PURPOSE: The purpose of this study is to observe unicameral bone cyst (UBC) outcome after the fracture has healed and if there is any identifiable prognostic factors. MATERIALS AND METHODS: 13 UBC patients with pathologic fracture from 2001 to 2010 were reviewed. The mean follow up were 26 months (3-90 months). There were 11 male and 2 female patients and the mean age of the patients were 10.2 years old (6-16 years). 9 involved proximal humerusand 2 involved humerus shaft and 1 involved proximal femur and 1 involved proximal tibia. The treatment of UBC fracture was conservative cast application to heal the fracture initially, and 1 patient was treated with primary auto bone graft and open reduction with internal fixation. 5 patients were treated with steroid injection during follow up period and 2 patients with auto bone graft. We analyzed the change of UBC during pathologic fracture healing period and prognostic factor about age, the size of UBC, the involvement of physis. RESULTS: The mean duration of the fracture healing was 8.2 months. Complete healing were occurred at 4 patients (31%). No statiscal difference was checked with age about UBC healing (p=0.42). But, more larger size about UBC and more closer to physis, the healing was difficult (p=0.05, p=0.03). CONCLUSION: While pathologic fracture of UBC was possibly healed, active treatment should be applied especially those cysts that involvescloser area of the physis or large size.
Bone Cysts ; Female ; Femur ; Follow-Up Studies ; Fracture Healing ; Fractures, Spontaneous ; Humans ; Humerus ; Male ; Tibia ; Transplants

PURPOSE: We wanted to investigate the radiographic and clinical results of internal fixation with cannulated screws in elderly patients with femoral neck fracture. MATERIALS AND METHODS: We reviewed the results of 47 cases of elderly patients with femoral neck fractures that were treated by osteosynthesis from May 2000 and March 2009 and these patients could be followed up for more than one year. There were 11 males and 36 females with a median age of 72 years (65~85 years). They were classified by the Garden stage. The number of stage I and II fractures was 34 and 16, respectively. The postoperative follow up period was 24 months (12~84 months). The union time, horizontal shortening and complications were investigated. Walking ability was evaluated by Koval's scoring system and the quality of life was measured by the Korean EQ-5D. RESULTS: The average union time was 4.4 months. The complications were one case of nonunion, 6 cases of avascular necrosis and one case of subtrochanteric fracture. The average of the horizontal shortening was 6.815 mm (0~20 mm) in the fracture site. The walking ability was on average 1 step down and it was possible to walk independently using a walker for 69% of the patients. The Korean EQ-5D quality of life was reduced from 0.856 to 0.561 (P <0.01). CONCLUSION: In elderly patients with femur neck fracture, the decreased abductor moment arm may reduce the quality of life and walking ability after cannulated screw fixation.
Aged ; Arm ; Female ; Femoral Neck Fractures ; Femur ; Femur Neck ; Follow-Up Studies ; Humans ; Male ; Necrosis ; Quality of Life ; Walkers ; Walking

purpose of this article to evaluate the availability of the rectus femoris flap in Korean subjects. Material and Methods is that Cadaveric dissections were done on 51 femoral triangles of 26 cadevers. We measured the length of the direct head of rectus femoris from anterior superior iliac spine to patella upper pole, ASIS to lateral border of femoral nerve, and entry point of femoral nerve and vessel branches to rectus. Usually, there were three terminal branches to rectus femoris from the femoral nerve. The entry point of the first branch was at the proximal 17.5~31.4% portion of the rectus femoris. The second and the third branch entered at the proximal 22.5~40.7% and 26.3~42.3%, respectively. The vessel entry was at 20.2~37.3%. The length from ASIS to femoral nerve was 3.5~8.5 cm. Among the 51 rectus femoris muscles, 44 had one nutrient artery, and 7 had 2 nutrient arteries. The nutrient artery originated from the descending branch of the lateral femoral circumflex artery in 18(40.9%) cases, directly from the lateral femoral circumflex artery in 8(18.0%) cases, and from proximal(6 cases, 13.6%) and distal(12 cases, 27.3%) portion of the deep femoral artery. The average length of the nutrient artery was 29.8 mm and the width was 2.14 mm. The point where it meets the main feeding artery of the rectus femoris was 9.0~15.0 cm from the ASIS. In all cases, the main artery's entrance was proximal to the first nerve branch. Conclusion is that rectus femoris has available data for functional flap
Arteries ; Cadaver ; Femoral Artery ; Femoral Nerve ; Head ; Muscles ; Patella ; Quadriceps Muscle* ; Spine

Most ingested foreign bodies often pass through the gastrointestinal tract uneventfully; however, complications such as perforation do occur. Most cases of perforation are caused by thin, pointed objects such as needles, toothpicks, or fish and chicken bones. Herein, we report an unusual case of duodenal perforation caused by a lollipop stick with blunt ends. A 23-year-old woman was admitted to the emergency department complaining of epigastric and right upper quadrant pain for the last 2 days. Abdominal computed tomography scans confirmed the presence of a foreign body in the duodenum, with signs of duodenal perforation and inflammation. The patient was not aware of ingesting the foreign body. Endoscopy revealed the presence of a lollipop stick in the duodenum, which was removed with forceps. The duodenal perforation was successfully managed by using hemoclips and a detachable snare.
Chickens ; Duodenum ; Emergency Service, Hospital ; Endoscopy ; Female ; Foreign Bodies ; Gastrointestinal Tract ; Humans ; Inflammation ; Needles ; SNARE Proteins ; Surgical Instruments ; Young Adult

Pegylated-interferon plus ribavirin is the standard treatment for chronic hepatitis C. Sustained virological response (SVR) rates of up to 80% are reported in genotype 2 and 3 chronic hepatitis C cases. Obesity, a modifiable risk factor, may have a deleterious effect on antiviral treatment. We performed this study to examine the efficacy and safety of pegylated-interferon and ribavirin therapy in Korean patients with genotype 2 and 3 chronic hepatitis C and to investigate the risk factors for nonresponse to antiviral treatment. A total of 121 patients were treated with peginterferon alpha-2a 180 mcg/week plus ribavirin 800 mg/day for 24 weeks. The end-of-treatment virologic response (ETVR), the SVR, the end-of-treatment biochemical response (ETBR), the sustained biochemical response (SBR), and the adverse events were analyzed. The ETVR and SVR were 94.1% and 89.1%, respectively. The ETBR was 80.2% and the SBR was 96%. Multivariate analysis showed that a body mass index of 25 and over was the only independent factor that affected the SVR (odds ratio=10.5, 95% confidence interval: 2.006-54.948, p=0.005). Twenty patients (16.5%) dropped out at the end of treatment, and 7 (5.8%) patients discontinued treatment because of treatment-related adverse events. Our study showed that combination therapy with pegylated-interferon and ribavirin as an initial treatment for genotype 2 and 3 chronic hepatitis C is very effective and safe, and that body mass index is an independent risk factor for nonresponse to antiviral treatment in patients with genotype 2 and 3 chronic hepatitis C.
Body Mass Index ; Genotype ; Hepatitis C, Chronic ; Hepatitis, Chronic ; Humans ; Interferon-alpha ; Multivariate Analysis ; Obesity ; Polyethylene Glycols ; Recombinant Proteins ; Ribavirin ; Risk Factors

Non-Hodgkin's lymphoma (NHL) is the secondary most common tumor in HIV-infected individuals. The AIDS-related lymphomas are a late manifestation of HIV infection and may increase in frequency as patients live longer with highly active antiretroviral therapy and effective prophylaxis of opportunistic infections. Histologically AIDS-related NHL are either high (2/3) or intermediate (1/3) grade lymphoma. We report a case of gastric Non-Hodgkin's lymphoma in AIDS patient. Two years ago, she was diagnosed as HIV-infected individual in public hospital. She presented with epigastric pain and mass-like sensation. Under the impression of gastric cancer, subtotal gastrectomy was done. But, she diagnosed as diffuse large B cell lymphoma by histologic finding, immunohistochemical study. This is the first report of gastric Non-Hodgkin's lymphoma from AIDS patients in Korea.
Antiretroviral Therapy, Highly Active ; Gastrectomy ; HIV ; HIV Infections ; Hospitals, Public ; Humans ; Korea ; Lymphoma ; Lymphoma, AIDS-Related ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin* ; Opportunistic Infections ; Sensation ; Stomach Neoplasms

BACKGROUND/AIMS: The catheter probe endoscopic ultrasonography (EUS) system is widely used to evaluate upper gastrointestinal tract lesions. The depiction of the esophageal wall by probe EUS remains problematic due to the difficulty of the filling of water in the esophageal lumen. In addition, filling the esophagus with water can be associated with an increased risk of aspiration. To resolve such problems, we recently applied the use of probe EUS with the jelly-filled method for the evaluation of subepithelial lesions. The procedure is characterized by filling the esophageal lumen with jelly. In this study, we evaluated the efficacy of probe EUS by using the jelly-filled method for esophageal subepithelial lesions. METHODS: We analyzed the records of the patients with suspected subepithelial lesions at the time of endoscopy that was performed from November 2005 to June 2007. Esophageal subepithelial lesions with both EUS findings and pathological reports were retrospectively compared. RESULTS: The study included 181 patients (96 males, 85 females), with an average age of 55.5 years (age range, 29~78 years). Sixty-eight patients had lesions in the upper esophagus, 60 patients had lesions in the middle esophagus and 53 patients had lesions in the lower esophagus. Secondary layers of esophageal lesions were predominant (91/181) in the cases. Pathological findings were available for 34 patients. Compared with the pathological findings, the diagnostic accuracy of EUS was 91.1%. CONCLUSIONS: Probe EUS by using the jelly-filled method is convenient and safe to perform and provides clear and full-circumferential imaging of a lesion. It is an alternative method to use in place of previously used probe-EUS procedures for the assessment of esophageal subepithelial lesions.
Catheters ; Endoscopy ; Endosonography ; Esophagus ; Humans ; Hypogonadism ; Male ; Mitochondrial Diseases ; Ophthalmoplegia ; Retrospective Studies ; Upper Gastrointestinal Tract

PURPOSE: Focal organizing pneumonia (FOP) is a benign condition which is often difficult to differentiate from bronchogenic carcinoma, and many patients with FOP undergo invasive procedures. We tried to determine which CT features might help provide a confident diagnosis of FOP. MATERIALS AND METHODS: We retrospectively reviewed the medical records, chest radiographs and CT scans of 13 patients with histopathologically proven FOP. Initial chest radiographs in all 13 suggested bronchogenic carcinoma. The CT scans were reviewed by three radiologists, and final decisions were reached by consensus. They were analyzed in terms of the size, shape, contour and localization of the lesion, internal characteristics of the nodule, changes in surrounding structures, and changes in any of these findings, as revealed by follow-up chest CT scanning. RESULTS: FOP lesions were oval or triangular in shape and between 1.8 and 6.5 cm in their largest diameter. All had irregular margins and all but one were peripherally located. Eight (61.5%) were in contact with the pleura and five (38.5%) were located along the peripheral bronchovascular bundle, with pleural indentation; in eight (61.5%), post-contrast CT scanning revealed inhomogeneous enhancement, and four (30.8%) had pleural tags. In five (38.5%), there was coarse spiculation; for six (46.2%), air bronchograms were available, and in four (30.8%), satellite nodules were present. Spotty calcification and lymph node enlargement were each evident in one case only. Follow-up CT scanning, available in four cases, showed that the mass decreased in size in three and disappeared completely in one. CONCLUSION: Although there were no consistent CT features for differentiating focal organizing pneumonia from lung cancer, the possibility of the former should be considered when a peripherally-located oval or triangular-shaped mass is in broad contact with the pleura or is located along the bronchovascular bundle, and satellite nodules are also present.
Carcinoma, Bronchogenic ; Consensus ; Diagnosis ; Follow-Up Studies ; Humans ; Lung Neoplasms ; Lymph Nodes ; Medical Records ; Pleura ; Pneumonia* ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed

The aim of this study was to compare the efficacy, rebleeding rates, survival, and complications of endoscopic variceal ligation (EVL) with those of endoscopic variceal obliteration (EVO) in patients with acute type 1 gastroesophageal variceal (GOV1) bleeding. Data were collected retrospectively at a single center. A total of 84 patients were selected (20 patients underwent EVL; 64 patients underwent EVO) from February 2004 to September 2011. Their clinical characteristics, laboratory results, vital signs, Child-Pugh score, Model for End-stage Liver Disease (MELD) score, and overall mortality were evaluated. There were no significant differences in baseline characteristics between the two groups. The success rate in initial control of active bleeding was not significantly different between the EVL and EVO groups (18/20 EVL, or 90.0%, compared with 62/64 EVO, or 96.9%; p=0.239). The early rebleeding rate was also not significantly different between the groups (3/18 EVL, or 16.7% compared with 17/62 EVO, or 27.4%; p=0.422). The late rebleeding rate of the EVL group was lower than that of the EVO group (3/18 EVL, or 16.7%, compared with 26/59 EVO, or 44.1%; p=0.042). The time-to-rebleeding was 594 days for the EVL group and 326 days for the EVO group (p=0.054). In the multivariate analysis, portal vein thrombosis (PVT) was a significant risk factor for early rebleeding. Hepatocellular carcinoma (HCC) and previous history of bleeding were significant risk factors for very late rebleeding. In conclusion, EVL is better than EVO in reducing late rebleeding in acute GOV1 bleeding. HCC, PVT, and previous bleeding history were significant risk factors for rebleeding.
Carcinoma, Hepatocellular ; Endoscopy ; Esophageal and Gastric Varices ; Hemorrhage ; Hemostasis ; Humans ; Ligation ; Liver Diseases ; Multivariate Analysis ; Portal Vein ; Retrospective Studies ; Risk Factors ; Survival Rate ; Thrombosis ; Vital Signs

PURPOSE: The purpose of this study was to evaluate the efficacy of treatment in patients with non-bothering nocturia. MATERIALS AND METHODS: In this prospective multicenter study, patients who visited hospitals for treatment of voiding symptoms were enrolled. Inclusion criteria were: 1) men >45 years, and 2) nocturia ≥2 confirmed by a three-day voiding diary. Subjects were divided into non-bothering and bothering groups based on International Consultation on Incontinence Questionnaire Nocturia (ICIQ-N) question 2b. Changes in voiding symptoms, frequency of nocturia, and bothersomeness were evaluated with international prostate symptom score (IPSS), ICIQ-N, and three-day voiding diary at 4 and 12 weeks after treatment. RESULTS: A total of 48 patients in the non-bothering nocturia group and 50 patients in the bothering nocturia group who completed the 12-week treatment were analyzed. The total IPSS was decreased by 5.8 in the non-bothering group and 5.2 in the bothering group. There was no significant difference in decrease of IPSS between the two groups. Both groups showed significant reduction in discomfort of nocturia. The ICIQ-N 2b score decreased from 3.9 to 2.7 (p=0.01) in the non-bothering group and from 6.9 to 4.6 (p=0.02) in the bothering group. The number of nocturia episodes was significantly decreased in both groups. CONCLUSIONS: Regardless of discomfort associated with nocturia, both groups showed significant improvement in nocturia-related discomfort and voiding symptoms. These results suggest that patients with nocturia who were unaware of its discomfort benefited from treatment.
Humans ; Lower Urinary Tract Symptoms ; Male ; Nocturia* ; Observational Study* ; Prospective Studies* ; Prostate ; Prostatic Hyperplasia