226 adult patients (235 fractures) with fractures of the shaft of the tibia were treated at the Department of Orthopaedic Surgery, Soon Chun Hyang College Hospital during the 6 and a half years from January 1975 to June 1981. These were analysed according to the methods of treatment and the results were categorized by the level, type, severity and whether open or closed in an attempt to seek the most suitable method of treatment. The following observations were made: l. Of the 226 cases, nine were bilateral, the total number of fractures being 235. Of these, 173 (73.6%) were treated conservatively, 26 (11.1%) by plate and screw fixation and the remaining 36 (15.3%) by in- tramedullary nailing. 2. There were no differences in the average healing time among the various levels of fractures. However, the upper one third and the lower one third healed more rapidly than the middle one third when treated con- servatively. When treated by intramedullary nailing, the middle one third healed most rapidly. 3. As to the types of freactures, spiral fractures healed most rapidly with 15.3 weeks and segmental fractures healed most slowly with 23.8 weeks. Transverse fractures and spiral fractures healed most rapidly when treated conservatively, oblique fractures healed most rapidly when treated by plate and screw fixation, segmental and comminuted fractures by intramedullary nailing. 4. The healing time was longer and complications were higher in open fractures than in closed ones. 5. Based on the modified Ellis classification of tibial fractures, the higher the severity, the longer the healing time and the lower the primary healing rate. 6. The primary intramedullary nailing group, which were treated within 24 hours of injury, was compared with the delayed intramedullary nailing group. The former showed faster healing and higher primary healing rate than the latter, while the infection rate was higher in the former.
Adult ; Classification ; Clinical Study ; Fracture Fixation, Intramedullary ; Fractures, Comminuted ; Fractures, Open ; Humans ; Methods ; Tibia ; Tibial Fractures

The present case first describes the spontaneous thigh hematoma induced by enoxaparin in a hemodialysis patient. A 64- year-old woman on a hemodialysis therapy was diagnosed with acute coronary syndrome, and treated with enoxaparin. Ten days after enoxaparin administration, diffuse swelling and pain developed suddenly in the right thigh without a history of trauma. There was a weak arterial pulse below the knee with an abrupt decrease of hemoglobin level. There were no significant abnormalities in the coagulation tests including the platelet count, prothrombin time, and activated partial thromboplastin time. Computed tomographic (CT) angiography and lower extremity arteriography were performed, which showed several bleeding foci involving branches of the right deep femoral artery. She was treated successfully by embolization at the bleeding sites, along with a transfusion.
Acute Coronary Syndrome ; Angiography ; Enoxaparin ; Female ; Femoral Artery ; Hematoma ; Hemoglobins ; Hemorrhage ; Humans ; Knee ; Lower Extremity ; Partial Thromboplastin Time ; Platelet Count ; Prothrombin Time ; Renal Dialysis ; Thigh

In order to investigate the prevalence and the factors related to the depression and burnout among private practice physicians, a SDS(self-rating depression scale) and MBl(Maslach burnout inventory) -based questionnaire study was performed on 344 private practice physicians in Kwangju and chonnam area. The results were summarized as follows. 1. Mean SDS score was 38.3 in total subjects and the prevalence rate of depression was 48.8%. As for the frequency order of the items of the SDS, decreased libido, diurnal variation and hopelessness were relatively high, and suicidal rumination, constipation and agitation were noted low. 2. Noticeable factors related with depression were smoking, coffee use, sleeping time and satisfaction with income. 3. As a result a factor analysis with the MBl data, five factors named as emotional exhaustion, depersonalization, personal accomplishment, involvement and self-interest were extracted. Statistical analysis of the data demonstrated that 48.8% of the physician sample reported high scores on emotional exhaustion, and 45.3% scored high on depersonalization. Personal accomplishment scores remained high with 45.3% reporting high personal accomplishment. 4. Variables related to the burnout were age, sleeping time, family size religion, medical speciality. duration of practice setting, visiting patient number, closing day per month and job satisfaction. 5. In the relationship with depression, burnout was closely related to depression. Above results showed that the high percentage of private practice physicians experiencing depression and burnout suggests the need for further research to establish trends, to identify causal factors, and to develop avenues to reduce stress.
Coffee ; Constipation ; Depersonalization ; Depression* ; Dihydroergotamine ; Family Characteristics ; Gwangju ; Humans ; Jeollanam-do ; Job Satisfaction ; Libido ; Prevalence ; Private Practice* ; Surveys and Questionnaires ; Smoke ; Smoking

This study was conducted to evaluate the accuracy of the official death registry in rural area. The base data used for the study was 379 deaths registered during the period of 1993 and 1994 in 4 rural townships of Chonnam Province. The interview survey for cause-of-death was performed on the next of kin and/or neighbor. Additional medical informations were collected from hospitals and medical insurance associations for the purpose of verification. The underlying cause-of-death of 278 cases presumed by the survey was compared to the cause on official death registry. There was a prominent disagreement of cause-of-death between the survey data and the registry data(agreement rate: 38.9~44.6%%, according to disease classification method). These results may be caused by extremely low rates of physicians' certification, which were mostly confined to the poisoning and injury. Symptoms, signs, and ill defined conditions on death registry could be classified into circulatory disease(32.3%), neoplasm(21.2%), digestive disease(7.l%), injury and poisoning(7.l%) and so on. These results suggest that careful attention and verification be required on utilization of death registry data in rural area.
Cause of Death ; Certification ; Classification ; Insurance ; Jeollanam-do ; Poisoning

In this study, we evaluated accuracy and usefulness of CyberKnife Respiratory Tracking System (SynchronyTM, Accuray, USA) about a moving during stereotactic radiosurgery. For this study, we used moving phantom that can move the target. We also used Respiratory Tracking System called Synchrony of the Cyberknife in order to track the moving target. For treatment planning of the moving target, we obtained an image using 4D-CT. To measure dose distribution and point dose at the moving target, ion chamber (0.62 cc) and gafchromic EBT film were used. We compared dose distribution (80% isodose line of prescription dose) of static target to that of moving target in order to evaluate the accuracy of Respiratory Tracking System. We also measured the point dose at the target. The mean difference of synchronization for TLS (target localization system) and Synchrony were 11.5+/-3.09 mm for desynchronization and 0.14+/-0.08 mm for synchronization. The mean difference between static target plan and moving target plan using 4D CT images was 0.18+/-0.06 mm. And, the accuracy of Respiratory Tracking System was less 1 mm. Estimation of usefulness in Respiratory Tracking System was 17.39+/-0.14 mm for inactivity and 1.37+/-0.11 mm for activity. The mean difference of absolute dose was 0.68+/-0.38% in static target and 1.31+/-0.81% in moving target. As a conclusion, when we treat about the moving target, we consider that it is important to use 4D-CT and the Respiratory Tracking System. In this study, we confirmed the accuracy and usefulness of Respiratory Tracking System in the Cyberknife.
Four-Dimensional Computed Tomography ; Prescriptions ; Radiosurgery ; Track and Field

BACKGROUND: Farnesylacetone compounds that dilate blood vessels by blocking calcium channels in sargassum siliquastrum have been reported. And this study was done to demonstrate the effect of YJ-7, a synthetic material derived from these compounds, on vessel dilation and blood pressure control. METHODS: We used vasoconstricted basilar and carotid artery of rabbits. Changes in blood pressure were measured in vivo at 15, 30, 45, and 60 minutes after intravenous injection of YJ-7 3 microM, EC50 value from in vitro experiment, and nimodipine 10 microM through the tail vein of 20 rats. Spontaneous hypertensive rat (SHR) has its blood pressure higher than 190 mmHg. Measurements of blood pressure were done 6 times and the mean values were used for data analysis. RESULTS: Systolic and diastolic blood pressure before the injection of YJ-7 were 194.2 +/- 6.1 mmHg and 140.2 +/- 6.4 mmHg. Blood pressure were decreased with time, 157.2 +/- 2.6 / 120.8 +/- 4.2 mmHg at 15 minutes, 161.8 +/- 18.3 / 123.2 +/- 13.9 mmHg at 30 minutes, and 156.0 +/- 4.1 / 112.4 +/- 1.7 mmHg at 45 minutes. The blood pressure lowering effect lasted until 45 minutes. However, the blood pressure increased to 182.2 +/- 16.4 / 149.0 +/- 20.4 mmHg at 60 minutes reaching similar levels of before the injection (P < 0.05). CONCLUSIONS: We could see YJ-7 has vasorelaxation effect and would be helpful to control blood pressure with short recovery period than nimodipine.
Animals ; Blood Pressure ; Blood Vessels ; Calcium ; Calcium Channels ; Carotid Arteries ; Glycosaminoglycans ; Injections, Intravenous ; Nimodipine ; Rabbits ; Rats ; Sargassum ; Terpenes ; Vasodilation ; Veins

Metastatic renal cell carcinoma is renowned for its potency to spread to almost any organ of the body; however metastasis to the gall bladder is very rare. We present a case of a 48 year old man who initially demonstrated renal cell carcinoma, and in who gallbladder metastasis was later detected. A review of the literature revealed only a small number of cases of renal cell carcinoma metastasizing to the gallbladder, and these were primary found upon necropsy. Gall-bladder metastasis in this case was detected clinically.
Carcinoma, Renal Cell/pathology/*secondary ; Gallbladder Neoplasms/pathology/*secondary ; Human ; Kidney Neoplasms/*pathology ; Male ; Middle Aged

In other to study relationship of anxiety and serum cholesterol in general population, we performed the interview survey and screening test for the Ju-am cohort and residents in controlling area at 1995. Among them, 622 people are selected for this analysis. The results were summarized as follows. 1. Anxiety and total serum cholesterol related each other in the group of anxiety. Correlation coefficient was 0.39(p<0.01). 2. According to the result of multiple regression that the total serum cholesterol regarded as the dependent variable, anxiety and total serum cholesterol were related each other positively in the group of anxiety(p<0.05). 3. As the symptoms of anxiety was dichotomized affective and somatic symptom. There was no relationship of 2 symptoms and total serum cholesterol in all subjects, but there was more relationship on the affective symptom than on the somatic symptom in the group of anxiety(p<0.05). The above results show that anxiety and total serum cholesterol related each other significantly in the anxiety group. And the relationship of psychological factors and serum cholesterol could be applied significantly in general population as well as in the special group.
Affective Symptoms ; Anxiety* ; Cholesterol* ; Cohort Studies ; Mass Screening ; Psychology

PURPOSE: Partial nephrectomy has a similar oncologic outcome to radical nephrectomy while reducing cardiac and metabolic morbidity. However, previous studies reported that partial nephrectomy had been underutilized. The purpose of this study is to analyze trends in the use of partial nephrectomy in Korea and evaluate which individual factors and hospital factor influenced the operative approach. MATERIALS AND METHODS: Using URO-PDS database, 11560 patients underwent nephrectomy for renal cell carcinoma between 2006 and 2010 were identified. International Classification of Disease (ICD-9) diagnosis codes were applied to target subject of interest. Logistic regression was applied to identify determinants of partial nephrectomy. RESULTS: Over the study period, the proportion of partial nephrectomies has steadily increased from 9.4% in 2006 to 30.4% in 2010 (p<0.001). Deviation of utilization in partial nephrectomy has been observed based on the area (p<0.001) and type of surgery (p<0.001). Individual of younger age, as well as male, were more likely to be treated with partial nephrectomy (p<0.001 for each). Furthermore, Patient treated at hospitals with higher nephrectomy volume were more prone to be treated with partial nephrectomy (p<0.001 for each). CONCLUSIONS: Partial nephrectomies have been increasingly performed over the study period but are still underutilized.
Carcinoma, Renal Cell* ; Classification ; Diagnosis ; Humans ; Korea* ; Logistic Models ; Male ; Nephrectomy*

To assess the adverse effects of dust on pulmonary function and to determine the association between subjective respiratory symptoms, cognitions about working environments and pulmonary functions, the study was conducted on 719 coal mine workers (395 workers on direct part, 324 workers on indirect part) being employed in a coal mine industry located in Hwa-Soon area. Questionnaires on respiratory symptoms and cognitions about working environments were filled out by themselves, and pulmonary function test was given by trained doctors. The results obtained were as follows ; 1. Significantly increased subjective respiratory symptoms prevalence were found in the workers on direct part comparing to workers on indirect part, and symptoms prevalence rate was higher in sputum, coughing, respiratory difficulty, palpitation and chest pain in order. 2. Significantly increased cognitions degree about working environments were found in workers on direct part comparing to workers on indirect part, and the degree was higher in dust concentration, temperature, working density and humidity in order. 3. FVC, FEV(0.5), FEF(200-1200ml) and FEF(25-75%) were lower for workers on direct part than that for workers on indirect part. 4. In workers on direct and indirect part, lung functions except FEF(200-l200ml) for the high subjective symptom group was smaller than that for the low group. There was not significane statistically, but the significane was found in FVC and FEVt in total coal workers. 5. In workers on direct part, FEVt and FEF(25-75%) for high cognition group about working environmental conditions was smaller than that for the low group but other lung functions were reversed. But in workers on indirect part, similar results was found and the significance was found in FEV(0.5) FEF(25-75%) and FEF(200-1200ml) in total coal workers. 6. Lung functions had negative correlation between sputum and FEF(200-1200ml).
Chest Pain ; Coal* ; Cognition ; Cough ; Dust ; Forced Expiratory Volume ; Humidity ; Lung ; Prevalence ; Questionnaires ; Respiratory Function Tests ; Sputum