Recently the treatment of femoral neck fractures has advanced, and results are generally satisfactory. In some cases however, their prognosis relatively unsatisfactory, for instance, nonunion or malunion cases are frequently encountered, because inadequate treatment is given by non-qualified paramedical personnel or general practitioners. This is a report of two cases of neglected fracture of the femoral neck. The first case was a 57 year old female who complained of painful limitation of motion of the left hip for 33 months. Roentgenological examination revealed a fracture of the femoral neck with severe neck absorption upward lateral displacement of the upper end of femur with generally osteoporotic changes. For treatment of this neglected femoral neck fracture, Colonna reconstruction was performed. The second case was a 19 year old female who complained of painful limited motion of the right hip joint for 5 months. Roentgenological examination revealed a fracture of the femoral neck with no absorption of the femoral neck, there was, however, slight sclerotic change in the head of the femur In this case, Open osteosynthesis was performed. A bleeding from the proximaI fragment was seen after curettage of the fracture surface at the time of operation. Post-operative results were relatively good in both cases.
Absorption ; Allied Health Personnel ; Curettage ; Female ; Femoral Neck Fractures ; Femur ; Femur Neck ; General Practitioners ; Head ; Hemorrhage ; Hip ; Hip Joint ; Humans ; Neck ; Prognosis

We studied on change of lens accommodation and pupil light reflex caused by VDT work in six women and compared them with those of other office works. The results were as follows. 1. In VDT work group, the accommodation contraction velocity decreased during the first 2-hr VDT task, then recovered markedly by the end of the one-hour lunch break, and then decreased again by the end of the 2nd 2-hr VDT task. Changes of relaxation velocity showed similar pattern although it was less typical than that of contraction velocity. 2. There was no marked change in accommodation contraction velocity and amplitude of accommodation in general office work group and near-distance office work group, and in the near-distance office work accommodation relaxation velocity decreased according to work load without recovery after lunch break. 3. Initial pupil diameter, initial pupil area of light reflex decreased significantly during VDT task only in VDT work group, and didn't recover after lunch break. These results suggest possibility that changes of accommodation contraction velocity, accommodation relaxation velocity, near point distance, and pupil diameter and area are useful in evaluating characteristics of VDT work. For this, more research adjusted individual differences, circadian rhythm, emotional stress needs.
Accommodation, Ocular ; Circadian Rhythm ; Female ; Humans ; Individuality ; Lunch ; Pupil* ; Reflex* ; Relaxation ; Stress, Psychological

BACKGROUND: This study aimed to assess the recent changes of radiation therapy (RT) modalities in Korea. In particular, we focused on intensity-modulated radiation therapy (IMRT) utilization as the main index, presenting the application status of advanced RT. METHODS: We collected information from the Korean Health and Insurance Review and Assessment Service data based on the National Health Insurance Service claims and reimbursements records by using treatment codes from 2010 to 2016. We classified locating region of each institution as capital vs. non-capital areas and metropolitan vs. non-metropolitan areas to assess the regional difference in IMRT utilization in Korea. RESULTS: IMRT use has been steadily increased in Korea, with an annual increase estimate (AIE) of 37.9% from 2011 to 2016 (P < 0.001) resulting in IMRT being the second most common RT modality following three-dimensional conformal radiotherapy. In general, an increasing trend of IMRT utilization was observed, regardless of the region. The rate of AIE in the capital areas or metropolitan areas was higher than that in non-capital areas or non-metropolitan areas (40.7% vs. 31.9%; P < 0.001 and 39.7% vs. 29.4%; P < 0.001, respectively). DISCUSSION: The result of our survey showed that IMRT has become one of the most common RT modalities. IMRT is becoming popular in both metropolitan and non-metropolitan areas, while metropolitan area has faster AIE possibly due to concentration of medical resources and movement of advanced patients.
Humans ; Insurance ; Korea ; National Health Programs ; Radiotherapy ; Radiotherapy, Conformal

Babesiosis is a tick-borne, malaria-like illness caused by Babesia species that infect erythrocytes of mammals incidentally. The family Babesiidae is characterized by consisting of non-pigmented intraerythrocytic parasites that reproduce within erythrocytes by asynchronous, asexual budding into two or four daughter cells (tetrad). We experienced a case of human babesiosis presenting fever and chills. The patient was a 49-year old man, who had been in Africa (Ethiopia, Uganda). Three weeks before admission intermittent spiking fever had developed, which had been accompanied by severe chills. The peripheral blood smear (Giemsa-stain) revealed characteristic forms of an intracellular quadruplet parasite compatible with Babesia. The patient was improved significantly by the treatment with quinine and clindamycin for a week.
Africa ; Animals ; Babesia ; Babesiosis* ; Chills ; Clindamycin ; Erythrocytes ; Fever ; Humans ; Mammals ; Middle Aged ; Nuclear Family ; Parasites ; Quadruplets ; Quinine

Carcinosarcomas of the esophagus are rare malignant neoplasms that consist of both carcinomatous and sarcomatous components, which comprise approximately 1~2% of all esophageal neoplasms. Usually, esophageal carcinosarcomas are the polypoid type, and patients with esophageal carcinosarcoma have progressive dysphagia. The multiplicity in terminology appears to be related to the uncertain histogenesis of these tumors. We report a case of a polypoid esophageal carcinosarcoma with a spontaneous resected stalk in a 45 year-old male patient who presented with progressive dysphagia and weight loss.
Carcinosarcoma* ; Deglutition Disorders ; Esophageal Neoplasms ; Esophagus ; Humans ; Male ; Middle Aged ; Weight Loss

BACKGROUND AND OBJECTIVES: The Chronic Ear Survey (CES) has been known to be a valid, disease-specific measure for the evaluation of health status and treatment effectiveness for chronic otitis media patients. As part of this study, we developed a Korean version by adapting from this CES, determined its reliability and validity. MATERIALS AND METHOD: The development of the Korean version of CES (K-CES) included the processes of standard independent translation and cross-cultural adaptation to check for cultural inconsistency. The finalized K-CES was administered to 166 patients visiting 10 referral hospitals in a prospective manner. K-CES was validated by using the Cronbach's alpha coefficient, confirmatory factor analysis and test-retest analysis for reliability and validity. The 36-Item Short Form Health Survey Instrument (SF-36) was assessed and the result was used to evaluate the criterion validity. RESULTS: The K-CES demonstrated good test-retest reliability and internal consistency (Cron-bach's alpha=0.850). Scale-item correlation coefficient was even higher than 1.0, which shows a very high reliability of K-CES. The validity of K-CES, checked by confirmatory factor analysis, also showed good construct validity. There was high correlation between SF-36 and the scores of K-CES, which indicates high criterion validity. CONCLUSION: We concluded that K-CES is a valid tool for clinical use and research studies in Korean patients with chronic otitis media.
Ear ; Health Surveys ; Humans ; Otitis Media ; Prospective Studies ; Referral and Consultation ; Reproducibility of Results ; Treatment Outcome

Paragonimiasis is a parasitic disease caused by Paragnonimus species. The primary site of infection is the lung, and extrapulmonary involvement is also reported. When infected with Paragonimus westermani, which is the dominant species in Korea, the central nervous system is frequently involved along with the liver, intestine, peritoneal cavity, retroperitoneum, and abdominal wall. Ectopic paragonimiasis raises diagnostic challenge since it is uncommon and may be confused with malignancy or other inflammatory diseases. Here, we report an ectopic paragonimiasis case initially presented with recurrent abdominal pain. The patient developed abdominal pain 3 times for the previous 3 years and the computed tomography (CT) of the abdomen revealed fluid collection with wall enhancement. Recurrent diverticulitis was initially suspected and part of the ascending colon was resected. However, the specimen showed intact colon wall without evidence of diverticulitis and multiple parasite eggs and granulomas were found instead. The size of about 70 μm, the presence of an operculum and relatively thick egg shell suggested eggs of Paragonimus species. With appropriate exposure history and a positive antibody test, the definitive diagnosis was made as peritoneal paragonimiasis.
Abdomen ; Abdominal Abscess* ; Abdominal Pain ; Abdominal Wall ; Abscess ; Animals ; Central Nervous System ; Colon ; Colon, Ascending ; Diagnosis ; Diverticulitis* ; Egg Shell ; Eggs ; Granuloma ; Humans ; Intestines ; Korea ; Liver ; Lung ; Ovum ; Paragonimiasis* ; Paragonimus ; Paragonimus westermani ; Parasites ; Parasitic Diseases ; Peritoneal Cavity

The prevalence of human taeniasis has decreased in Korea. The stool egg positive proportion decreased from 1.9% in 1971 to 0% in 2004 in nationwide surveys. The neurocysticercosis (NCC) is also presumed to decrease. However, detailed information regarding the recent status of NCC in Korea is lacking. We retrospectively reviewed NCC cases from 1990 to 2016 at Asan Medical Center, a 2700-bed tertiary referral hospital in Korea. We identified patients based on clinical symptoms, brain imaging, pathology and serological assay. The cases were classified as parenchymal, extraparenchymal, and mixed NCC. Eighty-one patients were included in the analysis. The mean age was 54.5 years, and 79.0% were male. The number of NCC cases was highest from 1995 to 1999, and continuously decreased thereafter. Forty (49.4%) patients had parenchymal NCC, while 25 (30.9%) patients had extraparenchymal NCC, and 16 (19.8%) patients had mixed NCC. The seizure and headache were most common symptom of parenchymal NCC and extraparenchymal NCC respectively. Hydrocephalus was more common in extraparenchymal NCC, and patients with extraparenchymal NCC were more likely to require a ventriculoperitoneal shunt. Cases of NCC are decreasing accordingly with human taeniasis and lesion location was the most important determinant of clinical presentation and outcome of NCC in Korea.
Chungcheongnam-do ; Headache ; Humans ; Hydrocephalus ; Korea ; Male ; Neurocysticercosis ; Neuroimaging ; Ovum ; Pathology ; Prevalence ; Retrospective Studies ; Seizures ; Taenia solium ; Taeniasis ; Tertiary Care Centers ; Ventriculoperitoneal Shunt

Background and Objectives: Leaflet thrombosis after transcatheter aortic valve replacement (TAVR) has been reported recently, whereas thrombus formation in sinus of Valsalva has yet to be fully evaluated. This study describes clinical and cardiac computed tomography (CT) findings of patients with sinus of Valsalva thrombosis. Methods: Between March 2011 and Aug 2019, 192 patients underwent cardiac CT after TAVR. After a retrospective review of CT images, 9 patients (82 years, male:female=2:7) who had sinus of Valsalva thrombosis identified by cardiac CT were selected for this study. Patient demographics, interval between TAVR and cardiac CT scan, location and CT attenuation of sinus of Valsalva thrombosis, and presence of concurrent leaflet thrombosis were evaluated. Results: The median interval between TAVR and cardiac CT was 11 days. Sinus of Valsalva thrombosis was frequently detected in the non-coronary sinus (89%, 8/9), and predominantly located in the bottom of the sinus extending upward towards the sinotubular junction. Three patients had concomitant leaflet thrombosis, and 3 patients had subclinical embolic stroke noted on brain magnetic resonance imaging. All patients had been prescribed aspirin and clopidogrel after TAVR for at least 6 months without anticoagulants. Conclusions Cardiac CT after TAVR can detect sinus of Valsalva thrombosis, and attention should be paid to this potential source of subsequent systemic embolization.