BACKGROUND: The purpose of our study was to evaluate the functional and radiologic outcomes of additive augmentation sutures through rotator cuff for proximal humeral fractures stabilized locking plate in elderly patients. METHODS: We enrolled 74 patients over the age of 60 years who received internal fixation using locking plates for proximal humeral fractures. Of these, 50 patients had additive augmentation sutures through rotator cuff. The mean age at the time of surgery was 72.1 years (range, 60-89 years), and the mean follow-up period was 17.5 months (range, 12-62 months). The humeral neck-shaft angle and humeral head height were used as radiological markers to assess the effect of additive augmentation sutures through rotator cuff. We allocated the patients who received additive augmentation sutures into group A and those who did not into group B. RESULTS: At the final follow-up, the mean Korean Showlder Society score and Constant scores were 88.96 +/- 12.1 and 86.6 +/- 11.9, respectively, in group A and 86.21 +/- 11.8 and 85.3 +/- 11.7, respectively, in group B (p=0.368, 0.271). At the final follow-up, the mean loss in humeral neck-shaft angle from the time of immediate postoperative measurement was 1.6degrees in group A and 4.8degrees in group B, whereas the mean loss in humeral head height was 0.82 mm in group A and 0.52 mm in group B (p=0.029, 0.178). CONCLUSIONS: The surgical outcomes of internal fixation using locking plates for proximal humeral fractures were clinically and radiologically good in elderly patients over the age of 60 years without any observable complications. Further, the loss of humeral head shaft angle at the final follow-up from its initial postoperative measurement was significantly smaller in patients who received an additive augmentation suture than in those who did not. Thus, we conclude that augmentation sutures are a beneficial option for elderly patients that clinicians can consider at the time of surgical decision making.
Aged* ; Decision Making ; Follow-Up Studies ; Humans ; Humeral Head ; Rotator Cuff ; Shoulder Fractures* ; Sutures*

In Asia, mammography following the injection of foreign materials into the breasts for cosmetic augmentation is frequently seen and diagnosis based on the typical radiologic findings is straightforward. We report the unusual radiologic findings in two patients with foreign body granulomas caused by injected foreign materials and discovered incidentally during screening work up. The mammographic findings were bilateral, hyperdense, spiculated masses, with occasional microcalcification, and at sonography, markedly hypoechoic, spiculated solid masses, located near the pectoralis muscle and partly extending into it, were observed. These radiologic findings mimicked malignancy.
Breast Neoplasms/radiography ; Case Report ; Cholesterol ; Diagnosis, Differential ; Esthetics ; Female ; Granuloma, Foreign-Body/etiology/*radiography/*ultrasonography ; Human ; Injections/adverse effects ; Mammography ; Middle Age ; Paraffin

The purpose of this study was to evaluate the tooth color changes of resin bonding sites and their adjacent sites on orthodontic bracket bonding. Sixty extracted sound premolars were used and the tooth color was recorded according to the CIE L(*)a(*)b(*) color system using a spectrophotometer. The tooth colors of the twenty premolars were measured and compared before bracket bonding and after removal. On a further twenty premolars, the tooth color was measured before and after only primer application. In the change of L(*) values, according to the bracket bonding and primer application, the lightness was decreased, and in the change of a(*) and b(*) values, the color was changed into a more yellowish color. The color differences (delta E(*)) were calculated from the L(*)a(*)b(*) values and compared with the standard value of clinical detection (delta E(*)=3.7). The color differences between before the bracket bonding and after removal noted exceeded the standard value and those of between before and after the primer application were not larger than the standard value. Toothbrushing was performed after application of the primer to evaluate the color changes according to the primer abrasion. As a control, toothbrushing was performed on the last twenty premolars. The color differences noted were larger than the standard value after toothbrushing. Also, to evaluate the color changes of the tooth which is exposed to sun irradiation after bracket removal, additional photoaging was performed and the color was measured for all teeth. The additional color differences after photoaging were smaller than the standard value. The above results suggest that the tooth color changes after fixed orthodontic treatment.
Bicuspid ; Orthodontic Brackets ; Solar System ; Tooth* ; Toothbrushing

A carcinoid tumor of the stomach is uncommon, has no clinical symptoms, and is regarded as a benign. It is also incidentally found in most cases. 48-year-old woman with gastric carcinoid tumor was admitted. She had suffered from a anorexia and a dry mouth for 4-months. A gastroscopy revealed a polypoid mass on the greater curvature of the mid-body of the stomach which was subsequently thought to be an adenocarcinoma. An endoscopic mucosectomy revealed however, that it was a carcinoid tumor. A case of carcinoid tumor of the stomach is here by presented with a brief literature review.
Adenocarcinoma ; Anorexia ; Carcinoid Tumor* ; Female ; Gastroscopy ; Humans ; Middle Aged ; Mouth ; Stomach*

The number of low vision patients and the demand for low vision rehabilitation are increasing as the life expectancy and visual impairment due to largely untreatable ocular conditions are.It is therefore, imperative to recognize the importance of low vision aids, which have recently been developed actively.To evaluate the efficacy of low vision aids for low vision rehabilitation, we reviewed the clinical records of 350 patients who had visited our low vision clinic more than twice and had been prescribed with low vision aids. According to the data analysed, optic nerve atrophy, macular degeneration and retinitis pigmentosa were the leading causes of visual impairment in those patients.The purposes to visit our low vision clinic were to read books, read letters on the black board, identify a person at a distance, etc.Hand-held magnifiers, aspheric doublet lens and telemicroscope with plus cap were commonly used for near vision, while Keplerian and Galilean telescope were popular aids for distant vision.Visual acuity after prescription was improved when it was compared with that before prescription.Majority of the patients benefited from attending low vision clinic.These results suggest that the optical low vision aids were required to rehabilitate the visually impaired patients.
Atrophy ; Humans ; Life Expectancy ; Macular Degeneration ; Optic Nerve ; Prescriptions ; Rehabilitation ; Retinitis Pigmentosa ; Telescopes ; Vision Disorders ; Vision, Low*

The relationship between obesity and ketonuria is not well-established. We conducted a retrospective observational study to evaluate whether their body weight reduction response differed by the presence of ketonuria after fasting in the healthy obese. We used the data of 42 subjects, who had medical records of initial urinalysis at routine health check-up and follow-up urinalysis in the out-patient clinic, one week later. All subjects in the initial urinalysis showed no ketonuria. However, according to the follow-up urinalysis after three subsequent meals fasts, the patients were divided into a non-ketonuria group and ketonuria group. We compared the data of conventional low-calorie diet programs for 3 months for both groups. Significantly greater reduction of body weight (-8.6 +/- 3.6 kg vs -1.1 +/- 2.2 kg, P < 0.001), body mass index (-3.16 +/- 1.25 kg/m2 vs -0.43 +/- 0.86 kg/m2, P < 0.001) and waist circumference (-6.92 +/- 1.22 vs -2.32 +/- 1.01, P < 0.001) was observed in the ketonuria group compared to the non-ketonuria group. Fat mass and lean body mass were also more reduced in the ketonuria group. In addition, serum free fatty acid concentration after intervention in the ketonuria group showed significant more increment than in the non-ketonuria group. The presence of ketonuria after fasting may be a predicting factor of further body weight reduction.
Adult ; Diet, Reducing ; Fasting/*physiology ; Female ; Humans ; Ketosis/*complications/*pathology ; Male ; Middle Aged ; Obesity/*complications/diet therapy/pathology/*urine ; Retrospective Studies ; Weight Loss/*physiology

PURPOSE: To evaluate the radiologic and clinical outcomes of AO type C pelvic ring injury and identify the prognostic factors. MATERIALS AND METHODS: We studied 53 patients who were treated for AO type C pelvic ring injury from January 2002 to February 2010. Mean age and mean follow-up duration were 42.4 years and 14 months, respectively. We had 8 cases of AO type C1-1, 19 cases of C1-2, 11 cases of C1-3, 6 cases of C2 and 9 cases of C3 injury. We analyzed type of fracture, displacement, method of fixation and associated injuries. Radiologic outcome was evaluated with Matta and Saucedo criteria and clinical outcome was evaluated using Majeed score. RESULTS: The average Majeed score was 86.2 distributing as 36 excellent cases, 15 good cases and 2 fair cases. Using radiologic Matta and Saucedo criteria, patients were divided as 31 excellent cases, 17 good cases and 5 fair cases. There was no significant difference between the outcomes of anterior, posterior and antero-posterior fixation. Neurologic injury was the reason for an unsatisfactory functional outcome. We identified two cases with complication, one with postoperative infection and the other with nonunion following anterior-posterior fixation. CONCLUSION: Satisfactory radiologic and clinical outcomes were obtained with open reduction and internal fixation in the management of AO type C pelvic ring injuries. Neurologic injuries affected the clinical outcome.
Follow-Up Studies ; Humans ; Pelvis

In 1974, Casson et. al. reported midfacial degloving approach to repair the midfacial bone fracture. After then, this approach has been used frequently to treat the lesions on nasal cavity, nasopharynx, facial plastic surgery and midfacial trauma. Midfacial degloving approach consists of 1) bilateral sublabial incision 2) complete transfixion incision/ septocolumellar incision 3) bilateral intercartilaginous incision 4) bilateral pyriform aperature incision. This approach provides proper access for midfacial bone structure without facial scar but has post-operative complications such as transient epistaxis, infraorbital nerve paresthesia and nasal crust. We treated three patients using midfacial degloving approach to correct traumatic deformity in midface area. In two patients, rhinoplasty with autogenous rib graft was done simultaneously. So we report these cases with review of literatures.
Cicatrix ; Congenital Abnormalities ; Epistaxis ; Fractures, Bone* ; Humans ; Nasal Cavity ; Nasopharynx ; Paresthesia ; Rhinoplasty ; Ribs ; Surgery, Plastic ; Transplants

OBJECTIVES: The present study takes part of the agricultural district cohort study of a certain county located in Gyeonggido and aims to investigate the difference of the heart rate variability(HRV) according to the social support level. METHODS: We used data from 1727 participants of a health promotion program who are older than 40 years old. A physical examination, as well as a one-to-one interview to obtain sociodemographic characteristics, was performed with each participant. In addition, the participants completed the Medical Outcomes Study-Social Support Survey(MOS-SSS) for their the social support level to be assessed, and their HRV were measured to evaluate their autonomic function. The entire group was divided in two groups according to its MOS-SSS points to facilitate the research. Those who were evaluated as the high 25%(432 persons) were denominated as high social support (HSS) group and those who were evaluated as the low 25%(425 persons) were denominated as poor social support(PSS) group. RESULTS: The two groups showed significant differences on the sociodemographic factor such as mean age and gender composition(p<0.05). Comparing the indices related to the HRV, the HSS group had the following values higher than the PSS group : SDNN(F=4.938, p=0.027), TP(F=8.088, p=0.005), VLF(F=6.220, p=0.013) LF (F=3.873, p=0.049). CONCLUSION: According to the research, the PSS group showed dysfunction on their autonomic nervous system comparing to the HSS group. The social support helps an individual overcome difficulties, helps the adaptation during the changes of circumstances and in stressful situations it serves like a buffer. Based on that, it's possible to define that a low social support level gave an impact on the autonomic function. Also, using the fact that the HRV can evaluate the autonomic function in an objective view, it was possible to visualize that it has a potential to be used as an assistant factor to evaluate the social support.
Autonomic Nervous System ; Cohort Studies ; Health Promotion ; Heart ; Heart Rate ; Physical Examination

To evaluate effect of coronary collateral circulation on left ventricular function in patients with acute myocardial infarction, global ejection fraction(EF), left ventricular end distolic pressure(LVEDP), peak creatine kinase(CK) level and regional wall motion were analysed and compared in 30 patients with acute myocardial infarction according to grade of coronary collateral circulation. Patients with total or near total(above 95% of diameter) occlsion of left anterior descending coronary artery without significant lesion in right coronary artery or left circumflex artery were selected and divided into 3 groups according to the degree of collateral circulation on coronary angiography, to be compared by the index of ejection fraction, peak creatine kinase level, left ventricular and diastolic pressure and regional wall motion. The result are as following : 1) There were no statistically significant differences in ejection fraction, peak creatine kinase level, left ventricualr and diastolic pressure among the groups. 2) Regional wall motion of infarct related area of G2+3 group(adequate collateral) were better than that of G0(no collateral) group(p<0.05). Therefore, adequate coronary collateral circulation in acute myocardial infarction is thought to have beneficial effect on left ventricular function especially in regional wall motion of infarct related area.
Arteries ; Blood Pressure ; Collateral Circulation* ; Coronary Angiography ; Coronary Vessels ; Creatine ; Creatine Kinase ; Humans ; Myocardial Infarction* ; Ventricular Function, Left*