From September 1992 to April 1994, we reviewed 7 patients after arthroscopic surgery for anterior impingement in the ankle, who complained ankle pain and limitation of motion. All patients were mem and main symptoms were severe pain at full dorsiflexion of ankle and limitation of motion. Bony spur was located on the anterior aspect of tibia, and it was possible to resect the tibial bony spur arthroscopically without distraction devices. Mean operation time was 55 minutes. Pain, swelling and limitation of motion were much improved. There was no postoperative complication. Arthroscopic resection of the anterior tibial bony spur is an effective treatment for anterior impingement in the ankle.
Ankle ; Arthroscopy ; Humans ; Postoperative Complications ; Tibia

Adenosine deaminase(ADA) is an enzyme capable of catalysing the pathway from adenosine to inosine. Previous studies have shown that this enzyme may be useful in recognition of a tubeculous etiology of pleural, peritoneal, or meningeal effusions. ADA activity was studied in 42 patients with large amount of pericardial effusion. Patients were subdivided into the following four group : (A) 15 cases of tuberculous effusions : (B) 4 with pyogenic effusions : (C) 15 with idiopathic effusions : (D) 9 with malignant effusions. The results were as follows ; 1) The mean ADA activities assessed in pericardial effusions were 134.0+/-77.6U/L in group A : 93.8+/-43.8 in group B : 38.3+/-23.2 in group C : 27.3+/-20.8 in group D. Comparing the level achieved in group A with all others, the difference is significant at the P<0.001 level. 2) The mean ADA activities assessed in sera were 50.7+/-57.2 U/L in group A : 63.5+/-24.1 in group B : 25.9+/-12.0 in group C : 14.0+/-7.5 in group D. Comparing the level achieved in group A with all others, there is no significant difference. 3) Specificity(0.87) and sensitivity(0.93) of the test for the differential diagnosis of patients with tuberculous effusion from those with idiopathic effusion is high, when a value of more than 50 U/L is considered. In conclusion, the assessment of ADA in pericardial effusions is of great value in the diagnosis of tuberculous pericarditis.
Adenosine Deaminase* ; Adenosine* ; Diagnosis ; Diagnosis, Differential ; Humans ; Inosine ; Pericardial Effusion* ; Pericarditis, Tuberculous

No abstract available.
Chylothorax* ; Lymphangiectasis*

OBJECTIVES: The aims of this study were to know the prevalence of cognitive disorders in patients with thyroid cancer, and identify related variables to them. METHODS: Subjects were consisted of fourty-two patients with thyroid cancer, who were admitted for radioiodine ablative therapy at 6-12 months after total thyroidectomy. The data were obtained from interviews about history and assessments of depression and cognitive function(Korean Version of the Montreal Cognitive Assessment, MoCA-K). RESULTS: 1) Among subjects, those with below 22 of total score of the MoCA-K were twenty-one(50.0%). 2) Upon age, education, Pre-radioiodine therapy thyroid stimulating hormone(TSH), there were statistically significant difference between subgroup with above 23 of the total MoCA-K score and those below 22. 3) The total scores of the MoCA-K in subjects had significant correlation with age, education, comorbidity, Pre-radioiodine therapy TSH, total score of the HDRS-17. CONCLUSIONS: Cognitive disorders were more prevalent among patients with thyroid cancer before radioiodine therapy. Therefore, further study should be needed to clarify the mechanism for the cognitive disorders in thyroid cancer. Furthermore, physicians should pay attention to the cognitive function and prepare preventative measures for cognitive disorder during management of thyroid cancer.
Carcinoma, Papillary* ; Comorbidity ; Depression ; Education ; Humans ; Prevalence ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy ; Thyrotropin

Scapholunate advanced collapse (SLAC) deformity most often occurs with chronic rotary scaphoid instability from scaphoiunate ligament tear and scaphoid fracture. Prior to 1984 when Watson HK reported his concept on SLAC wrist deformity, the most popular procedure for this pathology was scaphoid implant arthroplasty with or without midcarpal fusion. We have reviewed 15 cases of SLAC deformity treated with scaphoid excision and midcarpal fusion from 1984 to 1993. Among them, scaphoid implants made of silicone were inserted in 4 cases. Scaphoid implant arthroplsty without carpal fusion has been excluded. The mean period of follow-up was 8.8 years and the mean age of patients was 47.5 years. Males and right wrists were predominant. Wrist motion was 56% and grip power was 71% of the normal opposite side. On the average overall, 8 patients had no pain and 7 patients had mild pain. The grade of pain was minimal, 0.5 in grade (Rating system: no pain-0, mild- 1, moderate-2, severe-3). However, all of the 4 cases of limited carpal fusion with a scaphoid implant developed silicone particulate induced synovitis and pain. The procedure appears to be effective in maintaining function of the hand with minimal pain up to 5.8 years. However, silicone scaphoid implant appears not to be necessary and is not recommended with a limited carpal fusion for this pathology.
Arthroplasty ; Congenital Abnormalities ; Follow-Up Studies ; Hand ; Hand Strength ; Humans ; Ligaments ; Male ; Pathology ; Silicones ; Synovitis ; Wrist

Symptoms of deep cerebral vein thrombosis (DCVT) are variable and nonspecific. Radiologic findings are essential for the diagnoses. In the majority of cases of deep internal cerebral venous thrombosis, the thalamus is affected bilaterally, and venous hypertension by thrombosis causes parenchymal edema or venous infarction and may sometimes cause venous hemorrhage. Intravenous injections of mannitol can be administered or decompressive craniectomy can be performed for reduction of intracranial pressure. The objectives of antithrombotic treatment in DCVT include recanalization of the sinus or vein, and prevention of propagation of the thrombus. Herein, the authors report DCVT which was successfully treated by low molecular weight heparin.
Brain Edema ; Cerebral Infarction ; Cerebral Veins ; Decompressive Craniectomy ; Edema ; Hemorrhage ; Heparin, Low-Molecular-Weight ; Hypertension ; Infarction ; Injections, Intravenous ; Intracranial Pressure ; Intracranial Thrombosis ; Mannitol ; Thalamus ; Thrombosis ; Veins ; Venous Thrombosis

BACKGROUND: For most patients, recovery from anesthesia is a smooth uneventful. But for some, recovery can be life threatening. To prevent this, adequate and prompt evaluation of patients on recovery state is essential. Activity, respiration, circulation, awareness, and color are comprehensively assessed by PAR score. So we performed this clinical study to compare ongoing changes in PAR score and the effects of age, physical status, operation site and operation time on PAR score were evaluated. METHODS: Two hundred and fifty-four patients (ASA 1, 2) undergoing elective surgery under general anesthesia were evaluated in our recovery room. They were anesthetized with enflurane or isoflurane, and nitrous oxide, and were transferred to the recovery room when SpO2 was more than 97% and there was no supplemental oxygen during transport. Once there, O2 5 l/min was administered via a face mask to all the patients. Assessment of each patient's PAR score was made at ten-minute intervals by the same anesthesiologist. RESULTS: Emergence from anesthesia was significantly dependent on patient's age, preoperative physical status but not on operation site and time. PAR score was significantly increased according to PAR-stay time regardless of age, physical status, operation site or time. CONCLUSION: In evaluating the postanesthetic recovery state, it seems to be important to consider patient's age and physical status.
Anesthesia* ; Anesthesia, General ; Enflurane ; Humans ; Isoflurane ; Masks ; Nitrous Oxide ; Oxygen ; Recovery Room ; Respiration

BACKGROUND: An aggressive skin cancer on the nose, tends to have poorly defined clinical margins, and has a higher recurrence rate. A small tumor on the nose is usually easily treated by any of the standard methods. However, removal and reconstruction with preserved cosmesis is more laborous in a basal cell carcinoma larger than 10 mm in diameter. This is because the nose has complex contoures, unique skin color and texture, and the limited availability of mobile adjacent skin. When available Mohs micrographic surgery is the preferred treatment for these large tumors. OBJECTIVE: Our purpose was to investigate the preferred reconstruction method(especially, local flap reconstruction) by the cosmetic unit of the nose after Mohs micrographic surgery. METHODS: From March 1991 to February 1997, twenty-one patients were diagnosed with basal cell carcinoma on the nose at our department. All the tumors were removed with Mohs micrographic surgery, and then the defects were reconstructed with a primary closure, skin graft, and local flap.
Carcinoma, Basal Cell* ; Humans ; Mohs Surgery* ; Nose* ; Recurrence ; Skin ; Skin Neoplasms ; Transplants

PURPOSE: We evaluated the relationship of prostate-specific antigen (PSA) and obesity indices (weight, body mass index [BMI] and waist circumference [WC]) in Korean middle-aged men. MATERIALS AND METHODS: From February to September 2013, 1,900 police men under 60 years old who participated in a prostate health screening program were included this cross-sectional study. All subjects underwent clinical examinations including weight, height, BMI, WC, fasting blood sugar, lipid profiles, estimated glomerular filtration rate (GFR), and PSA. Total prostate volume (TPV) was assessed clinically. Spearman correlation and multiple linear regression tests were performed to evaluate the obesity indices and PSA relationships. RESULTS: The mean age was 52.0±4.7 years, and the mean PSA was 0.97±0.99 ng/mL. The PSA showed a significant positive correlation with the age (r=0.108, p < 0.01), TPV (r=0.349, p < 0.01), height (r=−0.052, p < 0.05), weight (r=0.186, p < 0.05), low-density lipoprotein cholesterol (r=0.056, p < 0.05), and GFR (r=−0.096, p < 0.01). All obesity indices including weight, BMI, and WC showed negative correlations with PSA (beta=−0.013, p < 0.001; beta=−0.039, p < 0.001; and beta=−0.010, p=0.005; respectively) in age and TPV-adjusted model. CONCLUSIONS: Common obesity indices (weight, BMI, and WC) were associated with lower PSA in Korean middle-aged population. Thus, an individual's degree of obesity should be considered when PSA is checked in the first prostate cancer screening of life.
Blood Glucose ; Body Mass Index ; Cholesterol ; Cross-Sectional Studies ; Fasting ; Glomerular Filtration Rate ; Humans ; Linear Models ; Lipoproteins ; Male ; Mass Screening ; Obesity ; Police ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Waist Circumference

PURPOSE: The goal of this study is to analyze the trends in surgical management of Benign prostatic hyperplasia (BPH) in Korea during the last 5 years from 2014 to 2018. MATERIALS AND METHODS: We retrieved the medical statistics associated with the Healthcare Big Data Opening System available online. We analyzed the number of cases after 2014 for transurethral resection of prostate (TURP), photoselective vaporization of the prostate (PVP), and holmium laser enucleation of the prostate (HoLEP), respectively. We then analyzed and charted the cases according to the number of patients hospitalized or treated as outpatients, depending on age group, type of medical institutions, and the location of medical institutions. RESULTS: The number of patients with BPH has increased steadily. The number of TURP and HoLEP procedures steadily increased, while the number of PVP interventions decreased dramatically. The number of HoLEP cases increased by 22% from 2014 to 2018, which is the fastest rate among the three surgeries. In addition, the number of patients aged 75 years or older as well as the proportion of inpatient surgeries compared with outpatient treatments has increased. The number of cases undergoing TURP increased rapidly in general hospital and those treated with HoLEP increased in the general and tertiary referral hospitals. CONCLUSIONS Interventions using TURP and HoLEP has increased, and the age of patients undergoing surgery has increased gradually. Cases treated with TURP and HoLEP in general and tertiary referral hospitals showed an increasing trend from the metropolitan area to the province.