Influence of Musculoskeletal Manifestations as the Only Presenting Symptom in B-Cell Acute Lymphoblastic Leukemia.

Objective: To evaluate the clinical and prognostic impact of musculoskeletal manifestations as the only initial presenting symptom in childhood acute lymphoblastic leukemia (ALL).

Study Design: We retrospectively reviewed 158 children with precursor B-cell type ALL who were followed up for >2 years. The patients were assigned to the groups musculoskeletal manifestations (n = 24) or nonmusculoskeletal manifestations (n = 134) based on initial presenting symptom.

Physical Condition Does Not Affect Gravity-Induced Loss of Consciousness during Human Centrifuge Training in Well-Experienced Young Aviators.

Background: Consensus on whether physical condition affects the risk of gravity-induced loss of consciousness (G-LOC) has not been reached, and most previous studies about the issue did not include well-experienced aviators. We compared the physical conditions of well-experienced young aviators according to the occurrence of G-LOC during human centrifuge training.

Methods: Among 361 young male aviators on active flight duty with experience in high performance aircrafts for at least 2 years, 350 had full data available and were reviewed in this study.

Cortical Atrophy Related to Tumor Prosthesis in Skeletally Immature Osteosarcoma Patients.

Background: Cortical atrophy is commonly observed after prosthetic reconstruction for bone sarcomas. However, relevant literature regarding this phenomenon in skeletally immature patients is limited. Therefore, in this study, we evaluated the incidence and patterns of cortical atrophy.

Outcomes of Hemiepiphyseal Stapling for Genu Valgum Deformities in Patients With Multiple Hereditary Exostoses: A Comparative Study of Patients With Deformities of Idiopathic Cause.

Background: Patients with multiple hereditary exostoses (MHE) frequently present with a genu valgum deformity. Temporary hemiepiphysiodesis, such as hemiepiphyseal stapling, is a relatively safe surgical method to correct angular deformities in skeletally immature patients, but its outcomes for genu valgum deformity in MHE patients have not been extensively reported. We investigated the outcomes of hemiepiphyseal stapling in MHE patients (MHE group) and compared those with the outcomes in patients with idiopathic deformities (idiopathic group) after adjusting for potential bias.

Lateral Tibiocalcaneal Angle As a Determinant for Percutaneous Achilles Tenotomy for Idiopathic Clubfeet.

Background: The aim of the present study was to evaluate the clinical value of using the lateral tibiocalcaneal (LTiC) angle, measured on a lateral radiograph made with the foot and ankle in maximal dorsiflexion, instead of the ankle dorsiflexion (ADF) angle, measured on physical examination, as a determining indicator of the need for percutaneous Achilles tenotomy after Ponseti serial cast treatment of idiopathic clubfoot.

Methods: We identified patients with idiopathic clubfoot who had been treated at our institution between March 2006 and June 2012. After exclusion of patients with Diméglio grade-I clubfoot and those followed for less than two years, 125 idiopathic clubfeet were evaluated.

Unplanned Excision of Extremity Soft Tissue Sarcoma in Korea: A Nationwide Study Based on a Claims Registry.

Unplanned excision of extremity soft tissue sarcoma (STS) is common and has detrimental effects not only on patients' oncologic outcomes but also on functional and economic issues. However, no study has analyzed a nationwide population-based database. To estimate the incidence and treatment pattern of unplanned excision in extremity STS in the Korean population, a nationwide epidemiologic study was performed using the Korean Health Insurance Review and Assessment Service database, a centralized nationwide healthcare claims registry of Korea that covers the entire Korean population.

Cross-cultural adaptation and validation of the Korean Toronto Extremity Salvage Score for extremity sarcoma.

Background: A Korean version of Toronto Extremity Salvage Score (TESS), a widely used disease-specific patient-reported questionnaire for assessing physical function of sarcoma patients, has not been developed.

Objectives: 1) to translate and cross-culturally adapt the TESS into Korean, and 2) to examine its comprehensibility, reliability and validity.

Methods: TESS was translated into Korean, then translated back into English, and reviewed by a committee to develop the consensus version of the Korean TESS.

Acute spinal injury after centrifuge training in asymptomatic fighter pilots.

Introduction: Many countries have hypergravity training centers using centrifuges for pilots to cope with a high gravity (G) environment. The high G training carries potential risk for the development of spinal injury. However, no studies evaluated the influence of centrifuge training on the spines of asymptomatic fighter pilots on a large scale.

Outcomes of curettage and anhydrous alcohol adjuvant for low-grade chondrosarcoma of long bone.

Background: Low-grade chondrosarcoma of long bones can be treated successfully with extended intralesional curettage using adjuvants. However, there is no study reporting the use of anhydrous alcohol as an adjuvant in the treatment of low-grade chondrosarcoma. We asked (1) whether intralesional curettage and anhydrous alcohol adjuvant for low-grade chondrosarcoma is associated with good oncologic outcomes; and we report (2) the complications of the procedure.

Predisposing Effect of Elbow Alignment on the Elbow Fracture Type in Children.

Objectives: Under the hypothesis that the elbow alignment, namely the carrying angle, could predispose individuals to a specific type of pediatric elbow fracture after a fall onto an outstretched arm, we investigated the relationship between radiographic carrying angle and elbow fracture type in children.

Design: Retrospective case-control study.

Setting: Level I pediatric trauma center.

Comorbidity is independently associated with poor outcome in extremity soft tissue sarcoma.

Background: Comorbidity has not been examined as an independent prognostic factor in soft tissue sarcoma (STS). We examined the prognostic impact of comorbidity on oncologic outcome in STS with an adjustment for possible confounding factors.

Methods: A retrospective review was performed on 349 patients who had undergone surgery for high-grade localized STS of extremity at our institute.

Incidence and Treatment Pattern of Extremity Soft Tissue Sarcoma in Korea, 2009-2011: A Nationwide Study Based on the Health Insurance Review and Assessment Service Database.

Purpose: We conducted a nationwide study to assess the incidence and treatment patterns of extremity soft tissue sarcoma (STS) in South Korea.

Materials And Methods: The nationwide incidence and treatment patterns of extremity STS were assessed using two nationwide databases, the Korea National Cancer Incidence (KNCI) database and the Health Insurance Review and Assessment Service (HIRA) database.

Results: A total of 1,236 patients were newly diagnosed with extremity STS during the 3-year study period, from 2009 to 2011.

Preoperative embolization for bone metastasis from hepatocellular carcinoma.

Preoperative transcatheter arterial embolization for hypervascular bone tumors is now widely accepted as a safe and effective procedure for reducing intraoperative blood loss and surgical morbidity. However, few studies have reported the use of preoperative transcatheter arterial embolization for nonspine bone metastases from hepatocellular carcinoma. The goal of this study was to assess the effect of preoperative embolization on blood loss and clinical outcomes in surgery for nonspine bone metastasis from hepatocellular carcinoma.

Soft tissue sarcoma misdiagnosed as benign peripheral neurogenic tumor.

Background: Because of the distinctive clinical and MR findings associated with benign peripheral neurogenic tumors (BPNTs), they are commonly diagnosed without histological confirmation. As such, they are one of the most frequently misdiagnosed entities among the soft tissue sarcomas (STSs) that undergo initial unplanned excision. In this study, we investigate the characteristics of STSs misdiagnosed as BPNTs.

Post-metastasis survival in extremity soft tissue sarcoma: a recursive partitioning analysis of prognostic factors.

Background: Recursive partitioning analysis (RPA) enables grouping of patients into homogeneous prognostic groups in a visually intuitive form and has the capacity to account for complex interactions among prognostic variables. In this study, we employed RPA to generate a prognostic model for extremity soft tissue sarcoma (STS) patients with metastatic disease.

Methods: A retrospective review was conducted on 135 patients with metastatic STS who had undergone surgical removal of their primary tumours.

Non-spine bone metastasis as an initial manifestation of cancer in Korea.

Non-spine bone metastasis accounts for approximately 20% of all skeletal metastases, but little data have been published that focused on bone metastasis to the pelvis and extremities as an initial manifestation of cancer. We determined 1) clinicopathologic characteristics of patients who presented with non-spine bone metastasis of unknown primary malignancy, and 2) process by which the diagnosis of primary cancer was made. We retrospectively reviewed 84 patients with bone metastasis of unknown primary cancer site at the time of presentation.

Unplanned excision of soft tissue sarcoma: the impact of the referring hospital.

Background: Unplanned excision of soft tissue sarcoma (STS) remains a common problem performed at various levels of hospitals, where clinical characteristics may differ. However, there is little literature describing the impact of the referring hospital on patient characteristics and/or outcome in unplanned excision of STS. This study examined the possible different patient characteristics and prognoses according to the level of referring hospitals where unplanned excision was performed.

Pseudonormalization of negative T wave during stress test in asymptomatic patients without ischemic heart disease: a clue to apical hypertrophic cardiomyopathy?

Introduction: Generally, apical hypertrophic cardiomyopathy (ApHCM) shows a negative T wave on an electrocardiogram (ECG), which waxes and wanes during the clinical course. However, some patients with ApHCM just have negative T waves and show no obvious diagnostic evidence on their echocardiography, so the diagnosis of ApHCM cannot be confirmed or is delayed for several years in many cases.

Case Report: In our study, 2 males in their 50s showed negative T waves on their ECG precordial leads, but no diagnosis was confirmed for over 10 years, despite all efforts.

Asymptomatic brain lesions in pilots: a comparative study with non-flying personnel using brain MRI.

Introduction: As modern aircraft fly at higher altitudes with rapid velocity, pilots have been put in the environment with a possible increasing risk of brain injury and could sustain cumulative brain damage. However, very few studies have investigated brain lesions using MRI in asymptomatic pilots. We evaluated asymptomatic pilots for the presence of cerebral lesions using MRI.

Measuring the cumulative effect of G force on aviator neck pain.

Introduction: In many studies, high G force is thought to be the most important causal factor of aviator neck pain. However, most of the studies performed to date have compared neck pain of aviators exposed to high G force with that of aviators not so exposed or with that of the general population. As a result, neck pain for aviators exposed to high G force as it relates to G level is not yet well-known.