No abstract available.
Aged* ; Femoral Neck Fractures* ; Femur Neck* ; Humans

The os calcis is most frequently fractured than any other tarsal bone and the displaced intraarticular fractures account for 60-75% of them. Because of complex contour of calcaneous, it is difficult to evaluate the pattern of fracture exactly by conventional roentgenograms. But recently, more detailed understanding of fracture pattern can be possible with CT scan, which is thought to be one of the most important factor in deciding method of treatment and predicting prognosis. From Jan. 1992 to Dec. 1992, intraarticular calcaneal fractures of 31 cases treated in Kyungpook university hospital were analysed preoperatively with CT scan and classified by Sanders classification system. The results were obtained as follows: 16 cases of 31 cases were classified as type II and this type were sudivided as IIA in 7 cases, IIb in 4 cases, IIC in 5 cases. Type III fractures were found in 9 cases and subdivided as III AB in 3 cases, III BC in 4 cases IIIAC in 2 cases. Type IV fractures were found in 6 cases.
Classification ; Gyeongsangbuk-do ; Intra-Articular Fractures ; Methods ; Prognosis ; Tarsal Bones ; Tomography, X-Ray Computed

Acupuncture, one of oriental medicine’s crucial treatment methods, is a popular practice around the world. Although its mechanism of effect remains uncertain and unknown, many people have confidence in this treatment method. Ironically, due to its rise in popularity, there are increased reports of treatment complications. We present here a case where a 75- year-old patient suffered acute cervical epidural hemorrhage mimicking symptoms of acute disc rupture, immediately after being administered acupuncture on the neck. Fortunately, the patient required no surgical intervention since his motor symptoms spontaneously improved with only pain management. After a close observation period of 10 days, the patient was discharged with mild radiculopathy. This case was unique since it mimicked the symptoms of acute disc rupture or severe stenosis. Thus, to successfully manage patients, the initial history taking at the emergency room is crucial. Patients should always consider that even though the reported complication rate for acupuncture is very low, there is a possibility of severe adverse effects, such as the consequences seen in this case.

OBJECTIVES: Posttraumatic stress disorder(PTSD) has devastating effects on multiple aspects of the quality of life(QoL). Therefore, the purpose of this study is to compare the QoL between PTSD group and non-PTSD group, and identify the variables affecting the QoL of the Vietnam War veterans. METHODS: We recruited 39 veterans with PTSD and 43 veterans without PTSD, all of whom had deployed to the Vietnam War. We used the Korean version of Mini International Neuropsychiatric Interview-Plus, the Korean version of Clinician-Administered PTSD Scale, Combat Exposure Scale and the Korean version of World Health Organization Quality of Life Assessment Instrument abbreviated version. We used independent samples t-test to identify the differences between PTSD and non-PTSD group in each domains of the quality of life. We also used stepwise multiple linear regression analysis to figure out the variables affecting the QoL of the Vietnam War veterans. RESULTS: In the PTSD group, all domains of the QoL and the QoL total score(p<0.01) were significantly lower than those in the non-PTSD group. In the Vietnam War veterans, PTSD, major depressive disorder and education levels were the variables affecting the QoL. Among these, PTSD uniquely explained the QoL of the overall and general health(beta=-1.411, R2=0.180), the physical health domain(beta=-2.806, R2=0.089) and the total score (beta=-11.479, R2=0.104). CONCLUSIONS: These results suggest that among the Vietnam War veterans, the QoL of the PTSD group is significantly lower than that of the non-PTSD group. Among the combat exposed veterans, PTSD may be one of the main reasons that affect the multiple domains of the QoL.
Depressive Disorder, Major ; Humans ; Linear Models ; Quality of Life ; Stress Disorders, Post-Traumatic ; Veterans ; Vietnam ; World Health Organization

Background: Since the advent of biologics, they have been an efficient treatment for severe psoriasis vulgaris. Psoriasis that is refractory to biologics is associated with factors, such as old age, a high initial psoriasis area and severity index, a high body mass index (BMI), and nail involvement. Objective: We evaluated the clinical characteristics and differences in laboratory parameters in patients with severe psoriasis who switched biologics at least once. Methods: We analyzed the demographics, medical records, and laboratory data of 29 Korean patients who had switched biologics. Patients were classified into two groups based on the number of times they switched to biologics. Results: The reasons for switching biologics in the 29 patients were primary failure (37.9%), secondary failure (58.6%), and occurrence of adverse events (3.5%). The multiple switching group showed higher mean values than the single switching group for the factors associated with low efficacy of biologics, such as age at initial presentation (43.4±9.6 years vs. 42.1±12.1 years), an initial psoriasis area severity index (15.3±6.3 vs. 12.9±4.4), and a BMI (27.4±4.0 kg/m2 and 26.3±3.4 kg/m2 ), respectively. Conclusion In this single-centered study, secondary failure was the most common reason for switching biologics. Higher mean values for factors affecting the efficacy of biologics were noted in the multiple switching group; however, the difference was not statistically significant. When choosing biologics for patients, dermatologists should be mindful of this as they select the second-line biologics.

The goal of this review is to present the similarities and differences among the latest guidelines for noninvasive diagnosis of hepatocellular carcinoma (HCC) of American Association for the Study of Liver Disease (AASLD), European Association for the Study of the Liver (EASL), Liver Imaging Reporting and Data System (LI-RADS), Asian Pacific Association for the Study of the Liver (APASL), and Korean Liver Cancer Association-National Cancer Center (KLCA-NCC) of Korea. In 2018, major guideline updates have been proposed by the AASLD, EASL and KLCA-NCC; AASLD newly incorporated LI-RADS into their HCC diagnostic algorithm. The AASLD and EASL guidelines now include magnetic resonance imaging (MRI) using hepatobiliary contrast media as a first-line diagnostic test in addition to dynamic computed tomography and MRI using extracellular contrast media and the KLCA-NCC and EASL guidelines also include contrast-enhanced ultrasound as a second-line diagnostic test. We will comprehensively review the HCC surveillance and diagnostic algorithms and compare and highlight key features for each guideline. We also address limitations of current systems for the noninvasive diagnosis of HCC.
Asian Continental Ancestry Group ; Carcinoma, Hepatocellular ; Contrast Media ; Diagnosis ; Diagnostic Tests, Routine ; Humans ; Information Systems ; Korea ; Liver ; Liver Diseases ; Liver Neoplasms ; Magnetic Resonance Imaging ; Ultrasonography

OBJECTIVE: Decreased bone mineral density has been found in the chronic schizophrenic patients who have been given a long-term administration of antipsychotics. Hyperprolactinemia from the antipsychotics and the negative symptom of schizophrenia were considered as the causes for this finding. In this study, the effect of hyperprolactinemia and the negative symptom of schizophrenia on bone mineral density was investigated on male schizophrenic patients. METHODS: The cross-sectional study was carried out with the subjects of 45 male schizophrenic patients who have undertaken the monotherapy with risperidone, olanzapine and clozapine for at least one year. The demographic factors, clinical symtoms, bone mineral density and hematological test were examined for all the subjects. RESULTS: No significant relationship was found between hyperprolactinemia and the decreased bone mineral density in the subjects. The negative schizophrenia symptom of the subjects showed a significant effect on the decreased bone mineral density. CONCLUSION: The decreased bone mineral density finding in the male schizophrenic patients may be caused by the negative schizophrenia symptom rather than the hyperprolactinemia due to the antipsychotics. Additional studies are further required regarding other factors that may affect the decreased bone mineral density such as activity, calcium intake and exposure to sunlight.
Antipsychotic Agents ; Benzodiazepines ; Bone Density ; Calcium ; Clozapine ; Cross-Sectional Studies ; Demography ; Hematologic Tests ; Humans ; Hyperprolactinemia ; Male ; Risperidone ; Schizophrenia ; Sunlight

PURPOSE: To compare the survival rates of patients with hepatoma using different methods of transcatheter arterial chemoemblization(THAE). MATERIALS AND METHODS: Four hundred and eighty three patients with hepatoma diagnosed by biopsy, serum alpha-fetoprotein, abdominal CT scan, abdominal ultrasonography or hepatic angiography were included, but not all had reccived surgical treatment. They were divided into two groups according to Child's classification and into subgroups according to different methods of THAE. Five-year survival rates among these groups were retrospectively Compared. The patients were aged between 24 and 85(mean, 58) ; male to female ratio was 324:61 for those who received THAE (396:87 when only hepatic angiography was considered). RESULTS: In the group with more than a single episode of chemoembolization, regardless of Child's classification, a better survival rate compared to the other groups with or without concommitant radiotherapy or without chemoembolization was noted. There was no difference in the survival rate of patients with multiple chemoembolization. Moreover, no difference in this rate was observed no matter what chemotherapeutic agents, including Adriamycin, Cis-Diaminedichloroplatinum or 1-131-Lipiodol, were used. Embolization by gelfoam in conjuction with Adriamycin resulted in no difference in survival rate regardless of requency of chemoembolization. CONCLUSIONS: An improved survival rate was seen when multiple episodes of chemoembolization were applied, but no difference was seen when there was concomitant application of either gelfoam or radiotherapy. Two different chemotherapeutic agents,Adriamycin and Cis-Diaminedichloroplatinum, were used, but there was no difference between them in their effect on survival rates.
alpha-Fetoproteins ; Angiography ; Biopsy ; Carcinoma, Hepatocellular* ; Classification ; Female ; Gelatin Sponge, Absorbable ; Humans ; Male ; Radiotherapy ; Retrospective Studies ; Survival Rate* ; Tomography, X-Ray Computed ; Ultrasonography

BACKGROUND: Propofol is an alternative to thiopental as an intravenous induction agent for cesarean section. It is also used as a sedative for supplementation of regional blockade during cesarean section. It has been reported that propofol relaxes not only vascular smooth muscle but also other smooth muscles. The aim of this study was to investigate the effect of propofol on rat uterine smooth muscle in an isolated preparation in the rat. METHODS: Uterine smooth muscle tissues were obtained from rats (n = 21). The muscle strips were suspended in tissue baths and isometric tension was recorded. After spontaneous or oxytocin induced activity had been accomplished in the buffer solution as a control, propofol (1 to 20microgram/ml) in fat emulsion was applied cumulatively to the bath and the effects were continuously recorded. RESULTS: In vitro, propofol induced a dose-dependent inhibition of spontaneous as well as oxytocin induced myometrial contractile activity. Propofol concentration of 1microgram/ml had no significant effects on the resting tension, active tention, and frequency of contraction developed by spontaneous and oxytocin induced uterine contractility. However, Complete muscular relaxations on spontaneous and oxytocin induced contractility were obtained at a concentration of 10microgram/ml and 20microgram/ml, respectively. CONCLUSIONS: Propofol inhibits spontaneous and oxytocin-induced uterine smooth muscle contractions in dose dependent pattern.
Animals ; Baths ; Cesarean Section ; Female ; Muscle, Smooth* ; Muscle, Smooth, Vascular ; Oxytocin ; Pregnancy ; Propofol* ; Rats* ; Relaxation ; Thiopental

PURPOSE: The purpose of our study is to evaluate the plain radiographic features of pulmonary tuberculosis in adult diabetic patients compared with those in patients without any underlying diseases. MATERIALS AND METHODS: We analyzed the chest PA and lateral views of 100 patients having active pulmonary tuberculosis;40 patients had diabetes mellitus and 60 patients had no other underlying diseases. images were assesed for anatomical distributions, extents of lesions, size and number of cavity and patterns radiographic findings. RESULTS: Diabetic tuberculosis had higher prevalence and wider involvement of unusual segments for the tuberculosis such as anterior segment, lingular segment of upper lobe and basal segment of the lower lobe, and they showed the tendency of having more cavities than those who had no other underlying diseases, but there were no meaningful differences in the cavity size between the two groups. CONCLUSION: Pulmonary tuberculosis in diabetic patients tends to have wider extent with unusual segmental involvement and multiple cavities than in the patients who had no other underlying diseases.
Adult* ; Diabetes Mellitus ; Equidae ; Humans ; Prevalence ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary*