Many modalities of the treatment of fractures of distal 1/3 of tibia were introduced. But, May anatomical bone plate is considered to be a valuable method in treating distal 1/3 tibial fractures because of reduction potentiality by their contour, ability of firm fixation, decreased complications. Twenty two patients having distal 1/3 tibial fractures, were treated by May anatomical bone plate, at the Department of Orthopedic Surgery, Inchon Chirstian Hospital from January 1988 to December 1993. The results were follows; 1. Ninteen cases(86%) out of 22 were closed fractures and the remaining 3 cases(14%) were open fracrues, the comminuted fractures were 6 cases(22%) and the segmental fractures were 2 cases(9%). 2. Average interval from injuy to operation was 16.8 days and 21 cases had associated injuries. 3. The mean duration of bone union was 16.9 weeks. 4. Seven cases(31.8%) of delayed union and two cases(9.1%) of superficial infection were noted.
Bone Plates ; Fractures, Closed ; Fractures, Comminuted ; Humans ; Incheon ; Methods ; Orthopedics ; Tibia ; Tibial Fractures

We present the case of a 7 year-old child who underwent angioplasty with a stent for anastomosis site stenosis between a left subclavian artery free graft and the left main coronary artery in an arterial switch operation.
Angioplasty* ; Child* ; Constriction, Pathologic ; Coronary Vessels ; Humans ; Stents* ; Subclavian Artery ; Transplants ; Transposition of Great Vessels

This prospective study was performed to determine the effective antibiotics for use in treating acute appendicitis patients during the perioperative period. To identify the sensitive antibiotics, the peritoneal fluid was cultured during operation. Also, wound infection was defined as pus or serous discharge in the wound or when we opened the wound under suspicious of a wound problem. The results were obtained as follows: 1) A total of 138 cases treated during the two years from January 1995 to December 1996 were examined; 84 of them (60.87%) were found to have positive peritoneal fluid cultures, of which 29 (34.52%) were monomicrobial and 55 (65.48%) were polymicrobial. 2) The most common species were Escherichia coli (73.81%), Bacteroides (32.14%), Klebsiella (16.67%), Pseudomonas (9.52%), and Streptococcus (9.52%). 3) In the sensitivity test, the most sensitive drugs were aminoglycosides and cefotaxime. 4) Infectious complications, which developed in 27 (19.6%) patients, were wound infection and intraabdominal abscess. 5) The average length of stay for all patients 9.9 days (range: 3 to 32 days). 6) The common organisms curtured from the complication cases were E. coli and Bacteroides.
Abscess ; Aminoglycosides ; Anti-Bacterial Agents* ; Appendicitis* ; Ascitic Fluid ; Bacteroides ; Cefotaxime ; Escherichia coli ; Humans ; Klebsiella ; Length of Stay ; Perioperative Period ; Prospective Studies ; Pseudomonas ; Streptococcus ; Suppuration ; Wound Infection ; Wounds and Injuries

Macrophage infiltration has been observed in the renal biopsy specimens of diabetic nephropathy (DN), and hyperglycemic state stimulates the renal expression of RANTES (regulated upon activation, normal T-cell expressed and secreted) and MCP-1 (monocyte chemoattractant protein-1). Upregulation of RANTES and MCP-1 with infiltrating macrophages may play a crucial role in the development and progression of DN. Genetic polymorphisms of RANTES and its receptors were reported to be independent risk factors for DN. We genotyped single nucleotide polymorphism (SNPs) in the MCP-1 G-2518A, CCR2 G46295A, RANTES C-28G and G-403A in 177 diabetic end-stage renal disease (ESRD) patients and 184 patients without renal involvement (controls) in order to investigate the effects of these SNPs on DN in Korean patients with type 2 DM. There were no differences in the frequencies of SNPs and the distribution of haplotypes of RANTES promoter SNPs between two groups. In conclusion, there were no associations of MCP-1, CCR2 and RANTES promoter SNPs with diabetic ESRD in Korean population. Prospective studies with clearly-defined, homogenous cohorts are needed to confirm the effect of these genetic polymorphisms on DN.
Aged ; Asian Continental Ancestry Group/*genetics ; Chemokine CCL2/*genetics ; Chemokine CCL5/*genetics ; Chi-Square Distribution ; Diabetes Mellitus, Type 2/complications ; Female ; Gene Frequency ; Genotype ; Haplotypes ; Humans ; Kidney Failure, Chronic/ethnology/etiology/*genetics ; Korea ; Male ; Middle Aged ; *Polymorphism, Single Nucleotide ; Promoter Regions, Genetic

We investigated the outcome of idarubicin plus N4-behenoyl-1-beta-D-arabinofuranosyl cytosine (BHAC)-based chemotherapy (BHAC group, n=149) compared to idarubicin plus cytarabine-based chemotherapy (cytarabine group, n=191) for childhood acute myeloid leukemia (AML). Between January 1996 and December 2005, 340 children with AML from 5 university hospitals in Korea received the BHAC-based or cytarabine-based chemotherapy, with or without hematopoietic stem cell transplantation. After induction therapy, 264 (77.6%) of 340 children achieved a complete remission (CR) and 43 (12%) achieved a partial remission (PR). The CR rate in the BHAC group was higher than in the cytarabine group (85.2% vs. 71.7%, P=0.004). However, the overall response rate (CR+PR) was not different between the two groups (93.3% vs. 87.9%, P=0.139). The 5-yr estimates of overall survival (OS) of children in the two groups were similar (54.9% for the BHAC group vs. 52.4% for the cytarabine group, P=0.281). Although the results were analyzed according to the treatment type and cytogenetic risk, the OS showed no significant difference between the BHAC group and the cytarabine group. In the present study, the clinical outcomes of the BHAC-based chemotherapy, consisting of BHAC, idarubicin, and 6-TG, are comparable to that of the cytarabine-based chemotherapy for childhood AML.
Adolescent ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Child ; Child, Preschool ; Combined Modality Therapy ; Cytarabine/*analogs & derivatives/*therapeutic use ; Cytogenetics ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Idarubicin/*therapeutic use ; Infant ; Infant, Newborn ; Leukemia, Myeloid, Acute/*drug therapy/mortality ; Male ; Republic of Korea ; Retrospective Studies ; Survival Analysis ; Thioguanine/*therapeutic use ; Young Adult

BACKGROUND: Unlike 99mTc-Sestamibi, microbubbles used during myocardial contrast echocardiography (MCE) exist only in the vascular space. Therefore, there may be a difference in the pattern of myocardial perfusion between MCE and 99mTc-Sestamibi Single-Photon Emission Computed Tomography (SPECT) in acute myocardial infarction (AMI). OBJECTIVES: The purpose of this study was to assess myocardial perfusion using MCE with intravenous infusion of perfluorocarbon-exposed sonicated dextrose albumin microbubbles (IV MCE), and to compare it with SPECT and MCE with intracoronary injection of sonicated Hexabrix (IC MCE). METHODS: Seventeen patients with AMI (male 13, age 59.5+/-8.8 years, anterior MI 10) underwent IV MCE at 8.1+/-3.7 days after onset. SPECT and IC MCE were also performed at 1.2+/-1.0 days and 2.0+/-1.5 days from IV MCE respectively. Any revascularization procedures were not performed between three studies. Perfusion defect by three methods was scored semiquantitatively as 1 : normal perfusion, 0.5 : moderate defect, and 0 : severe defect at 16 segments of the left ventricle. RESULTS: 1) Perfusion defect in infarction territory was detected in 15 patients with SPECT, 12 patients with IV MCE and 11 patients with IC MCE. 2) Concordance of perfusion score at each segment was 93% between IV MCE and IC MCE, 65% between IV MCE and SPECT, and 64% between IC MCE and SPECT. 3) With IV MCE, perfusion defect was observed in all 32 segments which were considered as having defect (score 0 and 0.5) by IC MCE. However, defect by IV MCE was found only in 31 out of 108 segments considered as having defect by SPECT. CONCLUSION: In the assessment of myocardial perfusion in pts with AMI, IV MCE and IC MCE showed similar results. However, there was some discrepancy in the extent of perfusion defect between MCE studies and SPECT.
Echocardiography ; Glucose ; Heart Ventricles ; Humans ; Infarction ; Infusions, Intravenous ; Ioxaglic Acid ; Microbubbles ; Myocardial Infarction* ; Perfusion* ; Technetium Tc 99m Sestamibi ; Tomography, Emission-Computed ; Tomography, Emission-Computed, Single-Photon

The efficacy of tandem high-dose chemotherapy and autologous stem cell rescue (HDCT/ASCR) was investigated in patients with high-risk neuroblastoma. Patients over 1 yr of age who were newly diagnosed with stage 4 neuroblastoma from January 2000 to December 2005 were enrolled in The Korean Society of Pediatric Hematology-Oncology registry. All patients who were assigned to receive HDCT/ASCR at diagnosis were retrospectively analyzed to investigate the efficacy of single or tandem HDCT/ASCR. Seventy and 71 patients were assigned to receive single or tandem HDCT/ASCR at diagnosis. Fifty-seven and 59 patients in the single or tandem HDCT group underwent single or tandem HDCT/ASCR as scheduled. Twenty-four and 38 patients in the single or tandem HDCT group remained event free with a median follow-up of 56 (24-88) months. When the survival rate was analyzed according to intent-to-treat at diagnosis, the probability of the 5-yr event-free survival+/-95% confidence intervals was higher in the tandem HDCT group than in the single HDCT group (51.2+/-12.4% vs. 31.3+/-11.5%, P=0.030). The results of the present study demonstrate that the tandem HDCT/ASCR strategy is significantly better than the single HDCT/ASCR strategy for improved survival in the treatment of high-risk neuroblastoma patients.
Adolescent ; Child ; Child, Preschool ; Combined Modality Therapy/mortality ; Drug Therapy/*mortality ; Female ; Humans ; Infant ; Korea/epidemiology ; Longitudinal Studies ; Male ; Neuroblastoma/*mortality/*therapy ; Prevalence ; Risk Assessment/methods ; Risk Factors ; Stem Cell Transplantation/*mortality ; Survival Analysis ; Survival Rate ; Treatment Outcome

PURPOSE: Despite the rapid improvement in survival rate from Burkitt lymphoma and mature B-cell lymphoblastic leukemia (B-ALL) in children, a small subset of patients do not respond to first-line chemotherapy or experience relapse (RL). Herein, we report the clinical characteristics and outcomes of these patients. MATERIALS AND METHODS: RL or refractory Burkitt lymphoma and mature B-ALL in 125 patients diagnosed from 1990 to 2009 were retrospectively analyzed. RESULTS: Nineteen patients experienced RL or progressive disease (PD). Among them, 12 patients had PD or RL less than six months after initial treatment and seven had late RL. Seven patients achieved complete response (CR), 11 had PD, and one had no more therapy. Six patients who achieved CR survived without evidence of disease and four of them underwent high-dose chemotherapy (HDC) followed by stem cell transplantation (SCT). However, 11 patients who failed to obtain CR eventually died of their disease. Five-year overall survival (OS) was 31.6+/-10.7%. OS of patients with late RL was superior to that of patients with early RL (57.1+/-18.7%, vs. 16.7+/-10.8%, p=0.014). Achievement of CR after reinduction had significant OS (p < 0.001). OS for patients who were transplanted was superior (p < 0.01). In multivariate analysis, achievement of CR after reinduction chemotherapy showed an association with improved OS (p=0.05). CONCLUSION: Late RL and chemotherapy-sensitive patients have the chance to achieve continuous CR using HDC/SCT, whereas patients who are refractory to retrieval therapy have poor prognosis. Therefore, novel salvage strategy is required for improvement of survival for this small set of patients.
Adolescent* ; B-Lymphocytes* ; Burkitt Lymphoma* ; Child* ; Drug Therapy ; Humans ; Multivariate Analysis ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Prognosis ; Recurrence ; Retrospective Studies ; Stem Cell Transplantation ; Survival Rate

We verified the reliability and validity of the Korean version of the Minneapolis-Manchester Quality of Life Instrument-Adolescent Form (KMMQL-AF) among Korean childhood cancer survivors. A total of 107 childhood cancer patients undergoing cancer treatment and 98 childhood cancer survivors who completed cancer treatment were recruited. To assess the internal structure of the KMMQL-AF, we performed multi-trait scaling analyses and exploratory factor analysis. Additionally, we compared each domains of the KMMQL-AF with those of the Karnofsky Performance Status Scale and the Revised Children's Manifest Anxiety Scale (RCMAS). Internal consistency of the KMMQL-AF was sufficient (Cronbach's alpha: 0.78-0.92). In multi-trait scaling analyses, the KMMQL-AF showed sufficient construct validity. The "physical functioning" domain showed moderate correlation with Karnofsky scores and the "psychological functioning" domain showed moderate-to-high correlation with the RCMAS. The KMMQL-AF discriminated between subgroups of different adolescent cancer survivors depending on treatment completion. The KMMQL-AF is a sufficiently reliable and valid instrument for measuring quality of life among Korean childhood cancer survivors.
*Adaptation, Psychological ; Adolescent ; Antineoplastic Agents/therapeutic use ; Asian Continental Ancestry Group ; Factor Analysis, Statistical ; Female ; Humans ; Interviews as Topic ; Male ; Neoplasms/drug therapy/*psychology ; Program Evaluation ; *Quality of Life ; Questionnaires/standards ; Republic of Korea ; Young Adult

Chronic obstructive pulmonary disease (COPD) results in high morbidity and mortality among patients nationally and globally. The Korean clinical practice guideline for COPD was revised in 2018. The guideline was drafted by the members of the Korean Academy of Tuberculosis and Respiratory Diseases as well as the participating members of the Health Insurance Review and Assessment Service, Korean Physicians' Association, and Korea Respiration Trouble Association. The revised guideline encompasses a wide range of topics, including the epidemiology, diagnosis, assessment, monitoring, management, exacerbation, and comorbidities of COPD in Korea. We performed systematic reviews assisted by an expert in meta-analysis to draft a guideline on COPD management. We expect this guideline to facilitate the treatment of patients with respiratory conditions by physicians as well other health care professionals and government personnel in South Korea.
Comorbidity ; Delivery of Health Care ; Diagnosis ; Epidemiology ; Humans ; Insurance, Health ; Korea ; Mortality ; Pulmonary Disease, Chronic Obstructive* ; Respiration ; Tuberculosis*