No abstract available.
Hearing* ; Humans ; Tinnitus*

No abstract available.
Otoacoustic Emissions, Spontaneous*

Endosteum and bone marrow thermal necrosis caused by reaming during tibial intramedullary nail insertion, and unskilled operation of soft tissue penestration by reamer resulted in chronic osteomyelitis and soft tissue defect. So, several times of free flaps were done but the result was unsuccessful. At last, the authors performed radical necrotic bone resection and internal bone transport using Ilizarov external fixator. The authors report case with literature review.
Bone Marrow ; External Fixators ; Fracture Fixation, Intramedullary ; Free Tissue Flaps ; Nails ; Necrosis ; Osteomyelitis ; Tibia

PURPOSE: A retrospective review of cases series about the outcomes of treatment for simple bone cyst in the long bones with flexible intramedullary nailing in children and adolescents. MATERIALS AND METHODS: Eighty-five cases with a simple bone cyst in the long bones diagnosed between April 2002 and December 2007 were enrolled in the study. The mean age of the patients was 10.8 years. Thirteen cases were accompanied by a pathological fracture, and 72 cases were not. Thirty-three cases had a simple bone cyst on the proximal humerus, 41 cases on the shaft of the humerus, and 11 cases on the proximal femur. Steroid injections were performed in 21 cases (group 1), curettage and a synthetic bone graft in 18 cases (group 2), and decompression and fixation using flexible intramedullary nailing in 46 cases (group 3). We followed up all cases for at least 24 months and evaluated the results according to the Capanna classification. RESULTS: The mean duration for absorption and healing of bone cysts was 18.4 months in group 1, 10.6 months in group 2, and 5.8 months in group 3. The complete cure rate according to the Capanna classification was 67% in group 1, 56% in group 2, and 78% in group 3. There was one case of recurrence in group 1 (5%), one case in group 2 (6%), and one case in group 3 (2%), as well as two cases of "no response to treatment" in group 1 (9%) and one case in group 2 (6%). CONCLUSION: Flexible intramedullary nailing for simple bone cysts in children and adolescents is effective for healing cystic lesions with a short healing duration and for mechanical stability.
Absorption ; Adolescent ; Bone Cysts ; Child ; Curettage ; Decompression ; Femur ; Fracture Fixation, Intramedullary ; Fractures, Spontaneous ; Humans ; Humerus ; Recurrence ; Retrospective Studies ; Transplants

A benign periosteal reaction, which can occur after trauma or stress, has a solid and uninterrupted appearance on radiography. In contrast, an aggressive periosteal reaction, which may indicate a malignancy, appears as a Codman's triangle or with a spiculated and sunburst pattern. In the present case, an 11-year-old boy with a previous injury to the distal radial growth plate presented with diffuse osteolysis on the distal radial metaphysis and decreased opacity of the lateral side cortex on plain radiograph. A Codman's triangle-like lesion was seen on the lateral side of the distal radius, and a few spicules were observed on the medial side of the distal radius. A T2-weighted coronal magnetic resonance image revealed a mass that had stripped the periosteum; the mass had heterogeneous signal intensity and a fl uid-fluid level on axial views. The margins of the mass were unclear, but enhanced. Suspecting a primary malignancy, we performed a biopsy. The pathology revealed that the mass was a simple hematoma.
Biopsy ; Child ; Growth Plate ; Hematoma ; Humans ; Magnetic Resonance Spectroscopy ; Osteolysis ; Periosteum ; Radius

PURPOSE: The purpose of this study was to evaluate the effectiveness of contact cryotherapy as an adjuvant therapy after intralesional curettage and autoiliac bone graft of enchondromas of the hand. MATERIALS AND METHODS: Thirty seven cases in 30 patients (17 males, 13 females) with enchondromas of the hand who underwent curettage, contact cryotherapy and autoiliac bone graft between July 2004 and March 2010 were reviewed with a minimum follow-up of 1 year. Radiologic evaluations were done periodically. Mean follow-up period was 26 months (range: 12-54 months). The radiologic results were evaluated according to the degree of new bone formation based on the Tordai's criteria. RESULTS: According to the Tordai's criteria, 33 cases (89%) were group I, and 4 cases (11%) were group II. There was no case of group III, which meant recurrence. Bone healing was achieved at average 4.8 months (range: 4-5.3 months) after the operation. There was no cryotherapy-related complication such as pathologic fracture, bone necrosis and skin necrosis during the follow-up periods. CONCLUSION: We suggest that the contact cryotherapy can be used as an effective adjuvant therapy for treatment of enchondroma of the hand without complications.
Chondroma ; Cryotherapy ; Curettage ; Follow-Up Studies ; Fractures, Spontaneous ; Hand ; Humans ; Male ; Necrosis ; Osteogenesis ; Recurrence ; Skin ; Transplants

BACKGROUND: The purpose of this study was to investigate longitudinal changes of the utilization of operational and surgical medical care inside and outside a metropolitan area over 10 years, analyzing the residential areas of patients and the locations of medical facilities for major cardiovascular surgery. METHODS: Data analysis was conducted by classifying the addresses of patients and the locations of medical care facilities of metropolitan cities and provinces, using data from the National Health Insurance Corporation from January 2003 to December 2013. RESULTS: There is serious concentration of major heart surgery to medical facilities in Seoul; this problem has not improved over time. There were differences in percentages of surgical procedures performed in the metropolitan areas according to major diseases. In the case of Busan and Daegu provinces, at least 50% of the patients underwent surgery in medical facilities in the city, but there are other regions where the percentage is less than 50%. In the case of provinces, the percentage of surgical procedures performed in medical facilities in Seoul or nearby metropolitan cities is very high. CONCLUSION: Policies to strengthen the regional capabilities of heart surgery and to secure human resources are required to mitigate the concentration of patients in the capital area. Many regional multi-centers must be designated to minimize unnecessary competition among regional university hospitals and activate a win-win partnership model for medical services.
Busan ; Coronary Artery Bypass ; Daegu ; Health Facilities ; Hospitals, University ; Humans ; Korea* ; National Health Programs ; Seoul ; Statistics as Topic ; Thoracic Surgery*

PURPOSE: Plantarmedial release and first ray extension osteotomy are often combined to treat paralytic cavovarus foot deformity. The purpose of this study is to evaluate the effect of additional first ray extension osteotomy in terms of dynamic pedobarography. MATERIALS AND METHODS: We reviewed findings of pre- and postoperative plain radiography and dynamic pedobarography for 25 patients in whom the flexibility of the hindfoot was confirmed by the Coleman block test. The results of treatment by extensive plantar medial release with first ray osteotomy (group I) were compared with the results of treatment by extensive plantar medial release alone (group II). RESULTS: Plain radiographs obtained pre- and postoperatively showed no statistically significant improvement in each group. Only in group I, peak forces at the 1st metatarsal head, 2nd metatarsal head and medial calcaneus were increased after operation. CONCLUSION: In paralytic hindfoot flexible cavovarus, extensive plantarmedial release with first ray osteotomy improve foot pressure distribution more than extensive plantarmedial release alone.
Adolescent ; Calcaneus/abnormalities/*radiography/surgery ; Child ; Child, Preschool ; Female ; Foot Deformities/*radiography/surgery ; Humans ; Male ; Osteotomy ; Retrospective Studies ; Treatment Outcome

PURPOSE: The Japanese encephalitis virus (JEV) genotype circulating in Korea has changed from G3 to G1. Therefore, the purpose of this study was to compare the antigenic relationship between the two genotypes by using antibody tests. MATERIALS AND METHODS: Blood samples from 42 sows and 216 horses were collected, and their seroprevalence was monitored using the hemagglutination inhibition and virus neutralization tests. Antisera against JEV G1 and G3 were isolated and prepared from guinea pigs. The cross-reactivity of these two viruses was then compared using the neutralizing antibody test. RESULTS: We found that there was a difference in the seropositive ratios of JEV G1 and G3. However, the difference was dependent on the antibody test used. There was also an observed difference in the antigenicity between the two genotypes, as ascertained using the neutralizing antibody test. CONCLUSION: There is an evident difference in JEV antigenicity between the genotypes G1 and G3. Therefore, we propose monitoring of the seroprevalence of JEV, and reevaluating the antigenicity of the current vaccine by using the relevant tests.
Animals ; Antibodies, Neutralizing ; Asian Continental Ancestry Group* ; Cross Reactions ; Encephalitis Virus, Japanese* ; Encephalitis, Japanese* ; Genotype ; Guinea Pigs ; Hemagglutination ; Horses ; Humans ; Immune Sera ; Korea ; Neutralization Tests ; Seroepidemiologic Studies

BACKGROUND: High risk myelodysplastic syndrome has various clinical courses and refractoriness to various therapies. It is important to analyze clinical characteristics and therapeutic responses in high risk myelodysplastic syndrome. METHODS: Sixty nine cases of primary high risk myelodysplastic syndrome at diagnosis were enrolled in this study at Kyungpook National University Hospital and Taegu Hyosung- Catholic University Hospital from January 1987 to June 1996. We have investigated the clinical characteristics and therapeutic outcomes after low dose cytarabine chemotherapy. RESULTS: 1) The median age of the patients was 48 years. Male to female ratio was 2.1:1. The each numbers of RAEB, CMML and RAEB-T patients were 38, 11 and 20, respectively. 2) The most common chief complaint was dyspnea on exertion. General weakness, fever and dizziness were also observed. The most common physical finding was pallor. 3) The peripheral blood findings showed anemia in 65 cases (94.2%), thrombocytopenia in 64 cases (92.8%), leukopenia in 32 cases (46.4%) and pancytopenia in 26 cases (37.7%). 4) Twenty two cases transformed to acute myelogenous leukemia during the follow-up periods. Chemotherapy was done in 18 cases among 22 cases of transformed acute myelogenous leukemia. Complete remission was achieved in 3 cases (16.7%), partial remission in 4 cases (22.2%) and no response in 11 cases (61.1%). 5) Forty seven cases were treated by low dose cytarabine chemotherapy. Complete response was achieved in 11 cases (23.4%), partial response in 13 cases (27.7%) and no response in 23 cases (48.9%). Median duration of complete response was 12 weeks. 6) We made score system, which based on Sanz score and Gattermann score, according to age, hemoglobin, platelet and bone marrow blast. Overall survival was higher in group A (score< or = 5) than group B (score> or = 6). Complete response of low dose cytarabine chemotherapy was higher in group A than group B but overall survival according to low dose cytarabine chemotherapy was not different in group A and group B. CONCLUSION: Low dose cytarabine chemotherapy was not effective in survival benefit. Score system according to prognostic factors was important to predict therapeutic response and prognosis. In the future, more intensive therapeutic plan and analysis of prognostic factors should be considered.
Anemia ; Anemia, Refractory, with Excess of Blasts ; Blood Platelets ; Bone Marrow ; Cytarabine* ; Daegu ; Diagnosis ; Dizziness ; Drug Therapy ; Dyspnea ; Female ; Fever ; Follow-Up Studies ; Gyeongsangbuk-do ; Humans ; Leukemia, Myeloid, Acute ; Leukopenia ; Male ; Myelodysplastic Syndromes* ; Pallor ; Pancytopenia ; Prognosis ; Thrombocytopenia