A fatigue or stress fractures is one in which there is no initial overt break in bone continuity. Rather, there is a gradual alteration in bone architecture as a result of repeated stress. The stresses are submaxmum and usually are the result of unaccustomed activity. If continued, they may eventually result in a complete fracture. Fatigue fractures have been described in almost every bone in the body, but they are more common in the bones of the lower extremities. Fatigue fractures are commonly seen in military personnel, especially at basic training center, and have been noted in athletes, ballet dancers, laborers, and even pregnant women. The following clinical results were shown by analysis of 57 cases of stress fractures experienced in the Department of Orthopaedic Surgery, Capital Armed Forces General Hospital from Jan. 1978 to Sep. 1979. 1. In 57 fatigue tractures in military recruits, 48 were in the tibial shaft and 9 were in the fibula. 2. The main cause of the fatigue fractures was running on hard roads, and the other causes were marching on hard surfaces, playing football, and long jumping. 3. The site of predilection in the tibia was the proximal one third of the shaft, occurring in 35 (72.9%) of the cases. In the fibula the junction of the upper and middle thirds was most frequently affected, occurring in 4 (44.4%) of the cases. 4. Most of the tibial and fibular fatigue fractures were grade I (40 cases among 57), showing periosteal reaction only on one or two cortices. 5. All soldiers were treated by immediate stoppage of physical activity, with no plaster immobilization or non weight bearing.
Arm ; Athletes ; Dancing ; Fatigue ; Female ; Fibula ; Football ; Fractures, Stress ; Hospitals, General ; Humans ; Immobilization ; Lower Extremity ; Military Personnel ; Motor Activity ; Pregnant Women ; Running ; Tibia ; Weight-Bearing

OBJECTIVE: To study the clinical characteristics of pregnancy induced hypertension(PIH). METHODS: Five hundred seventy-five cases of PIH and 7,702 cases of normotensive pregnancies who were delivered their infants at Wonkwang University Hospital from January, 1994 to December, 1998 were selected for the study. The data were collected by review of the hospital record and the statistical analysis was performed using Chi-square tests, and statistical significance was defined as p<0.05. RESULTS: The incidence of PIH was 7.1% of total deliveries. Among the PIH, the incidence of mild preedampsia was found in 59%, severe preeclampsia in 36%, and edampsia in 5%. The most prevalent gestational period was 38-42wks gestation in mild PIH and 33-37wks gestation in severe PIH & eclampsia. The incidence of cesarean section was significantly higher in severe PIH & eclampsia(72.2%) than in mild PIH(48.7%) and normotensive pregnancies(39.7%). The incidence of hypoalbuminemia, preterm labor, placental abruption, disseminated intravascular coagulation, and pulmonary edema were significantly higher in severe PIH & edampsia than in mild PIH and normotensive pregnancies. Compared with normotensive pregnancies or mild PIH, severe PIH & eclampsia had significantly elevated risks for low birth weight, intrauterine growth retardation, fetal distress, low apgar score, meconium stained, and neonatal deaths. CONCLUSION: The incidence of PIH is not decreasing and it still an important role in the cause of maternal and perinatal mortality and morbidity in Korea. So, further studies are necessary to prepare a guide for the treatment of PIH.
Abruptio Placentae ; Apgar Score ; Cesarean Section ; Disseminated Intravascular Coagulation ; Eclampsia ; Female ; Fetal Distress ; Fetal Growth Retardation ; Hospital Records ; Humans ; Hypertension, Pregnancy-Induced* ; Hypoalbuminemia ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Korea ; Meconium ; Obstetric Labor, Premature ; Perinatal Mortality ; Pre-Eclampsia ; Pregnancy ; Pregnancy* ; Pulmonary Edema

Kaposi's varricelliform eruption is a characteristic syndrome of disseminated vesiculopustules superimposed on variable pre-existing dermatoses. Among these, atopic dermatitis is most common disease. We report two cases of Kaposi's varicelliform eruption associated with atopic dermatitis in a pair of identical twins. Diagnosis was made by the history, clinical feature, histologic examination and serologic test. These patients' condition was much improved by the treatment with antiviral agent and antibiotics.
Anti-Bacterial Agents ; Dermatitis, Atopic ; Diagnosis ; Humans ; Kaposi Varicelliform Eruption* ; Serologic Tests ; Skin Diseases ; Twins, Monozygotic*

BACKGROUND: Antiphospholipid antibody syndrome (APS), an important cause of acquired thrombophilia, is diagnosed when vascular thrombosis or pregnancy morbidity occurs with persistently positive antiphospholipid antibodies (aPL). APS is a risk factor for unprovoked recurrence of pulmonary embolism (PE). Performing laboratory testing for aPL after a first unprovoked acute PE is controversial. We investigated if a specific phenotype existed in patients with unprovoked with acute PE, suggesting the need to evaluate them for APS. METHODS: We retrospectively reviewed patients with PE and APS (n=24) and those with unprovoked PE with aPL negative (n=44), evaluated 2006–2016 at the Asan Medical Center. We compared patient demographics, clinical manifestations, laboratory findings, and radiological findings between the groups. RESULTS: On multivariate logistic regression analysis, two models of independent risk factors for APS-PE were suggested. Model I included hemoptysis (odds ratio [OR], 12.897; 95% confidence interval [CI], 1.025–162.343), low PE severity index (OR, 0.948; 95% CI, 0.917–0.979), and activated partial thromboplastin time (aPTT; OR, 1.166; 95% CI, 1.040–1.307). Model II included age (OR, 0.930; 95% CI, 0.893–0.969) and aPTT (OR, 1.104; 95% CI, 1.000–1.217). CONCLUSION: We conclude that patients with first unprovoked PE with hemoptysis and are age <40; have a low pulmonary embolism severity index, especially in risk class I–II; and/or prolonged aPTT (above 75th percentile of the reference interval), should be suspected of having APS, and undergo laboratory testing for aPL.
Antibodies, Antiphospholipid* ; Antiphospholipid Syndrome* ; Chungcheongnam-do ; Demography ; Hemoptysis ; Humans ; Logistic Models ; Partial Thromboplastin Time ; Phenotype* ; Pregnancy ; Pulmonary Embolism* ; Recurrence ; Retrospective Studies ; Risk Factors ; Thrombophilia ; Thrombosis

PURPOSE: The purpose of this prospective multi-institutional study was to evaluate the nutritional status of patients undergoing radiotherapy (RT) for treatment of head and neck, lung, or gastrointestinal cancer. MATERIALS AND METHODS: A total of 1,000 patients were enrolled in this study at seven different hospitals in Seoul, Korea between October 2009 and May 2010. The nutritional status of patients after receiving 3 weeks of RT was evaluated using subjective global assessment (SGA). The nutritional status of each patient was rated as well nourished (A), moderately malnourished (B), or severely malnourished (C). RESULTS: The mean age of patients in this study was 59.4 +/- 11.9 years, and the male to female ratio was 7:3. According to the SGA results, 60.8%, 34.5%, and 4.7% of patients were classified as A, B, or C, respectively. The following criteria were significantly associated with malnutrition (SGA B or C; p < 0.001): loss of subcutaneous fat or muscle wasting (odds ratio [OR], 11.473); increased metabolic demand/stress (OR, 8.688); ankle, sacral edema, or ascites (OR, 3.234); and weight loss > or =5% (OR, 2.299). CONCLUSION: SGA was applied successfully to assess the nutritional status of most patients. The prevalence of malnutrition in a radiation oncology department was 39.2%. The results of this study serve as a basis for implementation of nutrition intervention to patients being treated at radiation oncology departments.
Animals ; Ankle ; Ascites ; Edema ; Female ; Head ; Humans ; Korea ; Lung ; Male ; Malnutrition ; Muscles ; Neck ; Nutrition Assessment ; Nutritional Status ; Prevalence ; Prospective Studies ; Radiation Oncology ; Subcutaneous Fat ; Weight Loss

BACKGROUND: It has been well known that the bone and kidney are the principle organs of parathyroid hormine (PTH) actions. Although patients with primary hyperparathyroidism show a high incidence of LVH and trophic effects of PTH on adult rat ventricular cardiomyocytes were investigated in vitro, effect of PTH on the cardiac tissue in vivo is unknown. METHODS: We examined the effects of PTH on the cardiomyocyte and interstitial tissue using adult rat heart. Twenty-two female Sprague-Dawley rats were ovariectomized bilaterally at three months old and weighing in 250 - 300 gm in order to exclude the trophic effect of estrogen. We administrated human parathyroid hormone (20 ug subcutaneously 5 times per week) to 12 rats for 4 weeks after raising for 8 weeks (PTH group):the remaining 10 rats received only normal saline (control). We measured left ventricular thickness [IVS+LVPW)/2] and number of cardiomyocytes and interstitial fibrosis on LM (H & E and Masson's trochrome stain) and EM. RESULTS: 1) LV wall thickeness tended to increase in PTH group as compared with control (2.16+/-0.31 vs 1.12+/-0.21 mm, p=0.099). 2) The number of cardiomyocyte in PTH group was significantly less than that of control (61.2+/-13.1 vs 70.5+/-14.9, p=0.003, Magnification x 400). 3) There was no significant change of interstitial fibrosis between PTH group and control. CONCLUSION: These results shggest that PTH may produce left ventricular hypertrophic effects in aged ovariectomized rat that resulted form hypertrophy of cardiomyocyte without increase of interstitial connetive tissue.
Adult ; Animals ; Estrogens ; Female ; Fibrosis ; Heart ; Humans ; Hyperparathyroidism, Primary ; Hypertrophy ; Hypertrophy, Left Ventricular* ; Incidence ; Kidney ; Myocytes, Cardiac ; Ovariectomy ; Parathyroid Hormone* ; Rats* ; Rats, Sprague-Dawley

Purpose: IL-1 is a multifunctional proinflammatory cytokine. As the proliferative effects of IL-6 and IL-6 receptor expressions on prostatic cancer cells in response to IL-1 have not been determined, the effects of IL-1 on prostatic cancer cell lines were investigated. Materials and Methods: PC-3 and DU-145 cells were cultured in RPMI-1640 medium containing 10% fetal bovine serum. Cell cultures were supplemented with various concentrations of IL-1 (0, 1, 10, 20 and 40ng/ml), and the MMT growth assay performed. PC-3 and DU-145 cells were treated for 2, 4, 8, 12 and 24 h both with and without IL-1. IL-6 and IL-6 receptor (IL-6R) mRNA expressions were investigated using RT-PCR, and the IL-6 levels in cultured supernatant measured by ELISA. Results: The viability of both PC-3 and DU-145 cells decreased after IL-1 treatment (10, 20 and 40ng/mul). With 40ng/ml the IL-1, IL-6 and IL-6RmRNA expressions were lower in PC-3 cells, but unchanged in DU-145 cells, whereas the IL-6 protein production was higher in both PC-3 and DU-145 cells. Conclusions: IL-1 inhibited the proliferation of both PC-3 and DU145 cells. In the PC-3 cells, IL-1 decreased the expressions of IL-6 and IL-6R mRNA, but paradoxically increased the IL-6 production. In the DU-145 cells, IL-1 treatment did not affect the IL-6 or IL-6R mRNA expressions, but the IL-6 production was increased. This discrepancy between IL-1-induced IL-6 mRNA and protein production may be mediated by modification to the protein synthesis or an increased cellular excretion.
Cell Culture Techniques ; Cell Line ; Enzyme-Linked Immunosorbent Assay ; Interleukin-1 ; Interleukin-1beta* ; Interleukin-6* ; Interleukins* ; Prostatic Neoplasms* ; Receptors, Interleukin* ; Receptors, Interleukin-6 ; RNA, Messenger

Undifferentiated carcinomas with osteoclast-like giant cells are rare pancreatic and periampullary neoplasms that mimic giant cell tumors of bone morphologically. Recently, we experienced an osteoclast-like giant cell tumor arising in the tail of the pancreas. A 76-year-old male was admitted with epigastric discomfort and indigestion. Abdominal computed tomography (CT) and abdominal magnetic resonance imaging (MRI) showed a 3x3-cm mass containing necrotic and hemorrhagic areas in the tail of the pancreas. A distal pancreatectomy and splenectomy were performed. Histological examination showed tumor cell components consisting of mononuclear pleomorphic cells admixed with osteoclastic giant cells. The final diagnosis was undifferentiated carcinoma with osteoclast-like giant cells with ductal adenocarcinoma in the pancreas.
Adenocarcinoma ; Aged ; Carcinoma ; Cellular Structures ; Dyspepsia ; Giant Cell Tumors ; Giant Cells ; Humans ; Hydrazines ; Magnetic Resonance Imaging ; Male ; Osteoclasts ; Pancreas ; Pancreatectomy ; Splenectomy

The hypothalamic-pituitary-adrenal (HPA) axis is the primary endocrine system to respond to stress. The HPA axis may be affected by increased level of corticotrophin-releasing factors under chronic stress and by chronic administration of monosodium glutamate (MSG). The purpose of this study was to investigate whether chronic MSG administration aggravates chronic variable stress (CVS)-induced behavioral and hormonal changes. Twenty-four adult male Sprague-Dawley rats, weighing 200~220 g, were divided into 4 groups as follows: water administration (CON), MSG (3 g/kg) administration (MSG), CVS, and CVS with MSG (3 g/kg) administration (CVS+MSG). In addition, for the purpose of comparing the effect on plasma corticosterone levels between chronic stress and daily care or acute stress, 2 groups were added at the end of the experiment; the 2 new groups were as follows: naive mice (n=7) and mice exposed to restraint stress for 2 h just before decapitation (A-Str, n=7). In an open field test performed after the experiment, the CVS+MSG group significant decrease in activity. The increase in relative adrenal weights in the CVS and CVS+MSG group was significantly greater than those in the CON and/or MSG groups. In spite of the increase in the relative adrenal weight, there was a significant decrease in the plasma corticosterone levels in the CVS+MSG group as compared to all other groups, except the naive group. These results suggest that impaired HPA axis function as well as the decrease in the behavioral activity in adult rats can be induced by chronic MSG administration under CVS rather than CVS alone.
Adult ; Animals ; Axis, Cervical Vertebra ; Corticosterone ; Decapitation ; Endocrine System ; Humans ; Male ; Mice ; Plasma ; Rats ; Rats, Sprague-Dawley ; Sodium Glutamate ; Water ; Weights and Measures

PURPOSE: To evaluate superiority of a night float (NF) system in comparison to a traditional night on-call (NO) system for surgical residents at a single institution in terms of efficacy, safety, and satisfaction. METHODS: A NF system was implemented from March to September 2017 and big data analysis from electronic medical records was performed for all patients admitted for surgery or contacted from the emergency room (ER). Parameters including vital signs, mortality, and morbidity rates, as well as promptness of response to ER calls, were compared against a comparable period (March to September 2016) during which a NO system was in effect. A survey was also performed for physicians and nurses who had experienced both systems. RESULTS: A total of 150,000 clinical data were analyzed. Under the NO and NF systems, a total of 3,900 and 3,726 patients were admitted for surgery. Mortality rates were similar but postoperative bleeding was significantly higher in the NO system (0.5% vs. 0.2%, P = 0.031). From the 1,462 and 1,354 patients under the NO and NF systems respectively, that required surgical consultation from the ER, the time to response was significantly shorter in the NF system (54.5 ± 70.7 minutes vs. 66.8 ± 83.8 minutes, P < 0.001). Both physicians (90.4%) and nurses (91.4%) agreed that the NF system was more beneficial. CONCLUSION: This is the first report of a NF system using big data analysis in Korea, and potential benefits of this new system were observed in both ward and ER patient management.
Electronic Health Records ; Emergency Service, Hospital ; Hemorrhage ; Humans ; Internship and Residency ; Korea ; Medical Staff ; Mortality ; Statistics as Topic ; Vital Signs