PURPOSE: This study aims to determine the correlation between the fracture patterns and the complications in patients with femoral neck fracture treated with internal fixation. MATERIALS AND METHODS: The study comprises 45 patients with femoral neck fracture treated with multiple screws or compression hip screw between May 2008 and April 2012. The mean age was 48 years at the time of the surgery and the mean duration from initial injury to surgery was 20 hours. The fracture patterns were identified according to the anatomical location, the Garden classification and the Pauwels classification. The occurrence of nonunion and avascular necrosis were reviewed with clinical results including Harris hip score and Lunceford hip function test. The correlation between the fracture pattern and occurrence of complications were analyzed. RESULTS: Fracture site union was achieved in 40 hips with the average union time of 17 weeks. Five nonunions occurred which showed high likelihood to occur in subcapital type, displaced (Garden stage III or IV) and Pauwels type III fractures (P<0.05). Avascular necrosis was developed in 10 hips which was mostly in subcapital type and Pauwels type III fracture but no statistical significance was found (P>0.05). The mean Harris hip score was 91 points, and Lunceford functional results were excellent in 15 hips, good in 24, fair in 4 and poor in 2. CONCLUSION: There was high risk of nonunion in subcapital type fracture, displaced fracture (Garden stage III and IV) and vertically oriented fracture (Pauwels type III). Careful attention is needed in these fracture types.
Classification ; Femoral Neck Fractures* ; Femur Neck* ; Hip ; Humans ; Necrosis

BACKGROUND: Although core needle biopsy (CNB) is considered to be the standard technique for histological diagnosis of breast lesions, it is less reliable for diagnosing atypical ductal hyperplasia (ADH). We therefore assessed the characteristics of CNB-diagnosed ADH that are more likely to be associated with more advanced lesions on subsequent surgical excision. METHODS: We retrospectively examined 239 consecutive CNBs, 127 of which were diagnosed as ADH following surgical excision, performed at Asan Medical Center between 1995 and 2010. Archival slides were analyzed for the number of cores per specimen, the number of ADH foci, and the ratio of ADH foci to number of cores (FC ratio). RESULTS: We found that ADH foci in 3 or more cores (p=0.003) and the presence of ADH in 3 or more foci (p=0.002) were correlated with malignancy following excision lesion. Moreover, an FC>1.1 was significantly associated with malignancy in the subsequent excision (p=0.000). CONCLUSIONS: Including the number of ADH foci, the number of cores involved according to ADH, FC ratio, and histologic type in a pathology report of CNB may help in making clinical decisions about surgical excision.
Biopsy, Large-Core Needle ; Breast ; Breast Neoplasms ; Hyperplasia ; Needles ; Retrospective Studies

Squamous cell carcinoma infrequently occurs at the soft palate. Although various methods can be used for reconstruction of soft palate defects that occur after resecting squamous cell carcinoma, it is difficult to obtain satisfactory results from the perspective of the functional restoration of the soft palate. A combination of bilateral palatal mucomuscular flap for the oral side and superiorly based posterior pharyngeal flap for the nasal side were performed on two patients who were diagnosed with squamous cell carcinoma of the soft palate in order to reconstruct the soft palate defects after surgical resection. After surgery, the patients were followed-up for a mean period of 11 months. The flaps were well maintained in both patients. The donor site defects were epithelialized and completely recovered. Additionally, no recurrence of the primary sites was shown. Slight hyponasality was observed in the voice assessments that were conducted 6 months after surgery. No food regurgitation or aspiration was observed in the swallowing tests. We used a combination of bilateral palatal mucomuscular flap and superiorly based posterior pharyngeal flap to reconstruct the soft palate defects that occurred after resecting the squamous cell carcinomas. We reduced the donor site complications and achieved functionally satisfactory outcomes.
Carcinoma, Squamous Cell ; Deglutition ; Head and Neck Neoplasms ; Humans ; Palate, Soft ; Recurrence ; Surgical Flaps ; Tissue Donors ; Voice

PURPOSE: We evaluated the usefulness of an additional, 2.7 mm mini-locking plate for tibial pilon fractures. MATERIALS AND METHODS: We studied 21 patients (14 males and 7 females), who were treated with a 2.7 mm mini-locking plate via the anterolateral approach for tibial pilon fractures between September 2012 and April 2014. The mean age was 43.85 years, and the mean follow-up period was 16.6 months. The radiologic outcomes were graded by the Burwell and Charnley modified system and clinical outcomes were evaluated by the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hind foot score and visual analogue scale (VAS) score. RESULTS: The mean union period was 14.3 weeks. At the final follow-up, radiologic results showed 16 excellent results, 4 fair results, and 1 poor result. The average VAS was 3.4 points; the average AOFAS score was 81.8 points. During the follow-up period, there were three cases of posttraumatic osteoarthritis and one case of superficial skin infection. CONCLUSION: Additional anterolateral, 2.7 mm mini-locking plate may be a good treatment method to manage tibial pilon fractures.
Ankle ; Follow-Up Studies ; Foot ; Humans ; Male ; Methods ; Osteoarthritis ; Skin

PURPOSE: People with a family history of mood disorder are more likely to have depression. This study compared the characteristics of non-psychotic major depression disorder according to family history of depression. METHOD: Subjects were total of 817 persons recruited for the CRESCEND-K multicenter trial. Characteristics of depression and suicide history of patients with and without a family history of depression were assessed. Family history was determined through self-report. RESULTS: Of 817 participants, 12.4% had a positive family history of depression. Those with family history of depression reported an earlier age at onset of MDD, and more psychiatric comorbidity. Severity of depression and anxiety were not different according to family history of depression. There were no difference in attempted suicide history, number of attempted suicide and age at onset of 1st attempted suicide according to such a family history. CONCLUSION: Patients with family history of depression reported earlier onset of MDD and more history of psychiatric comorbidity.
Anxiety ; Comorbidity ; Depression ; Depressive Disorder, Major ; Humans ; Mood Disorders ; Suicide ; Suicide, Attempted

We report a rare case of the idiopathic membranous glomerulonephritis (IMGN) in association with the thin glomerular basement membrane nephropathy (TGBMN) in a 63-year-old female with hematuria. This is the first case reported in Korea. In renal biopsy of this case, direct immunofluorescence demonstrated anti-IgG Ab along the glomerular capillary wall with granular pattern. The basement membrane was thin, about 170-220 nm and small epimembranous electron dense deposits were observed by electron microscopy. As this case, the combination of TGBMN and IMGN is very uncommon because the IMGN is characterized morphologically by diffuse global thickening of the glomerular capillary wall, while the TGBMN is defined as an extreme thinning of the glomerular basement membrane, less than 200 nm. Our case showed no renal function deterioration and benign prognosis as other reports showed.
Basement Membrane ; Biopsy ; Capillaries ; Female ; Fluorescent Antibody Technique, Direct ; Glomerular Basement Membrane* ; Glomerulonephritis, Membranous* ; Hematuria ; Humans ; Korea ; Microscopy, Electron ; Middle Aged ; Prognosis

BACKGROUND: Atopic dermatitis is a global public health concern owing to its increasing prevalence and socioeconomic burden. However, few studies have assessed the economic impact of atopic dermatitis in Korea. OBJECTIVE: We conducted a cost analysis of atopic dermatitis and evaluated its economic impacts on individual annual disease burden, quality of life, and changes in medical expenses with respect to changes in health related-quality of life. METHODS: The cost analysis of atopic dermatitis was performed by reviewing the home accounting records of 32 patients. The economic impact of the disease was evaluated by analyzing questionnaires. To handle uncertainties, we compared the results with the data released by the Health Insurance Review & Assessment Board on medical costs claimed by healthcare facilities. RESULTS: The direct cost of atopic dermatitis per patient during the 3-month study period was 541,280 Korean won (KRW), and expenditures on other atopic dermatitis-related products were 120,313 KRW. The extrapolated annual direct cost (including expenditures on other atopic dermatitis-related products) per patient was 2,646,372 KRW. The estimated annual indirect cost was 1,507,068 KRW. Thus, the annual cost of illness of atopic dermatitis (i.e., direct+indirect costs) was estimated to be 4,153,440 KRW. CONCLUSION: The annual total social cost of atopic dermatitis on a national level is estimated to be 5.8 trillion KRW.
Cost of Illness ; Costs and Cost Analysis ; Delivery of Health Care ; Dermatitis, Atopic* ; Health Expenditures ; Humans ; Insurance, Health ; Korea ; Prevalence ; Public Health ; Quality of Life ; Surveys and Questionnaires

Sialadenosis is a unique form of non-inflammatory, non-neoplastic bilateral salivary gland disorder characterized by recurrent painless swelling which usually occurs in parotid glands. Alcoholism is one of the main causes of sialadenosis along with diabetes, bulimia, and other idiopathic causes. The prognosis is verified according to the degree of liver function. We present a case of a 46 year-old man who had alcoholic fatty liver disease diagnosed as alcoholic sialadenosis based on clinical points of recurrent bilateral parotid swelling after heavy alcohol drinking, computed tomography, and fine-needle aspiration biopsy. After stopping alcohol drinking and treated with conservative treatment, he got improved without specific sequela.
Adult ; *Alcohol Drinking ; Fatty Liver, Alcoholic/*diagnosis/etiology/radiography ; Humans ; Male ; Parotid Gland/*radiography/secretion ; Positron-Emission Tomography ; Sialadenitis/*diagnosis/etiology ; Tomography, X-Ray Computed

Although primary care has been recognized as an essential element of the healthcare system, the primary healthcare of Korea has not been highly valued. Listening to the voices of physicians who are engaged in primary care should be the first step for improving the level of primary care in Korea. In this study, we conducted a questionnaire survey of general internists to investigate their perspectives regarding primary care, and which included the evaluation of current primary care, perception of the five, key attributes of primary care, and their opinions regarding the management system of chronic diseases. A total of 466 general internists' responses were used in this analysis. The results showed that primary care is considered to have an important role, according to general internists, although their evaluation of the overall status of primary care in Korea indicated that it is poor. The respondents also indicated that the functions of coordination and comprehensiveness in primary care, which can be integral for treating patients with chronic diseases, are most vulnerable. Given the high level of agreement regarding the need for a new medical management system for chronic diseases, based on physicians' autonomy and provided by clinics, establishing a policy encouraging the participation of general internists should be emphasized.
Adult ; Aged ; Attitude of Health Personnel ; Chronic Disease ; Female ; Humans ; Male ; Middle Aged ; Physicians/*psychology/trends ; Practice Patterns, Physicians'/*trends ; Primary Health Care/*trends ; Republic of Korea ; Surveys and Questionnaires

PURPOSE: The large disparity in outcomes of out-of-hospital cardiac arrest (OHCA) between communities makes it important determine pre-hospital factors associated with outcome of OHCA. The study evaluated pre-hospital care performed by 119 rescuers in OHCA and investigated pre-hospital factors that influenced return of spontaneous circulation (ROSC) and automated external defibrillator (AED) use. METHODS: We retrospectively analyzed 119 OHCA patients with presumed cardiac origin admitted to our emergency department transported by 119 rescuers from May 2007 to April 2010. Patients were divided according to achievement of ROSC and AED use prior to comparative analysis. RESULTS: Twenty six patients (21.8%) experienced ROSC and only five patients (4.2%) survived to discharge. In the study area, scene-to-hospital arrival time was significantly shorter in the ROSC group (15.0+/-5.8 minutes) than the non-ROSC group (19.4+/-9.1 minutes) (p=0.02) and electrocardiography (ECG) application was associated with non-AED use. CONCLUSION: Cooperation of emergency medical services and hospitals in the community to reduce hospital arrival time is needed to improve ROSC in OHCA patients. AED use on scene prior to ECG application will be encouraged and higher level training and continuous education of 119 rescuers for AED use will be needed to enhance AED application.
Achievement ; Defibrillators ; Electrocardiography ; Emergencies ; Emergency Medical Services ; Humans ; Out-of-Hospital Cardiac Arrest ; Retrospective Studies