The major blood supply to the femoral head is probably damaged by the fracture of the femoral neck especially when it is a displaced fracture. Complications such as delayed or nonuion of the fracture and avascular necrosis of the femoral head are common. Revascularization after reduction and internal fixation appears to be a slow process and in many patients late segmental collapse occurs. Various techniques have been proposed to restore the blood supply or to improve the circulation to the femoral head. Hereby we performed internal fixation and an autogenous muscle-bone pedicle graft composed of the quadriceps femoris muscle in 3 cases of old, neglected displaced femoral neck fracture. The results seemed to be good in regard to bony union in all 3 cases but it would be needed further follow up study for developing of any avascular necrosis.
Femoral Neck Fractures ; Femur Neck ; Follow-Up Studies ; Head ; Humans ; Necrosis ; Quadriceps Muscle ; Transplants

No abstract available.
Renal Insufficiency*

STUDY DESIGN: We studied the changes of the adjacent-level after performing anterior cervical interbody fusion. OBJECTIVES: We retrospectively analyzed the radiologic changes such as the degenerative changes and osteophyte formation in the adjacent-level and the affecting factors that affect the changes of the adjacent level after anterior cervical interbody fusion. SUMMARY OF LITERATURE REVIEW: We studied the patients who were more than sixty years old and who had more degeneration at the time of operation and who developed symptomatic new disease within the first four years after their procedure. When the interbody spacer was shortened by 10% to simulate subsidence, the plate lost nearly 70% of its load-sharing capabilities. MATERIALS AND METHODS: All the patients were treated with a plate and an autoiliac bone graft. We reviewed the correlation between the changes in the adjacent level and the factors that included gender, age, the fused segments, the plate-to-disc distance, the preoperative degenerative changes in the adjacent level, subsidence of the graft bone, the height of the graft bone, fracture and dislocation, and loosening of the implant. RESULTS: Radiologic changes in the adjacent-level were seen in 35 cases and these cases included 27 cases in the upper level and 17 cases in lower level. Adjacent level changes were seen in 27 of the 37 (73%) patient who were above 50 years old. Adjacent level changes were seen in 19 (90.5%) of the 21 cases that had preoperative cephalad level degeneration, and adjacent level changes were seen in 9 (81.8%) of the 11 cases that had preoperative caudal degeneration. Adjacent level degeneration developed or increased in the cases of subsidence of a graft over 2 mm. CONCLUSIONS: The patients who undergo anterior cervical interbody fusion need to be continuously followed up because radiologic changes can increase in the case with degenerative change in the adjacent segment and subsidence of the bone graft of more than 2 mm.
Dislocations ; Follow-Up Studies ; Humans ; Osteophyte ; Retrospective Studies ; Transplants

OBJECTIVES: Occupational stress management is particularly important for successful business operations, since occupational stress adversely affects workers’ health, eventually lowering their productivity. Therefore, this study aimed to investigate the correlation between occupational stress and health-related productivity loss (HRPL) among Korean workers. METHODS: In 2021, 1,078 workers participated in a web-based questionnaire survey. HRPL was measured using the Work Productivity and Activity Impairment Questionnaire, and occupational stress was measured using the Korean Occupational Stress Scale-Short Form. The occupational stress level was divided into tertiles (low, intermediate, and high), and the low occupational stress group was used as the reference group. Using a generalised linear model, differences in labour productivity loss according to the level of occupational stress were tested after adjusting for demographic characteristics such as age, gender, education level, household income, occupation, and underlying medical conditions. RESULTS: Non-parametric regression analysis of HRPL according to occupational stress showed a direct association between occupational stress and HRPL. A statistically significant difference was observed in HRPL between participants with intermediate and high occupational stress and those with low occupational stress. CONCLUSIONS Our results support the hypothesis that high occupational stress is associated with decreased labour productivity.

Adverse drug reactions can cause considerable discomfort. They can be life-threatening in severe cases, requiring or prolonging hospitalization, impeding proper treatment, and increasing treatment costs considerably. Although the incidence of severe cutaneous adverse reactions (SCARs) is low, they can be serious, have permanent sequelae, or lead to death. A recent pharmacogenomic study confirmed that genetic factors can predispose an individual to SCARs. Genetic markers enable not only elucidation of the pathogenesis of SCARs, but also screening of susceptible subjects. The human leukocyte antigen (HLA) genotypes associated with SCARs include HLA-B*57:01 for abacavir (Caucasians), HLA-B*58:01 for allopurinol (Asians), HLA-B*15:02 (Han Chinese) and HLA-A*31:01 (Europeans and Koreans) for carbamazepine, HLA-B*59:01 for methazolamide (Koreans and Japanese), and HLA-B*13:01 for dapsone (Asians). Therefore, prescreening genetic testing could prevent severe drug hypersensitivity reactions. Large-scale epidemiologic studies are required to demonstrate the usefulness and cost-effectiveness of screening tests because their efficacy is affected by the genetic differences among ethnicities.
Allopurinol ; Carbamazepine ; Cicatrix ; Dapsone ; Drug Hypersensitivity ; Drug Hypersensitivity Syndrome ; Drug-Related Side Effects and Adverse Reactions ; Epidemiologic Studies ; Genetic Markers* ; Genetic Testing ; Genotype ; Health Care Costs ; HLA Antigens ; Hospitalization ; Humans ; Incidence ; Leukocytes ; Mass Screening ; Methazolamide ; Pharmacogenetics ; Stevens-Johnson Syndrome

Lung volume reduction surgery, resecting the most severely affected regions of emphysema, was designed to improve quality of life for selected patients with severe emphysema. We report a case of a 72 year old severe emphysema patient who received bilateral lung volume reduction surgery and showed marked improvement of quality of life and lung function.
Aged ; Emphysema* ; Humans ; Lung* ; Pneumonectomy* ; Quality of Life

OBJECTIVE: The purpose of this study was (1) to evaluate the expressions of clusterin, bax, Ki-67, p53, and apoptotic index in epithelial ovarian tumors, borderline and malignant ovarian tumors, (2) to find out the correlation between their expressions and clinicopathological parameters, and (3) to evaluate the effect on the patient's survival according to their expressions. METHODS: The histological and clinical findings of 22 cases of ovarian cystadenomas, 44 cases of borderline tumors and 96 cases of carcinomas were evaluated. Expressions of clusterin, bax, Ki-67, p53, and apoptotic index were studied on paraffin-embedded tissue sections by immunohistochemical methods. RESULTS: The expressions of clusterin, p53, and Ki-67 were higher in ovarian carcinomas than borderline tumors. The overexpression of p53, and Ki-67 were frequent in high stage, poorly differentiated and bilateral ovarian carcinomas. The overexpressions of clusterin, bax, p53, and Ki-67 showed a statistically significant correlation with histologic type. Apoptotic index was higher in bax overexpression group, but there was no correlation with overexpression of clusterin or p53. Ki-67 was higher in p53 overexpression group, but there was no correlation with overexpression of clusterin or p53. There was no statistically significant correlation with each other between the overexpressions of clusterin, bax, p53, and Ki-67. The overexpressions of clusterin, Ki-67, p53 was associated with overall patient's survival in borderline significance. CONCLUSION: The overexpression of p53, and Ki-67 were frequent in poorly differentiated ovarian carcinomas. So the overexpression of p53, and Ki-67 can be used as prognostic factor. The overexpression of clusterin was more in epithelial ovarian carcinomas than in borderline tumors but showed no significant correlation with the overall patient's survival. Further studies are required to clarify the possibility of using clusterin for target therapy in epithelial ovarian carcinomas.
Clusterin ; Cystadenoma

PURPOSE: To evaluate the advantages of the antiglide plate fixation procedure for Danis-Weber type B lateral malleolar fractures of ankle compared to other methods of lateral plate fixation. MATERIALS AND METHODS: We reviewed 70 cases that antiglide plate fixation and lateral plate fixation procedures were performed from Mar. 2001 through Mar. 2006. Of the total 70 cases, they were divided into two groups ; 22 cases were treated with the antiglide plate procedure (Group I) and 48 cases were treated with the lateral plate procedure (Group II). The results of the two groups were analyzed both radiographically and clinically using Ankle-Hindfoot scale of the American Orthopedic Foot and Ankle Society (AOFAS). RESULTS: All fractures were healed at average of 8 weeks both radiographically and clinically. According to the Ankle-Hindfoot scale, all cases of Group I and 48 cases of Group II were above 80 points. 2 cases (9%) in Group I complained of peroneal tendinitis, while 19 cases (39%) in Group II showed skin irritation resulting from the screw or the plate. A total of 6 cases (27%) in Group I and 27 cases (55%) in Group II complained cosmetic problems. CONCLUSION: we concluded that the antiglide plate fixation for Danis-Weber type B lateral malleolar fractures is one of the good methods. But, further analysis will be need to find a solution for the peroneal tendinitis.
Ankle ; Foot ; Orthopedics ; Skin ; Tendinopathy

Menetrier's disease is a protein losing hypertrophic gastropathy characterized by hypoproteinemia, and often is associated with the development of gastric cancer. Though the cause of Menetrier's disease has been unknown, the association with Helicobacter pylori was reported. A 30-year-old man was hospitalized for the evaluation of progressive dyspepsia for 2 years, hypoproteinemia, and recently aggravated epigastric pain with weight loss. Gastroscopy revealed prominent folds and multiple variable sized polypoid eminence in the body and antrum with positive CLO test. Histological findings revealed gastritis with erosions and foveolar hyperplasia. Any other diseases causing protein losing enteropathy were excluded. After the eradication of the H. pylori and long term treatment with proton pump inhibitor, clinical, endoscopic, and biochemical resolution ensued. Thus, we suggest that H. pylori eradication should be tried in patients with Menetrier's disease before invase treatment modalities such as surgical resection.
Adult ; Dyspepsia ; Gastritis ; Gastritis, Hypertrophic* ; Gastroscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Hyperplasia ; Hypoproteinemia ; Protein-Losing Enteropathies ; Proton Pumps* ; Protons* ; Stomach Neoplasms ; Weight Loss

There has been a great improvement in height and weight of Korean children owing to economic development over the last 25 years. This study aimed to evaluate the penile length of Korean children today and to compare it with a previous Korean study reported in 1987. The cross-sectional study was conducted with 909 Korean boys aged 0-14 years who had been brought to outpatient clinics of five tertiary hospitals (Busan, Ulsan, and Changwon) between September 2013 and May 2015. The stretched penile length (SPL) was measured and the testicular size was measured using orchidometry (mL). Student's t-test or Mann-Whitney U test was used to compare the result of our study and the study reported in 1987. SPL of Korean children gradually increased from 4.1 ± 0.8 cm at 0-1 year old to 9.6 ± 3.0 cm at 13-14 years old, the most rapidly during the age of 13. While body weight and testicular size significantly increased from 1987 in most of age groups, there were no significant changes in SPL although there was in some age groups. Height decreased in the infants < 1 year old and increased in the children > 6 years old. With the great economic development over the last quarter century in Korea, height, body weight, and testicular size of children significantly increased but there was no significant change in SPL except penile growth pattern.
Ambulatory Care Facilities ; Anthropometry ; Body Height ; Body Weight ; Child* ; Cross-Sectional Studies ; Economic Development ; Humans ; Infant ; Korea ; Male ; Penis ; Tertiary Care Centers ; Ulsan