OBJECTIVES: Percutaneous vertebroplasty has recently been introduced as an interesting therapeutic alternative for the treatment of thoracolumbar vertebral body fractures in elderly persons with osteoporosis. The authors present the early results of this method. METHOD AND MATERIAL: From July 1999 to April 2000, percutaneous transpedicular technique was used in 20 patients (2 men and 18 women) whose mean age was 67.5 years old(range 59-79) with painful vertebral compression(22) and burst(2) fractures. The interval between fracture and vertebroplasty ranged 1 day to 4 months. The procedure involved percutaneous puncture of the injured vertebra via transpedicular approach under fluoroscopic guidance, followed by injection of polymethylmetacrylate(PMMA) into the vertebral body through a disposable 11-guage Jamshidi needle. RESULT: The most common cause of fracture was slip down and the most frequent injured level was the twelfth thoracic spine. The procedure was technically successful bilaterally in 18 patients(9 thoracic and 15 lumbar spines) with an average injection amount of 7.7ml PMMA in each level. Seventeen(94.4%) patients reported significant pain relief immediately after treatment. Two leaks of PMMA were detected with postoperative CT in spinal epidural space and extravertebral soft tissue without clinical symptoms. CONCLUSION: Although this study represents the early results, percutaneous vertebroplasty seems to be valuable tool in the treatment of painful osteoporotic vertebral body fractures in elderly, providing acute pain relief and early mobilization.
Acute Pain ; Aged ; Early Ambulation ; Epidural Space ; Fractures, Compression ; Humans ; Male ; Needles ; Osteoporosis ; Polymethyl Methacrylate ; Punctures ; Spine ; Vertebroplasty*

No abstract available.
Psoriasis*

Higt energy electron beam therapy is a method which is used for the treatment of superficial tumors (less than 5 cm deep) with a characteristically sharp drop-off in dose beyond the tumor. This method offers distinct advantages in dose uniformity and in minimizing the dose to deeper tissues. We report herein three cases of epithelial skin cancer treated with high energy electron beam. The first patient was a 79-year-old male who had primary basal cell carcinoma(BCC) on the right lateral canthus. The second patient was a 67-year-old male who had recurreiit BCC on the right cheek. Both of them received electron beam therapy on the lesion and there were no clinical relapse signs over 1 year. The third patient was a 46-year-old male who had squamous cells, carcinoma on the lower lip. He also received electron beam therapy on the lesion, but it recurred.
Aged ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cheek ; Humans ; Lip ; Male ; Middle Aged ; Recurrence ; Skin Neoplasms* ; Skin*

Three cases of congenital pseudarthrosis of the tibia were treated at Department of Orthopedic Surgery, Seoul national University Hospital during last four years. In all cases, many Cafe-au-lait spots and subcutaneous nodules were shown on the whoIe body skin, which are suggestive of neuro-fibromatosis. Case 1, A thirteen years old boy was treated with plate and screw fixation with massive iliac cancellous and cortical graft. In a follow-up of three and one half years, solid bony union has been obtained with successful result. Case 2, A 5 years old boy was treated with Boyds dual cortical graft with plate and screw fixation. In a follow-up to eight months, bony union were satisfactory. Case 3, A six months old boy who is young brother of case 2, was treated with Charnleys intramedullary nailing and iliac cancellous and cortical graft. The patient is still in the Iong leg cast, six months postoperatively. The evidence of familial and hereditary factor in pedigree is elicited on case 2 and 3. This congenital pseudarthrosis of the tibia in the sibling is regared as the first report in Korean literature.
Cafe-au-Lait Spots ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Humans ; Leg ; Male ; Orthopedics ; Pedigree ; Pseudarthrosis ; Seoul ; Siblings ; Skin ; Tibia ; Transplants

PURPOSE: This study was to evaluate the effect of rinsing time on the accuracy of interim crowns fabricated by digital light processing. MATERIALS AND METHODS: The maxillary right first molar master die was duplicated using a silicone material, while a study die was produced using epoxy resin. Scans of the epoxy resin die were used in combination with CAD software to design a maxillary right first molar interim crown. Based on this design, 24 interim crowns were fabricated with digital light processing. This study examined the trueness and precision of products that were processed with one of the three different postprocessing rinsing times (1 min, 5 min, and 10 min). Trueness was measured by superimposing reference data with scanned data from external, intaglio, and marginal surfaces. Precision was measured by superimposing the scan data within the group. The trueness and precision data were analyzed using KruskalWallis, nonparametric, and post-hoc tests, and were compared using a MannWhitney U test with Bonferroni correction (α=.05). RESULTS: The trueness of the external and intaglio surfaces of crowns varied significantly among the different rinsing times (P=.004, P=.003), but there was no statistically significant difference in terms of trueness measurements of the marginal surfaces (P=.605). In terms of precision, statistically significant differences were found among the external, intaglio, and marginal surfaces (P=.001). CONCLUSION Interim crowns rinsed for 10 minutes showed high accuracy.

BACKGROUND: Numerous studies have identified that physical activity (PA) has positive influences on quality of life. However, there has been little domestic research about the relation of PA to health-related quality of life (HRQoL) among the general population. The purpose of this study was to evaluate the effect of PA on HRQoL in Korean adults aged 40 years or over. METHODS: This cross-sectional study was based on data acquired from the Korean National Health and Nutrition Examination Survey IV. Final study subjects were 10,392 adults aged 40 years or over. According to the severity and frequency of PA, the subjects were divided into three PA groups as follows: high-activity, mid-activity, and low-activity group. We compared the HRQoL estimated by the EuroQoL 5-dimension (EQ-5D), the EQ visual analogue scale (EQ-VAS), and EQ-5D index between three PA groups. RESULTS: The odds ratios for mid-activity group and high activity group compared with low activity group were significantly decreased in the dimension of mobility of EQ-5D (mid-activity group, 0.81 [0.69-0.94]; high activity group, 0.81 [0.67-0.99]). EQ-VAS was decreased as PA level was lowered from high activity group and mid-activity to low activity group. EQ-5D index was the highest in mid-activity group and the lowest in low activity group. CONCLUSION: PA above mid-activity group showed better HRQoL compared than low activity group.
Adult ; Cross-Sectional Studies ; Humans ; Korea ; Motor Activity* ; Nutrition Surveys* ; Odds Ratio ; Quality of Life*

No abstract available.
Diagnosis* ; Exanthema* ; Lymphadenitis* ; Scrub Typhus*

PURPOSE: This study was undertaken to determine the adequate cutoff value of the neonatal screening test to decrease recall and false-positive rates. METHODS: During the period of January 1999 through December in Asan Medical Center, newborn screening tests for phenylketonuria, congenital hypothyroidism, congenital adrenal hyperplasia, and galactosemia were performed in 3,775, 3,707, 3,783, and 3,806 newborns respectively using commercial ELISA kits. We reviewed and analyzed the recall rate at currently used cutoff values. RESULTS: 1)In neonatal screening test for congenital hypothyroidism, using a current cutoff value, 17 microIU/mL, the recall rate was 0.9% and using a 99.7% cutoff value, 21.3 microIU/mL, the predictive recall rate was 0.4%. There were no significant differences in the other reports that suggest adequate recall rate. 2)In neonatal screening test for phenylketonuria, using a current cutoff value, 3.6 mg/dL, the recall rate was 1.5% which was no significant difference compared with expected presumptive positive rate, 1.44%. 3)In neonatal screening test for congenital adrenal hyperplasia and galactosemia, the recall rate was high when using current cutoff value. But all results were within normal limits in reevaluation. CONCLUSION: The cutoff values of screening test which are currently recommended by manufacturers of commercial kits for congenital hypothyroidism, congenital adrenal hyperplasia and galactosemia, are needed to be reset to decrease the recall rate by false-positive results on the basis of data from an individual newborn screening laboratory.
Adrenal Hyperplasia, Congenital ; Chungcheongnam-do ; Congenital Hypothyroidism ; Enzyme-Linked Immunosorbent Assay ; Galactosemias ; Humans ; Infant, Newborn ; Mass Screening ; Neonatal Screening* ; Phenylketonurias

No abstract available.

Here we report two cases of isolated diffuse mesangial sclerosis (IDMS) with early onset end-stage renal failure. These female patients did not show abnormalities of the gonads or external genitalia. Direct sequencing of WT1 PCR products from genomic DNA identified WT1 mutations in exons 8 (366 Arg>His) and 9 (396 Asp>Tyr). These mutations have been reported previously in association with Denys-Drash syndrome (DDS) with early onset renal failure. Therefore we suggest that, at least in part, IDMS is a variant of DDS and that investigations for the WT1 mutations should be performed in IDMS patients. In cases with identified WT1 mutations, the same attention to tumor development should be required as in DDS patients, and karyotyping and serial abdominal ultrasonograms to evaluate the gonads and kidney are warranted.
Base Sequence ; DNA/chemistry/genetics ; DNA Mutational Analysis ; Fatal Outcome ; Female ; Glomerular Mesangium/*pathology ; Humans ; Infant ; Infant, Newborn ; *Mutation ; Nephrosclerosis/*genetics ; WT1 Proteins/*genetics