Although intramedullary nailing is mostly used in the management of fractures in the long bone shaft, plate fixation is still alternative option in periprosthetic or metaphyseal fractures. For the rigid fixation during plating, sometimes we need wiring. Many surgeons experience slippage of wire resulting in loss of rigid fixation because plate and wire is so slippery and the diameter of bone is changing by level especially in the metaphyseal area. Wiring plate(CHO plate) was designed to prevent slippage. This plate has transverse holes for wires between screw holes on traditionally used dynamic compression plate. Sixteen fractures of long bone shaft were fixed with wiring plate and 11 cases which were followed up for more than one year were evaluated. There were periprosthetic fractures(4 cases), spiral or butterfly fractures(4 cases) and fractures of poor bone quality(two cases of malignancy and one case of osteoporosis). Nine cases were successfully reduced and the healed without loss of fixation. In two cases, delayed union and nonunion were observed due to wire breakage with plate loosening. Preliminarily, wiring plate fixation can be used for the periprosthetic fracture and one of alternative option in butterfly or spiral fracture and fracture in osteoporotic bone or pathologic fracture.
Butterflies ; Fracture Fixation, Intramedullary ; Fractures, Spontaneous ; Periprosthetic Fractures

PURPOSE: To evaluate changes of pancreatic size with aging in control subjects and in non-insulin-dependent diabetic patients. MATERIALS AND METHODS: Two groups of non-insulin-dependent diabetic patients were examined; one had been treated with an oral hypoglycemic agent(n=59), and the other with insulin(n=56). The CT findings of 175 patients without clinical evidence of pancreatic disease were included as a normal control. RESULTS: In control subjects, pancreatic size and age correlated. The pancreas was smaller in non-insulin-dependent diabetics than incontrol subjects and smaller in insulin- treated non-insulin-dependent diabetics than in non-insulin treated patients. CONCLUSION: The pancreas was smaller in non-insulin-dependent diabetic patients than in control subjects within the same age range.
Aging ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Humans ; Pancreas* ; Pancreatic Diseases

We studied the activity of adenosine deaminase in the urine of 38 patients who were divided into four groups :Urinary tract tuberculosis without ureteral obstruction(Group I ), Urinary tract tuberculosis with ureteral obstruction (Group II ), Urinary tract infection ( Group III ) and control subjects (Group IV). In patients with urinary tract tuberculosis with ureteral obstruction the adenosine deaminase activity in aspirated renal urine was significantly higher than for the rest of the groups (p<0.001). Adenosine deaminase activity in renal aspirated urine has proved to be a simple and reliable diagnostic method for urinary tract tuberculosis with ureteral obstruction.
Adenosine Deaminase* ; Adenosine* ; Humans ; Tuberculosis* ; Ureter ; Ureteral Obstruction ; Urinary Tract Infections ; Urinary Tract*

Although multiphasic CT is an efficient technique for determination of hepatocellular carcinoma (HCC), occasionally, diagnosis of HCC using multiphasic CT can be difficult. Herein we present a case of HCC that was indicative of a typical abscess on CT imaging and compared the image findings with the gross specimen. The patient's body temperature and laboratory results indicated that inflammation were in the normal range. This case emphasizes that not only imaging findings but also clinical presentation should be considered to achieve a correct diagnosis in clinical practice.
Abscess ; Body Temperature ; Carcinoma, Hepatocellular ; Inflammation ; Reference Values

There are two factors which influence the long term outcome of renal transplantation. One is the immunological factor such as HLA typing, the other is the nonimmunological factor such as physiologic match of the donor kidney to the recipient. We analyzed the relation between serum creatinine on the day of discharge which is known as a good predictor of long term graft survival and several nonimmunological factors influencing long term outcome of renal transplantation. One hundred fourteen renal transplanted patients in Yeungnam university hospital for 3 years after 1994 were included except the patients had experienced rapid deterioration of renal function like acute graft rejection. Several indices(KW/R.BSA, KW/R.BW, KW/ R.BMI, D.BSA/R.BSA, D.BW/R.BW : KW=kidney weight, R=recipient, D=donor, BSA=body surface area, BMI=body mass index, BW=body weight) representing relative kidney size to recipient were significantly correlated with serum creatinine on the day of discharge(KW/R.BSA : r=-0.30, KW/R.BW : r=-0.35, KW/R.BMI : r=-0.41, D.BSA/R.BSA : r=-0.47, D.BW/R.BW : r=-0.44). Serum creatinine levels on the day of discharge were lower at the male kidney donated to female recipient than the female kidney donated to male recipient (0.89 vs. 1.22mg%, P<0.05). The age of donors had positive correlation with serum creatinine on the day of discharge (r=0.28). That was, when donor is more younger person, renal function after transplantation is better. But several indices by renal scan(effective renal plasma flow, perfusion index, peak renal uptake, T1/2) done after transplantation, urine output of the next day after transplantaton, renal function of donor before transplantation(creatinine level) were not correlated with serum creatinine on the day of discharge. In conclusion, nonimmunological factor such as nephron mass size, age, gender should be considered when selecting renal donor, and the more actual, new criteria for kidney transplantation and long term prognosis should be worked out by further study.
Creatinine* ; Female ; Graft Rejection ; Graft Survival ; Histocompatibility Testing ; Humans ; Kidney Transplantation* ; Kidney* ; Male ; Nephrons ; Perfusion ; Prognosis ; Renal Plasma Flow ; Tissue Donors

PURPOSE: To investigate whether tumor aggressiveness in patients with prostate cancer has changed in Korea since the introduction of prostate-specific antigen (PSA) testing. MATERIALS AND METHODS: The data from 2,508 patients with pathologically confirmed prostate cancer who underwent radical prostatectomy at Asan Medical Center between 2000 and 2011 were reviewed. The patients were divided into four 3-year time series, and the changes between the groups in terms of serum PSA levels, pathological Gleason score (GS), and pathological stage were assessed. The change in GS over time in organ-confined disease and in patients whose PSA was below 10 ng/ml was also analyzed. RESULTS: The mean PSA levels dropped significantly over the 12-year period (p<0.001). The frequency of organ-confined disease increased (55.7% vs. 64.7% vs. 62.9% vs. 63.5%, p=0.043). The frequency of patients with a GS of 8 or more decreased (38.9% vs. 25.7% vs. 18.2% vs. 19.7%) and the frequency of patients with a GS of 6 or less increased (15.0% vs. 18.9% vs. 26.7% vs. 18.2%, p=0.003). However, the vast majority (more than 70%) of all cases had a high GS (7 or greater) at all time points. The GS distribution did not change over time in patients whose PSA levels were below 10 ng/ml or in those who had organ-confined disease. CONCLUSIONS: In 2000 to 2011, the preoperative PSA, pathological stage, and pathological GS dropped. However, the majority of the prostate cancers in Korean men were poorly differentiated, even when the patients had organ-confined disease or their PSA levels were less than 10 ng/ml.
Humans ; Korea ; Male ; Neoplasm Grading ; Prostate ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms

We want to add funding statement in ACKNOWLEDGEMENTS section of this article.
Financial Management* ; Thyroid Gland* ; Thyroid Neoplasms*

Bisphosphonates (BPs) are a class of agent used to treat patient with osteoporosis or malignant bone metastases. BPs can be categorized into 2 groups: nitrogen-containing and non-nitrogen containing. Nitrogen-containing BPs are considered to have more toxicity. Despite their clinical benefits, bisphosphonate-related osteonecrosis of jaw(BRONJ) is a significant complication to patients receveing these drugs. Since the first description of BRONJ in 2003 by Marx, the number of reports on BRONJ has been rapidly increasing. BRONJ is considered as an emerging problem in oral & maxillofacial surgery. Generally, osteonecrosis in the maxilla is rare, however BRONJ is found both in the maxilla and the mandible. This is an important feature of BRONJ compared to common infectious osteomyelitis of the jaw. Growing number of case reports, suggest that bisphosphonate therapy may cause exposed, necrotic bone. BRONJ has simillar features compared to IORN (infected osteoradionecrosis). BRONJ has meaningful features established through the interestigation on histopathologic and radiographic findings. These features have an impact on treatment plan and prognosis. This presentation contemplates on features of histopathologic and radiographic findings in bisphosphonate-related osteonecrosis of the jaw.
Alendronate ; Bisphosphonate-Associated Osteonecrosis of the Jaw ; Diphosphonates ; Humans ; Jaw ; Mandible ; Maxilla ; Neoplasm Metastasis ; Osteomyelitis ; Osteonecrosis ; Osteoporosis ; Prognosis ; Surgery, Oral

STUDY DESIGN: Retrospective case-control study. OBJECTIVES: To compare the clinical and radiographic outcomes of a hybrid construct (HC) of cervical artificial disc replacement (CADR) combined with anterior cervical discectomy and fusion (ACDF) (group I) with 2-level ACDF (group II) in patients with 2-level cervical disc disease. SUMMARY OF LITERATURE REVIEW: ACDF is reported to potentially promote degenerative changes in the adjacent segment. CADR has been expected to reduce the risk of adjacent segment degeneration. However, its clinical course has yet to be sufficiently clarified. MATERIALS AND METHODS: Twenty-six patients underwent 2-level cervical disc surgery. Single-level CADR combined with ACDF was performed in 14 patients. Twelve patients underwent 2-level ACDF. Clinical profiles were assessed using the neck disability index (NDI) and visual analogue scale scores of arm and neck pain. Dynamic lateral cervical radiographs were obtained preoperatively and at 1, 6, 12, and 18 months postoperatively. The range of motion (ROM) of the overall cervical spine (C2-7) and the adjacent segments was measured. RESULTS: Group I showed superior NDI 18 months postoperatively (p < 0.05). The mean C2-7 ROM of both groups recovered to the preoperative ROM. At 18 months postoperatively, the C2-7 ROM of group I was higher than that of group II (p < 0.05). The superior adjacent segment ROM was higher in group II (p < 0.05), starting at 6 months. The inferior adjacent segment ROM showed no significant difference between the groups (p>0.05). CONCLUSIONS: The HC group showed comparable clinical and radiographic outcomes to those of the 2-level ACDF group. HC can be used selectively in the treatment of patients with 2-level cervical disc disease.
Arm ; Case-Control Studies ; Cervical Vertebrae ; Diskectomy* ; Female ; Humans ; Neck ; Neck Pain ; Range of Motion, Articular ; Retrospective Studies ; Spinal Fusion ; Spine ; Total Disc Replacement*

Idiopathic retroperitoneal fibrosis is a fibrotic process of the retroperitoneum that frequently produces ureteral obstruction. We report a case of idiopathic retroperitoneal fibrosis in a 22 year-old male patient with brief review of literatures.
Humans ; Male ; Retroperitoneal Fibrosis* ; Ureteral Obstruction ; Young Adult