Twenty four patients with gap nonunions of the tibia were treated with the Ilizarov intercalary bone transport method. The purpose of this retrospective study is to evaluate the results and complications in gap nonunions of the tibia treated using the Ilizarov method. There were 22 males and two females with an average age of the 35.8 years(range, 23-63 years). The mean follow up period was 30.2 months(range, 17-70 months). Ten of the 24 patients had no external shortening with bone gap, 13 external shortening with gap and one hemicircumferential defect. On average, the size of bone loss measured 8.2 cm(range, 3-18 cm). Twenty-one of 24 patients were treated by whole segment internal transport(fifteen were proximal fragment transport, five were distal fragment transport, one was proximal and distal fragment transport), one patient by anterior hemicircumferential corticotomy and partial bone fragment internal transport and tow patients by fibula transfer. All patients healed with solid bony union, although twelve patients required bone grafts, eleven at the docking site and one at the distraction site. On average, the healing index was 49 days/cm(range, 18-82 days/cm). There was on relationship between the percentage transport(size of the distraction gap/the transporting fragment length x 100) and healing index. Numerous complications were encountered, most commonly delayed union and pin site infection, Conclusively, the application of Ilizarov techniques to gap nonunions of the tibia was very effective, but required correct technique and careful follow-up examination.
Female ; Fibula ; Follow-Up Studies ; Humans ; Ilizarov Technique ; Male ; Methods ; Retrospective Studies ; Tibia ; Transplants

We report a mild variant of hypomelia-hypotrichosis-facial hemangioma syndrome in a 3 month-old female. The patient showed major features of the previously reported cases including flexion deformities of both upper extremities, sparse light colored hair, mid-facial hemangioma and a characteristic facial appearance. Roentgenogram showed radio-humeral synostosis at both elbow joints by which shortening of upper limbs could be anticipated. However, intra- and extrauterine growth retardation were not remarkable and the lower limbs were not affected.
Congenital Abnormalities ; Elbow Joint ; Female ; Hair ; Hemangioma* ; Humans ; Hypotrichosis ; Lower Extremity ; Synostosis ; Upper Extremity

No abstract available.
Nail-Patella Syndrome*

BACKGROUND: The quick and accurate radiologic evaluation is essential to minimize the sequelae of temporal bone trauma. High resolution computed tomography(HRCT) is regarded as a method of choice in the evaluation of the head trauma including temporal bone fractures. Although the diagnosis of ossicular dislocation with HRCT has been described, we could find only one report on the usefulness of coronal sections in the diagnosis of lateral displacement of the incus. OBJECTIVES: The purpose of this study is to evaluate the usefulness of a recently reported radiologic sign, named the "Y" sign, for the diagnosis of lateral dislocation of the incus on the coronal HRCT sections of the temporal bones. MATERIALS AND METHODS: We retrospectively reviewed the axial and coronal HRCT sections of 13 cases who the laterally dislocated incus was confirmed operatively. RESULTS: In the axial HRCT sections, abnormal ice cream cone was shown in only 3 cases, but normal ice cream cone was shown in 10 cases. In the coronal HRCT sections, the Y-sign was shown in 11 cases-open Y-sign: 3 cases, closed Y-sign: 8 cases, in contrast, only 2 cases did not shown Y-sign. CONCLUSION: The Y-sign in the coronal sections is more correlated with the dislocated incus than with abnormal ice cream cone configuration in the axial sections. So, the Y-sign seems to be very useful in the diagnosis of the dislocated incus.
Craniocerebral Trauma ; Diagnosis* ; Dislocations* ; Ice Cream ; Incus* ; Retrospective Studies ; Temporal Bone

Background: In the early stage of the coronavirus disease 2019 (COVID-19) epidemic, small- and mid-sized enterprises (SMEs) may be an important transmission consideration. The study aimed to identify the pattern of COVID-19 prevention measures during the outbreaks in Daegu and Gyeongsangbuk-do at the early stage of COVID-19. Moreover, we investigated whether SME size and past experiences affected the preventive measures implemented in the region. Methods: A survey detailing the general characteristics and implementation of 12 preventive activities was conducted in 122 SMEs in Daegu and Gyeongsangbuk-do. The survey was analyzed by size and operation period. Results: The study subjects consisted of 53 (43.4%) workplaces with 1–5 employees, 50 (40.9%) workplaces with 6–30 employees, and 19 (15.6%) workplaces with 31–49 employees. The lowest three items among those surveyed were ‘symptomatic workers to stay home for 3–4 days’ (17.2%), ‘work remotely’ (18.9%), and ‘video meetings’ (20.5%). There were significant differences in the rate of several preventive measures implemented. The larger sized SMEs, the higher the number of implementations (p < 0.01). The operation period had no significant relationship with the implementation of preventive measures. The same pattern was observed in multiple generalized linear regression with covariate adjustment. Conclusion Preventive measures among SMEs with fewer than 50 employees were identified. Even within SMEs, a gap in preventive measures according to size was confirmed. To prevent the spread of infection and protect workers' right to health, different support for different sized SMEs is necessary.

BACKGROUND AND OBJECTIVES: Human epidermis is a continuously dividing tissue, in which keratinocytes gradually differentiate and mature while moving from basal cells to suprabasal cell layers. Epidermal homeostasis is maintained by a delicate balance between proliferation and terminal differentiation. Cholesteatoma is characterized by the presence of a squamous epithelium invading the middle ear, which is believed to have hyperproliferative properties. The aim of this study is to determine whether the hyperproliferative character of cholesteatoma is associated with differentiation of basal cell or suprabasal cell layers. MATERIALS AND METHODS: Using immunohistochemical techniques, we investigated the reaction pattern of monoclonal antibody to involucrin and filaggrin as differentiation markers in the cholesteatoma matrices which were harvested during surgery. For the control, the same immunohistochemical study was also done in deep meatal skin and retroauricular skin during the same surgery. RESULTS: The immunostaining intensity of filaggrin at suprabasal cell layers was higher in cholesteatoma than in retroauricular skin and deep meatal skin. The immunostaining intensity of involucrin at suprabasal cell layers was higher in cholesteatoma and deep meatal skin than in retroauricular skin. CONCLUSION: This result represents that the epidermal cells in cholesteatoma at suprabasal layers actively differentiate more than the epidermal cells in retroauricular skin. So this study suggests that hyperkeratinization in cholesteatoma might be due to altered differentiation of suprabasal keratinocytes. Furthermore, this study reveals that the deep meatal skin has unusual hyperproliferative behavior in contrast to the retroauricular skin.
Antigens, Differentiation ; Cholesteatoma ; Cholesteatoma, Middle Ear* ; Ear, Middle* ; Epidermis ; Epithelium ; Homeostasis ; Humans* ; Keratinocytes ; Skin

BACKGROUND AND AIMS: FibroScan(R) is a new medical device that noninvasively measures liver stiffness. The aim of this study was to assess the accuracy of the liver stiffness measurement by FibroScan(R) for making the diagnosis of liver fibrosis in patients with chronic viral hepatitis. METHODS: We studied 103 patients with chronic viral hepatitis B or C and they underwent FibroScan(R) and liver biopsy between October 2005 and August 2006. Liver fibrosis was staged on a 0-4 scale according to the Korean Society of Pathologists Scoring System. The diagnostic accuracy was assessed by analysis of the receiver operator characteristics (ROC). RESULTS: The liver stiffness was 3.5-57.1 kPa (mean: 11.8, SD: 8.9). The mean value of liver stiffness in each fibrosis stage group (F1, F2, F3 and F4) was 5.8+/-1.8 kPa, 11.3+/-6.8 kPa, 11.8+/-6.0 kPa and 23.4+/-16.5 kPa, respectively. Liver stiffness measured by FibroScan(R) showed reliable correlation with the liver fibrosis stage as confirmed by liver biopsy (r=0.56, p<0.001). The AUROC (95% CI) of > or = F2, > or = F3 and F4 was 0.93 (0.86-0.99), 0.72 (0.62-0.82) and 0.80 (0.67-0.92), respectively. The sensitivity and specificity of 7.5 kPa, which was the cutoff value for > or = F2, was 84% and 90%, respectively. CONCLUSIONS: FibroScan(R) is a reliable method for the diagnosis of significant fibrosis (> or =F2) and cirrhosis in patients with chronic liver disease. The liver stiffness measurement by FibroScan(R) showed good diagnostic performance for significant fibrosis.
Adult ; Aged ; Disease Progression ; Female ; Hepatitis B, Chronic/complications/*ultrasonography ; Hepatitis C, Chronic/complications/*ultrasonography ; Humans ; Liver/*ultrasonography ; Liver Cirrhosis/etiology/*ultrasonography ; Male ; Middle Aged ; Predictive Value of Tests ; ROC Curve ; Sensitivity and Specificity

OBJECTIVES: Research has shown that obesity appears to spread through social ties. However, the association between other characteristics of social networks and obesity is unclear. This study aimed to identify the association between social network characteristics and body mass index (BMI, kg/m2) in an elderly Korean population. METHODS: This cross-sectional study analyzed data from 657 Koreans (273 men, 384 women) aged 60 years or older who participated in the Korean Social Life, Health, and Aging Project. Network size is a count of the number of friends. Density of communication network is the number of connections in the social network reported as a fraction of the total links possible in the personal (ego-centric) network. Average frequency of communication (or meeting) measures how often network members communicate (or meet) each other. The association of each social network measure with BMI was investigated by multiple linear regression analysis. RESULTS: After adjusting for potential confounders, the men with lower density (<0.71) and higher network size (4-6) had the higher BMI (beta=1.089, p=0.037) compared to the men with higher density (>0.83) and lower size (1-2), but not in the women (p=0.393). The lowest tertile of communication frequency was associated with higher BMI in the women (beta=0.885, p=0.049), but not in the men (p=0.140). CONCLUSIONS: Our study suggests that social network structure (network size and density) and activation (communication frequency and meeting frequency) are associated with obesity among the elderly. There may also be gender differences in this association.
Aged ; Aged, 80 and over ; *Body Mass Index ; Comorbidity ; Depression ; Female ; Humans ; Male ; Middle Aged ; Regression Analysis ; Republic of Korea/epidemiology ; Self Concept ; Smoking ; *Social Networking

BACKGROUND: Increasing evidence supports an association between age-related loss of muscle mass and insulin resistance. However, the association has not been fully investigated in the general population. Thus, we investigated the association between appendicular skeletal muscle mass (ASM) and insulin resistance in an elderly Korean population. METHODS: This cross-sectional study included 158 men (mean age, 71.8) and 241 women (mean age, 70.6) from the Korean Social Life, Health and Aging Project, which started in 2011. In this study, ASM was measured by bioelectrical impedance analysis and was analyzed in three forms: ASM (kg), ASM/height2 (kg/m2), and ASM/weight (%). The homeostasis model assessment of insulin resistance (HOMA-IR) was used as a measure of insulin resistance. The relationships between the ASM values and the HOMA-IR were investigated by multiple linear regression models. RESULTS: The HOMA-IR was positively associated with ASM (beta=0.43, P<0.0001) and ASM/height2 (beta=0.36, P<0.0001) when adjusted for sex and age. However, after additional adjustment for body weight, HOMA-IR was inversely associated with ASM (beta=-0.43, P<0.001) and ASM/height2 (beta=-0.30, P=0.001). Adjustment for other potential confounders did not change these associations. Conversely, HOMA-IR was consistently and inversely associated with ASM/weight before and after adjustment for other potential confounders. CONCLUSION: Our results support the idea that lower skeletal muscle mass is independently associated with insulin resistance in older adults. When evaluating sarcopenia or muscle-related conditions in older adults, their whole body sizes also need to be considered.
Adult ; Aged* ; Aging* ; Body Size ; Body Weight ; Cohort Studies* ; Cross-Sectional Studies ; Electric Impedance ; Female ; Homeostasis ; Humans ; Insulin Resistance* ; Korea ; Linear Models ; Male ; Muscle, Skeletal* ; Sarcopenia

Familial adenomatous polyposis (FAP) is a precancerous clinical entity, which is characterized by the development of numerous adenomatous polyps throughout the colon and rectum. The majority of FAP are associated with mutations of the adenomatous polyposis coli (APC) gene. Until now, more than 1,000 different APC mutations have been reported and some mutations express attenuated phenotypes which are milder forms with 10~100 colorectal polyps. We identified a novel mutation of APC gene which expressed an attenuated FAP but caused large gastroduodenal tubular adenomas requiring repeated endoscopic resections. A 16-year-old girl was referred to Incheon St. Mary's Hospital for evaluation of gastric polyposis. Initial esophagogastroduodenoscopy (EGD) showed numerous gastric polyps in the fundus and upper body and a few polyps in the duodenum. Pathologic examination confirmed gastric polyps as fundic gland polyps and duodenal polyps as tubular adenomas. Only a few colonic polyps of 2 to 5 mm in size were found on colonoscopy. Genetic analysis using polymerase chain reaction and direct sequencing revealed a novel stop codon mutation at codon 1522 in exon 16 of APC gene. At 12-month, 18-month, and 35-month follow-up EGD, large duodenal polyp and gastric polyps were removed endoscopically.
Adenoma ; Adenomatous Polyposis Coli* ; Adenomatous Polyps ; Adolescent ; Codon ; Codon, Terminator ; Colon ; Colonic Polyps ; Colonoscopy ; Duodenum ; Endoscopy, Digestive System ; Exons ; Female ; Follow-Up Studies ; Genes, APC* ; Germ-Line Mutation* ; Humans ; Incheon ; Phenotype ; Polymerase Chain Reaction ; Polyps* ; Rectum