PURPOSE: evaluate the effectiveness of minimally invasive plate osteosynthesis (MIPO) in unstable fractures of the distal tibia. MATERIALS AND METHODS: From March 2001 to December 2003, 21 cases with unstable fractures of the distal tibia were treated with MIPO technique and followed for at least one year. Eighteen cases were extra-articular and three cases were intra-articular fractures. According to AO classification, six cases were 42-A, four 42-B, one 42-C, seven 43-A, and three 43-C. There was only one case of Gustilo-Anderson type II open fracture. We reviewed the results of fracture healing, axial and rotational deformity, ankle motion, and complications RESULTS: All fractures were healed in an average of 16.1 weeks (range, 11 to 24 weeks). There was only one case of 7-degree posterior angular deformity, but no cases of rotational malalignment. Recovery of ankle motion was satisfactory in all patients within 5-degree loss of motion. Subcutaneous abscess was developed in one case after fracture healing and cured by a drainage with implant removal. CONCLUSION: Although MIPO technique is technically more demanding than the traditional open technique, MIPO technique is an effective method for unstable fractures of the distal tibia because it minimizes incidence of soft-tissue compromise and infection and provides good fracture healing.
Abscess ; Ankle ; Classification ; Congenital Abnormalities ; Drainage ; Fracture Healing ; Fractures, Open ; Humans ; Incidence ; Intra-Articular Fractures ; Tibia*

PURPOSE: To evaluate the functional results of the elbow and the complications after internal fixation for distal humeral fractures. MATERIALS AND METHODS: We reviewed 38 distal humeral fractures; 12 type A, 7 type B and 19 type C by AO classification. There were six low columnar fractures in type A and nine in type C. Six type C fractures were open. The fracture healing and complications were assessed and the functional result was evaluated by rating system of Jupiter et al. RESULTS: Type A fractures were healed in an average of 10.6 weeks, type B 7.7 weeks and type C 11.5 weeks. Ulnar neuropathy occurred in six cases, loss of fixation in two cases, nonunion in one case, heterotopic ossification in one case and traumatic arthritis in one case. The functional result showed excellent or good in 34 cases (89%) and fair or poor in 4 cases (11%). Open fractures showed significantly worse result than closed fractures. CONCLUSION: To obtain the satisfactory results, stable fixation followed by early motion is required in most distal humeral fractures. Ulnar neuropathy occurs postoperatively in high incidence and the result of open fractures is worse than that of closed fractures.
Arthritis ; Classification ; Elbow* ; Fracture Healing ; Fractures, Closed ; Fractures, Open ; Humeral Fractures ; Humerus* ; Incidence ; Ossification, Heterotopic ; Ulnar Neuropathies

No abstract available.
Neural Tube Defects* ; Spinal Canal*

BACKGROUND AND OBJECTIVES: To determine the clinical application of otoacoustic emissions (OAE) in screening of cochlear function, author studied changes of OAE in Meniere's disease patients. MATERIALS AND METHODS: The author has measured several parameters of OAE with 34 meniere's patients and 15 normal persons. Pass rate, response amplitude, reproducibility were recorded at TEOAE. Amplitude of DP-gram were measured at 2 F2 frequencies-1000, 2000 Hz. The input/output functions of DPOAE were recorded at 2 F2 frequencies -1001, 2002 Hz (respectively DP-1000, DP-2000). Input/output function were determined based on 2 parameters- maximal level and Detection threshold of DPOAE. RESULTS: 1) TEOAE: Significant lower rate of positive finding was recorded at involved ears (55.8%, 19/34) than normal ears (100%, 30/30). 2) DP-gram: At frequency was 2000 Hz, amplitude of involved ears (n=28, 6.3+/-.5 dB/SPL) was significant smaller than normal ears (n=30, 6.3+/-.5 dB/SPL). 3) DP-input/output function: At maximum DP level of DP-2000, response of involved ears (n=11, 51.6+/-.9 dB/SPL) was significant larger than normal ears (n=22, 48.5+/-.0 dB/SPL). CONCLUSION: Parameters of OAE, such as pass rate of TEOAE, amplitude of DP-gram at 2000 Hz, and maximum DP level of DP-2000 was considered to good indicators for monitoring cochlear function of Meniere's disease. Furthermore, evaluation by changes in the TEOAE & DPOAE combined parameters, appeared to be very useful for detection of subtle change in cochlear function of Meniere's disease.
Ear ; Humans ; Mass Screening ; Meniere Disease*

BACKGROUND AND OBJECTIVES: To determine the clinical application of otoacoustic emissions (OAE) in screening of cochlear function, author studied changes of OAE in Meniere's disease patients. MATERIALS AND METHODS: The author has measured several parameters of OAE with 34 meniere's patients and 15 normal persons. Pass rate, response amplitude, reproducibility were recorded at TEOAE. Amplitude of DP-gram were measured at 2 F2 frequencies-1000, 2000 Hz. The input/output functions of DPOAE were recorded at 2 F2 frequencies -1001, 2002 Hz (respectively DP-1000, DP-2000). Input/output function were determined based on 2 parameters- maximal level and Detection threshold of DPOAE. RESULTS: 1) TEOAE: Significant lower rate of positive finding was recorded at involved ears (55.8%, 19/34) than normal ears (100%, 30/30). 2) DP-gram: At frequency was 2000 Hz, amplitude of involved ears (n=28, 6.3+/-.5 dB/SPL) was significant smaller than normal ears (n=30, 6.3+/-.5 dB/SPL). 3) DP-input/output function: At maximum DP level of DP-2000, response of involved ears (n=11, 51.6+/-.9 dB/SPL) was significant larger than normal ears (n=22, 48.5+/-.0 dB/SPL). CONCLUSION: Parameters of OAE, such as pass rate of TEOAE, amplitude of DP-gram at 2000 Hz, and maximum DP level of DP-2000 was considered to good indicators for monitoring cochlear function of Meniere's disease. Furthermore, evaluation by changes in the TEOAE & DPOAE combined parameters, appeared to be very useful for detection of subtle change in cochlear function of Meniere's disease.
Ear ; Humans ; Mass Screening ; Meniere Disease*

BACKGROUND AND OBJECTIVES: Hypopharyngeal cancer is notorious for its poor prognosis and severe surgical morbidity with functional deficits. This study was conducted to compare the efficacy between the neoadjuvant chemotherapy followed by radiotherapy and surgery with postoperative radiotherapy in the treatment of hypophayngeal cancer. MATERIAL AND METHOD: Medical records of 64 patients, treated for hypopharyneal cancer at Pusan National University Hospital from March 1986 through May 2000, were retrospectively reviewed. Thirty-three patients were grouped into the chemotherapy and radiotherapy (CRTx) group, who received neoadjuvant chemotherapy and radiotherapy. Thirty-one patients were grouped into the operation and radiotherapy (ORTx) group, who received laryngectomy with or without reconstruction and postoperative radiotherapy. RESULTS: There was no significant difference of three years survival rate between CRTx group and ORTx group (p>0.05). Laryngeal preservation rate was 45% in CRTx group but 3% in ORTx group (p<0.05). CONCLUSION: Although this had not been a randomized study of chemotherapy followed by radiotherapy versus surgery plus postoperative radiotherapy, the survival rate of CRTx group appears to be as identical as ORTx group and more effective in the preservation of the larynx.
Busan ; Drug Therapy* ; Humans ; Hypopharyngeal Neoplasms* ; Laryngectomy ; Larynx ; Medical Records ; Neoadjuvant Therapy ; Organ Preservation ; Prognosis ; Radiotherapy* ; Retrospective Studies ; Survival Rate

OBJECTIVE: The purpose of this study was to assess the mean fetal biometry and to create a formulae for estimation of gestational week using sonographic biometry measurement. METHODS: A total 271 women of singleton gestation were involved in this study of ultrasonographic fetal biometry. During the period from June 1996 to March 1998, the length of CRL (Crown Rump Length), BPD (Biparietal Diameter), HC (Head Circumference), AC (Abdominal Circumference), HL (Humerus Length) and TL (Tibia Length) of fetuses in normal pregnancy were measured by ultrasonography at Samsung Cheil Hospital and Women's Healthcare Center. The gestational age prediction equations were derived from sigletons with the use of liner regression analysis. RESULTS: We present the percentile ranks of fetal CRL, BPD, HC, AC, HL and TL measurement from 11 to 39 week's gestation and mean value of fetal size at each week. These data were analyzed and several second grade equations were derived from the data. CONCLUSION: We created these authentic equations and tables for mean value of fetal biometry in normal pregnancy at each gestation week with minimal intervariable errors.
Biometry* ; Delivery of Health Care ; Female ; Fetus ; Gestational Age ; Humans ; Pregnancy* ; Ultrasonography*

BACKGROUND: Constipation occurs frequently in diabetes mellitus (DM). However, there are few reports that investigated the characteristics of constipation associated with DM. The purpose of this study was to evaluate the clinical features of constipation associated with DM. METHODS: Among constipated patients who visited Asan Medical Center from January 2000 to December 2004, 45 patients with DM (DM group) and 104 patients without DM (non-DM group) were included in this study. We reviewed the clinical presentation, results of anorectal manometry, colon transit time study, and defecogram. We also analyzed the response to biofeedback therapy. RESULTS: The severity of constipation symptoms before treatment was not different between DM and non-DM group. Patients with colon transit time over 56 hours were more frequent in DM group than in non-DM group (21/45, 46.7% vs. 31/104, 29.8% ; p=0.047). Among DM group, colon transit time and the duration of DM showed positive correlation (r=0.431, p=0.003). The resting anal sphincter pressure was significantly lower in DM group than in non-DM group (43.5+/-21.5 mmHg vs. 51.7+/-22.6 mmHg ; p=0.048). The results of defecography were similar between DM and non-DM group. Successful responses to biofeedback therapy were not different between DM and non-DM group (19/34, 55.9% vs. 43/79, 54.4% ; p=0.887). CONCLUSIONS: Slow transit constipation was more frequent in DM group than in non-DM group. The successful responses to biofeedback therapy appear to be similar between DM and non-DM group.
Anal Canal ; Biofeedback, Psychology ; Chungcheongnam-do ; Colon ; Constipation* ; Defecography ; Diabetes Mellitus* ; Humans ; Manometry ; Time and Motion Studies

BACKGROUND/AIMS: To evaluate the yields and utility of 19-gauge (G) Trucut biopsy (TCB) versus 22 G fine needle aspiration (FNA) for diagnosing gastric subepithelial tumors (SETs). METHODS: We retrieved data for 152 patients with a gastric SET larger than 2 cm who had undergone endoscopic ultrasonography (EUS)-guided 19 G TCB (n=90) or 22 G FNA (n=62). Relevant clinical, tumor-specific, and EUS procedural information was reviewed retrospectively. RESULTS: A specific diagnosis was made for 76 gastrointestinal stromal tumors (GISTs) and 51 non-GIST SETs. The diagnostic yield of TCB was greater than that of FNA (77.8% vs. 38.7%, p<0.001). The percentage of non-diagnostic specimens (suspicious and insufficient) was significantly lower in the TCB group (6.7% and 15.5%, respectively) than in the FNA group (22.6% and 38.7%, respectively; both p<0.001). TCB accurately diagnosed 90.9% of GISTs and 81.1% of non-GIST SETs, whereas FNA accurately diagnosed 68.8% of GISTs and 14.3% of non-GIST SETs. There were nine technical failures with TCB, and the rate of adverse events did not differ between the groups (TCB vs. FNA, 3.3% vs. 8.1%; p=0.27). CONCLUSIONS: Nineteen-gauge TCB is safe and highly valuable for diagnosing gastric SETs larger than 2 cm if technical failure can be avoided.
Biopsy* ; Biopsy, Fine-Needle* ; Biopsy, Large-Core Needle ; Diagnosis ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Endosonography ; Gastrointestinal Stromal Tumors ; Humans ; Retrospective Studies ; Stomach

BACKGROUND/AIMS: Metastasis to the stomach is rare. The aim of this study was to describe and analyze the clinical outcomes of cancers that metastasized to the stomach. METHODS: We reviewed the clinicopathological aspects of patients with gastric metastases from solid organ tumors. Thirty-seven cases were identified, and we evaluated the histology, initial presentation, imaging findings, lesion locations, treatment courses, and overall patient survival. RESULTS: Endoscopic findings indicated that solitary lesions presented more frequently than multiple lesions and submucosal tumor-like tumors were the most common appearance. Malignant melanoma was the tumor that most frequently metastasized to the stomach. Twelve patients received treatments after the diagnosis of gastric metastasis. The median survival period from the diagnosis of gastric metastasis was 3.0 months (interquartile range, 1.0 to 11.0 months). Patients with solitary lesions and patients who received any treatments survived longer after the diagnosis of metastatic cancer than patients with multiple lesions and patients who did not any receive any treatments. CONCLUSIONS: Proper treatment with careful consideration of the primary tumor characteristics can increase the survival period in patients with tumors that metastasize to the stomach, especially in cases with solitary metastatic lesions in endoscopic findings.
*Endoscopy, Gastrointestinal ; Female ; Gastric Mucosa/*pathology ; Humans ; Male ; Melanoma/*pathology ; Middle Aged ; Stomach Neoplasms/mortality/*secondary/therapy ; Survival Analysis