Arthroscopic Treatment for Septic Arthritis of the Shoulders in Neonates: A Case Report

Septic arthritis in neonates is a rare condition. A failure to make an early diagnosis of septic arthritis in neonates may leave a permanent disability as a result of a delayed treatment. Thus, septic arthritis, requires a prompt diagnosis and a timely treatment especially in this subset of patients. In this case report, we describe our treatment protocol for septic arthritis and concurrent osteomyelitis in the right shoulder of a 28-day-old newborn. Using 2.4 mm wrist arthroscopy, we performed an arthroscopic irrigation and drainage, to remove intra-articular debris and inflammatory tissue, and multiple drilling. We report a satisfactory clinical outcome without any postoperative complications or side effects.

Is the Incidence Rate of Hip Fractures still Increasing in Korea?: An Epidemiologic Study Based on National Health Insurance Database / 대한정형외과학회잡지

PURPOSE: A retrospective study was conducted to examine the current trend in incidence rates of hip fractures among patients aged 50 years and older in Korea. MATERIALS AND METHODS: A retrospective study was conducted using data on the population, collected by Statistics Korea within the different gender and age groups in total population of Korea from 2007 to 2012. The International Classification of Diseases-10 classification method from the Health Insurance Review and Assessment Service was used to investigate the number of patients with hip fractures, and determine the crude incidence rate (CR) and the age-adjusted incidence rate (AR) for comparison. RESULTS: The CR of hip fractures for patients aged 50 years and older was 178 per 100,000 for men and 350 per 100,000 for women in 2007. In 2012, the CR was 194 per 100,000 for men, and 418 per 100,000 for women. The AR was 197 per 100,000 for men and 281 per 100,000 for women in 2007. In 2012, the AR was 206 per 100,000 for men, and 310 per 100,000 for women. During the observation period, the AR and the CR of hip fractures showed a statistically significant increase. However, the increasing trend has been slowing since its peak in 2010. Comparison of the AR of men and women, showed statistical significance only for women. CONCLUSION: In Korea, the incidence of hip fractures increased significantly from 2007 to 2012. The AR showed statistical significance only for women and the increasing trend is slowing down from 2010.

Arthroscopic Treatment for Septic Arthritis of the Shoulders in Neonates: A Case Report

Septic arthritis in neonates is a rare condition. A failure to make an early diagnosis of septic arthritis in neonates may leave a permanent disability as a result of a delayed treatment. Thus, septic arthritis, requires a prompt diagnosis and a timely treatment especially in this subset of patients. In this case report, we describe our treatment protocol for septic arthritis and concurrent osteomyelitis in the right shoulder of a 28-day-old newborn. Using 2.4 mm wrist arthroscopy, we performed an arthroscopic irrigation and drainage, to remove intra-articular debris and inflammatory tissue, and multiple drilling. We report a satisfactory clinical outcome without any postoperative complications or side effects.

Gastrostomy in a Patient with Situs Inversus Totalis

Situs inversus totalis (SIT) is a rare condition in which there is complete right to left reversal of the abdominal and thoracic organs. SIT generally does not bear any pathophysiological significance, and the survival rate of patients with SIT does not differ from that of healthy individuals. However, patients with SIT require a thorough radiological examination to identify the presence of associated anatomic variations before undergoing invasive procedures such as surgery or hemostasis of gastrointestinal hemorrhage because they may have accompanying abnormalities in anatomical structures along with reversed organs. Percutaneous endoscopic gastrostomy (PEG) is a relatively safe procedure that is most commonly performed for the enteral feeding of patients with dysphagia and a normal gastrointestinal function. However, the procedure requires extracaution because minor complications may lead to life-threatening situations due to the underlying illnesses. Here, we report the case of a patient with SIT who underwent a PEG procedure without complications, and review the existing literature on this subject.

Small lymphocytic lymphoma that developed in a patient with long-standing cold agglutinin disease / 대한내과학회지

Cold agglutinin disease (CAD) is an autoimmune hemolytic anemia (AIHA) induced by cold antibodies. CAD constitutes 16~32% of AIHA cases and the causative cold autoantibodies are commonly specific against blood group I or i antigens. CAD is closely related to lymphoid neoplasia and infections such as Mycoplasma and Epstein-Barr virus (EBV). Primary CAD has a tendency to develop into malignant lymphoma over its course. We experienced a case of small lymphocytic lymphoma during the treatment of primary CAD over 11 years. The patient was a 67-year-old man who complained of a neck mass. Node biopsy revealed diffuse neoplastic proliferation of small monotonous lymphoid cells with polygonal or oval nuclei;these cells were CD20- and CD5-positive. Follow-up chest and neck computed tomography after treatment with chlorambucil and prednisolone showed partial resolution and stable disease status for over 2 years. We report a case of small lymphocytic lymphoma that developed in a patient with long-standing cold agglutinin disease for 11 years and review the literature.

The Effect of Coffee Consumption on Serum Total Cholesterol Level in Healthy Middle-Aged Men / 예방의학회지

In present study, the authors investigated the possible effect of coffee consumption on serum cholesterol level in 1017 men between the ages of 40 and 59 years, who were randomly selected from the members of Seoul Cohort Study. Serum total cholesterol data was collected with other serologic indices(e.g. systolic blood pressure, diastolic blood pressure, hight, weight, etc.)through the program of biennial health check-up offered by Korean Medical Insurance Corporation(KMIC). The amount of coffee consumption was assessed by a self-administered questionnaire through mailing. Other confounding factors, such as age, body mass index, cigarette smoking, alcohol consumption, physical activity, and other dietary intake pattern were also determined by the questionnaire. The differences in means of serum total cholesterol in compared to non consumers were -0.4+/-3.56mg/dl for those drinking less than 1 cup a day, -0.6+/-3.60mg/dl for those drinking 1 cup a day, and 7.1+/-3.41mg/dl for those drinking more than 2 cups a day. Since smoking interacted the relationship between coffee consumption and serum total cholesterol, we re-analyzed those relationship in smokers and non-smokers separately. Other atherogenic behaviors were well correlated with total cholesterol, so we adjusted the mean values of serum total cholesterol through multivariate model selection with age(r=0.12), total cigarette index(cigarette-years; r=0.10), Quetelet's index(kg/m2, r=0.16), daily calory expenditure(kcal/day, r=0.06), weekly meat and poultry consumption(g/week, r=0.05), weekly fish consumption(g/week, r=0.08), other caffeinated beverage intake(cups/week), and the amount of sugar and prim added to the coffee. Among those variables only age, Quetelet's index, fish consumption, and total cigarette index(in smokers)were remained in the models. After adjustment, the corresponding differences of total cholesterol in smokers were changed to 0.4+/-5.24mg/dl, -0.5+/-4.97mg/dl, and 8.9+/-4.78mg/dl, which were significantly different among themselves(P=0.011). In non-smokers, however, the differences were not statistically significant(P=0.76). Adjusted mean values of systolic blood pressure and diastolic blood pressure were also determined to evaluate the direct effect of coffee to cardiovascular system, but their means were not significantly different by coffee consumption(p=0.18 for SBP, P=0.48 for DBP). Assuming instant coffee on the most popular type of coffee in Korea, the association observed in our study between coffee and serum total cholesterol, especially in smokers , is very interesting finding for the connection between coffee and serum total cholesterol, because only 'boiled coffee' tend to show significant lipid raising effect rather than to other types of coffee, like filtered or espresso, in most of the western countries. We concluded that people who drink coffee more than 2 cups a day have significantly higher serum total cholesterol level than those who never drink coffee, especially in smokers.