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Objective: This study aimed to establish an academic basis for using a computed tomography (CT) model for predicting osteoporosis in the clinical setting by illustrating the effectiveness of morphometric texture analysis. We introduce texture analysis and quantitative approaches using CT Hounsfield units (HU) to screen osteoporosis. Method: From March 6th, 2013, to August 11th, 2020, a total of 4,333 cases (1,766 patients) were included in the study. After applying exclusion criteria concerning the patient status and scan interval between CT and DXA, we selected only 1,647 samples (736 patients) and analyzed both their CT and DXA bone mineral density (BMD) results. BMD was measured in the femoral neck and L1 spine body. A region of interest (ROI) was extracted from each patient’s CT as the maximum trabecular area of the L1 spine body and femoral neck. A total of 45 texture features were extracted from every ROI using gray-level co-occurrence matrices. Machine-learning techniques, including linear regression (LR) and artificial neural network (ANN), were applied to predict BMD. Results: We assigned samples to (1) Set 1 (857 lumbar spine samples in chest model, L1 spine DXA BMD), (2) Set 2 (392 lumbar spine samples in lumbar spine CT model, L1 spine DXA BMD), (3) Set 3 (1,249 lumbar spine samples in both chest and lumbar spine CT model, L1 spine DXA BMD), (4) Set 4 (398 femoral neck samples in hip and pelvis CT model, femoral neck DXA BMD), and (5) Set 5 (a total of 1,647 samples). When we applied LR, the correlation coefficients between estimated and reference values for Sets 1, 2, 3, and 4 were 0.783, 0.784, 0.757, and 0.652, respectively. For total samples (Set 5), LR and ANN provided correlation coefficients of 0.707 and 0.782, respectively. Conclusion: The modality using morphometric texture analysis with CT HU can be an additional diagnostic tool for osteoporosis and an alternative for DXA.

Purpose To compare efficacy of ultrasound (US)-guided single-injection nerve blocks (SINB) before bipolar hemiarthroplasty (BHA) of the hip in patients with femoral neck fractures. Materials and Methods Clinical outcomes of 89 patients who underwent BHA between September 2016 and February 2018 were retrospectively compared. Eight patients were excluded according to exclusion criteria and the remaining patients were divided into two groups: patients who received SINB before surgery (Group I; n=40), and patients who did not (Group II; n=41). The femoral, obturator, and lateral femoral cutaneous nerves were each blocked separately under US guidance. Pain scores determined using the visual analogue scale (VAS) were recorded 6, 12, 24, and 48 hours postoperatively, and all use of analgesics were recorded separately for 72 hours after surgery. Duration of hospitalization, general complications, and local complications due to SINB were also compared among the groups. Results Significant differences were observed between the two groups: I) VAS at 6 hours and at 12 hours after the operation, II) total amounts of analgesics used. VAS at 24 hours and at 48 hours were not significantly different between the two groups. General complications and duration of hospitalization were also not significantly different between the groups. Conclusion US-guided lower limb nerve blocks provide excellent immediate postoperative pain relief and can be used as a safe, and effective method of pain control after BHA.

Background: Subscapularis tendon insertion at the first facet has separate layers (deep and superficial). The purpose of this study is to evaluate postoperative clinical outcomes and radiological healing according to each layer of detachment in the first facet involving subscapularis tendon tear.Methods: Eighty-three patients who underwent arthroscopic repair due to First facet involving the scapularis tendon tear accompanying small to medium sized posterosuperior cuff tear were classified into three groups (group A: deep layer partial detachment, group B: deep layer complete detachment, but no superficial layer detachment, and group C: deep layer and superficial layer complete detachment). Subscapularis tendon healing was evaluated using computed tomography arthrogram and clinical result was evaluated using American Shoulder and Elbow Surgeons (ASES) shoulder score, Constant score and University of California Los Angeles (UCLA) shoulder score.Results: Retear rate of the subscapularis tendon was 2.2%, 18.2%, and 33.3% in group A, group B, and group C, respectively. These rates showed statistically significant difference among the three groups, which were classified by deep and superficial layer detachment in the first facet (p=0.003). Group A showed significant difference in subscapularis tendon healing compared with group B and group C (p=0.018 and p

The Manchester-Oxford Foot Questionnaire (MOXFQ) is a practical, reliable, and valid questionnaire for hallux valgus surgery and has been translated into several languages. However, the MOXFQ has not been translated into Korean. In the present study, we aimed to translate and evaluate the validity and reliability of the Korean version of the MOXFQ for patients affected by hallux valgus. In accordance with the guidelines of cross-cultural adaptation, we translated the English version of MOXFQ into Korean and then backward translated it into English. We sent out letters that included the Korean version of the MOXFQ, a visual analog scale measure of pain, and a validated Korean version of the short-form 36-item Health Survey to 135 patients with hallux valgus. A retest was administered after 2 weeks. Of the 135 patients, 104 responded to the first questionnaire, and 82 of the first-time responders returned their second questionnaires. We evaluated the test–retest reliability, internal consistency, concurrent validity, and construct validity of the Korean version of the MOXFQ. The intraclass correlation coefficient for test–retest reliability was 0.82 for the total MOXFQ and ranged from 0.81 to 0.82 for the 3 subscales. Cronbach's alpha for the total MOXFQ was 0.85 and ranged from 0.8 to 0.92 for the 3 subscales. Concurrent and construct validity was supported by significant correlation with the visual analog scale and short-form 36-item Health Survey subscale scores. The Korean version of the MOXFQ was tested, and it was found to be a valid and reliable instrument for patients with hallux valgus.

Although translated versions of the Foot Function Index (FFI) in several languages are available, the absence of a Korean version has precluded comparing the data from Korea with the data from other countries using the FFI. We, therefore, evaluated the reliability and validity of the adapted Korean version of the FFI. We translated the English version of the FFI into Korean and back into English. We mailed the Korean version of the visual analog scale, FFI, and the previously validated Medical Outcomes Study Short-Form 36-item questionnaire (SF-36) to 121 patients with treated foot complaints. To evaluate the test-retest reliability and internal consistency, we used the intraclass correlation coefficient and Cronbach's α, respectively. We also evaluated the concurrent and construct validity of Korean version of the FFI by comparing the visual analog scale and SF-36. Cronbach's α was 0.91 and 0.95 for the pain and disability subscales, respectively. The reproducibility was good, and a strong correlation between the FFI and the SF-36 and visual analog scale with related content was observed, indicating good construct validity.The Korean version of the FFI is a reliable and valid questionnaire for the self-assessment of pain and disability in Korean patients with foot complaints.

After chinese reform and opening up, why the law related religion of main land china is so different from capitalist countries and even other socialist sountries? perhaps, it`s because their epistemic position on the sinisizing of marx-leninist religious theory have produced contemporary law related religion throughout the socialist process of modern china. especially going through social market economy, the law related religion of main land china both internally and externally have been specialized, and distinguished from capitalist countries and even other socialist sountries. on a focus of religion state and society relationship, this paper illuminates that the law related religion of main land china have been built on their own perceptions, and have been had what kind of difference from old foundation. so to speak, this paper researches What kinds of interrelationship have been existence between chinese reformation opening and their law related religion.

Streptococcus dysgalactiae subspecies dysgalactiae (SDSD), Lancefield group C streptococcus, is an animal pathogen which often causes pyogenic infection in domestic animals. Human infection by SDSD has been reported as a cellulitis on the upper arm, but a prosthetic joint infection caused by SDSD after total knee arthroplasty (TKA) has not yet been reported in the literature demonstrating that its clinical manifestation and management have not been well established. In this case report, we aimed to present a case of SDSD prosthetic joint infection after TKA, which was successfully treated by two-stage re-implantation with an application of antibiotic-impregnated cement spacer.

Ionic polymer metal composite(IPMC) has been used as a promising material for various actuator applications. The IPMC actuator is difficult to be fabricated with complicated 3-dimensional shape. We propose a simple heat treatment process that can fabricate IPMC actuator with various shapes. Experimental results show the pre-shaped IPMC actuator by heat treatment does not show any degradation of its actuation abilities such as bending displacement, generation force and reliability in bending motion.

Large, engaging Hill-Sachs lesions can be one of causes for recurrent glenohumeral instability after initial anterior shoulder dislocation or Bankart repair for the torn anteroinferior labrum. However, there have been relatively few articles describing specific treatments for the humeral head defects. This article described a case of an alternative treatment for large Hill-Sachs lesion using the corticocancellous iliac autograft. The authors present a case of recurrent anterior shoulder dislocation, with a large humeral head defects, and an irreparable massive rotator cuff tear in a 74-year-old man. The size of this Hill-Sachs lesion was 2.7 × 2 cm with a depth of 1.2 cm. After arthroscopic anterior capsulolabral repair, a 3 × 2 cm semicircular graft was harvested from the inner table of anterior iliac crest, trimmed, and transplanted to the humeral defect by cancellous screw fixation. At his 2-year follow-up, the patient remained free of dislocation and apprehension. We recommend this technique as an alternative method for symptomatic patients with engaging Hill-Sachs lesion.

In treatment of failure in ankle joint replacement therapy, talar avascular necrosis with massive bone defect, talus fracture with severe comminution and bone defect and ankle dislocation, treatment of large bone defects is considerably important for ankle joint stability and union, therefore, the choice of treatment for large bone defects is use of femoral head or iliac crest bone graft and rigid internal fixation. Because first generation total ankle arthroplasty performed for the first time using a cemented fixation technique requires a large amount of bone resection during re-surgery and there is some possibility of a larger bone defect after removal of implants, in cases where prosthesis for the defect is needed, performance of palliative femoral head or iliac crest bone graft and rigid internal fixation can be difficult. We report on a case of a 48-year-old woman who had experienced ankle pain for 25 years since undergoing total ankle arthroplasty. Because the patient had little ankle motion and rigid soft tissue despite a large bone defect caused by aseptic loosening, a good outcome was obtained only for the femoral cancellous bone graft using allo femoral head without internal fixation.

Septic arthritis caused by Klebsiella pneumonia in adults is rare and is rarely observed after total knee arthroplasty. Acute or early onset of septic arthritis caused by K. pneumoniae has been reported after total knee arthroplasty. However, to date the only one overseas case of late K. pneumoniae infection after total knee arthroplasty has been reported, with no such case in Korea. In addition, monomicrobial infections by K. pneumoniae are not frequently found but are found primarily in the form of polymicrobial infections. The purpose of this paper is to report on a case in which an 85-year-old female patient, who had undergone a total joint arthroplasty 11 years ago, developed the late onset of septic arthritis caused by monomicrobial K. pneumonia infection with a periprosthetic fracture through literature reviews.

Between January 1988 and December 2006, a total of 3014 primary total knee arthroplasties (TKAs) in 2042 patients were performed, and survivorship analysis was performed. Survivorship analysis showed a 10-year survival of 93.8% and a 20-year survival of 70.9%. There was no significant difference in the survival rate according to sex and diagnosis (P = .142 and .443, respectively). The survival rate was higher in the patients older than 60 years (P < .001). The survival rate of Total Condylar IV (TC-IV) was higher than that of Ortholoc (Dow Corning Wright Medical, Arlington, Tenn) (P < .001). Total knee arthroplasty results in satisfactory long-term survival rates. However, the survival rate decreases over time. The risk of requiring revision TKA was related to age and type of implants. Careful consideration is necessary to decide the time for TKA and select type of implants.

Purpose: Although the standard treatment of diaphyseal forearm fractures in children is conservative treatment with closed reduction and cast immobilization, unstable or irreducible fractures are usually needed by surgical intervention. The aim of this article is to determine the efficacy of the percutaneous transphyseal intramedullary K-wires fixation for the forearm diaphyseal fractures in children. Materials and Methods: In this retrospective study, we reviewed 18 cases of forearm diaphyseal fractures in children, which were treated with percutaneous transphyseal intramedullary nailing using K-wires from January 2001 to December 2004. We analyzed the period for radiologic bone union and the complications until the last follow-up. Results: The average period of follow-up was 15 months with mean age of 7.8 years. The average time to bone union was 6.2 weeks and nonunion, malunion, radio-ulnar synostosis and refracture were not found, just 2 local pin site infections were seen but healed by conservative treatment. Postoperative scar was small and the complications until the last follow-up were not found. Conclusion: In the operative treatment of the forearm diaphyseal fractures in children, we think percutaneous transphyseal intramedullary K-wire fixation is one of the effective methods because of the minimal invasiveness, simplicity and easiness in removal.

목 적: 동반 질환이 있는 고령의 대퇴골 전자간 골절 환자에 대해 변형된 술식에 의한 Ender nail 내고정술을 시행하여 임상적 및 방사선학적 결과를 보고하고자 한다. 대상 및 방법: 1997년 5월부터 2004년 12월까지 본원에서 비관혈적 정복술 및 변형된 술식에 의한 Ender nail 내고정술을 시행 받은 대퇴골 전자간 골절 31례를 대상으로 수술시 마취 방법, 출혈량, 수술 시간 및 nail의 개수를 분석하였으며, 임상적으로 술 후 보행능력 및 합병증을 분석하였고, 방사선학적으로 골유합 시기를 분석하였다. 결 과: 수술시 마취는 22례에서 경막외 마취를, 9례에서 전신마취를 시행하였고, 출혈량은 평균 55 ml이었으며 수술 시간은 평균 37분이었다. Nail의 개수는 평균 3.1개를 사용하였다. 임상적으로 술 후 보행능력은 23례에서 골절 전 보행능력으로 회복하였으며 8례에서 골절 전에 비해 보행능력 저하를 보였다. 합병증으로는 슬관절 동통 및 운동제한이 7례에서 보였으며 Ender nail의 하방전위가 3례에서 관찰되었다. 방사선학 적으로 골유합 시기는 평균 17.1주이었다. 결 론: 동반 질환을 가진 고령의 대퇴골 전자간 골절 환자에서 변형된 Ender nail 고정술은 수술 시간 및 출혈량을 줄일 수 있는 유용한 술식 의 하나로 사료된다.

PURPOSE: We present an atypical case of calcific tendinitis of the shoulder with intraosseous loculation.MATERIALS AND METHODS: A 59 year-old female complained of acute exacerbation of chronic left shoulder pain and restricted range of motion. Simple radiographs showed a subacromial calcific deposit and magnetic resonance imaging revealed cortical erosion with intraosseous extension of calcific material mimicking infection or tumor. She was managed with arthroscopic excision of the calcific deposit, curettage of the intraosseous lesion and subsequent rotator cuff repair with a suture anchor.RESULTS: Her acute pain promptly subsided. Her rehabilitation was uneventful and she gained full range of motion. Radiographs five months after the operation showed no recurrence of calcific material.CONCLUSION: Calcific tendinitis of the shoulder can present with a variety of images involving the adjacent bone. The correct recognition of this disorder may avoid unnecessary investigation and treatment.