Treatment of Peri-prosthetic Fracture about Total Knee Replacement

No abstract available.

Surgical treatment option in rheumatoid arthritis

A large number of patients who are diagnosed with rheumatoid arthritis undergo a chronic and progressive course. Surgical treatment is often needed for these patients, who have not responded to medical treatment. The aim of surgical intervention in rheumatoid arthritis is to restore function and quality of life by preventing joint destruction, correcting deformity, relieving pain, and making cosmetic improvements. There are many surgical options, including synovectomy, osteotomy, arthrodesis, resection arthroplasty, joint replacement, surgeries for the treatment of the tendon involved (repair, transfer, graft), and cervical spine surgery (fusion or decompression). The selection of the optimal surgical option requires consideration of not only the articular status and the degree of regional deformity involved, but also the physical status and age of the patient. In addition, timely surgical intervention is important because a delay of surgery often results in poorer functional outcomes and an increase in postoperative complications. Early referral to orthopedic treatment can provide better functional outcomes for patients with rheumatoid arthritis. Precise prediction of the disease progress and selection of the optimal treatment option are needed for excellent results to be expected. Therefore, a cooperative and multidisciplinary treatment strategy should be made among the relevant teams, such as physical medicine, rheumatology, orthopedics, physical therapy, occupational therapy, social work, and psychology.

Alendronate use and Changes in Bone Mineral Density

PURPOSE: To evaluate the changes in bone mineral density (BMD) after alendronate intake and to determine the side effects and patient compliance. MATERIALS AND METHODS: Two hundred twelve patients with osteoporosis were treated with alendronate. One hundred sixty-two patients were excluded because of early discontinuation. Thus, 50 patients were included in the analysis. RESULTS: The annual increase in BMD in patients taking alendronate was 7.2% (1st year), 3.4%, 2.0%, and 0.9% (4th year) in the L-spine, and 2.2%, 1.5%, -0.9%, and 0.9% in the femur. The changes in BMD of patients70 of age were 2.9% and 1.2% in the L-spine and femur, respectively. The BMD changes in patients with a T-score3.0 were 2.5% and 3.1% for the Lspine and femur, respectively. The reasons for early discontinuation of alendronate were difficulty in intake, economic reasons, and adverse events. CONCLUSION: The BMD changes were greater in the L-spine than the femu in alendronate users. At the first year, the changes in BMD was greatest. There was no significant difference in BMD change according to age. In the Lspine, however, BMD changes were greater in the group with lower T-scores. The early discontinuance rate was 74%, and the adverse events rate was 19.8%.

Correlation of liver dysfunction in Oriental medicine and liver disease in Western medicine

BACKGROUND: Among the outpatient clinic visitors who were diagnosed as "your liver is fragile or weak" by Oriental doctors, many patients asked Western medical doctors of the opinion about their status of liver. No study exists on the correlation of Oriental and Western medicine concerning liver disease. The authors have investigated to evaluate the correlation of liver disease which was diagnosed in Oriental and Western medicine. METHODS: From January to March 1997, 122 subjects had undergone health screening program in Oriental Western Integrated Health Promotion Center of Pundang CHA General Hospital. Liver dysfunction in Oriental medicine was diagnosed by on Oriental medical doctor in the Center. Cases were reviewed and compared with laboratory and abdominal ultrasonographic findings on chart record. RESULTS: Of the total 122 subjects, 15 were diagnosed as having normal liver and 107 as having liver dysfunction in Oriental medicine. Comparing these two groups, there was no statistical significant difference. No statistical significance was found between liver dysfunction in Oriental medicine and HBsAg, HBsAb, HBeAb, alcohol drinking. 43 subjects had findings of fatty liver on abdominal ultrasonography in which. 26(21.3%) were mild, 14(11.5%) moderate, and 3(2.5%) severe. There was no statistical significance between liver dysfunction in Oriental medicine and fatty liver. Among the abnormal findings on abdominal ultrasonography, 43(35.2%) were fatty liver, 3(2.5%) polyp of gallbladder, and 2(1.6%) were gallstone. There was no statistical significance between liver dysfunction in Oriental medicine and abdominal abnormalities on ultrasonography. 58 patients were diagnosed as having liver disease by laboratory test and sonographic finding among which 43(35.2%) were fatty liver, 7(5.7%) hepatitis, 3(2.5%) alcoholic liver dysfunction, 3(2.5%) polyp of gallbladder, and 2(1.6 %) were gallstone. There was no statistical significance between liver dysfunction in Oriental medicine and liver disease in Western medicine. CONCLUSIONS: The result suggests that the meaning of liver dysfunction in Oriental medicine is different in Western medicine.