Freibergs disease is avascular necrosis of the second or third metatarsal bone. Since 1914, numerous causes and treatments have been proposed but no definite single cause and treatment method were developed. The simple method, joint debridement could not recover the pathophysiologic condition of Freibergs disease and the destructive method, metatarsal head resection and prosthetic replacement arthroplasty had many postoperative problems. Recently, dorsiflexion osteotomy, which was described by Gauthier and Elbaz for the first time, and joint debridement and reshaping of the metatarsal head, which was described by Mann, were very effective method to manage Freibergs disease. This paper was aimed to evaluate the result of joint debridement and reshaping of the metatarsal head which were relatively simple, less destructive and safe method in treatment of the advanced Freibergs disease. We treated 7 cases of Freibergs disease from August 1993 to March 1997. The results were as follows: 1. All the patients of the last follow-up improved pain. 2. The passive range of motion was increased from 39.1 preoperatively to 57.6 postoperatively. 3. Follow-up X-rays showed no loose body and further metatarsal head destruction. The above results suggested that the joint debridement and reshaping of metatarsal head provided good result in the treatment of advanced Freibergs disease.
Arthroplasty, Replacement ; Debridement* ; Follow-Up Studies ; Head* ; Humans ; Joints* ; Metatarsal Bones* ; Necrosis ; Osteotomy ; Range of Motion, Articular

PURPOSE: The purpose of this study was to evaluate the long-term efficacy of ultrasound (US)-guided steroid injections in patients with piriformis syndrome. METHODS: Between January 2010 and October 2012, 63 patients (23 men and 40 women; average age, 63.2 years; range, 24 to 90 years) were diagnosed with piriformis syndrome based on clinical history, electromyography, and flexion-adduction-internal rotation test results. They were divided into two groups. The first group (37 subjects) received a US-guided steroid injection around the piriformis muscle. The second group (26 subjects) received both piriformis muscle and spinal epidural injections. The therapeutic effect was categorized as improvement, partial improvement, or failure depending on the degree of symptom alleviation one month after injection, based on a review of each patient's medical records. RESULTS: In the first group, 15 patients (40.5%) showed improvement, seven (18.9%) showed partial improvement, and 15 (40.5%) failed to respond to the initial treatment. In the second group, eight patients (30.8%) showed improvement, 11 (42.3%) showed partial improvement, and seven (26.9%) failed to respond to the initial treatment. A second piriformis injection was performed in four cases, after which two patients showed improvement within 3 years, but the other two showed no therapeutic effect. CONCLUSION: US-guided steroid injection may be an effective treatment option for patients with piriformis syndrome.
Electromyography ; Female ; Humans ; Injections, Epidural ; Male ; Medical Records ; Piriformis Muscle Syndrome* ; Steroids ; Ultrasonography

Porphyromonas gingivalis is strongly implicated in the pathogenesis of adult periodontitis, the major cause of tooth loss in adults. Use of an antibacterial agent controlling P. gingivalis as a periodontal therapeutic agent has been rationalized. The present study was performed to observe the antibacterial effect of inorganic polyphosphates (polyP) on P. gingivalis. P. gingivalis 2561 was grown in half-strength brain-heart infusion broth containing hemin and vitamin K with or without polyP. Minimal inhibitory concentration (MIC) of polyP with various chain lengths was determined by measuring the absorbance of the grown cells at 540 nm. MIC of polyP for the bacterium was determined to be 0.05%. The effect of polyP with a chain length of 75 (polyP 75) was further examined. PolyP 75 added to the growing culture of P. gingivalis at its exponential phase was as effective in inhibiting the growth of P. gingivalis as polyP 75 added at the very beginning of the culture. More than 99% of the cells lost their viability determined by viable cell count when polyP 75 was added to the culture of growing P. gingivalis at the concentration of 0.06%, suggesting that polyP 75 has a bactericidal effect on the bacterium. Intracellular nucleotide release from the cells was increased by approx. 20% in the presence of polyP 75 but was not reversed by the addition of divalent cations like Ca++ and Mg++. Under the transmission electron microscope, only a small number of the growing P. gingivalis cells were actually lysed. However, the majority of the cells appeared to be atypical in their shape, demonstrating accumulation of highly electron-dense granules and bodies of condensed nucleic acid-like material in the cytoplasm. In the presence of polyP 75, the protein profile of P. gingivalis was changed as determined by SDS-polyacrylamide gel electrophoresis and immunoblot, and the proteolytic activity of the bacterium demostrated on the zymograms was decreased. The overall results suggest that polyP have a strong bactericidal activity against P. gingivalis in which lysis in relation to chelation may not play the major role but unknown mechanism that possibly affects the viability of the bacterium may be involved. PolyP may be used as an agent for prevention and treatment of periodontitis.
Adult ; Cations, Divalent ; Cell Count ; Chronic Periodontitis ; Cytoplasm ; Electrophoresis ; Hemin ; Humans ; Periodontitis ; Polyphosphates* ; Polyps ; Porphyromonas gingivalis* ; Porphyromonas* ; Tooth Loss ; Vitamin K

No abstract available.
Endometriosis* ; Female ; Humans

This study was performed to determine whether the LHbeta -subunit gene missense mutation is present in Korean infertile patients with 46,XX POF women. The variants of LHbeta exon 2 (Trp 8Arg; TGG to CGG and Ile15Thr; ATC ti ACC) were studied in forty-four 46.XX idiopathic POF and 54 nonpregnant women. The LHbeta exon 2 variants were more frequent in POF patients (20.5%) than nonpregnant( 16.7%) women (p>0.05). POF patients with the variant was slightly higher than nonpregnant women with the variant.
Exons ; Female ; Humans ; Korea* ; Mutation, Missense ; Primary Ovarian Insufficiency*

BACKGROUND AND PURPOSE: Antiepileptic drug (AED)-associated cutaneous adverse drug reactions can lead to the discontinuation of medications. The aim of this study was to determine the long-term efficacy and safety of performing desensitization to oxcarbazepine. METHODS: This study involved 20 patients who exhibited cutaneous adverse drug reactions associated with oxcarbazepine use between July 2009 and March 2016 at Samsung Medical Center. All of the participants had to discontinue oxcarbazepine despite presenting initially positive responses. Human leukocyte antigen genotyping was performed to detect the genetic predisposition to Stevens-Johnson syndrome. The desensitization to oxcarbazepine was performed with a starting dosage of 0.1 mg/day. Efficacy was evaluated by comparing the frequency of seizures before and at 1 and 3 years after desensitization. Adverse events occurring during desensitization and the retention rate after desensitization were also investigated. RESULTS: Nineteen patients (95%) safely completed the desensitization protocol. One withdrew owing to emotional problems that appeared to be associated with oxcarbazepine. The follow-up period was 4.6±1.2 years (mean±SD), and oxcarbazepine was maintained for more than 3 years after desensitization in 15 patients (83.3%). The response rates were 84.2% and 77.8% at 1 and 3 years after desensitization, respectively. Eight patients remained seizure-free for 3 years, and two discontinued all AEDs. Transient adverse reactions such as mild rash and itching were reported by five patients during desensitization. CONCLUSIONS: This study has demonstrated the long-term efficacy and safety of desensitization to oxcarbazepine in patients exhibiting cutaneous adverse drug reactions. This favorable outcome should encourage the implementation of desensitization in patients presenting with hypersensitivity to oxcarbazepine as an alternative strategy in clinical practice.
Drug Resistant Epilepsy ; Drug-Related Side Effects and Adverse Reactions ; Exanthema ; Follow-Up Studies ; Genetic Predisposition to Disease ; Humans ; Hypersensitivity ; Leukocytes ; Pruritus ; Seizures ; Stevens-Johnson Syndrome

No abstract available.
Female ; Humans ; Polycystic Ovary Syndrome*

BACKGROUND: An insertion-deletion polymorphism of angiotensin converting enzyme (ACE) gene has been shown to be associated with enzyme activity levels of ACE. Reported results that have been mutually contradictory about asthmatic hypersensitiveness and occurrence according to ACE gene insertion (I)/deletion (D) polymorphism. Also, the involvement of the ACE genes as the genetic basis of bronchial asthma is currently controversy. We investigated whether there was any association between polymorphisms of the ACE genes and airway hyper-responsiveness in chronic obstructive pulmonary disease (COPD). METHODS: A total of 100 patients with COPD were enrolled in this study. The ACE genotypes were determined in all subjects by polymerase chain reaction. Pulmonary function test including bronchodilator response (BDR), methacholine bronchial provocation test (MBPT) were done in those patients. Airway hyper-responsiveness include any findings of positive BDR or MBPT. RESULTS: In COPD patients, the ACE genotype distribution did not differ significantly among groups of patients with severities of COPD, and with or without airway hyper-responsiveness. CONCLUSIONS: These results suggest that polymorphisms of the ACE gene may not be associated with airway hyper-responsiveness, development and severity of COPD.
Angiotensins ; Asthma ; Bronchial Provocation Tests ; Genotype ; Humans ; Methacholine Chloride ; Mutagenesis, Insertional ; Peptidyl-Dipeptidase A ; Polymerase Chain Reaction ; Pulmonary Disease, Chronic Obstructive* ; Respiratory Function Tests

Internal myiasis is a rare disease, which has not been reported in Korea, yet. This case report describes a patient with pneumonia associated with internal myiasis. She was 84-year old female who was admitted to the emergency department, Konyang University Hospital as a result of dyspnea and fever and a drowsy mental state. Approximately twenty fly maggots continuously crawled out from the nose at the third hospital day in the intensive care unit. These maggots were almost 7.2mm long and were identified as the genus lucilia belonging to the family Calliphoridae. In addition, a bronchial washing study showed eggs of the dipterous larvae. A lesion of this myiasis case might have been located in the respiratory system of patient. This case is the first internal myiasis of the respiratory system reported in Korea. This cases is discussed with a review of the relevant literature.
Aged, 80 and over ; Diptera ; Dyspnea ; Eggs ; Emergency Service, Hospital ; Female ; Fever ; Humans ; Intensive Care Units ; Korea ; Larva ; Myiasis* ; Nose ; Ovum ; Pneumonia* ; Rare Diseases ; Respiratory System

PURPOSE: This study aimed to compare the results of laparoscopic resection with those of open resection for consecutive colorectal cancer patients who underwent surgery at a single center. METHODS: During the thirty-month period between January 2003 and August 2005, patients with a colorectal adenocarcinoma admitted to our hospital were assessed. Cancers related with FAP or HNPCC, cancers treated with endoscopy or local excision, and recurrent cancers were excluded from the study. Three hundred two laparoscopic resection patients were matched to 302 open resection patients. RESULTS: The mean age of the laparoscopic resection group was 59.5 years while that of the open resection group was 59.4 years. Patients in two groups were similar in terms of gender distribution, level of CEA and ASA, and location and size of tumor. The modified Dukes' stages showed 51 patients in stage A, 33 in stage B1, 62 in stage B2, 17 in stage C1, and 139 in stage C2 for the laparoscopic resection group and 33 in stage A, 52 in stage B1, 82 in stage B2, 18 in stage C1, and 117 in stage C2 for the open resection group (P=0.024). The operative time averaged 9.6 minutes longer in the laparoscopic group (188.9 vs. 179.3 min, P<0.0001). The rate of stoma formation for protection of anastomosis in the laparoscopic group was 4.9% (5.8% in open group). There were significant differences in blood loss (556.2 vs. 952.8 ml, P<0.0001), the amount of intraoperative blood transfusion (1.6 vs. 2.3 unit, P=0.004), the number of harvested lymph nodes (21.1 vs. 16.9, P<0.0001), and the rate of high ligation of IMA (91.7 vs. 75.5%, P<0.0001). The length of the distal resection margins from cancer was longer in the open group (2.9 vs. 3.5 cm, P=0.037). Patients in the laparoscopic group had a faster recovery of bowel function (P<0.0001) and a significant reduction in the mean length of hospital stay (11.5 vs. 16.8 days, P<0.0001). There was no mortality in either group. Early and late complications were comparable. The conversion rate was 1.6 percent. CONSLUSIONS: The benefits of a laparoscopic resection for colorectal cancers are less blood loss and transfusion, faster postoperative bowel motion, a shorter hospital stay, low morbidity, and a large number of harvested lymph nodes. In conclusion, a laparoscopic resection for colorectal cancers can be done safely and effectively and is an acceptable alternative to a conventional open resection.
Adenocarcinoma ; Blood Transfusion ; Colorectal Neoplasms* ; Endoscopy ; Humans ; Length of Stay ; Ligation ; Lymph Nodes ; Mortality ; Operative Time