test was done for corroboration of cold allergy. Cholinergic urticaria, was diagnosed by the appearance of small wheals surrounded by erythema after exercise, emotional disturbances or hot drinks. The diagnosis of urticaria due to drug was based on the history of urticaria following the taking of a certain drug. Infection as the inciting cause was determined by history and physical examination. The results: 1. The incidence of urticaria is 4. 6% to total number of dermatologic patients. 2. Among the 760 urticaria patients, acute cases were 498 which were 2 times more than chronic cases, and female patients were 474 cases that revealed marked high incidences than male patients. 3. The age of the patients ranged from 2 months to 87 years, and the patients between 20 and 39 years occupied more than half of the all patients. 4. Abnormal hematologic findings were more marked in acute form; leukocytosis and neutrophilia were dominate in acute form, and lymphocytosis and eosinophilia were more marked in chronic form. 5. Among the etiologic factors, the bacterial infection was the most frequent which occupied 22. 4% of the all urticaria patients. 6. Seven cases of urticaria due to parasites were clonorchis sinensis, in which I had experienced the complete recovery with the treatment of subcutaneous injection of clonorchis sinensis antigen (1: 10,000) 0.01- 0.1ml at the interval of one week. 7. In this study, the inciting or perpetuating causes could not be found in 50.8% of patients-46.2% of acute form and 59.5% of chronic form.

A Case of Lymphocytoma Cutis Treated with CD2 Slush / 대한피부과학회지

A case of lymphocytoma cutis, the circumscribed form in 9 year-old girl is reported. This is seldom conclusive without histological examinatien for a wide variety of conditions has to be considered. The circumscribed form usually responds rapidly to radiotherapy, although recurrence is possible and good results from the use of procaine penicillin especially in the disseminated form. In this case, I experienced good results from CO, slush and topical application of 0.25 % fluocortolone 3 times a day without recurrence in 3 months after treatment.

Toxic Epodrmal Necrolysis: Report of a Case / 대한피부과학회지

A case of toxic epidermal necrolysis(TEN) in 20 years old female was presente d. The characteristic skin lesions of toxic epidermal necrolyais developed after oral administration of Aspirin for common cold. The cause of the disease. was probably due to Aspirin, but on the microscopic pathologic findings intraepithelial and subcorneal bullae which is characteristic in the staphylococcal induced TEN were noticed. She was treated with a massive systemic corticosteroids(Dexamethasone 12mg/d), antibiotics(Lincocin l.5grn/d), Fluids with electrolytes, sedatives and topical measures. So she was discharged with excellent results in a week of admission.