Three hundred and fourty two patients with a fracture of tibial shaft were treated and managed in the Department of Orthopaedic Surgery, Soon Chun Hyang University Hospital from January 1981 to December 1985. In 147 cases, 62 cases had only tibial shaft fracture and 85 tibial and fibular shaft fracture. All of these were treated conservatively by manipulation and cast immibilization. We analyzed the initial fracture characteristics, the treatment employed, and the subsequent complications in fracture healing in a series of patients who had sustained a tibial shaft fracture with and without a fibular fracture. The results were as follows; 1. Duration of average bone healing was more slowly in the patients more than twenty years old who were treated for a tibial shaft fracture with and without a concomitant fibular fracture than in the patients less than twenty years old. 2. Duration of average bone healing was more slowly by one or two weeks in the the group of tibial shaft fracture without fibular fracture than in than in those with fibular fracture. 3. The frequency of delayed union, nonunion, varus malunion and pain in the ipsilateral ankle joint were more increased in the group of the tibial shaft fractures without fibular fracture in than those with fibular fracture. 4. The frequency of valgus malunion was more increased in the group of the tibial shaft fractures with fibular fracture than in those without fibular fracture.
Ankle Joint ; Fracture Healing ; Humans ; Tibia

Various sequences have been developed for MRI to aid in the radiologic diagnosis. Among the various MR sequences, susceptibility-weighted imaging (SWI) is a high-spatial-resolution, threedimensional gradient-echo MR sequence, which is very sensitive in detecting deoxyhemoglobin, ferritin, hemosiderin, and bone minerals through local magnetic field distortion. In this regard, SWI has been used for the diagnosis and treatment of various neurologic disorders, and the improved image quality has enabled to acquire more useful information for radiologists.Here, we explain the principle of various signals on SWI arising in neurological disorders and provide a retrospective review of many cases of clinically or pathologically proven disease or components with distinctive imaging features of various neurological diseases. Additionally, we outline a short and condensed overview of principles of SWI in relation to neurological disorders and describe various cases with characteristic imaging features on SWI. There are many different types diseases involving the brain parenchyma, and they have distinct SWI features.SWI is an effective imaging tool that provides complementary information for the diagnosis of various diseases.

V. parahaemolyticus was isolated from blood culture of a 34-year old female patient with HCV viral hepatitis and liver cirrhosis. V. parahaemolyticus is one of the frequent causative agents of gastrointestinal infection, but rarely causes septicemia. This case is thought to be the 3rd report of V. parahaemolyticus septicemia in Korea.
Adult ; Female ; Hepatitis ; Humans ; Korea ; Liver Cirrhosis* ; Liver* ; Sepsis* ; Vibrio parahaemolyticus* ; Vibrio*

Granular cell tumor is one of the rare tumorous condition. At present there are estimated 600 reported examples of the tumor in the medical literature. Malignant granular cell tumor is a well established but extremely rare entity that is found in appr- oximately 2 % of all granular cell tumor. Diagnosis should be restricted to neoplasms that are similar in their histological appearance to benign granular cell tumors but can be seperated on the basis of cellular pleomorphism, mitotic activity, and, most importantly, their capacity to produce metastases. The authors had experienced that a 55 years old male patient had two large malignant granular cell tumors at the left thigh and left inguinal area with metastatic lesion.
Diagnosis ; Granular Cell Tumor ; Humans ; Male ; Neoplasm Metastasis ; Thigh

BACKGROUND: In modern society, many workers are stressed. Supervisors' support or behavior can affect the emotional or psychological part of the worker. The purpose of this study is to investigate the effect of supervisor's behavior on worker's stress. METHODS: The study included 19,272 subjects following the assignment of weighted values to workers other than soldiers using data from the Fourth Korean Working Condition Survey. Supervisors' behavior was measured using 5 items: “supervisor feedback regarding work,”“respectful attitude,”“good conflict-resolution ability,”“good work-related planning and organizational ability,” and the encouragement of participation in important decision making. Job stress was measured using 1 item: “I experience stress at work.” Multiple logistic regression analysis was performed to examine the effects of supervisors' behavioral, general, occupational, and psychosocial characteristics on job stress in workers. Organizational characteristics associated with supervisors' behavior were also analyzed. RESULTS: The results showed that supervisors' provision of feedback regarding work increased workers' job stress (OR = 1.329, 95% CI = 1.203 ~ 1.468). When a supervisor respect workers (OR = 0.812, 95% CI = 0.722 ~ 0.913) or good at planning and organizing works (OR = 0.816, 95% CI: 0.732 ~ 0.910), workers' job stress decreased. In particular, the two types of supervisor behaviors, other than feedback regarding work, were high in private-sector organizations employing less than 300 employees. CONCLUSION: Supervisors' behavior influenced job stress levels in workers. Therefore, it is necessary to increase education regarding the effects of supervisors' behavior on job stress, which should initially be provided in private-sector organizations with up to 300 employees.
Decision Making ; Education ; Humans ; Korea* ; Logistic Models ; Military Personnel ; Salaries and Fringe Benefits*

BACKGROUND/AIMS: The prevalence and clinical characteristics of entecavir (ETV) resistance is not well known. The aim of this study was to determine the frequency of genotypic resistance in nonresponders and virologic breakthrough (VBT) patients. METHODS: The medical records of 76 chronic hepatitis B patients treated for a least 6 months from October 2006 to October 2008 were reviewed retrospectively. We divided patients into two groups: nucleoside analogue (NA)-naive patients (n=38) and LAM experienced patients (n=38). NA-naive and LAM experienced patients received ETV at 0.5 and 1.0 mg/day, respectively. The virologic response and VBT were investigated in both groups. We used the multiplex restriction fragment mass polymorphism (RFMP) method to test genotypic resistance at the rtI169, rtT184, rtS202, rtM204, and rtM250 sites. RESULTS: Age, gender, serum ALT, and HBV DNA level before treatment did not differ between the groups. Neither VBT nor nonresponse was observed in the NA-naive group, whereas VBT and nonresponse were observed in three patients each in the lamivudine (LAM)-experienced group; all six patients had YMDD mutation at study enrollment, all three patients with VBT had genotypic resistance to ETV, but the three nonresponse patients did not have genotypic resistance to ETV. CONCLUSIONS: We suspect that VBT is mostly associated with genotypic resistance to ETV. However, nonresponse might be associated with the continuance or reselection of the YMDD mutant in LAM-experienced patients.
Adult ; Antiviral Agents/*therapeutic use ; Drug Resistance, Viral/genetics ; Female ; Genotype ; Guanine/*analogs & derivatives/therapeutic use ; Hepatitis B/genetics ; Hepatitis B, Chronic/*drug therapy/virology ; Humans ; Lamivudine/therapeutic use ; Male ; Middle Aged ; Mutation ; Polymorphism, Restriction Fragment Length ; RNA-Directed DNA Polymerase/genetics ; Retrospective Studies

Damages on the recurrent laryngeal nerve (RLN) during thyroid surgery is the most common iatrogenic cause of vocal cord paralysis. Identification of the recurrent laryngeal nerve and meticulous surgical techniques can significantly decrease the incidence of this complication. The nonrecurrent inferior laryngeal nerve is an exceedingly rare anomaly of the recurrent laryngeal nerve. The nonrecurrent inferior laryngeal nerve is associated with abnormal development of the aortic arch, where the innominate (brachiorephalic) artery is not found and the right common carotid artery rises directly from the aortic arch. The aberrant right subclavian artery can always be felt against the vertebral column behind the esophagus. Surgeons need to be aware of the positions of these arteries to avoid damaging them. We experienced a case of nonrecurrent inferior laryngeal nerve in the right side with the aberrant right subclavian artery. The patient received a total thyroidectomy with neck dissection for thyroid carcinoma with nodal metastasis. Incidentally, we also found nonrecurrent inferior laryngeal nerve, and also found an aberrant right subclavian artery by the computed tomography scan. The patient presented transient vocal cord paralysis but gained complete recovery of vocal cord mobility after one and a half month later.
Aorta, Thoracic ; Arteries ; Carotid Artery, Common ; Esophagus ; Humans ; Incidence ; Neck Dissection ; Neoplasm Metastasis ; Recurrent Laryngeal Nerve* ; Spine ; Subclavian Artery ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy ; Vocal Cord Paralysis ; Vocal Cords

BACKGROUND: Although levels of D-dimer and fibrinogen/fibrin degradation products (FDP) are low in the circulation of healthy individuals, their levels are significantly elevated in patients with thromboembolic diseases. The aim of this study was to investigate the clinical utilities of D-dimer and FDP in the early diagnosis of stroke subtypes and the prediction of early prognosis. METHODS: Hospitalized patients due to acute ischemic stroke underwent measurement of plasma levels of D-dimer and FDP within 12 hours after admission. Stroke severity was assessed on admission and 2 weeks later using the National Institutes of Health Stroke Scale (NIHSS). Stroke subtypes were classified according to the criteria of the Trial of ORG 10172 in Acute Stroke Treatment criterion. RESULTS: D-dimer and FDP levels were significantly higher in the cardioembolic group than in the atherosclerotic and lacunar groups. There was independent correlation between the level of FDP and cardioembolism. Ninety-six patients showed clinical improvement that was defined by a reduction of more than 4 points on the NIHSS two weeks later compared with that on admission. The level of D-dimer was higher in patients with clinical improvement than in patients without improvement (p=0.032). However, there was no correlation between the level of D-dimer and early improvement. CONCLUSIONS: These results show that measurement of FDP in acute ischemic stroke could be helpful in subtype classification. However, D-dimer and FDP were not related with early prognosis.
Cerebral Infarction ; Chondroitin Sulfates ; Dermatan Sulfate ; Early Diagnosis ; Fibrin Fibrinogen Degradation Products ; Formycins ; Heparitin Sulfate ; Humans ; National Institutes of Health (U.S.) ; Plasma ; Ribonucleotides ; Stroke ; Thromboembolism

No abstract available.
Cerebral Infarction* ; Hematoma* ; Humans ; Intestines*

BACKGROUND: The presence of late potentials on the signal-averaged electrocardiography (SAECG) is predictive of ventricular tachycardia and sudden cardiac death. We investigated the acute effect of HD on the SAECG in patients with end-stage renal disease (ESRD). METHODS: Twenty HD patients with normal sinus rhythm on a routine ECG were enrolled. SAECGs were recorded immediately before, within 30 minute after, and then 24 hour after the completion of HD. Serum electrolyte, BUN, calcium, echocardiogram and body weight were examined before and after the HD. RESULTS: Positive late potentials on SAECG were detected in 8 patients (40%) before HD, 12 patients (60%) at 30 minute after HD, and 5 patients (25%) at 24 hour after HD. There was a significant change in QRSd (QRS duration) after HD: (110.3+-9.7 msec before HD; 112.3+-9.3 msec at 30 minute after HD; 109.5+-8.6 msec at 24 hour after HD) (p<0.05). The reduction of serum potassium was greater in positive late potential (n=12) than in negative late potential group after HD (n=8) (p<0.05). A significant negative correlation was seen between the changes of dialysis-induced serum total CO2 and QRSd changes (r=-0.534, p<0.05). CONCLUSION: SAECG parameters tended to be aggravated after HD in patient with ESRD. Prolongation of QRSd after HD could be explained by the changes of potassium and bicarbonate.
Body Weight ; Calcium ; Death, Sudden, Cardiac ; Electrocardiography* ; Humans ; Kidney Failure, Chronic* ; Potassium ; Renal Dialysis* ; Tachycardia, Ventricular