This study analyzed the factors causing the angular deformity as the tibia fracture below isthmus were treated with interlocking nails. For this purpose, we observed 70 cases of tibia fractures in the Gil General Hospital as subjects. Of the 70 cases under the treatment, 32(45.7%) showed the angulation of over one degree, and 11(15.7%) showed that of 5-10 degrees in any plane. According to the outcomes of this studies, the degree of angulation seemed to have close relation to the length of fracture line. Also, if the fracture line reached to the isthmus, angulation was apt to be caused. Even though most angulated cases had concomitant fibular fracture, fibular fracture, itself, seemed to have no direct relation to angulation. In consequence, the intramedullary interlocking nailing needs special carefulness in the case of breakage of cortical buttress such as long fracture line, butterfly fragment and fracture including isthmus.
Butterflies ; Congenital Abnormalities* ; Hospitals, General ; Tibia*

We studied 30 patients who participated in accelerated rehabilitation program after ACL reconstruction to evaluate the effects on knee joint function prospectively. This program emphasizes early full hyperextension, early weight bearing as tolerated, and closed-chain quadriceps functional activities with rapid return to sports. Timing of the return to occupation, activity level, manual knee test, range of motion, thigh circumference, Lysholm knee score and KT-2000 arthrometer measurement were checked at the latest follow-up which is at least more than 1 year. The result were as follows: 1. The mean time for patients to return to occupation was 7.5 weeks (2 weeks-6 months). 2. Range of motion of the knee were not limited in 25 cases (83%) at 1 year after reconstruction. 3. The mean Lysholm score was 92.7. 4. The mean manual maximum KT-2000 arthrometer score was 2.0mm. The results of this study show that patients who had an ACL reconstruction with an autogenous central 1/3 patellar tendon graft and followed an accelerated rehabilitation program obtained longterm stability, achieved full range of motion, had a low complication rate, and were able to return to full sporting activities predictably.
Follow-Up Studies ; Humans ; Knee Joint* ; Knee* ; Occupations ; Patellar Ligament ; Prospective Studies ; Range of Motion, Articular ; Rehabilitation* ; Sports ; Thigh ; Transplants ; Weight-Bearing

PURPOSE: Primary thyroid lymphoma (PTL) is a rare disease and it has been investigated in a limited number of studies. The present multicenter study evaluated the clinical features and treatment outcomes of PTL. METHODS: The medical records of patients diagnosed with PTL between 2000 and 2013 in three centers were retrospectively reviewed. RESULTS: The study included 11 men and 27 women with a median age of 63.3 years (range, 42-83 years). The median follow-up was 56.0 months (range, 3-156 months). Of the 38 patients included, 16 had mucosa-associated lymphoid tissue (MALT) lymphoma, six had mixed MALT and diffuse large B-cell lymphoma (DLBCL), and 16 had DLBCL. Thirty-five patients (92.1%) had early stage (stage I/II) disease. Of the 16 MALT lymphoma patients, 14 were treated by surgery, and radiotherapy (RT) or chemotherapy was combined in five patients. Two patients received RT or chemotherapy alone. Of the six mixed MALT and DLBCL patients, three underwent surgery with chemotherapy and three underwent chemotherapy alone, RT alone, or surgery with RT. All of the 16 DLBCL patients received chemotherapy, and surgery and RT was combined in 4 and 1 patients, respectively. The 5-year survival was 100% for MALT lymphoma (7 of 7) and mixed MALT and DLBCL patients (5 of 5) and 87.5% for DLBCL patients (7 of 8). CONCLUSION: Early stage PTL has an excellent prognosis when managed by single or combined treatment modalities. Clinicians should consider PTL in patients with underlying Hashimoto's thyroiditis presenting with an enlarging thyroid mass.
Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Lymphoid Tissue ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone ; Male ; Medical Records ; Prognosis ; Radiotherapy ; Rare Diseases ; Retrospective Studies ; Thyroid Gland* ; Thyroiditis

BACKGROUND: Serum uric acid (UA) and anemia could be a valid and useful prognostic marker of chronic heart failure (CHF). We investigated the relationship of anemia and UA with clinical outcomes in CHF patients. METHODS: We analyzed 109 patients with congestive heart failure between August 2001 and October 2002 (age 67 +/- 15 years, follow-up 14 +/- 5 months). We distributed the patients into 3 groups according to hematocrit (Hct) level [Hct group 1 (Hct <30%, n=21), Hct group 2 (Hct 30~38%, n=49), Hct group 3 (Hct >38%, n=39)] and into 3 groups according to serum uric acid (UA) level [UA group I (UA <5.2 mg/dL, n=20), UA group II (UA 5.2~7.5 mg/dL, n=25), UA group III (UA >7.5 mg/dL, n=20)]. Primary end point were rehospitalization resulting from aggravation of CHF and all-cause of death. RESULTS: Among the groups according to Hct level, readmission rates were 57.1%, 28.6%, 15.4%, respectively (p<0.05). Among men, readmission rates were 82.3%, 22.2%, 14.3%, respectively (p<0.05). No significant difference in death rate was observed among the 3 groups. Among the groups according to UA level, there was no significant difference in readmission rates. Death rates were 5%, 8%, 35%, respectively (p<0.05) and there was significant difference in death rate especially among male patients. CONCLUSION: In male patients, lower hematocrit level was associated with higher readmission rate and higher serum uric acid level was associated with death rate.
Anemia* ; Estrogens, Conjugated (USP)* ; Follow-Up Studies ; Heart Failure* ; Hematocrit ; Humans ; Male ; Mortality ; Uric Acid*

BACKGROUND/AIMS: Although several groups have demonstrated the usefulness of natural orifice transluminal endoscopic surgery (NOTES), there is still concern about frequent serious adverse events. We performed this study to determine the technical feasibility and safety of pure NOTES with a transgastric approach in a porcine model from the endoscopist's point of view. METHODS: Diagnostic peritoneoscopy, liver biopsy, salpingo-oophorectomy, and Fallopian tube ligation with a transgastric approach using a two-channel therapeutic endoscope were performed in 10 healthy female minipigs. These procedures were performed in two acute models and eight survival models in consecutive order. RESULTS: The technical success rate was 100% for peritoneoscopy (10/10), liver biopsy (5/5), salpingo-oophorectomy (10/10), and Fallopian tube ligation (10/10). Eight cases of adverse events occurred, including one case of splenic injury, one case of bleeding after liver biopsy, two cases of small bowel adhesion after salpingo-oophorectomy, two cases of hematoma at the salphingo-oophorectomy site, and two cases of partial dehiscence at the gastric closure site. The gastric puncture site was closed with seven to eight hemoclips in four cases and two hemoclips and an endoloop in four cases. CONCLUSIONS: The use of pure NOTES for peritoneoscopy, liver biopsy, salpingo-oophorectomy, and Fallopian tube ligation may be technically feasible, but considerable adverse events can occur during or after the procedure. Further studies utilizing specialized techniques overcome several limitations of pure NOTES are therefore necessary.
Biopsy ; Endoscopes ; Endoscopy ; Fallopian Tubes ; Female ; Hematoma ; Hemorrhage ; Humans ; Laparoscopy ; Ligation ; Liver ; Natural Orifice Endoscopic Surgery ; Punctures ; Swine ; Swine, Miniature

PURPOSE: Postdialysis urea rebound(PDUR) causes the overestimation of actual amount of delivered dialysis in Kt/V from single pool urea kinetic. To correct PDUR and predict equilibrated Kt/V(eKt/V) some methods have suggested by Daugirdas, et al., Smye, et al. and Tattersall, et al. The purposes of this study were to determine the optimum intradialytic urea sample time that fits best with PDUR and to compare calculated Kt/V by this sample with the different other methods. METHODS: The subjects were 21 patients who were dialyzed at three times 4 hours weekly, using bicarbonate and cellulosynthetic membranes. Blood samples to measure BUN were obtained at initiation of dialysis session and then at 80, 120, 180, 200, 210, 220 minutes, and the end of dialysis session times and then at 45 minutes of postdialysis. We compared four different methods of eKt/V with the equilibrated 45-minute PDUR Kt/V(eKt/V PDUR) as the reference method. RESULTS: The mean PDUR was 17.2+/-%. spKt/V and eKt/V PDUR was 1.300+/-.24 and 1.120+/-.20 respectively, leading to overestimation of actual delivered Kt/V by 13.5+/-%. The best time for intradialytic sampling to fit with PDUR BUN was 40 minute before the end of session. eKt/V by Daugirdas formulae(eKt/V Dau=1.315+/-.21, r=0.972, p<0.001), Tattersal formulae(eKt/V Tat=1.134+/-.22, r= 0.972, p<0.972, p<0.001) and Smye formulae(eKt/V Smye=1.156+/-.24, r=0.900, p<0.001) showed good correlation with eKt/V PDUR. eKt/V calculated by the sample of 40 minute before end of session(eKt/V T-40=1.120+/-.20, r=0.984) had tendency of the best correlation with eKt/V PDUR. Among these different methods, eKt/V T-40 had the best degree of agreement with eKt/V PDUR by Bland-Altman analysis. CONCLUSION: Our results suggest that the use of spKt/V is not adequate to estimate the amount of delivered hemodialysis dose because of the existence of significant postdialysis urea rebound even conventional 4 hour dialysis. Intradialytic sampling method is a simple and accurate method to predict eKt/V for use in clinical practice.
Dialysis ; Humans ; Membranes ; Renal Dialysis ; Urea*

BACKGROUND: Arm span measurements provide a practical substitute for standing height to predict normal spirometric values in subjects unable to stand or those with a skeletal deformity such as kyphoscoliosis. The relationship between arm span and height has previously been reported as either a fixed ratio unaffected by age or as a regression equation in which the ratio varies as a function of age. The fixed ratio or regression equation is known to be specific for sex and race. METHODS: We studied the relationship between standing height, arm span, and age in 381 Korean adult female subjects (ages 20 to 69 yrs) sampled in a general population. RESULTS: The mean ratio for arm span to height is 1.004. Multiple linear analysis found arm span and age to be predictive of standing height (p=0.0001, r2=0.76). We performed the analysis of the difference between the predicted height using either fixed ratio or regression equation and actual height. At the extremes of arm span and age, the ratio method either underestimated (at smaller arm span or younger age) or overestimated (at larger arm span or older age) as compared with actual height (p=0.0001). CONCLUSION: This results indicate that the estimated height using the fixed ratio method provides a less acceptable method of estimating height for the prediction of lung volumes in the Korean adult women when compared with the regression equations, especially at the extremes of stature or age.
Adult* ; Arm* ; Congenital Abnormalities ; Continental Population Groups ; Female ; Humans ; Lung ; Spirometry

PURPOSE: We evaluated the complications and failures after total ankle arthroplasty during at least 2 years short term follow up. MATERIALS AND METHODS: There were 45 cases of 42 patients of HINTEGRA(R) (Newdeal SA, Lyon, France) model from November 2004 to August 2006. Follow up averaged at least 2 year. We evaluated the complications and analyzed the cause of the failures. RESULTS: There were totally 15 cases of complication, 5 cases of medial impingement syndrome, 3 cases of varus malposition, 2 cases of delayed healing of wounds, and each one case of deep peroneal nerve problem, medial malleolus fracture, post-operative deep infection, gouty arthritis pain, and Achilles tendinitis. CONCLUSION: Total ankle arthroplasty had higher complication rate than any other joint arthroplasty, so we need a more meticulous preoperative and peri-operative care.
Animals ; Ankle ; Arthritis, Gouty ; Arthroplasty ; Arthroplasty, Replacement, Ankle ; Follow-Up Studies ; Humans ; Joints ; Peroneal Nerve

BACKGROUND: Tranilast is an anti-allergic drug that suppresses the release of cytokines. An antioxidant, probucol, prevents endothelial dysfunction and oxidation of low density lipoprotein and also inhibits the secretion of interleukin-1 by macrophages. In several studies, both the tranilast and probucol with multivitamins have been shown to decrease the frequency of angiographic restenosis after PCI. METHODS: We analyzed clinical events and restenosis at 6 months following percutaneous coronary angioplasty in 93 patients with 113 coronary arterial lesions after coronary stenting at Soonchunhyang University Hospital between Jan 2001 and Apr 2003. The patients were assigned to following three groups: 39 patients who didn't receive tranilast and antioxidants (control group, M 29, F 10, 61 +/- 10 years) ; 25 patients who received probucol (500 mg), vitamin C (1,000 mg), vitamin E (400 mg) (antioxidant group, M 19, F 6, 62 +/- 10 years) ; 29 patients who received tranilast (400 mg) (Tranilast group, M 18, F 11, 59 +/- 9 years). RESULTS: The restenosis per lesion between three groups was not different significantly (control group, 32.7%; antioxidant group, 26.7%; Tranilast group, 20.6%). At follow-up, minimal luminal diameter (MLD) was not different significantly between three groups (control group, 1.8 +/- 1.07 mm; antioxidant group, 2.1 +/- 1.18 mm; Tranilast group, 2.1 +/- 0.94 mm). Target lesion revascularization was lower in Tranilast group (3.4%) as compared with control group (25.6%) and antioxidant group (16%, p<0.05). CONCLUSION: Neither probucol combined with vitamin C and E nor tranilast did not improve significantly the angiographic restenosis rate. But tranilast had reduced the target lesion revascularization rate as compared with control group and antioxidant group.
Angioplasty ; Antioxidants ; Ascorbic Acid ; Cytokines ; Follow-Up Studies ; Humans ; Interleukin-1 ; Lipoproteins ; Macrophages ; Percutaneous Coronary Intervention* ; Phenobarbital ; Probucol* ; Stents ; Vitamin E ; Vitamins

The brain is the highly organized organ which attributes to consciousness, memory and language. Approximately 85ml of oxygenated blood from the heart is delivered to the brain each minute. In human beings, a steady cerebral blood flow is maintained which cerebral structures are perfused roughly in proportion to their metabolic demands which are actively depend on function. Therefore, cerebral function is the most important physiologic regulator of cerebral blood flow. The measurement of cerebral blood flow is a very important toolin exploring the function of the human brain in healthand disease. An impairment of normal cerebral blood flow indicates clinical derangement of central neruous system. Besides the clinical sympatoms, cerebral blood flow investigation has become our main guideline for judging the timing of operation and prognosis of disease as well as evaluation of treatment. The determination of normal cerebral blood flow in Korean seemed to be enormously important for further study on this subject. For the purpose of establishing normal value of cerebral blood flow in Korean, the author have studied 93 healthy persons with 133Xe-inhalation method using Obrist's two compartmental analysis. Followings were the results. 1) Normal values of FI, ISI, and WIin children below the age of 9 were 113.5+/-36.9, 62.5+/-13.0 and 55.6+/-6.4 each. 2) Normal values of FI, ISI, and WI in the group above the age of 9 were 75.5+/-15.5, 44.6+/-5.7 and 43.1+/-3.95 each. 3) There was no significant difference between mean values of right and left side hemisphere. 4) There was significant decrease in r-CBF in the group above the age of 9, but the decrement by age since after the age of 9 was not significant statistically. 5) The difference of mean values among each lobe was not significant statistically.
Brain ; Child ; Consciousness ; Heart ; Humans ; Memory ; Oxygen ; Prognosis ; Reference Values