Distal Femoral Medial Opening Wedge Osteotomy for Post-Traumatic, Distal Femoral Varus Deformity

Restoration of neutral mechanical alignment of the lower limb is an important factor in the treatment of unicompartmental arthrosis. Traditionally, medial opening wedge high tibial osteotomy has been widely performed to correct varus malalignment with unicompartmental arthrosis. However, an ideal indication for the high tibial osteotomy is the knee with metaphyseal tibial varus malalignment. The basic principle of corrective osteotomy is performing an osteotomy at the center of the deformity to prevent abnormal joint line obliquity. If pathologic distal femoral varus deformity is the cause of genu varum, the osteotomy should be performed in the distal femur. Reports of medial opening wedge distal femoral osteotomy (DFO) to correct varus malalignment are rare. We present a case of this very rare and challenging condition in a 47-year-old male, which was successfully treated by medial opening wedge DFO.

Percutaneous Vertebral Augmentation for the Treatment of Osteoporotic Spinal Fractures

STUDY DESIGN: Review of the literature. OBJECTIVES: To present updated information on percutaneous vertebral augmentation (PVA) for osteoporotic spinal fractures (OSFs). SUMMARY OF LITERATURE REVIEW: Vertebroplasty and kyphoplasty have been used to treat osteoporotic spinal fractures for many years. A recent meta-analysis provides strong evidence in favor of cement augmentation in the treatment of symptomatic vertebral compression fractures. MATERIALS AND METHODS: Review of the relevant literature. RESULTS: A meta-analysis showed greater pain relief, functional recovery, and improvement in quality of life with cement augmentation compared with control subjects. CONCLUSIONS: Percutaneous vertebral augmentation of osteoporotic spinal fractures results in shorter hospital stays, reduced incidence of complications, and more rapid return of functional independence.

Equipment for Difficult Airways in 67 Korean Academic Emergency Departments

PURPOSE: In Korea, there has been no research about the devices that are used for dealing with difficult airways in emergency departments (ED). This study reports the results of the first research of this kind, assessing the equipment in Korean EDs that is used to manage patients with difficult airways. METHODS: We surveyed 92 EDs via the Internet from October 2007 to March 2008. All respondents were asked if they have the following categories of devices in their EDs; alternative intubation devices, alternative rescue ventilation devices, and surgical airway devices. Alternative intubation devices were defined as devices that do not use a direct laryngoscope for tracheal tube insertion. Alternative rescue ventilation devices were defined as ventilation devices that do not use a face mask. Surgical airway devices were defined as devices that use a surgical technique for the placement of endotracheal tube. RESULTS: We obtained data from 67 of the 92 (72.8%) EDs we contacted. Of those, 32 (47.8%) EDs have at least one alternative intubation device, 52 (77.6%) EDs have at least one alternative rescue ventilation device, and 59 (88.1%) EDs have at least one surgical airway device. A total of 30 (44.8%) EDs have equipment in all 3 categories, but 4 (6.0%) EDs do not have any equipment for dealing with difficult airways. The most common alternative intubation device was a flexible fiberscope (29.9%). CONCLUSION: The possession of devices to deal with difficult airways varies across EDs. It seems that not all Korean EDs have enough devices for difficult airways.

Isolation and purification of total RNA from Streptococcus mutans in suspension cultures and biofilms

The presence of extracellular polysaccharides matrix makes extraction and purification of RNA from Streptococcus mutans within biofilms challenging. In this study, several approaches to purify RNA extracted from S. mutans in suspension cultures and biofilms were examined. The combination of sonication (3 pulses of 30 s at 7 W), suspension in NAES buffer (50 mM sodium acetate buffer, 10 mM EDTA and 1 percent SDS; pH 5.0) and homogenization-mechanical cells disruption in NAES- acid phenol:chloroform, yielded 9.04 mg (or 0.52 mg) of crude preparation of RNA per 100 mg of total cell (or biofilm) dry-weight. The crude RNA preparations were subjected to various DNAse I treatments. The combination of DNAse I in silica-gel based column followed by recombinant DNase I in solution provided the best genomic DNA removal, resulting in 4.35 mg (or 0.06 mg) of purified RNA per 100 mg of total cell (or biofilm) dry-weight. The cDNAs generated from the purified RNA sample were efficiently amplified using gtfB S. mutans-specific primers. The results showed a method that yields high-quality RNA from both planktonic cells and biofilms of S. mutans in sufficient quantity and quality for real-time RT-PCR analyses.

A Case of Primary Pulmonary Artery Sarcoma Mimicking Pulmonary Embolism: Role of PET/CT for Differential Diagnosis / 결핵및호흡기질환

Primary pulmonary artery sarcoma is a rare malignant tumor arising from the pulmonary artery. Diagnosis of primary pulmonary artery sarcoma is quite difficult and the conditon is often misdiagnosed as a more common disease, such as a pulmonary embolism. PET can help in diagnosing a pulmonary artery sarcoma due to the increased uptake of 18F-FDG in the area of the tumor. However, the poor anatomic resolution of PET has limited its clinical applications in pulmonary vascular disease. The recently developed PET/CT is the fusion of PET and CT that improves the anatomical resolution of PET. We report a case of a primary pulmonary artery sarcoma mimicking a pulmonary embolism that was diagnosed with PET/CT and confirmed with a surgical resection.

A Clinical Analysis of Abdominal Stab Injuries

PURPOSE: This study was done to evaluate the incidence, type of injury, medical consequences, mortality, and prognostic factors associated with stab wounds in patients who visited Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea. METHODS: A retrospective analysis of the clinical data of 40 patients with abdominal stab wounds who visited Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea from January 1, 2000 to December 31, 2004. RESULTS: 1) The most prevalent age group was patients in their the twenties to fourties (77.5% of all patients), and average age of the patients was 39.3 years. The male-to-female ratio was 2.07:1. 2) The external site of stab wounds was most commonly the periumbilcal area of the abdomen (14 cases, 33.3%). 3) The most commonly injured organs were the liver and the stomach (10 cases each, 16.9%). 4) Operations were performed on all 40 patients, with 9 (22.5%) negative operation findings. 5) Death occurred in 5 cases (12.5%). 6) The trauma indices of the death group were TRISS 51.9%, RTS 3.6 points, and APACHE II 23.0 points. 7) The average transfusion amount of the death group was 13.8 pints CONCLUSION: These data suggest that the transfusion amount and the trauma index of abdominal stab injuries may be statistically significant factors for predicting mortality.

A Clinical Analysis of Abdominal Stab Injuries

PURPOSE: This study was done to evaluate the incidence, type of injury, medical consequences, mortality, and prognostic factors associated with stab wounds in patients who visited Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea. METHODS: A retrospective analysis of the clinical data of 40 patients with abdominal stab wounds who visited Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea from January 1, 2000 to December 31, 2004. RESULTS: 1) The most prevalent age group was patients in their the twenties to fourties (77.5% of all patients), and average age of the patients was 39.3 years. The male-to-female ratio was 2.07:1. 2) The external site of stab wounds was most commonly the periumbilcal area of the abdomen (14 cases, 33.3%). 3) The most commonly injured organs were the liver and the stomach (10 cases each, 16.9%). 4) Operations were performed on all 40 patients, with 9 (22.5%) negative operation findings. 5) Death occurred in 5 cases (12.5%). 6) The trauma indices of the death group were TRISS 51.9%, RTS 3.6 points, and APACHE II 23.0 points. 7) The average transfusion amount of the death group was 13.8 pints CONCLUSION: These data suggest that the transfusion amount and the trauma index of abdominal stab injuries may be statistically significant factors for predicting mortality.

Tuberculous Pleurisy: Clinical Characteristics of Primary and Reactivation Disease / 결핵및호흡기질환

BACKGROUND: Traditionally, tuberculous pleurisy has been known to largely develop as primary tuberculosis. However, as the incidence of tuberculosis decrease, recent studies have shown reactivation tuberculosis has become the main cause of tuberculous pleurisy. METHODS: 141 cases of tuberculous pleurisy, between January 2003 and February 2006, at the Dankook university hospital. were retrospectively studied. The patients were divided into primary and reactivation tuberculosis. based on the history and radiological characteristics, and the clinical, radiological characteristics at the time of diagnosis and residual pleural thickening after 6 month of chemotherapy were compared between the two groups. RESULTS: 1. Of the 141 tuberculous pleurisy cases, in 135 it was possible to differentiate between primary and reactivation tuberculosis. 2. Of the 135 tuberculous pleurisy cases, 38 (28%) showed a primary tuberculosis pattern, and 98 (72%) showed a reactivation tuberculosis pattern. 3. There were no significant differences between primary and reactivation tuberculosis in relation to age, sex, duration of symptom, amount of pleural effusion, pleural fluid WBC, lymphocyte count, and level of protein, LDH and ADA at the time of diagnosis. 4. 124 patients were followed for 6 months after diagnosis of tuberculous pleurisy, and there was no significant difference in the residual pleural thickening between primary and reactivation tuberculosis. CONCLUSION: In South Korea, a reactivation disease is currently a more common cause of tuberculous pleurisy than a primary disease. There was no difference in the clinical characteristics between primary and reactivation tuberculosis.

Incidence of Congenital Anomalies and Diagnosis of Congenital Anomalies by Antenatal Ultrasonography / 대한산부인과학회잡지

OBJECTIVE: To determine the incidence and types of congenital anomalies and evaluate the efficiency of antenatal ultrasonography for detection of congenital anomalies METHODS: This was a retrospective study, undertaken on 157 cases with congenital anomalies among 5,554 delivered newborns at Chungnam National University Hospital from Jan. 1, 1998 to Dec. 31, 2002. For statistical evaluation, Chi-square test were used. RESULTS: Among the total 5,554 newborns, the overall incidence of congenital anomalies was 2.8%. The incidence of congenital anomalies in birth weights less than 2,500 gm was 9.2% which was 7.5 times higher than that of birth weights more than 2,500 gm. The incidence of congenital anomalies in stillbirth was 19.3% which was 8.2 times higher than that of the live birth. When classified according to the type of congenital anomalies, the incidence of congenital anomalies were 26.5%, 21.0%, 19.8%, 13.0%, 7.4%, 6.2%, 3.7%, and 2.5% respectively in urogenital system, central nervous system, digestive system, cardiopulmonary system, dermatologic system, musculoskeletal system, chromosomal anomaly syndrome, and fetal tumor. Among 157 cases of congenital anomaly babies, anomaly babies were detected antenatally by ultrasonographic examination in 122 cases, and then the rate of antenatal ultrasonographic detection was 77.7%. CONCLUSION: The overall incidence of congenital anomalies was 2.8%. The most common congenital anomalies were urogenital anomalies. The rate of antenatal ultrasonographic detection for congenital anomalies was 77.7%.

Clinical and Cytogenetic Analysis of Midtrimester Amniocentesis / 대한산부인과학회잡지

OBJECTIVE: To analyze the indications, clinical features, cytogenetic results and complications of amniocentesis and to determine the efficacy of antenatal genetic amniocentesis. METHODS: We analyzed retrospectively maternal age, gestational age, indications, transplacental puncture, frequency, discoloration of amniotic fluid, karyotype and complications in 325 cases of prenatal genetic amniocentesis performed at Chungnam National University Hospital from January 2000 to December 2002. RESULTS: The most common age group was from 30 to 34 (31.4%) and mean age was 32.7 years old. 85.3% of cases were performed at 16th-20th gestational weeks. Abnormal maternal serum markers were the most common indication of amniocentesis (56.0%) and the second most common indication was maternal age over 35 (33.2%). Abnormal karyotypes were found in 12 cases (3.6%) and normal variants were 21 cases (6.5%). Numerical aberration were 9 cases (2.7%) and structural aberration were 3 cases (0.3%). Among the autosomal aberrations, Down syndromes were 5 cases and Edward syndrome was 1 case. Among the sex chromosomal aberrations, 47,XXX were 2 cases and Turner syndrome was 1 case. As the increasing maternal age, the incidence of abnormal karyotype was increased. Procedure-related complications occurred in 11.7% of cases and fetal loss rate was 7.4%. No significant associations were found between procedure-related complications and maternal age, gestational age, transplacental puncture, frequency, discoloration of amniotic fluid, and antibiotic treatment. CONCLUSION: Amniocentesis is useful for prenatal genetic diagnosis in pregnancies with increasing risk of chromosome aberrations, such as advanced maternal age, abnormal maternal serum markers or abnormal US findings. Further studies are necessary to identify risk factors of complications after invasive procedure.

Effect of saccharin on antibacterial activity of chlorhexidine gel / Efeito da sacarina na atividade antibacteriana da clorexidina

Embora clorexidina seja reconhecida como o agente antimicrobiano mais eficiente contra placa dental, seu gosto extremamente amargo é uma limitação nos preparos farmacêuticos. Substâncias adoçantes e flavorizantes usadas para preparar formulações podem inibir a atividade antibacteriana da clorexidina. Sacarina tem sido considerada uma substância compatível para ser usada em enxaguatórios bucais ou géis, entretanto o efeito da concentração deste adoçante não tem sido estudado. A atividade antibacteriana de géis de clorexidina a 1 por cento, contendo sacarina de 0,0 a 1,0 por cento, foi avaliada a partir de preparações farmacêuticas formuladas. Atividade contra Streptococcus mutans foi avaliada através da inibição do crescimento em ágar e determinação da concentração inibitória mínima (CIM). Os halos de inibição de crescimento foram de 7,83 ± 0,54 mm, na ausência de sacarina, e de 7,75 ± 0,50,7,63 ± 0,48, 6,21 ± 0,40 e 4,13 ± 0,38 quando da presença de sacarina a 0,02, 0,10, 0,5 e 1 por cento, respectivamente, nos géis de clorexidina a 1 por cento. A faixa de CIM foi de 1-2 µg/ml quando da presença de 0,0, 0,02 e 0,1 por cento de sacarina nos géis. Quando o gel de clorexidina a 1 por cento continha sacarina a 0,5 e 1 por cento a CIM foi de 4-8 e 8-16 µg/ml, respectivamente. Teste "t" pareado mostrou que sacarina sódica nas concentrações de 0,5 e 1 por cento inibiu a atividade anti mutans de digluconato de clorexidina a 1 por cento em gel. Estes resultados in vitro sugerem que sacarina pode inibir a eficácia de clorexidina contra streptococcus do grupo mutans, dependendo da concentração usada

Is a Subcostal Approach Always Suitable for Emergency Pericardiocentesis?

BACKGROUND: The aim of this study was to determine whether the conventional subcostal approach is suitable for emergency pericardiocentesis in patients with cardiac tamponade or impending cardiac tamponade. METHODS: This study was a prospective, observational study conducted at the emergency department of a tertiary hospital. Patients who had symptomatic pericardial effusion and who needed emergency pericardiocentesis in the emergency department were included in this study. We measured the epicardium-to-pericardium distance at the subcostal, parasternal, and apical area with two-dimensional echocardiography to determine the appropriate puncture site for pericardiocentesis. An epicardium-to-pericardium distance of more than 1.0cm was considered as the primary safety factor in determining the puncture site for pericardiocentesis. The skin-to-pericardium distance was considered as secondary safety factor. RESULTS: Ninety-five consecutive patients(55 males and 40 females; total mean age: 53 year old) with cardiac tamponade or impending cardiac tamponade were enrolled in this study. The puncture site for pericardiocentesis, as determined by echocardiography, was the subcostal area in 43 patients(45%), the apical area in 40 patients(42%), the left parasternal area in 11 patients(12%), and the right parasternal area in one patient(1%). Pericardiocentesis failed in 2 patients(2%) with the subcostal approach and in one patient(1%) with the apical approach. The average epicardium-to-pericardium distance was 31+/-21mm in patients with the subcostal approach and 21+/-8mm in patients with other approaches. There were no differences in the amount of pericardial fluid and in the intrapericardial pressure among patients groups according to puncture site. There were two procedure related complications: a puncture of the right ventricle with the subcostal approach and a ventricular tachycardia with the apical approach. CONCLUSION: The puncture site for emergency pericardiocentesis should be determined by using two-dimensional echocardiography because approaches from other areas can be safer than the subcostal approach.

Avaliaçäo in situ de um dentifrício contendo mfp/dcpd na incorporaçäo de flúor e remineralizaçäo do esmalte dental humano / In situ evaluation of a dentifrice containing mfp/dcpd on fluoride uptake and remineralization by human dental enamel

O objetivo deste estudo foi analisar in situ a efetividade de um dentifrício contendo monofluorfosfato (MFP) e sistema abrasivo fosfodicálcio didratado (DCPD), quando comparado com dentifrício placebo. O estudo foi do tipo cross-over com oito voluntários em duas etapas de 45 dias. Os voluntários utilizaram dispositivo intra-oral palatino de resina acrílica contendo 4 blocos de esmalte com lesäo de cárie artificial. Após cada etapa, foi analisada a incorporaçäo de flúor (flúor total em ppm F) e microdureza (em Knoop) dos blocos de esmalte dental. Os resultados obtidos (média ñ E.P.) das áreas integradas sob as curvas demonstraram que a concentraçäo de flúor incorporado no esmalte tratado com dentifrício MFP/DCPD foi significantemente maior que no placebo (4.508,55 ñ 965,82 e 1.485,51 ñ 191,72, respectivamente) e os dados de microdureza demonstraram que o dentifrício MFP/DCPD foi capaz de remineralizar o esmalte dental em 34 por cento, enquanto no placebo observou-se perda de 14 por cento de mineral...

Histiocytosis-X: A Case Report / 대한정형외과학회잡지

Histiocytosis-X has several mode of presentation, from the mildest solitary eosinophilic granuloma of bone to the most severe, with multiple granulomata in bones and soft tissues. This disease previously described as eosinophilic granuloma, Hand-Schuller-Christian disease and Letterer-Siwe disease. Lichtenstein (1953) used the term histiocytosis-x to encompass the above three names. We experienced a case of histiocytosis-x which had occured at multiple site of bones. The patient has good general condition with complete subsidance of specific symtoms and signs in our thirty-eight months follow up treatment.

Clinical Observation on Vasectomy / 대한비뇨기과학회지

Clinical observation which was made on 136 cases of vasectomy carried out during the first year of National Family Plan, from January to December, 1961, and follow-up study on these patients for 6 months to 1 year after the operation are as follows: 1. 94 cases (69%) of them were aged between 31 and 40, and the average age of total patients was 36.1 years. 2. Official, merchant, and farmer were their occupations in the order of frequency. 3. 47 cases (34.5%) of them had five children respectively, and 52 cases (38.2%) had three boys. 4. 55 cases (41.2%) had used some kind of contraceptive methods, and 65 cases (47%) had experienced artificial abortion. 5. 104 cases (74%) did not work on the day of operation. 6. 97 cases (8.9%) had no postoperative local discomfort. 7. 97 cases (88.9%) had no change in their working efficiency. 8. There were no changes in libido 94 (86,4%), frequency of sexual intercourse 87 (79,8%), ejaculation time 94 (86,4%), amount of semen 81 (74.3%), their orgasm 92 (85,4%), and their wives' orgasm 92 (85.4%) following the operation.

Retroperitoneal Teratoma: A Report of A Case / 대한비뇨기과학회지

A case of retroperitoneal teratoma, found in a ten month old female infant was reported. Twenty four hours after the direct retroperitoneal air insufflation, a retrograde pyelography was performed using B.B. 16F. cytoscope. These two studies were essential to make preoperative diagnosis. Review of retroperitoneal tumor was also added.