Clinical feature of Fitz-Hugh-Curtis syndrome: Analysis of 25 cases / 대한간학회지

BACKGROUND/AIMS: Fitz-Hugh-Curtis syndrome is defined as perihepatitis associated with pelvic inflammatory disease (PID). We retrospectively analyzed clinical and laboratory manifestations as well as the therapeutic response in patients with clinically diagnosed Fitz-Hugh-Curtis syndrome. METHODS: A cohort of 25 patients with PID and perihepatitis (as diagnosed by dynamic abdominal computed tomography (CT)) was enrolled. The prognosis, clinical manifestations, and physical examination, laboratory, and CT findings were analyzed. RESULTS: The mean (+/-SD) age of the patients was 32(+/-8) years, and all of them were sexually active, premenopausal women, and presented with abdominal pain. Of these, 52% complained of vaginal discharge. On physical examination, right upper-quadrant tenderness was the most common finding (84%), with lower-abdominal tenderness being present in 20% of patients. On laboratory examination, erythrocyte sedimentation rate and C-reactive protein were increased in 76% and 92% of the patients, respectively. The white blood cell count was increased in 60% of them. Most patients had a normal liver function test. Using a specimen of the cervical discharge, the polymerase chain reaction to test for Chlamydia trachomatis were positive in 87% (13/15) of the patients, and Chlamydia antigen was found in 75% (9/12) of them. Dynamic abdominal CT revealed subcapsular enhancement of the liver in the arterial phase. All of the patients improved with antibiotic therapy. CONCLUSIONS: Symptoms and physical findings suggestive of PID are not present in many patients with Fitz-Hugh-Curtis syndrome. When a premenopausal woman complains of upper abdominal pain and shows CT findings compatible with perihepatitis, examination of cervical discharge would be recommended to assess the possibility of Fitz-Hugh-Curtis syndrome.

Total Knee Arthroplasty with NexGen(R) System: 3-8 Year Follow-up Results / 대한정형외과학회잡지

PURPOSE: To evaluate the 3 to 8 year follow-up clinical and radiological results after NexGen(R) total knee arthroplasty (TKA). MATERIALS AND METHODS: Ninety-six knees in 75 patients, who could be followed up more than 3 years after NexGen(R) TKA [cruciate retaining (CR) type:34, posterior cruciate substituting (PS) type:62] from March 1997 to May 2002, were evaluated retrospectively. The evaluations included the preoperative and postoperative range of motion (ROM), Knee Society Score (KSS), knee functional score, tibiofemoral angle and postoperative complications. RESULTS: The ROM increased from preoperative mean flexion contracture of 9.3 degrees and further flexion of 116.4 degrees to a postoperative mean flexion contracture of 2.1 degrees and further flexion of 126.3 degrees (ROM: 124.2 degrees). The ROM of CR type improved from 112.7 degrees to 123.1 degrees, and the PS type improved from 105.3 degrees to 124.9 degrees (p>0.05). The KSS and knee function score improved from 54 and 41 before surgery to 94 and 87 after surgery, respectively (p>0.05). The tibiofemoral angle changed from preoperative varus 5.7 degrees to postoperative valgus 5.2 degrees. The complications were two cases of infection and two cases of early loosening. CONCLUSION: The 3 to 8 year follow-up results after NexGen(R) TKA were satisfactory in both the CR and PS types. However, a longer term follow-up evaluation will be necessary.

Early Results of Mini-incision vs Conventional Total Knee Arthroplasties

PURPOSE: To compare the radiographic and early clinical results of mini-incision total knee arthroplasty(TKA) with those of conventional TKA. MATERIALS AND METHODS: A prospective study was made for 40 primary TKAs(20 mini-incision TKAs; group I and 20 conventional TKAs; group II) done by one surgeon between Dec. 2005 and Feb. 2006, followed up more than 1 year. There were no significant differences between the two groups in all the preoperative evaluations, including age, sex, body mass index, range of knee motion, knee society score(KSS) and radiographic alignments. Postoperative evaluations included length of skin incision, operative time, blood loss, immediate postoperative course, range of knee motion, KSS and radiographic results. RESULTS: Except for the shorter skin incision in mini-incision TKAs(group I), no significant difference was noted between the two groups in all the postoperative evaluations. There were no significant complications in both groups. CONCLUSION: Mini-incision TKA had the advantage of a shorter skin incision and could give us the similar early clinical and radiographic results as conventional TKA.